I am SOOOOOO excited to share this birth story with you all. I have been following Sally and her little family since way back when I still used blogger and had a different blog name. This birth of her third boy is beautiful, but it involves a pretty scary postpartum hemorrhage (PPH). I irony in reading her story this weekend was that last week I had a patient have a PPH. It does not happen very often but when it does, it sticks with you. I find myself reflecting on every moment, each little step we made to help the patient feel calm, safe, and stop the bleeding. As Sally mentions in her post below, the care a patient receives at any time is critical but especially so when something scary happens. Feeling like you’re going to die after giving birth is probably one of the scariest thoughts anyone can have. Thank you, Sally, for allowing me to share Theodore’s birth story.
Theodore Atticus (Teddy) arrived on Wednesday morning at 11:13AM after almost twenty-four hours of labor. I want to go ahead and give the heads up that, much like my other two births, this labor and delivery did not go exactly as planned. If you’re looking for a natural birth story where every thing goes to a T, you should probably skip this one. However, unlike the others, I had such a better experience when it came to feeling supported and listened to during my experience. My hospital staff was absolutely incredible. My nurses were amazing. The OB who delivered Teddy was perfection. Here’s our story:
Monday was Memorial Day. At our CrossFit box, the gym was running a hero work out known as “Murph.” Taylor and I got there with the boys around 10:30AM to cheer on the athletes and get a little work out in ourselves. I headed to the squat rack and started doing a slow triplet of three squats, three pull ups, two sled pushes. I added a little weight every round, and I had just done my second squat at 115lbs when I felt a thump. I stood back up, and water gushed down my legs like someone had turned on a bath tub faucet. I racked the weight, turned to look at Taylor, and said, “Um, Tay, my water broke…we need to go.” He started laughing, and we gathered up the boys while I waddled to the car with a towel between my legs.
We were supposed to show our house that morning, but obviously, that wasn’t going to happen. I hopped in the shower while Taylor fed the boys. We made calls to the people who were coming to help watch Sully and Arlo while we were at the hospital and before our families arrived. I went back and forth between the birth ball and sitting on the toilet trying to get some contractions going. They were there, but very mild and not at all consistent. At about 2:30PM, we decided to head on to the hospital. I was GBS+ again, and honestly, being at home was far from relaxing between the kids and the dog. Our good friends arrived to watch the boys, and we made our way.
When we checked in, I was still not having any contractions and was at about 2cm. I walked and walked some more, bounced on the ball some more, and four hours later, still nothing. At this point, I agreed to being put on the lowest level of pitocin in order to hopefully get contractions going. The nurses and OB were all absolutely fine with me walking around, taking a shower, doing whatever I could to try to get things moving. Eventually, the contractions picked up. They became incredibly uncomfortable, but they still were not regular. After about six hours on pitocin, they took me off and checked me again. I was at 3cm. We decided to let me try to labor on my own for awhile off the pitocin to see if I could try to progress some more. For several more hours, I labored in the shower, on the ball, in the bed, whatever I could try to do. The contractions were steady, and I would say they were very painful. It was intense pressure with each wave and very little rest in between. I asked to be checked again, convinced I had to be close. I was only 3.5cm. After being in labor this long, looking at the middle of the night, and recognizing that I just wasn’t progressing like I wanted, I asked for the epidural. I needed rest, and my mom and Taylor were exhausted, too. I hoped an epidural would bring some relief and let me sleep. I honestly could have kissed the anesthesiologist. I told him my epidurals before had never really worked, and I always ended up with “hot spots.” He had to place it twice, but he finally got it working, and I could rest.
I expected to be disappointed by this choice. After all, I really wanted to go naturally. But after having been in labor for so long with no change, I felt like I was only torturing myself. Labor should an experience where you feel in control and on top of all the decisions made. I truly feel like I was in control this time. Every decision made was passed by me and approved by me, and the nurses and OB were so amazing at ensuring my experience was the best possible one for me. I laid down and rested and by 10:30AM, I had a little lip of cervix between me and baby. The anesthesiologist had to do another dose of medicine when I started getting hot spots, but it fixed the problem. My epidural was light enough that I could feel all the contractions and pressure, and I could move my legs, but I was no longer fighting against the contractions. When it came time to push, three pushes, and Teddy joined us, screaming and pink.
