I decided to start a blog because I realize there are a lot of you that really aren’t sure exactly what has been going on with this pregnancy and I wanted a central spot to update everybody. Plus it will give me one more thing to do from my couch . This first entry will be kind of long as I catch you all up to speed but after that it will just be updates.
As many of you know, I have struggled a lot with infertility. It took a year of failed attempts with a fertility specialist before we finally gave up as we weren’t in a position for IVF at that point of our lives. During one of many, quite invasive exams they discovered I have what is called a bicornuate uterus, which basically means that my uterus was not one big open area, but was divided by a septum which gave it a heart shaped appearance. They theorized that the septum was keeping the sperm and the egg from meeting. They also diagnosed me with Polycystic Ovary Syndrome (PCOS) which is an imbalance in hormones which causes sporadic ovulation and prevents the eggs from maturing and releasing from the ovaries. Instead, they form cysts in the ovary that can get very large (and painful!). So it was a double whammy that basically did away with any hopes I had of ever conceiving on my own.
So we gave up and decided to focus on all the fun things that people without kids got to do. Imagine my surprise when almost 2 years later, a number of days before my husband left for Basic Training and AIT , I got a positive pregnancy test. There was a question of if I would even be able to carry that pregnancy to term in half a uterus but thankfully I was able to make it to 36 weeks before he was born. To make a long labor and delivery story short, I was unable to fully dilate and he was lodged partially transverse so when he was born I gave birth to the side of a face instead of the top of a head, and the corner of my cervix that hadn’t opened tore and I began to hemorrhage. I had to have a surgeon fix it and of course it left scar tissue behind on my cervix as well as leaving it weaker for the wear and with a small hole that never did close up like it should have.
So we began our little life together as a family of three, happy as could be with our miracle baby who we named Nathan which means “Gift from God”. I had always wanted 4 kids, but was so grateful for my one child that it really helped ease the blow that I would never have the big family I wanted.
Fast forward 2 years and 1 month, my husband David had just got home from Iraq. I was three days late but never even suspected I may be pregnant. I had been having horrible, practically debilitating cramps for the past week or so and was actually getting anxious for my period to hurry up and get here so that I could get it over with. It was a Sunday morning and David had just left for a pheasant hunt and I thought it wouldn’t hurt just to make sure I wasn’t pregnant. I had an extra pregnancy test that had been sitting in my closet for who knows how long. So, I peed on it, and didn’t even think about it as I started the shower and got undressed. As I was stepping into the shower I glanced at it out of the corner of my eye and saw two lines. I didn’t believe it and I stood there for about a minute staring at it, sure my eyes were playing tricks on me. When I finally realized it was positive I started shaking so bad I had to hold on to the countertop to keep from passing out. Once I got that under control (and 2 more positive tests later) I started calling everybody I knew with the exciting (albeit somewhat embarrassing) news that “My husband came home from Iraq and all I got was pregnant”
This excitement was short lived however. Three days later I was laying bed doing the “ring test” when I felt a gush of blood. It was a small gush followed just by spotting. As my luck would have it, it was a Friday night so I had to wait until Monday to see my doctor. The bleeding and cramping continued throughout the weekend and I was devastated as I was sure that I was miscarrying. I was able to get in right away Monday morning and my doctor had me do some blood work to test my HCG levels. I had to go in the next morning to have it drawn again to see that my hormone levels were rising appropriately. After what seemed like a torturous amount of time to wait I finally got a call that no my levels were not rising like they should be. While they were incredibly high and did go up, they just weren’t doubling like they should. I was ordered for an ultrasound the next morning. A full night of Google had me terrified of either a molar pregnancy or an eptopic because both had symptoms of abnormally rising HCG levels. I was scared that I would show up the next morning, at exactly 6 weeks pregnant to find a baby with no heartbeat.
The next day I got to my appointment way too early with way too full a bladder and waited to hear the bad news. But there was a heartbeat. I’m not typically an emotional person but when I heard that tiny beating heart I teared up and felt a wave of relief. That was all the tech would tell me though and said that I would have to wait on my doctor to call me with my results. My doctor was out of the office the next day and it was one of the longest 48 hours of my life waiting to hear back.
Friday afternoon I finally got a call that I had a subchorionic hematoma (SCH). That is when during egg implantation; the egg slightly separates or tears from the uterus causing a bleed. This bleed causes a clot which can either bleed out or reabsorb into your body. It can just stay there and never get bigger and never cause you another problem or it can raise your risks for all sorts of things such as miscarriage, stillbirth, placental abruption and preterm labor.
The bleeding had stopped by that point which I took as a good sign and although I spent most days overly paranoid that I was going to start bleeding at any moment I began having a more positive outlook on my whole pregnancy.
