I was shocked to learn that I was
pregnant 12 yrs after my first
pregnancy, which resulted in a healthy
daughter born at 38 wks, despite 1st
trimester placental abruption &
preterm labor at 33 & 36 wks. We'd
tried to get pregnant again for years
with no success. When we learned that
even max doses of Clomid weren't
making me ovulate, we finally decided
to simply let it go with the thought
that if God wanted us to have another,
he'd make it happen. After all those
years passed, we never thought it
would happen. The doctor said it was
probably brought on by Metformin, a
drug I started taking 3 months earlier
after being diagnosed with diabetes.
Apparantly, they were just discovering
that Metformin can increase fertility
in some women, particulary those with
PCOS, like me.
I knew from the beginning that there
were going to be problems because of
the difficulties I had in the first
pregnancy along with the added
complication of pre-existing diabetes.
It started with my 8 wk sonogram, when
they discovered that the baby was in
the lowest possible position, right on
top of my cervix. The doctor said as
the placenta grew, it might move up
the side and placed me on "pelvic"
rest, but he didn't sound very
optimistic. At 12 wks, the placenta
had moved off my cervix, but the baby
was still very low & I started getting
a very ominous feeling. They had a lot
of trouble finding the heartbeat at
every visit & I just knew something
was wrong. I couldn't explain why, but
I started getting anxiety attacks &
the doctor responded as if I were
becoming psychotic or something
because he didn't think anything was
wrong. At 16 wks, he referred me to a
perinatologist, but with an attitude
that it was because I was
a "difficult" patient rather than
because of any problem. Even though we
both knew I'd eventually go to a
specialist because I was high-risk, he
seemed annoyed to be sending me so
early.
At 17 wks, I went to the hospital
because I just didn't feel right. The
foreboding feeling was constant &
strong, I was already having stress
incontinance & constipation problems
even though I barely looked pregnant
and I felt a lot of pressure & weight
in the pelvic area all the time, like
I was carrying a bowling ball. I had a
lot of sharp pains which I know are
generally normal due to ligament
stretching, but they were so frequent
and even when the sharpness subsided,
the ache continued for hours
afterward. When I'd complained to the
OBGYN he told me to watch the weight
gain (I'd only put on 7-8 lbs at this
point, so it's not like I was packing
them on unabashedly) & that being
miserable was a good sign for the
pregnancy, not a bad one. Believe it
or not, for what is supposedly the
best maternal-fetal hospital in the
area (and the only one any
perinatologist in the area is
affiliated with), the OBGYN at the
hospital actually told me to go home
because everything was normal without
ever verifying a heartbeat(after
saying, "you women are so emotional,
you need to relax"). They tried once
with a doppler, but couldn't find it &
never performed a sonogram or even
tried again with the doppler. I was in
tears as I left, but the appt with the
perinatologist was coming up so I
decided to discuss it with him.
I have a very high stress job &
thought maybe that was part of the
problem, so I talked the doctor into
taking me off work in the hopes that a
reduction in stress level might help
control the anxiety attacks & stablize
my blood sugars. It's not that they
were uncontrolled because my average
was perfect, but I had a lot of highs
& lows. I'm not even going to go into
the problems I had with the disability
insurance company over this. Let's
just say they made sure my stress
level wasn't reduced and I'm not so
sure they adhered to ethical
procedures in the way it was
handled.
I had my consultation with the
perinatologist & discovered that I had
a fibroid that was growing along with
the baby. The sonogram (almost 18 wks)
looked good & he tried to give me a 3D
picture, but the fibroid was right in
front of the baby & all I could see
was a face and an arm. He couldn't
confirm the sex of the baby because of
the fibroid. I felt it was a boy,
which was particularly special to us
because there are no sons in this
generation on my husband's side of the
family. He completed the disability
papers (as did the OBGYN) and also put
me on Wellbutrin to help calm my
nerves. It's not actually for anxiety
attacks, but he said the medications
that are really shouldn't be taken in
pregancy if they can be avoided so
we'd see if the Wellbutrin might help
stablize me.
I watched all the pregnancy & birth
shows (Birth Day, A Baby Story, etc.)
on cable & not once did I ever see
anything about PPROM. I never even
considered it because I didn't think
it was possible for the water to break
before getting close to term.