Now, here’s the hard part. My labor and delivery went so well. I had one tiny tear that required a few stitches, and I was able to get up and walk around almost immediately after Teddy was born. He latched like a champ and took to nursing right away. About six hours after delivery, while we were settled into our recovery room and after my shower, I got up to use the bathroom. As I walked into the bathroom, I felt a ton of pressure and cramping. Suddenly, blood gushed everywhere. Huge clots covered the floor, and the walls looked like a horror film. I yelled to Taylor to get the nurse, and more blood gushed again. I stood there completely shocked, and the nurses rushed in. They put me in the bed, where the gushes kept happening. Soon, my room was filled with nurses and my OB. They gave me percocet, a shot of some of sort, and cytotec to try to stop the bleeding. The OB then explained to me she would have to do a manual extraction, where she would have to reach up into my uterus to pull out the massive clots that were preventing my uterus from contracting back to normal size and containing the bleeding like it should have.
I have never had anything done that felt so horrific. I was screaming and crying and begging for them to stop, but they were pulling out baseball sized clots of blood, and I knew it had to be done. I think this was the point where I honestly thought I might die. I’ve never seen so much blood in my life, and I have certainly never seen so much blood come out of someone and them still live. The OB explained that if they couldn’t stop the bleeding, I would have to go under anesthesia for an emergency D&C and then possibly a hysterectomy if it continued. Once the manual extraction was over, they began a blood transfusion. I received four pints of blood because it was estimated I had lost about two liters (the human body generally has 4.7-5 liters of blood). They pumped me full of fluids. This part is pretty hazy, but I remember being cold and not being able to stop shaking. They kept asking me how I felt and random questions to keep me alert. Poor Taylor and Teddy had to be there the whole time.
Once they had me stabilized, they inserted a postpartum balloon. It was basically a massive balloon that they filled with water to put pressure on my uterus and hopefully help the blood vessels seal. They kept it in overnight, and in the morning, they removed it. I had no more clotting, so I was asked to stay in bed twelve more hours before I started moving around. They kept me another couple of days, but I was finally in the clear.
They speculate that my long labor exhausted my uterus, and when it was time to contract back to normal size, it was contracting but not shrinking. Blood vessels never sealed, and it started a vicious cycle of clotting, releasing the clots, and clotting again. There is no real way of knowing WHY this happened.
I can tell you a few things about this experience:
1) Teddy was our last baby. I can’t risk something like this happening again. Thinking I was about to die was the most terrifying thing in this entire world, and while he is so, so, worth it, I want to be here for Taylor and my babies.
2) I appreciate my little family so much more.
3) I am so incredibly grateful for my medical team. Had I given birth at home or had I been released earlier than 24 hours, I would have bled to death. An ambulance would not have made it in time for me to survive. Which means, if I had birthed anywhere but the hospital, I wouldn’t be here today. That does not mean that I am against home or birth center births, but this experience made me realize how grateful I am that I personally did not chose that path.
4) Having a good hospital staff and OB makes an absolute world of difference. My labor and delivery could not have been more precious to me. My OB that had privatized me the entire pregnancy was actually out of town. I ended up with another female OB, Dr. Jones, who is my new best friend. She was so incredible, and I am so grateful I had her. My nurses handled our labor and following emergency so well. No one panicked or made me feel like they were not in control. Even at the worst moment, Taylor says he did not really think he would lose me because everyone was so competent.
We are home and settled now. I feel pretty rough, but I guess that is to be expected. Teddy is nursing so well, and the big boys are loving him. Teddy has a little jaundice, but we are staying on top of it, and his numbers are lower today, so we feel better about that. I am so grateful things turned out the way they did, and now we are just hunkering down to enjoy this newborn phase.