By Abby, Virginia City, MT USA
PROM at 15 weeks + 3 days. Delivery at 17 weeks.
Story added: 2011-10-17

I went in for my first appointment with my OB at 12 weeks. The evening before, I began experiencing some discharge with a pale pink color. I told my OB of this and she performed some tests and diagnosed me with a yeast infection & bacterial vaginosis. She gave me two prescriptions for the infections. 3 days later, the discharge turned into bleeding...enough for me to want to go into the ER. After an ultrasound, I was then diagniosed with placenta previa. I bled consistantly with days of low flow, days of medium flow and a few days of heavy flow until week 17. One of the heavy flows also produced a clot which prompted me to call my doc and self-prescribe bed rest. I was on bed rest for 1.5 weeks and at 13 weeks + 3 days, I woke up at 12:30am soaked (it wasn't just blood, but rather a mixture of moisture & blood, which I now realize was my water breaking/membrane rupturing). After going to the bathroom, a very large blood clot came out. I went into the hospital that morning. The ultrasound showed very low amniotic fluid, but the baby had a healthy heartbeat. My doc called a specialist and he suggested continuing bed rest and a repeat ultrasound in 1 week. I bed rested & stayed well hydrated. At the next ultrasound, it showed that the fluid levels were even lower than the week prior (was at 5 cms...or something like that), but again the baby's heartbeat was still normal. Since I was bleeding constantly, it was difficult to tell if I was also continuing to leak fluid (I obviously was). My doc came in to talk to me and made me realize the severity of the situation...that in this case, not many babies survive and if they do, the risk of permanent life-long health problems are very high. She suggested that I consult with a high-risk pregnancy doc to discuss my options. Also, my hospital does not do D&Es, nor does it perform the induction/labor process while the baby still has a heartbeat. She hypothisized that the reason my membrane ruptured is due to the constant bleeding caused by the previa. It's also important to mention that I had surgery removing siginificant fibroids (in size & number) from my uterus 2.5 years prior to this pregnancy. This is my first pregnancy. We made an appointment with the specialist and his diagnosis was the same. He did say that there is the small chance that the baby would survive and an even smaller chance that the baby would be born healthy. That if the baby was born alive, it would require months and months in the NICU and a lifetime of health problems. And, if I was able to carry the baby past 24 weeks, that I'd then have to be hospitalized at that point for constant monitoring. The fact that I was only 17 weeks certainly complicated everything since the baby is not viable outside of my uterus until after 24 weeks...and even after 24 weeks, the level of prematurity is also extremely dangerous even in a textbook/normal pregnancy. After a ton of discussion, my husband & I decided to move forward with the D&E. We couldn't bear further heartbreak of our baby dying at birth (whenever that would take place) and the probability of the baby dying from health issues if it did survive birth. Also, there was a risk of infection to myself since the membrane had broken...that I could become septic and that was life-threatening to me. Our appointment to begin the D&E process was on Wednesday (17 weeks + 3 days). On 16 weeks + 6 days, I was feeling very crampy...compared to period cramps (not horrible, but not comfortable) that ranged from 4 to 5 to 7 up to 20 minutes apart beginning around 7pm. I finally laid in bed around 10pm and the cramping subsided. I woke up a few times in the middle of the night with constant & pulsing cramping. I woke up in the morning feeling fine...slight bleeding (would consider it one of my lower bleeding nights), no cramping but felt something was in my vagina when I peed...kind of like I was wearing a soaked/uncomfortable tampon. I called the specialist and he suggested that I report to Labor & Delivery (the specialist's hospital does perform D&Es no matter the fetus heartbeat up to 20 weeks). We were at the hospital around 10am. The doctor checked me vaginally and could feel the baby was coming. He administered a dose of medication (orally) to boost the labor process. At 11:10am, I felt about 4 or 5 large gushes of blood and after one push, delivered our baby girl...minimal cramping or pain and no pain medication (we named her Hope, she was 4.5 ounces and 7.5 inches long). About 30 minutes later after a few pushes which resulted in large clots, I delivered the placenta (the doc did administer a more aggressive medication via a shot in my thigh to assist in getting the placenta delivered once I had delivered the baby). After all was delivered, I began feeling harder cramping, chills, was nauseous and had diarrhea (due to the medication given to induce/continue labor). The nurse gave me pain medication via my IV and I immediately felt better. I was discharged by 4pm that afternoon and returned home. We did get to see & hold our baby. I believe that will help in our grieving process...to have closure and no regrets in the future. My husband decided from the beginning that he wanted to see the baby...I was on the fence. I didn't want to see her immediately after birth as I was afraid that she wouldn't look like a baby, but rather something alien/foriegn. My husband saw her and held her immediately after birth and even watched over her as the doctor determined the sex (it wasn't immediately clear as to the sex since that part wasn't completely developed yet). The nurse took the baby and cleaned her up. After I recovered from the symptoms after the birth and was able to think clearly, I decided that I did want to see/hold her. I thought that if I didn't, that it would be something that I'd regret for the rest of my life. I needed to say goodbye to my baby (she did look like a normal baby...just tiny and more red than peach). The nurse brought her back in the room when I was ready. I looked at her while my husband held her and then I finally felt the need to hold her. We spent about 45 minutes together alone with our baby, a time that I'll cherish with my husband forever. Social services visited and helped us make a decision on what to do with the baby (burial, cremation, or have the hospital take care of it) as well as offer grief counseling. We decided to have her cremated so my husband & I can have our own ceremony when we spread her ashes somewhere that is dear to us. The funeral home here offers burial & cremation services for free to those who miscarry in the 2nd & 3rd trimesters. Our wonderful nurse also prepared a "memory box" of some keepsakes for us...a certificate with her name/date of birth & death/weight/height and her sweet foot/hand prints, the blanket she was wrapped in, a card of condolence from her, and a few other items. My husband & I are both relieved that nature took its course and we didn't have to go through the active process of terminating the pregnancy. We would have proceeded with the D&E if things didn't happen the way they did. This all happened today. As I sit here and write my story, I'm feeling physically fine, emotionally sad but numb too.