Tuesday, August 16, 2011

Miscarriage Part 2

Sunday morning, I got out of bed early. I was starving. I wasn't
allowed to eat at all while I was at the hospital, and now my body was
complaining about missed calories the day before. I poured myself a
bowl of cereal and then sat at the computer. I googled "what to expect
during a natural miscarriage" and read some other women's stories. It
seemed pretty straightforward. My cramping might become more severe,
and then I would pass the baby, placenta, and membranes... and then
this would all be over.
Isaac's phone chirped. We got a text. Our nephew Devon was born that
morning. I cried.
We stayed home from church that morning. I faithfully monitored my
temperature: 100 degrees. I had a low fever, I felt lousy, and I
continued cramping and bleeding all morning. I put on red panties and
red shorts... in case I started to bleed more, they wouldn't stain as
much (little did I know!). I wrote a long e-mail to my friend Annie. I
mentioned that my cramping was starting to feel like early labor
contractions. I sent the email at 2:04pm. As soon as I finished up
the e-mail, things got WAY more intense. The next 40 minutes were
excruciating. It honestly felt like labor, except instead of
contractions a minute or two apart, these contractions were 15 seconds
apart. I got practically no break from the intense pressure. I had a
natural labor and birth with Galilee... 15 hours of labor with no pain
meds... so I know that I can cope well with pain. This, though, was so
hard. It hit me really hard and really fast and I didn't get chance to
rest in between contractions.
I tried to use my hypnobabies techniques that I learned for Galilee's
birth, but it was so hard to focus. I just couldn't cope with the
intensity. Isaac brought me my big exercise (labor/birth) ball to sit
on while I labored. I moaned and yelled... my children were so
confused. I felt terrible that I was scaring them, but I could not
control myself from vocalizing so loudly. I never thought that
miscarriage would be that intense... but wow. It was honestly worse
than childbirth.
At 2:45, I suddenly felt a "pop" inside me. I think my little bag of
waters broke. "Something's coming out!" I yelled. I got up and ran to
the bathroom. I knew in my heart the baby was about to be born, and I
DID NOT want to lose him into the toilet. Without really thinking, I
grabbed Judah's little potty training seat and squatted over it. Sure
enough, out slid our tiny little baby. I knew right away... he was
pink and perfectly formed. "Isaac! It's our baby!" I squealed. It is a
miracle that we caught him. In all of the miscarriage stories I read,
most women never see their babies. For those that do, most are still
inside their amniotic sacs. Our baby was completely whole, separate
from all other tissue, with a tiny little umbilical cord coming from
his belly. He was amazing... we could see his little vertebrae and
ribs... his arms and legs... his eyes... mouth... even his fingers and
toes. Beautiful.
I had been anxious about what he was going to look like, since he had
died weeks before. But, God really blessed us in that our baby was
whole, pink, and perfectly formed.
God blessed us then with a few minutes of peace. My cramping and
bleeding miraculously stopped for a short time and we were able to
take pictures of our sweet little one. I was, surprisingly, very
happy. It was such a miracle to get to see and hold my baby. I had
worked hard for him, and I was glad to have those precious moments
alone with him. It was such a beautiful time... just my husband and
our baby and me. I have no idea what our other kids were doing at
this time, but I'm so glad that they were behaving!
Isaac took our baby and placed him in a plastic bag with some water
and he put him in the refrigerator. Immediately, my cramping picked up
and I began to bleed. A LOT. I couldn't get off the toilet. I was
gushing blood. I called my midwife and left a message on her phone.
"Khristeena, I just passed the baby, but now I'm bleeding pretty
heavily... when do I know when it's too much blood? Please call me."