According to the information I was
getting, the age of viability is 20
wks. The day after I passed that mark,
I mentioned to my husband that I was
feeling much better because now at
least if anything were to happen the
baby would have a chance. A few days
later as I was sitting on the toilet
one morning, straining from
constipation as normal, I suddenly
heard & felt a "pop" followed by a
huge gush of water. It was so
shocking, I jumped to my feet. I
instantly knew what had happened, but
I just couldn't believe it & I thought
I was imagining things. As I got
dressed, much smaller gushes continued
so I knew it was true. My husband was
at work & I was alone. I called the
doctor's office & they told me to go
to the hospital. In hindsight, I
should have lied down & called my
husband home to take me, but my mind
was racing & I was just thinking about
getting there as soon as possible, so
I drove myself & called my husband on
the way.
There were about 4 other pregnant
women in triage when I got there, 1 of
them also with PROM between 20-21 wks
& the others at or near term,
complaining of contractions. First I
thought it was an awful coincidence
that the same thing was happening to
someone else at the same time because
I thought this was extremely rare.
Next I thought it was really odd that
they were taking the term pregnancies
in first. That was the first sign
about what was to come, though I
didn't recognize it then.
The other PPROM was talking to the
people around her as we waited, saying
that she hoped they'd go ahead &
deliver her baby right away because
last time this happened to her, she
had to stay in the hospital on bedrest
forever & that was awful. She was very
calm about the whole thing, which fed
my hopes that they'd probably be able
to save the pregnancy. Still, I was so
scared that I wasn't talking to
anybody. My heart was racing and the
wait time, which ended up being almost
an hour, was agonizing. My husband
(and Mom, since he called her) didn't
get there until I had finally been
brought into an exam room. I was the
last one called.
They took hours trying to verify that
my water truly had broken through the
standard methods because I had so
little water left they couldn't get a
sample. Finally, the nurse said we
both knew it was true so we'd just go
ahead & proceed as if it were
confirmed. She strapped on a fetal
monitor for less than a minute before
I recognized a deep dip & made the
mistake of telling her I saw it, at
which point she immediately took the
monitor off, saying that it wasn't
getting a good reading. I knew better,
but I also knew that she was doing it
to try to keep me calm. I figured that
since they were sure to be done with
the assessment soon, admit me & put it
back on, I'd let it go for the moment.
I was so wrong.
They did a sonogram & wouldn't let me
see the screen. After asking several
times, the doctor finally told me that
there was no water at all so he
couldn't see much of anything so there
was nothing for me to see & nothing he
could tell me. When I reviewed my
medical records weeks later, I saw
that the sonogram report included all
the normal size measurements, and AFI
of 1.8 (ok, not much, but not "none at
all") & confirmed the heartbeat. After
the sonogram, the doctor left to go
discuss the case with the chief
perinatologist on staff before he
could discuss it with me.
When the doctor returned, he began to
tell me that I should allow them to
induce labor to terminate the
pregnancy because there was virtually
no chance that the baby would survive.
I told him I wanted this baby, that I
came to the hospital to be admitted &
I expected they would put me on
antibiotics to prevent infection while
we try to delay birth as long as
possible. He simply said "No." I was
speechless for a moment, then asked
why not? He told me they consider the
age of viability to be 24 wks & nobody
is admitted until they reach that
point, so if I wouldn't agree to
induce labor I could just go home.
Honestly, he really was that blunt. I
told him I wasn't leaving & I wasn't
agreeing to induce. He responded by
saying there was no way they would
admit me & I could come back when I
went into labor spontaneously,
probably within 24 hrs (which they
won't try to stop), when I developed
an infection (very likely), or when I
reached 24 wks if I was lucky enough
to beat the odds & make it that far,
whichever is first. I started
bargaining - isn't there anything at
all that can be done? no. What about
something like that procedure I saw
for meconium problms during labor, the
amnioinfusion, can't you add water
like that somehow? no. After hitting
the brick wall over & over again, I
finally sent him out saying that I
needed to think about it, then called
the nurse in & told her I didn't want
him to come back in the room, period,
& she needed to call my perinatologist
and bring him in to see me. I asked
the nurse about the other PPROM that
had been hospitalized & was told that
her prior PPROM was after 24 wks but
this time she was going through the
exact same thing that I was.
