***Warning, this is a continuation of a childbirth experience in which things went wrong and medical interventions were required. A few medical procedures will be described and while I am not going out of my way to be graphic, some of this may not be particularly pleasant to read.
With each step towards the bed, blood gushed from between my legs. I knew it was a lot of blood, much more than there should have been. It truly hit home, however, when the midwife began asking the nurse to give me shots of pitocin and another drug to help my uterus contract and clamp down. I knew from previous conversations that the midwives only used pitocin if they had to, so it was obvious this was not routine.
The placenta came out with a couple of pushes but the bleeding would not stop. Jessica, my midwife, massaged my abdomen and called for an iv of pitocin to be started. Before long, a team of ob-gyns, residents, and nurses were called into the room to assist.
Meanwhile, Jared was across the room taking pictures of Ray being measured and weighed.
At this point the pictures end because Jared looked up, saw the blood, and rushed back to be with me. We would not take another picture that day. At some point the nurse called that Ray was 9 lb, 9 oz and I remember saying something like "That's ridiculous!" in disbelief that he could be so huge.
The bleeding continued, and it was decided that one of the doctors would perform a "manual exploration of the uterus" which basically involves the obstetrician reaching her hand inside and scraping any remaining clots out of the uterus with her finger. If this sounds painful, I can assure you it is! Most women who undergo this procedure are fairly numb at this point from an epidural, but I had received no pain meds up to this point. An iv with pitocin had been started and narcotics were added to this as well. It took a few minutes for them to kick in, however, and I remember Jared crying with me as he held my hand and tried to help me through the agonizing pain.
Somewhere during the manual exploration process, a very stern young Eastern European doctor (we would later learn her name was Stefka and she was the Chief Resident) got in my face and told me I needed to be brave. I told her "I already was brave!" thinking "I just gave birth to an almost 10 lb baby without pain meds, it's supposed to be over." Her response was, "Well, unfortunately it's not over, you can do this."
They performed the "manual exploration" a couple of times and removed at least one clot to my knowledge. An ultrasound machine was brought in so they could look and see if there was anything else in the uterus causing the bleeding.
After awhile the bleeding slowed and the room calmed down. I was lying in pools of blood and had blood crusted to almost every part of my lower body. The nurses tried to clean me up as best they could and I was able to nurse my baby and be fed bites of an omelet by Jared. I also called my mom and told her a little of what happened. She was at our house caring for Nathan and Hannah and it was so reassuring to know that in the middle of our crisis they were in good hands with Nana.
At this point, due to a combination of the blood loss and narcotics I suppose, I felt like I was in a fog. Usually right after I have a baby, the rush of adrenaline and oxytocin makes me feel very energized and excited. With Nathan and Hannah, I couldn't sleep for hours afterwards and just laid awake and stared at my beautiful new baby while Jared and the baby slept.
This time was different. Although I was thrilled about my sweet new baby, I felt very lethargic and kept thinking "I just want to sleep, I'm so tired."
The attending obstetrician came in with my midwife Jessica and talked about what had happened. The doctor attributed the bleeding problems to the size of my baby and told me I just shouldn't have any more kids because they would continue to get bigger. (My other two were 8 lb 14 oz, and 8 lb 4 oz). "Well, we'll have at least one more," I said. She replied that hopefully it would be a girl since girls are generally smaller. At this point it was unfathomable to me that we would stop at 3 kids, this had never been an option to us. We had originally wanted 6 kids although during my pregnancy with Ray we had started leaning more towards 4.
Every time I shifted in bed, blood would gush out again. I was lying on chux pads and soaking them every few minutes. The nurses would massage my uterus every 10 minutes and the bleeding would stop, only to start again a minute or two later. The nurses started weighing the pads to try determine how much blood had been lost. It was not looking good, so a blood draw was ordered. We were told that depending on how it looked, a spinal may have to be administered and a D&C performed.
Jared and I were left alone for a minute and he asked me if I wanted him to give me a blessing. I agreed, but he was only a sentence into the prayer before the doctors were back in the room. He started to ask for a minute alone but we could see in their eyes that things were urgent.
My blood work had come back even worse than had been feared. We learned later that my hemoglobin was 3.8 (normal for an adult woman is between 12 and 16) and my hematocrit was 13 (normal is between 38 and 46). Instead of a spinal, I would be placed under general anasthesia. And if the D&C didn't work, a hysterectomy would be performed. What a shock to be told as a 27 year old who has always been perfectly healthy and had textbook periods and pregnancies that you may have to undergo such a drastic surgery! But there was no time to process this. As I was rushed off to surgery I barely had time to kiss my husband goodbye. "I love you. It will be okay," I told him.
It is strange what that amount of blood loss does to your brain (when all was said and done I was told I lost 3.5 liters of blood total). By the time I was put under, I knew there was a chance I might die and I was strangely at peace with it. I felt bad for Jared knowing that he was waiting outside the operating room, worried sick, but for myself I knew that whatever happened, I would be asleep. And at that point, that was all I wanted. Sleep.