I tried putting on a pad, but it soaked completely through in less
than 15 minutes. I sat back on the toilet. Every time I tried to
wipe the blood away, I just dripped more blood on my hand. I know
this is gross, but I filled the toilet bowl with blood twice in only
about 30 minutes. I was passing huge blood clots and the rest of the
bleeding was bright, red, fresh blood. At this point, I knew I could
be in trouble. Khristeena called back and asked a few questions about
the baby and if I had passed any other tissue- membranes? placenta? I
hadn't... I knew that if my body didn't expel these tissues, that I'd
just keep on bleeding until they came out. "Ok, Sigrid, put on a pad
and go lay down. Call your mom to come and stay with the kids in case
you need to call an ambulance. You already passed the baby, so tell
your body that you don't need to bleed anymore. Imagine your uterus
closing. Turn off the bleeding. Do you want me to come over and
examine you? You might have some tissue caught on your cervix. I can
try to release clots and give you a shot of pitocin." [I absolutely
love this midwife. She is a CNM and a CPM as well as a WHNP. She is
so caring and compassionate and very thoughtful at trying to honor and
respect her client's wishes. She knew I had a bad experience at the
ER the day before and wanted to try to avoid the hospital if we
I was so touched that she would come to my home... "You would do that
for me?" [also helpful to note that this was the first homebirth i had
planned, and I was a new client of Khristeena's. My first birth was a
hospital induction-turned c-section, and my second birth was a natural
VBAC in hospital with a CNM].
"Of course I would! I will leave in a few minutes!"
I slowly stood up and made my way to the couch. I had Isaac slide a
thick pillow under my hips so that I could be in trendelenburg (where
your head is lower than the rest of your body). I was cramping so
badly. All of a sudden, I felt a huge clot and gush of blood release
from my body. It felt like an explosion.... I knew this was BAD. I
called Khristeena and told her I was getting worried. She said "Ok,
hang up, and call 911 right now. They'll take you to the hospital.
Call me when you're settled and I'll meet you wherever they take you."
It turns out that my body was using up all of my platelets trying to
clot off the hemorrhage. I would create these HUGE clots (like
placenta-sized!) and then they would eventually release like a dam
giving way. It was a crazy sensation and very very scary.
I dialed 911 and got put on hold!!! I couldn't believe it. "All
operators are currently assisting others. Please DO NOT hang up." It
took about 4 minutes before I finally got through to an operator. I
gave them my name and address and then said "I just had a miscarriage
and now I'm hemorrhaging. Please come quick." I just lay on my couch,
checking my pulse... it was about 90... not bad just yet. Khristeena
called and I told her I was feeling ok, but bleeding a lot.
"Isaac, you have to get my shoes, my purse, and a change of clothes
for me... Is my mom here, yet??"
"She's on her way."
Thank God, my kids were as content as could be, playing quietly in
another room. Isaac was busy in the kitchen; he had started baking
cookies before everything got crazy! He knows chocolate chip cookies
are my favorite food in the world and he was so thoughtful in trying
to cheer me up. I just lay on the couch, checking my pulse
occasionally, and willing my body to stop bleeding.
The fire department was there less than 10 minutes later. Several big
burly men came in and asked me questions. I knew they were checking to
see if I was alert and oriented. To my surprise, my friend Edie was
there. She is with the Grand Island Volunteer Fire Department. She
told me she got the call that there was a miscarriage and came
straight over. She was so surprised to see that it was me. She held my
hand and told me that I'd be ok. [I later found out that another young
man from my old church was there on the call. His mom told me months
later that he came home that day and told her: "mom, there is a girl
from church that we need to pray for right now... it was BAD." It was
so encouraging to know that from the very beginning, I had people
praying over me.]
They asked if I was sure I had miscarried and how long I had been
bleeding. "I had the baby at 2:45 and have been bleeding since then.
The baby is in our refrigerator." I remember thinking that that
statement sounded just so ridiculous. It was now about 3:45.
They started an 18 gauge IV in my right arm right away and started IV
fluids. They said they were just waiting for Twin Cities (the
ambulance) to get there. It seemed like it was taking forever. I kept
peeking at the clock... 4:00. I had been hemorrhaging for an hour and
15 minutes. I looked down at my lap... my shorts were completely
soaked in blood. I got an idea: after childbirth, when moms have
postpartum hemorrhages, it helps to nurse their babies because
breastfeeding releases oxytocin which is the same hormone that
contracts the uterus. I knew that breastfeeding Galilee might help to
clamp my uterus down to stop the bleeding. I asked for my baby, and
everyone looked a little confused. "No... not the baby... Galilee...
bring her to me." Someone laid her next to me on the couch and I began
to nurse her in front of all those firemen. This is by far my favorite
breastfeeding memory... She started to play with my hair and she made
sweet "MMMMmmmmMMM" noises of satisfaction. She kept rubbing her
chubby little legs against my body, and her legs and feet got all
bloody. It was almost comical. I was so glad that I had a baby to
nurse and hold in my arms at that time. It made things just a little
less scary.