When my perinatologist arrived, he was
much more tactful & understanding, but
he wouldn't offer anything helpful
either. He gave me the statistics,
saying that the baby was extremely
unlikely to survive no matter what and
even if by divine miracle it did, it
would almost certainly have severe
problems like cerebral palsy. He said
the lungs would not continue to
develop if there was no fluid to fill
them. What I learned later that he
didn't tell me that the fluid is
produced by the baby urinating & if I
drank tons of water & stayed in bed, I
might help it accumulate. By that time
it had been several hours & I didn't
even know if the baby was still alive.
I had visions of him being squeezed
tightly, maybe even crushed, by my
uterus & my mom thought it had
probably already cut off his air
supply by compressing the cord. The
doctors had already considered this to
be a hopeless situation & weren't
monitoring the baby in any way. The
doctors mentioned risk to my own life
from infection & hemorrage and though
I wasn't listening to any of that, my
mom & my husband were. The doctors
must have talked to them separately
too because when I insisted to my
husband that there had to be a way to
repair the rip in my membranes, he
said it wasn't just a little hole,
there was a huge flap torn away. He
didn't want to risk my life in any way
at all & he didn't want to take the
chance that the baby might be severely
disabled if it did survive because one
of his friends has a daughter with
cerebral palsy & he said he couldn't
handle that. My mom kept saying that I
couldn't risk my life because I
already had a daughter that needed me.
I eventually agreed to the induction
and it was the worst experience in my
entire life. About a year later our
house caught fire & burned all the way
to the ground in nothing more than a
pile of ashes. We lost everything but
our lives (and miraculously, our son's
urn because it survived without a
crack or even a any singe marks on the
felt bottom even though the entire
entertainment center fell on top of it
& continued burning during the fire).
We even lost 2 cats and a dog because
of that fire, but all of it pales in
comparison to the experience of losing
our son. In fact, I've never even shed
a single tear due to the fire because
I felt like I've been through so much
worse. After the fire, loads of people
offered support, many more than we
imagined & extremely generously.
Nobody was there after the loss of our
baby. Even my mom & to some degree, my
husband, didn't understand what I was
going through. Those few that tried to
be supportive rather than avoiding
didn't know how or what to say. I
didn't know what to ask for or how to
ask. There are support groups, but I
couldn't motivate myself to get out &
go meet a bunch of strangers,
particularly during the most severe
stages of depression. For anyone who
is considering undergoing this
procedure, please consider what it
actually entails before making the
choice. I didn't know what I was in
for. I can't say that I made the wrong
choice because I don't know what
would've happened otherwise. I just
know that it was too awful to ever go
through it again, particularly since
the fact that it happened as a result
of my choice still haunts me.
First, after I finally agreed to the
induction, I asked for something to
calm my nerves, but they wouldn't give
me anything until after all the
paperwork was signed. That made sense,
but I didn't know it wasn't going to
happen until 4 hours later even though
my blood pressure was through the roof
by then because they have to get all
kinds of sign-offs from the right
people since it's technically a late-
term abortion. I thought they were
going to take me to labor & delivery,
but they don't. You go to the maternal
unit instead, where you get a regular
room with a regular bed & are left on
your own to deliver there
when the time comes. The nurses told
me that in most cases, that happens
alone & in the bathroom. They do check
on you, but not very often. At the
hospital I was in, the elevator door
to the maternal unit opens facing a
bulletin board full of healthy newborn
baby pictures. I had just managed to
compose myself when I saw that &
started bawling again. From the start
of my admission in that unit, the
staff handled it as what it truly was,
an abortion. The experience is painful
enough, but when all you care about is
the baby & you come from a unit where
they do focus on the baby at least to
some degree to another where you alone
are the patient & they could care less
about what you care for most - it's
really difficult. For those of us in
this situation, every detail is a
heartwrenching reminder that the
hospital no longer has any
consideration for the baby whatsover.