2 weeks later morning sickness kicked in in all her glory. I spent most of my mornings puking 4, 5, 6+ times. I usually had a few hours in the afternoon where I felt a little better (and by a little better I mean water didn’t send me to the bathroom to spew like Linda Blair in the Exorcist) but by dinnertime I was so queasy I could hardly choke down anything but chicken noodle soup. Around 12 weeks I also started feeling a lot of pelvic pressure, the sort of feeling that you get at the end of pregnancy when you have a head right there. I didn’t think that was normal since my kid weighed about as much as a housefly at that point but I thought maybe that was par for the course with your second pregnancy.
At my 16 week OB appointment I had opted to have a quad screening, which is a blood test that checks the different levels in your blood to test for things like Down’s syndrome, Edward’s Syndrome and neural tube defects. I had one done with Nathan and it came back normal so I never gave a second thought to this test. I had it done only so that if there was a problem with the baby that would require immediate care, I would be prepared and could deliver in a better hospital. . The puking continued all the way up until 19 weeks when I started to feel a little better.
During that week I received a call from my doctor’s office that my doctor wanted to send me to see a perionatologist the following week for an ultrasound. The receptionist didn’t seem to know anything other than that it was listed on my referral that it was for a first trimester bleed. I set the appointment up and didn’t think twice about it because I was driving and distracted. When I got home late that night I Googled the doctor that I was being sent to , only to find out that he was a geneticist who only saw mothers of babies who were suspected to have a genetic abnormality.
I freaked again. I hadn’t heard back from my quad screen and I just knew in my heart that it had come back abnormal. I started thinking of all the things that they test for, many of them fatal. Although I knew that the quad screens had a high false-positive rate, I had a sinking feeling in my chest. Something hadn’t felt right about this pregnancy from the beginning but up until that point I had chalked it all up to just having a good spook from that early bleed. The next morning I placed a call to my doctor’s office to see what the results of those tests were and they told me my doctor would have to call me back.
That evening around dinner time I did get a call that my tests had indeed come back abnormally high for Down’s Syndrome. So high in fact that they thought it was suspiciously high for my age and history. Another level had come back abnormal too which made them think that there was actually something wrong with my placenta.
I was so relieved to hear it was Down’s Syndrome. I know that sounds silly but I had been so terrified at the horrible possibilities that “just” Down’s Syndrome seemed like good news. I knew that I could handle that. I decided to try my hardest to enjoy my weekend since it was the 4th of July. We went to the rodeo parade and had a family cookout on Thursday, Friday we went to see fireworks but that night I started to have that pressure feeling worse than before. It was actually becoming almost painful to walk. Saturday, which was the actual 4th, we spent most of the day sitting around the house. We had plans to take the boat down the river that night once it cooled off so I took a shower and got ready to head to Manawa, David was outside getting the boat ready and I was packing up a few last things when I felt a little gush. I ran to the bathroom and sure enough, I had started bleeding again. It was very short lived, but was followed by about 20 minutes of contractions.
As Murphy would have it, these things always happened on a weekend so I had to call the on call nurse at the hospital who told me to go into Labor and Delivery. When I explained to her that they were suspecting there might be something wrong with my placenta she told me that she would have my doctor paged and he would call me back. He called and told me that I could stay home if the bleeding had stopped but if the contractions or the bleeding started back up then I needed to go into the hospital. Thankfully it stayed calm for the rest of the night so I was able to make it until Wednesday when I had my ultrasound.
That morning I woke up, exactly 20 weeks pregnant. I puked and puked and puked some more. Half morning sickness and half nerves. I felt a little robbed that what should be such an exciting day, off to find out the sex of my child and get a sneak peek at him, was actually terrifying. I didn’t know if I was going to find out that my child had a severe disability or if there was something so wrong with my placenta that I wouldn’t even be able to sustain my child.
I met with a man who was supposed to be one of the best in the country. He came up from Milwaukee to see me in Appleton. After an agonizingly long counseling session we were off to the ultrasound. They checked part after part, even counted 10 fingers and 10 toes. About 15 minutes in they told us it was another boy. I was so happy that once again I teared up, I had wanted another boy so bad! Finally they told me that the baby looked perfect in every single way, but that he was much too small.
Again I felt like I had been punched in the stomach, but fortunately that was short lived. After a short conversation we discovered that he had been given the wrong dates (by over a month) and that the baby was indeed measuring within the normal limits. He was on the smaller size, but still normal. The doctor said that he would have my quad screen re-tested with the correct dates and send me a corrected report.
