Thursday, April 4, 2013

Lost Pregnancy at 11 Weeks 4 Days

Warning: This will be a very graphic post.  Please don't read it if it will cause you distress.  This is a story of pregnancy loss.  I had a miscarriage on 4/1/13. This pregnancy was far enough along that it is something like a birth and will probably bring back traumatic memories for those who have experienced loss in the past.  Please be aware and don't read if it will cause you pain.  This is for my healing, and for those who come later looking for someone to share their story.  I found solace in reading other's stories of loss over the last few days.  

I found out I was pregnant very early.  I had a stomach virus, and I thought it might be pregnancy symptoms.  It turned out, it was both.  It was only 3 weeks and 4 days into the pregnancy.  I could hardly believe it was happening.  We'd been trying for close to 1.5 years.  I breastfed during most of that time, in fact C didn't fully wean until I was about 8 weeks pregnant.  This had been an odd cycle.  My fertility monitor never registered ovulation.  My charting software drew a cover-line indicating I hadn't ovulated, but I saw a temp spike that could indicate ovulation, and in the end, I was pregnant. We did early blood work, my HCG levels were rising well, but my progesterone was low.  It dropped from the first blood test to the second.  I was put on progesterone to try and offset the missing hormone.  We suspected it was because I was still nursing.  I was afraid it would sustain a pregnancy that wasn't meant to be, but I wasn't willing to risk that the pregnancy was viable, but my nursing C was the real concern.

Thursday, March 28th, I went to the doctor for my monthly checkup.  We heard a strong heartbeat at 171 beats per minute.  My OB smiled at me, I smiled at her and I felt so relieved.  We had just reached the 11 week mark.  I was feeling pretty good.  We were so close to the 12 week mark, after which, miscarriage odds drop so low.  I felt like we were out of the woods.  

Last weekend, I dreamed I'd lost a baby and I hadn't remembered it until then.  The dream was so real it took me almost 20 minutes to figure out whether or not I really had lost a baby.  I'd dreamed the baby was called Joe.  Later, after I fell back asleep, the dream got strange and I dreamed the baby had been pulled apart by dogs.  It was very scary and felt very real. 

On Monday afternoon, I had a strange awareness of my uterus.  I'd been having a bit of blood, but I had a cervical polyp, so that was expected.  I called my OB and she wasn't concerned either.  I was going to get my NT scan in 1 week, and see her in 3, so we thought I didn't need a check.  At around 9pm that evening, I felt a strange sensation and found that the cervical polyp had fallen out.  I was so relieved I was giddy.  I was so worried that polyp would do something to cause me to lose the baby.  About 30 minutes later, I started actually feeling contractions.  I called the on call OB.  He called back by 10.  While I was on the phone with him, my water broke.  At first I didn't realize what had happened.  I said "Something just came out of me".  I got up, the bed was wet, but it wasn't all blood.  I went to the toilet, and just after I sat down, I felt the baby start to slide out.  I caught him in my hands.  I told the doctor I had the baby, he was out and he was still moving.  My husband and I sat with him and watched him move until he was still.  He moved for about 5 minutes. We bundled him in a wash cloth.  The doctor asked me if the placenta had come out.  It hadn't.  He told me to call if I had any other concerns.  He said if I started soaking through more than 4 pads an hour, I'd need to go in and possibly have surgery to finish the miscarraige.

Thirty minutes after I got off the phone with him, I started to bleed.  I bled through a pad in about 2 minutes.  I looked down and could see blood pouring out of me like water from a faucet.  I called back the doctor.  He asked if I could make it the 25 minute drive to their hospital.  I didn't think that was wise.  While I stood still and my husband gathered clothes for me, blood pooled at my feet.  We got me dressed in clothes I didn't mine having thrown away. I used inserts from our cloth diapers to try and contain the blood. We gathered C and headed to the car.  My husband had put down a garbage bag and a bath mat on the seat to try to protect it.  We drove very quickly to the hospital.  We ran a few red lights, it was very rushed.  He dropped me at the front door.  I went in and calmly told the lady at admitting I was hemorrhaging, I had lost a baby and the bleeding wouldn't stop.  She had me fill out some paperwork.  We'd left my purse in the car, she needed my driver's license.  After I signed her paperwork, she disappeared into the back.  I stood in front of her desk and told her there was nowhere I could sit, the chairs were cloth and I was bleeding too much.  I waited what felt like eternity, but was probably only a few minutes.  I told her I needed to sit, that my extremities were cold, My vision was graying out and I was going to pass out.

She told me she'd informed them I was here, and I'd just need to wait.  I started chanting "I need a chair".  She sighed, got up and walked back to the entry, where there were wheel chairs.  She brought it to me and they helped me figure out how to sit.  I'm told I said "I don't want to die" then I passed out.  My husband tried to tear down the magnetically locked door to the ER.  A security guard came to see what the disturbance was about.  I am told I started foaming at the mouth.  My husband's efforts resulted in several people coming out to get me.  They quickly took me back to the room.  I came to as they turned the chair around to put me on the bed.  