They really don't even consider it a
baby anymore, just something your body
needs to be rid of. It was so
different from the way I saw it - an
unavoidable preterm birth from which
my much-loved baby was unfortunately
too small to survive. The nurse was
smiling & cheerful when she said no
anesthesia would be used, but I could
have all the demerol I wanted because
it didn't matter for the baby. At that
point, was was still convinced that
the baby would be born live & die
shortly afterwards because he couldn't
breathe and I was horrified that both
she & the doctor would talk to me like
that when all I wanted was to protect
the baby and delay his death as long
as possible - and how could she be so
cheerful about it? Was I supposed to
respond with a smile? My mother had to
pull the doctor out of the room & tell
him off. They gave me a different
nurse after that & it got better
because she was sympathetic. I wish
they would have told me why they knew
he was going to be stillborn because
it might have made a big impact on my
decision. The drug of choice for this
procedure, Misoprostal, is so strong
that at this stage of development, it
kills the baby in utero so you have no
chance of holding it alive (which some
doctors think is best for the mom -
nice to see that they can make that
decision for us) and it also means
that the life insurance company denies
any benefits because it wasn't a live
birth, so you get nothing with which
to have a funeral or burial for the
baby.
From what I've read, the Mistoprostal
is supposed to be placed on the
cervix. I'm certain that the doctor
placed it INSIDE my cervix because it
took him a long time with quite a bit
of apparant difficulty & it was
extremely painful. There are lawsuits
pending regarding this drug because
the contractions are so strong uterine
rupture is a very real risk & has
happened in many cases. Doctors like
it because it's cheap & it's fast.
They told me they'd wait 4 hours after
my first dose, then consider a 2nd if
needed. I went from 0 centimeters to
10 centimeters in 3.5 hours with no
pain drugs at all (because I wanted to
be as alert as possible for the
birth). I pushed a couple times but
the nurse said the baby was high & she
didn't want to make me work that hard,
so we'd just let him come down
naturally. I went ahead & got a
demerol shot at that point. After
that, I remember getting up to pee a
little while later & feeling as if
something were going to come out when
I sat down, so I went back to the bed
& called the nurse. She came in time
to deliver my son (which is the first
moment his sex was confirmed) so I
guess I was one of the lucky ones. I
have a dream-like memory of sitting up
to see the nurse holding him up
between my legs & that's it. He was
born 1/10/04 at about 2:30am. My
husband says that after the first shot
of demerol, he called the nurse in for
another every time I whimpered at all
because he couldn't stand to see me
hurting like that so I got a total of
6 shots during the 2 hrs that it took
to deliver him from the time I was
fully dilated. He also confirms my
memory of the birth, saying that after
I saw the baby, I fainted. He tells me
that the nurse showed him the baby,
saying, "see, he's stillborn" but he
saw the baby move a little at first.
My son weighed 11.4 ounces at birth &
was 10.5 inches long. His feet were a
little more than an inch long. He was
perfectly formed, but thin & dark red
because his skin wasn't fully
developed yet. He had a lot of
bruising & some swelling, particularly
on the right side of his face. The
nurse said that was from being "beat
up" coming down the birth canal due to
his size. My husband said the
Misoprostal still hadn't completely
dissolved yet & was stuck to his head
when he delivered. Once I woke up, I
went to the bathroom & passed the
placenta. I guess they don't feel any
need to stay with the patient through
this process. They just ask you if
it's happened yet & if the bleeding
doesn't slow down after a certain time
period, they do a sonogram to make
sure nothing's wrong. They brought my
son in, dressed in a little robe &
hat, wrapped in a little blanket. I
held him for awhile & fussed with him
a little, but his skin was so delicate
that the slightest touch seemed to rub
it off. His features looked just like
my daughter's. I called my parents &
the clergy in for a prayer, then
wanted nothing more than to go home as
soon as possible. We called a local,
family-owned funeral home & they
offered to cremate him for us at no
charge. They also sold us an urn that
looks like a ceraminc cherub at a
substantially reduced price.
