Thursday, July 03, 2014

The Beginning - The Scary Part

I left off the story of our youngest son's birth alluding to the fact that things didn't go as expected after he was born. Here's the rest of the story:

A birthing room at hospital can be a busy place for a very short period of time. You go from hanging out in the room with your partner and your nurse and whomever you've elected to join you, to suddenly having extra nurses, a resident doctor, sometimes an attending physician and in more urgent cases, a neonatal team hovering nearby. When this little Bunny was born, I remember there being two nurses and the resident in the room and maybe the doctor and nurse who check on the babies after they are born. After he was born and everything seemed ok with him and me, it went back to being just me, my husband,  my nurse and this little tiny new person in the room. It was quiet. It was wonderful. I felt so good. I felt amazed at how much easier it had been. I felt like I could go out and bench press a car. I was a superhero.

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At the IWK Maternity Hospital, you stay in the delivery room for a while after the birth. I assume this is for observation while the nurse finishes writing up your paperwork, encourages you to nurse the baby for the first time and probably does another Apgar scoring on the baby. I guess. I'm not an expert.

Not long after I fed the Bunny for the first time, I felt a gush of something being expelled from my body. This being my second birth experience, I knew to tell my nurse and have her check that everything was ok. I had passed a rather larger clot after the Mogrunt was born, and that's what I expected this time.

This is not what Denise saw when she pulled back the sheet. Instead, she saw a whole lot of blood. She grabbed the phone and called for assistance, then, (and this is where my memory gets a bit choppy), she changed the padding on the bed underneath me.

A moment later there was another gush. I told her but she had already seen it, grabbed the phone and shouted, "Tell the doctor to get here NOW!" As she was speaking, I could already hear the sound of sneakers racing down the hallway. The doctor burst into the room.

The next thing I knew, the back of my bed was dropped down and they were restarting my epidural. The doctor (resident), let's call her Dr. B., was checking to see if she could find the source of the bleeding and after checking around for what seemed only a few moments thankfully stated that she seemed to have found it.

The sides on my bed went up and they got ready to push me out of the room.

I turned to look at my husband, who was sitting there holding our baby with a startled look on his face, as if he couldn't quite believe what was going on.

"I love you." I said.

"I love you too." he said, "You're going to be ok." He told me he said it because he knew it was true, he had no doubts that I would be ok. I, on the other hand, wasn't so sure.

My bed burst through the door and they wheeled me to the OR, just down the hallway.To this day, I can close my eyes and still see the ceiling tiles and lights above me and hear the sound of their shoes squeaking as they pushed my bed as fast as they could.

"Please Mom," I said, "I really don't want to see you today."

A nurse, hearing me, and being the amazingly protective women that those nurses at the IWK are, said, "Is your mom here? Do you need us to do anything?" Imagining, perhaps, that I had a difficult mother who might cause me some sort of stress.

My nurse, with whom I had swapped stories all night, said, "Her mom is gone. She passed away. It's ok, Stephanie. You're not going to see her today. We'll take good care of you."

We burst through the next set of doors to the OR and immediately an entire team surrounded me.

The anesthesiologist, whose name was George, introduced himself and his assistant, whom I swear was named Denny, and got to work monitoring my vitals and ensuring I was comfortable. George and Denny were going to be my best friends.

"We are going to wrap you in towels ok? You lost a lot of blood and we don't want you to start shaking because you might feel cold or go into shock." This seemed unnecessary to me at the time, but as I was there with my legs propped up at angles which seemed indecent, I was happy that some parts of me were going to be covered up.

We had been met in the operating room by Dr. Z, the attending physician. At this point, Denise, who had positioned herself on my left hand side, said, "If you were to pick a doctor to work on you in this moment, you couldn't have picked two better." All I saw of Dr. B and Dr. Z for the next hour and a bit was tops of their heads.

While the two doctors toiled away at what I would later find out was a tear that required many, many stitches to fix (thanks to friable tissue that continued to tear when they stitched it), I alternated between a range of emotions. I was chatty at first, likely from the adrenalin running through my body.

I realized that George was trying to get blood from my earlobe.

George: "Nice earrings, but I'm having a hard time getting any blood from your ear. You have tiny earlobes."

Me: "Don't get any ideas, those earrings were my mom's, George. Maybe you should try my finger." I wiggled my ring finger on my left hand. "I always have success with that one."

George: "How would you know that one will work?"

Me: "I used to teach pharmacists how to use a point-of-care testing device. I've stuck that finger a lot. I'm a good bleeder. Unfortunately."

(He swabbed my finger, sliced it and sure enough, got his readings.)

George: "You're going to need blood. Are you ok with that?"

Me: "Yes. BRING IT ON!"

George asked someone to hang a bag of O negative. I told him "I'm a nerd, I have nerd blood: A+".

George laughed and of course, they checked my type to be sure, but the next bag they hung was A+.

Two bags of blood.

I asked Denise if she could get someone to ask Andrew to call three people - my dad and two of my friends:  Rebecca and Angela. Someone came back and informed me that he would do just that. Imagining him there, holding our baby, calling the two of them, yeah, I can't think about that. I've known the two of them, well, Angela I've known since I was 18 and Rebecca since I was 20, so we've been through some things together. From my perspective, at least, this was the worst thing.