After a few more minutes of poking and prodding around they said that I had a complete placenta previa which was perfectly centered over my cervix and was not going to move. It meant a C-section and pelvic rest but I was so relieved that I had a healthy little baby that I didn’t care about a C-section and a 14 month deployment had prepared us both for no sex so I didn’t care about either of them.
For those that aren’t familiar with placenta previa here is a little explanation. Placenta previa is a complication of pregnancy in which the placenta grows in the lowest part of the uterus and covers all or part of the opening to the cervix. This occurs in 1 out of every 200 pregnancies. In 95% of the cases the placenta will move up by the time that you will deliver. The ones that do not move will require a C-section before you go into labor. If you begin to labor and dilate, the cervix will tear away from the placenta and you will begin to hemorrhage. The main symptom of placenta previa is sudden, painless vaginal bleeding that often occurs near the end of the second trimester or beginning of the third trimester.
In some cases, there is severe bleeding, or hemorrhage. The bleeding may stop on its own but can start again days or weeks later.
There may be uterine cramping with the bleeding. Labor sometimes starts within several days after heavy vaginal bleeding. However, in some cases, bleeding may not occur until after labor starts. I was kind of a walking target for placenta previa because my bicornuate uterus had basically sectioned off an entire side of my uterus from allowing the placenta to attatch, and since the placenta likes to attach to scar tissue, the scar on my cervix from my first delivery was just the icing on the cake.
So, we left the office that afternoon feeling pretty good and decided to go up north until Saturday to visit David’s dad. The next day was pretty uneventful although walking was getting downright miserable, the pressure felt like I had been punched in the crotch. Friday morning I woke with a rock hard stomach, I figured it was just Braxton Hicks(harmless “practice” contractions) and got out of bed. I was walking to the bathroom when I felt another gush. I ran to the bathroom to find the worst bleed yet, but was pretty unscathed by it now that I knew what was causing it. I did however have to go into the ER to have a Rhogam shot since I had lost so much blood (that’s a shot they give to moms with negative blood types to prevent them from building up an antibody to the baby’s blood if the baby is a positive bood type). I had another ultrasound and the ER doctor called my doctor who ordered bedrest. I was told to expect a call from him that night.
In honesty I didn’t really take bedrest as seriously as I should have. But in my defense I wasn’t home, I was sitting all alone in a cabin 3 hours from home. When my doctor called that evening he sounded more serious than I had made the situation out to be. He said that he wanted to see me Monday morning and that he would be referring me to a specialist OB for the rest of my pregnancy since he couldn’t handle high-risk cases. He told me to stay off my feet and that if I bled anymore to go into the ER. He also told me my risk for losing the baby went way up. I insisted that we go home that night so that I could be near my hospital if something did happen. So we left and got home around 2 am and the next day I spent my first day on dedicated bedrest.
It almost killed me to sit there all day but my husband was a champ. He got up and did all the dishes and laundry and cooked and cleaned. That night his step-brother came by. They were going to go fishing after Nathan and I went to sleep and I was just going to call if I needed anything. I was feeling pretty good about having one good day of bed rest checked off my calendar and fell asleep easily that night. And it’s all downhill from there.
I woke up at 2:15 AM. I knew something wasn’t right. Then I felt a pop followed by more than just a gush. It felt just like my water broke. In a panic I flew out of bed. In the time it took me to walk the ten feet to my bathroom I was soaked in blood. It was running down my legs, had soaked through a maxi pad, my underwear and my pants. Was up my shirt and was leaving a trail on the floor. I yelled for David, who thankfully was home, he had Nathan ready and strapped in the carseat in about 2 minutes flat. I cleaned up the best I could in a hurry, changed my clothes and we flew to the hospital.
Apparently showing up to the ER covered in blood after 20 weeks pregnant gives you priority over everybody else. I was immediately admitted and wheeled up to labor and delivery. They hooked me up to monitors and IVs and called in all the nurses to observe since they never had anyone in there in my condition before. The next morning I had another ultrasound and since the bleeding had dwindled down to just spotting again they said that I was free to go but to come back if I bled again. I was told to see my doctor first thing Monday morning.
On Monday my doctor referred me to a doctor in Appleton who could see me the following Wednesday. Like every other doctor up until this point he told me that he had no way of even giving me an idea of how things might go from here. He told me that it looked like I would be delivering much earlier than the 36 week mark we originally expected though.