Several hours later I woke up, still in the operating room. Everyone seemed so happy to see me awake! "You're husband and baby are right outside!" they told me. "They're waiting to see you!" My lower abdomen felt like it was on fire.
"I hurt," was my response. I knew the pain was a bad sign, but no one had told me what had happened yet.
I was wheeled out into the hall and there were Jared and Ray. I'm sure Jared said something sweet to me but all I could say was "I hurt." They continued to wheel me down the hall and we got in an elevator. The nurse who had been my nurse since we arrived at the hospital that morning was with me. "Do you know where you are?" she asked me.
"Yes, I just came out of surgery," I said. I hesitated, not sure I wanted to hear the answer, "Did I have a hysterectomy?"
"Yes," she said. Then, "I'm sorry," as I began to cry.
I was taken to what they called the PACU for post-op care. In my memory it was a long room with lots of beds with people in them looking half-alive and hooked up to lots of beeping machines. I am sure I fit right in with all of them. I kept telling the nurses that I hurt and they sent for a pump for pain meds (morphine I think, but I am not sure). It seemed like it took forever for them to get it, and I could not understand why they would not have had it ready, knowing I would be in pain after surgery. Looking back, I realize I probably had received plenty of pain medication already, and I can not imagine how horrible I would have been feeling otherwise!
My midwife, Jessica, came to see me in a few minutes. She was such a sweet, reassuring presence. Jessica told me that Jared had been outside the operating room holding Ray the entire surgery. Since he could not come into the PACU, he had gone home briefly to visit Nathan and Hannah and make sure my mom had everything she needed for the night. Soon I would be transferred to ICU and Jared could see me there.
Then Jessica told me about the surgery. What happened was described to me in detail several times by Jessica, Stefka the Chief Resident, and the attending physician. This is what I was told:
After they had put me under, the doctors had tried the manual exploration procedure again. When that failed to control the bleeding, they performed a D&C. The bleeding continued and they attempted to place a balloon catheter into the uterus to control the bleeding. This also failed and the decision was made to cut me open to see if they could figure out what was going on. A stitch was placed on the outside of the uterus to try to force it to clamp down. Once again it failed and at this point they were running out of time. Stefka told me, "At this point, we had to perform the hysterectomy to save your life." Jessica and both doctors all told me that they knew how much I wanted to have more kids, and so they tried everything they could to avoid the hysterectomy. I received 9 units of blood total and 2 units of plasma. We are so thankful for blood donors!
Before long, one of the nurses told Jessica that she should leave me so I could rest. I really wished she could have stayed, she was such a comforting person. After awhile I was taken to the Burn ICU (I guess because the regular ICU was full). I had my pain pump at this point and was pushing the button as often as I could and starting to feel slightly better although I was hooked up to all kinds of contraptions.
Jared came into the room and immediately started crying, I think from relief to see me alive. I have always felt that we had a good marriage, but the events of that day bound us closer together than ever.
Jared asked if I wanted to see the baby and I said "Yes!!!" just thinking he meant a picture. But he had talked to the baby nurses and they had agreed to bring Ray down, which was so kind because the maternity/postpartum ward was nowhere near the Burn ICU.
When they brought him in, he was so sweet. They helped me hold him and his nurse even did some checking and found out that I could nurse him. I had been really nervous about this because I have always breastfed my babies for a year each, and I did not want to get off on the wrong foot by giving him bottles the first couple of days because I was on meds. But the doctors said I was fine to nurse him, and we got started right away.
I wish that I could remember the name of Ray's nurse that night. She was an angel. She set Jared and Ray up with their own room on the postpartum floor so Jared could sleep and tend to the baby in between feedings. Every 3 hours she brought Ray down to me and helped me feed him (not an easy thing for me to do with two ivs in one arm, one in the other, an O2 moniter on one finger, and a blood pressure cuff on one arm as well). Each feeding took 30-40 minutes, but she never complained that she had other things to do. I am so grateful for her efforts.
That was a hard night. I slept fitfully, about ten minutes at a time, always awakened by the pain, or by a machine beeping, or the blood pressure cuff inflating periodically. When I would wake up, I would be disoriented then I would remember everything that had happened. Pain and grief would wash over me, then I would look at the clock and think "In 1 more hour, I will get to see my baby again," and it would be okay. When I held Ray, I didn't feel the physical pain anymore. It was impossible to feel sad while holding such a precious, new baby boy.
I knew how blessed I was to be alive and to have the opportunity to raise my three beautiful children with my husband by my side. I felt God's presence with me that night, and I knew I was not alone. He showed me His love by providing comfort to me in one of my hardest times, and I am so thankful for that.
To be continued...
Sweet Baby Ray's Birth Story Part 3