I stared at the ceiling. I thought about stuff. A lot of stuff.

I thought about my mom. About how much I missed her. About how mad I was that she wasn't able to be here. I hated cancer more in that moment than I have hated it in a long time.

I thought about my son, at home, still asleep. I missed him. I wanted nothing more than to hold him and snuggle him and run with him. We had been talking about how Mommy couldn't really run because of the heavy baby in her belly. He could hardly wait for me to have the baby so we could have fun running and biking again.

I thought about Andrew, sitting there with our baby and hoped that they were ok. I wondered if anyone told him how I was doing. I was upset at being separated from him and the baby.

Suddenly I thought about my brother. He's not mentally well. He hadn't spoken to me in a year at that point. I got angry thinking I might die and he wouldn't even know I was at the hospital to have a baby.  I got really angry then and I started to cry.

George wiped my tears. George, I'm forever grateful.

Denise sidled up to me again. "Don't you cry on me. You're going to be fine. They've got things under control now. I thought you were going to be my easy patient tonight."

"Me too," I said, "me too."

I looked at her, "Denise, it's almost 7, you're off your shift soon. You need to go home." I know, it's weird that I thought that. Because I really didn't want her to leave me. I felt like I would be alone without her.

Denise said, "Don't you worry. I've got two nurses coming in to take my place. And I'll check in to see how you made out, ok?"

Not long after that, Denise brought two wonderful nurses to my side. For the life of me, right now I can't remember their names, but I know that one of them was a graduating student and it was her birthday. She asked all sorts of questions about the Bunny to help distract me from what was going on. They told me that as maternity nurses, it's always fun to meet babies that are born on their birthdays.

The doctors finished up and announced that I would be ok. They were going to watch me to make sure my blood levels didn't drop but they had fixed the issue.

I was lucky the tear wasn't higher - I could have ended my night with a hysterectomy. Instead, I ended it with a whole lot of stitches, about a thousand, as Dr. Z told me later. Do doctors exaggerate? I kind of hope that they sometimes do.

Eventually I was wheeled back into the room where my husband waited with our little baby. I smiled weakly at them and started to cry. Andrew rushed to my side, kissed me and smoothed my hair.

It would be another day before I got a look at myself in the mirror. I was unbelievably pale with huge black circles under my eyes. I had tubes everywhere. Me, the person who gets the heebie-jeebies when looking at IVs had needles sticking in both hands and pieces of surgical tape stuck to me everywhere.

But I was alive.

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This photo is in black and white, but let me tell you, 
I was pretty much the same shade in full colour.

I think about this all the time. I think about what might have happened had the situation been different:

  • What would have happened had I not had a previous birth experience?
  • I knew to tell the nurse about the feeling of passing a clot, what about women who don't know to do that?
  • What if I had been younger, less confident? I am an open book when it comes to speaking with health care professionals, some women, younger perhaps, more shy, yes, might not have said anything.
  • What if I had had the baby at home? I asked my doctor about this last week after asking her to review the report from this day. I would likely not have made it, she told me. There's a good chance I would have died trying to get to the hospital.

So, while I support a woman's right to choose where she gives birth and who she involves in her birthing experience, I want my story to serve as a reminder that it doesn't always go the way you plan. There were no warning signs. There was no intervention in this birth that could have caused that laceration. The birth was not the problem. We don't know what caused the tear.

Women still die as a result of childbirth. It is horrible. But it happens. In Canada, in 2013, the rate was 11 in 100 000. In the United States, in 2013, the rate was 28 in 100 000.  Those rates have actually RISEN in the last 20 years. Meanwhile, many European countries have death rates in the single digits:

"Globally, most maternal deaths are caused by severe bleeding, high blood pressure, infections and obstructed labour. More than one in four is caused by malaria, HIV/AIDS, obesity or diabetes. Abortion complications account for 8 per cent of deaths."

"In 1990, 23 countries had at least 1,000 maternal deaths per 100,000 live births. By 2013, only Sierra Leone remained above that threshold, but it had still managed to more than halve its death rate over the period." 

{via}

We should all be so fortunate as to have the access to medical care that I had, but let's face it, some of us choose not to have it and some have no choice but to go without it. Please, if you make the decision to give birth at home with a midwife or a doula, please understand the risks and be prepared for them. Have alternate plans. Be ready to accept those alternate plans for both your baby's safety and your own. There's a lot at stake here.

And for those women who have no choice but to go without medical care, let us all do what we can to support them and the organizations that endeavour to help them.

4 comments:

  1. I'm relieved to hear that you and your son were okay in the end, despite a very frightening situation. Neither of my births went as planned either, though not to the same extent. I was glad to be in hospital, and fortunate to be well looked after.

    Thanks for sharing your story. You have a beautiful baby and by now, I'm sure, a busy toddler. Congrats!

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    1. Thank you, Marti. I hope all is well with your family.

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  2. I felt the same way which is why I started a project in Sierra Leone. Please check out the website if you have time euphoriaprojects.org

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  3. Sorry for your experience.

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