So I returned home to my couch. When I met my current doctor that Wednesday he pretty much crushed every last bit of optimism that I had been holding on to up until that point. He explained the extent of my placenta previa and how it wouldn’t move and the risks that come along with that. But then he told me that wasn’t causing my bleeding. That was a bit of a shocker. He told me that at 20 weeks pregnant I might, at most, get a little warning bleed that wasn’t much more than spotting but it would be a onetime thing and that bed rest would have stopped it. He explained that placenta previa didn’t start to cause problems until around 34 weeks, at earliest 28 weeks. By then the baby would be viable so you would just deliver to get the bleeding under control.
He also showed my amniotic fluid measuring low, but because there was a complete blockage over my cervix he knew that nothing could leak out. He said that the bleeding I was having could be caused my one of two things. I was dilating, which he didn’t think was the case because my ultrasounds had shown my cervix to be long and closed. He said he couldn’t be for sure because he couldn’t do a vaginal exam unless he was prepared to take me down the hall to surgery. He explained that under no circumstances was anybody to do an exam on me other than him. But he didn’t really believe that I was dilating and he didn’t want to check. Just let sleeping dogs lie I suppose.
What he thought was happening was a placental abruption. Usually they happen in older women with multiple children, or those that smoked while pregnant or did cocaine. It also wasn’t uncommon in women who had previous C-sections. I didn’t meet any of the criteria. Apparently having a placenta previa makes you more likely to have an abruption though because as your uterus grows it tries to pull the placenta up with it.
If you imagine making a little circle with a pen on the bottom of a balloon and then blowing it up, although the circle doesn’t actually move, it appears to as the balloon is stretched. That is essentially what happens with your uterus and cervix. However, since so much of my placenta is attached to the cervix and unable to stretch and move, it was just tearing away. That’s where the bleeding was coming from. He told me that my ultrasound at the hospital showed no evidence of a detachment but that ultrasounds are very poor tools for detecting an abruption and that they can only find about 50% of them.
He told me that if I can make it until 24 weeks gestation he would administer the steroid shots that help speed up the baby’s lung development and hopefully the baby would hang in there until 26 or 28 weeks. He also explained that there is no way to know how fast an abruption will go, that sometimes you can have a complete separation in 5 minutes or you can go for months with only half a placenta. We really would just have to wait and see.
I was directed to go home and continue bedrest and when my next big bleed happened to call for an ambulance and be immediately transported to AMC. With a placental abruption you can bleed to death in ten minutes if it’s severe enough. The only way to stop the bleeding and essentially save my life, would be to deliver the baby regardless of how far along he was. Then to add insult to injury told me that I was also at risk of accreta , which is when the placenta attaches too deeply into the uterine wall and doesn’t detatch properly at delivery. In the event that I should have to go in for an emergency C-section and they were not able to control the bleeding fast enough they would have to do a hysterectomy to save my life.
That was a hard pill to swallow….Not only was I on bedrest and scared for this child, but now I was at risk of having any hope of future children erased, instead being sent into menopause at 24 years old. The doctor told me that he wanted to see me every week until I had the baby and that he wasn’t going to admit me just yet, but that if the bleeding didn’t stop he would probably have me checked into the hospital to be monitored. Once you have had a big bleed it’s not a question of if you have another, it’s a question of when and how bad will it be. They get increasingly worse until they become life threatening. He scheduled me for another ultrasound with a perionatologist the following Tuesday and I am scheduled to see him the following Wednesday.
I also got a letter this week with a corrected report from my quad screening, thank the Lord it did come back negative for Down’s, Edwards and all neural tube defects. However it did come back with off the chart HCG levels (which explains the never ending morning sickness) and one other level was elevated. That indicated fetal growth restriction, meaning that the baby is not growing as fast as he should be because of problems with my placenta. Another reason to deliver early.
I was told by my OB that in the event I was able to make it to 32 weeks pregnant they would take the baby then because at that point he would be much better off outside of me then inside me. I would be a ticking time bomb by that point that you don’t want to bump for fear that I might lose my placenta completely which would cut off oxygen to the baby and he would suffocate before they could deliver him.
So here I sit on day 11 of my bedrest, my appointment for my ultrasound is tomorrow. It’s been a long week of spotting with 1-4 minor bleeds per day. They typically happen right before bed or at dawn, I read somewhere on the internet that your uterus contracts more during the night and early morning hours and the contractions are what irritates the placenta and causes bleeds. It’s an awful feeling, not like a period at all. I will be sitting there just fine when without warning it will be like someone dumped a bucket of blood out, and then it will be over almost before I even realized it started. Often times it is accompanied with minor labor pains which is to be expected.
So, I know this has been a ridiculously long post and they will be nowhere near this long in the future. But just wanted to catch those of you up to speed who have been asking because this does get to be a lot to repeat! I will try and post at least a small update everyday but this is the place to check for the most current information.
We ask that you all continue to pray for baby Noah over the next several weeks.