They asked if they could cut my clothes off, and if I could tell them what was going on.  I explained the situation as clearly and calmly as I could.  A man who I later learned was the charge nurse reported to the doctor that I'd been told to call 911 but chose to drive to the hospital instead.  I vehemently corrected him.  I was told I should drive to the plaza, I didn't think that was safe and instead chose to drive to the nearest hospital.  If I had been told to call 911, I would have.  I would have hated it, even more people would need to have explanations as to what had happened.  My neighbors would have been concerned.  But if I had known I needed to, I would have. 

They spent some time trying to sop up the blood.  It just kept coming.  They placed an IV and started me on saline.  I kept having contractions, blood kept flowing.  I heard them outside the room on the phone with the on call OB. I started to shiver, I was very cold.  10 minutes after ,they first assessed me, they checked me again and the blood had not slowed.  They covered me with warmed blankets, started a second IV to get more fluid into me.  They inserted a foley catheter, that was quite unpleasant.  They worked to clean up the blood that ran down my legs. I continued to bleed.  They used a  speculum with a light to try and see if all of the "products of conception" had made it out.  The amount of bleeding indicated it probably had not.  The on call OB told them to give me IV pitocin, an intramuscular shot of methergine and 4 pills of cytotec as a suppository.  All in all, it was most unpleasant.  Once all the meds were in, after yet another check with the speculum, I passed the rest of the placenta.  They removed it and several more clots with forceps and the bleeding started to slow.  

After 10 more minutes, it was time to move me up to the floor with the OB nurses.  They asked if I wanted to keep the baby.  I couldn't stand the thought of him being thrown in the trash, so I kept him with me.  The nurses on the OB floor were very kind.  They helped clean up the blood once again.  It was around 3am.  I finally got to see my husband and son again.  It had been several hours and I was glad to see them again.  I sent them home to sleep, I slept an hour and a half.  We hadn't had time to grab anything, all I had was my phone.  I e-mailed work to let them know I was in the hospital.  They sent their condolences and FMLA paperwork.  I asked if the baby qualified for bereavement leave.

I asked repeatedly to have the cath removed.  It wasn't working correctly.  I had to work to push urine through it. Finally, I met the OB that had been supervising my case overnight.  She said we could get rid of the cath.  They also removed one of my IVs.  The ER uses the crook of the arm because it is easiest, but it is also the most uncomfortable.  I couldn't really bend my arms.  

The OB was very kind.  She told me this was not my fault, that in all likelihood this was a chromosomal problem and there was nothing I could do.  They offered to take care of the baby for me. They also informed me there was a funeral home in town that would cremate him for me if I'd prefer.  We chose the cremation option.  I asked if they could take a sample of the baby to determine if there were chromosomal problems.  Pathology said they could not do anything with the baby at this point.  We chose to take him with us.  

My OB called, she was very sad and concerned.  We spoke at length.  They don't believe it was the polyp.  This is just one of those things. We called the funeral home and they explained that since we were residents of the county they served, they would perform this service for free, as they do for any baby born to residents of this county, regardless of gestational age.  We were overwhelmed with gratitude.  We made an appointment to drop him off as soon as I was released from the hospital. 

I've received a ton of support and well wishes.  The day after I lost the baby I was very angry with my body.  I felt he'd still be alive and fine if it hadn't thrown him out.  I discussed the situation with my aunt who works in Maternal Fetal Medicine.  We thought about the fact that my progesterone was low, we talked about my age and all things that could be.  She assured me that progesterone could support a baby and depending on the chromosome issue it could continue to develop right up until there just wasn't enough hormonal support for it to continue.  I'm working to find comfort in that answer.  It sounds right and it feels right.

I'm worried about the age spread between C and his next sibling.  I don't want him to be an only child.  The clock is ticking.  I am trying to figure out how long I can wait, when we'd have to start trying to adopt if my body won't sustain a pregnancy and a thousand other things.  I know in my head it is a bid for control, I hope time will give me perspective.

So many people have reached out to support me, I've worked hard at accepting that help and I so appreciate everything everyone has done.  For those who have disrupted their lives and changed their plans to be there for me, I am incredibly grateful for everything you've done.  Thank you to everyone for their positive thoughts and kind words.  This has been a very difficult experience and it is one I pray I won't have to repeat.

There are so many other moments that stand out for me. Since I was in an L&D ward, I took time to educate on CHD.  They were happy to say the entire hospital network performs pulse-ox tests on all newborns as a matter of policy.  I was happy to know that and they were happy to learn about my experiences as a CHD mom.

We took a few pictures of Joesph just after he arrived.  I chose not to include them here, they are personal and I've seen what people do with those kind of pictures on the Internet.  He was beautiful and looked perfect.  He had 10 fingers, 10 toes and I could see his fingernails. I'm sorry he couldn't stay, but I'm glad I met him.