I called the disability insurance
company & told them they didn't have
to worry about my claim anymore
because of what happened. That's when
they said they would go ahead &
approve it retroactively. How
thoughtful. They also gave me a full 6
wk maternity leave though, since it
was a delivery (>20wks), and that was
better than I'd expected. I cried non-
stop, 24 hrs a day for two solid weeks
& at that point, my doctor put me on
Xanax and antidepressants. It helped
me stop crying so much and I stopped
taking them after a few weeks. I had
it out with the OBGYN (who sent me to
this hospital & wouldn't help me
convince them to admit me) at my 6 wk
check up. He said something that made
me come to terms with his involvement
though, when he told me that I'm very
lucky that they're getting pretty good
at saving high-risk mothers these
days, but they can't always save the
babies too. He explained that he'd had
a patient hemorrage & die on the table
once. I still don't agree with him in
my case, but at least I understand
where he's coming from & why he holds
that opinion. I'm still angry with the
hospital staff, for the way they
treated me, their refusal to give me
any information about the condition of
my own baby vs. general statistics,
their failure to tell me that they
weren't just inducing labor to allow
the baby to die naturally but actually
killing him themselves, and for not
telling me that there's a
perinatologist at another hospital
less than 2 hrs away that performs
amniopatches and I could have gone
there when they refused to admit me. I
talked to a few lawyers, but none of
them would touch a case involving a
baby less than 28 wks gestation, maybe
because you can't prove the baby
would've survived otherwise, maybe
because of the great abortion debate,
maybe a little of both. Nobody ever
gave me a reason why this happened.
They just don't know. I took my
hospital records to the perinatologist
& all he could find that was abnormal
was evidence of some fibrosis (scar
tissue) in the membranes on pathology,
but even some degree of that is
normal. There was no evidence of any
infections. I felt a little silly
asking if it might have had something
to do with straining from
constipation, but I had to ask since
that's when it happened and he
confirmed that would have absolutely
nothing to do with it. The
perinatologist is the one who told me
the Misoprostal is what caused my son
to be stillborn, without a doubt. He
also said I have a 30% chance of PPROM
in the future, though when I asked why
that would be if there's no particular
reason it happened in the first place,
the only answer he had was that since
it happened once, my body's shown a
propensity for it. That doesn't make
any sense to me.
I still blame myself (for having an
abortion regardless of the
circumstances, and for not looking
into my options before I went to the
hospital even though I thought it was
an emergency so there wouldn't be
time) and my husband (for talking me
into the termination) to some degree,
but it's getting easier with time. One
of the things that helped me most was
getting a bereavement doll, made to
the specifications of the baby's birth
measurements & weight. My mom thought
it was creepy, but she didn't
understand it wasn't about carrying
a "baby" around as a substitute &
therefore not letting go, but it was
about finally being able to let go
because it calmed my greatest fear,
that of forgetting him. I admit I
slept with the doll twice, during
particularly painful & depressing
moments, but other than that the doll
was wrapped in my son's receiving
blanket & stashed away in a cabinet
stocked full of other memorabilia.
Like I said, it was all about making
sure he wouldn't be forgotten. The
hospital gives you pictures,
footprints, the clothes & the
bracelet, but it's not the same and
somehow having a reminder of the
baby's size was extremely helpful. I
guess it's because I hardly had a
chance to feel pregnant before he was
born & a doll of the same size
confirmed to me that he was a real
baby.
We started trying to get pregnant
again immediately. I know you're not
supposed to, but my chances are so low
anyway I couldn't help myself. We
wound up with a fertility specialist
again after 8 months. Clomid didn't
work, again. We got to Repronex &
Femara (similar to Clomid) and I had
two really good follicles in the first
round. My appt for the pregnancy test
was 1/26 at 8am. I just couldn't wait
that long & took a home pregnancy test
the day before. It was positive and I
was really excited. Unfortunately, I
missed the doctor's appt because the
house fire that I mentioned above
happened at 6am on 1/26. I started
bleeding a couple hours later and a
few hours after that, I passed two
tiny, similarly sized pale pink bits
of tissue. We decided to wait until
our housing situation stablized before
continuing any further. Today, 9
months later, we've moved to TN & are
almost ready to find another RE. We
plan to ask him skip the preliminaries
& go straight to another Repronex
cycle and hopefully that'll result in
at least one more healthy baby. This
time I'll be making sure to ask the
OBGYN & perinatologist about their
philosophies regarding management of
problems in that critical 20-24 wk
period before I select one because I
know now that what happened to me is
not necessarily standard practice for
all medical providers.
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