FINALLY, the ambulance got there. They transferred me to a stretcher,
buckled me up, and slowly carried me out to the rig. I asked Isaac to
stay with me, but they wouldn't let him ride in the back... he had to
ride in the passenger seat up front. I told them to take me to
Children's, since that's where we were yesterday and they knew me. Big
mistake... It was, again, terrible. I sooo should have gone to my
hospital (a catholic hospital that I know would have had more
sensitivity and respect for my little baby), but at the time, I
thought a little anonymity would be good.
The paramedic kept asking me if I wanted the head of my bed raised.
"NO!" I said emphatically. He was surprised with my reaction. I knew
that if I sat up, I would pass out. I was terrified of losing
consciousness. I had never fainted before, and I was afraid that if I
passed out, I would wake up after surgery and not know where I was. I
knew that, without consciousness, there would be no way to advocate
for myself. I started to feel really funny... I was going into shock.
My heart was racing (Isaac told me that for the next few hours, my
heart rate stayed above 120 at all times) and my blood pressure
dropped to 70/50. I was sweating. My hands and feet were freezing. The
paramedic kept checking my pupils and he told me "it's ok if you pass
out. I'm here... I'll take care of you." I fought it so hard. I did
not pass out. "I'm O+, in case you need to know" I said weakly. "Oh,
don't worry! We're not going to transfuse you! We can't do that here.
Just relax..."
I got extremely nauseous just then. I told them I thought I was going
to vomit. I think they gave me Zofran in my IV because I quickly began
to feel better. They wouldn't drive anywhere though, until after my
nausea went away. We sat on the street, not moving, for 10-15 minutes.
It seemed like such a long time and I started getting anxious. "Why
aren't we moving?" I kept asking.
The paramedic in the ambulance with me tried to start a second IV in
my left arm. By now, though, all my veins had collapsed because I was
so hypovolemic. He had a really hard time getting it in. I knew this
meant I had lost a lot of blood. I have never had a problem with my
veins before. Phlebotomists always remark: "You've got great veins!"
The paramedic was very friendly. I told him that I was an OB nurse at
Sisters and that I didn't get squeamish at the sight of blood. He told
me that that was a good thing, because I was his bloodiest patient
I remember thinking "why don't they put their sirens on? Why is this
taking so long??" My bladder was filling up from all the IV fluids and
was incredibly painful. I remember telling them that I had to pee so
bad. The only two thoughts on my mind at this time: "I have to pee and
this is taking so long!" The paramedic told me that I shouldn't
pee... that that might be "the only thing keeping you conscious right
now." I didn't understand what he was saying, and I remember thinking
that it was so cruel to not let me pee!
Finally, the paramedic called in to the ER and told them my vital
signs, age, and status. "We're two minutes out" he said. We were
almost there-- Thank God!
We finally roll in. The first person I saw in the ER was my triage
nurse from yesterday. She recognized me and her face fell. "It's you!"
she said. She seemed very surprised that I was back. I feel like the
staff from Saturday didn't believe me that I was having a miscarriage.
Even though there was NO HEARTBEAT on ultrasound and I had been
cramping and bleeding... and I was supposed to be 12 weeks pregnant,
and had the HCG of a 5 week pregnancy and the baby was measuring 9
weeks... Um... hello!
They put me in room 5. There was no air conditioning in there and it
was so hot. They hooked me up to monitors right away. I remember
insisting that I had to pee. "Please, get me a bed pan or a straight
cath!" I begged.
Finally, a nurse came in with a bed pan and helped me remove my bloody
shorts. When I began to urinate, bearing down just slightly, a
humungous clot and a lot of blood came out... filling the bed pan. It
felt just like passing my placenta after Galilee was born. It was
huge. I began to freak out! "I'm BLEEDING" I whined.
The nurse was very kind to me and told me that my bleeding was slowing
down now that I passed that huge clot. She helped me to remove my
clothing and she sweetly gave me a sponge bath. I remember remarking
to her that she was so kind and that "it feels so good to have someone
take care of me."
Unfortunately, my care at the hospital only went downhill from there...
The ER attending (a different doc from Saturday) came in and
introduced himself. He seemed relieved that my bleeding was slowing
down. He told me they had just sent some bloodwork and he was going to
have the "OB guys" come down to look at me. He saw the red plastic
"biohazard" bag on the counter that the paramedics had put our baby in
and went over to take it with him as he headed out the door.
"Please... don't take our baby. We want to keep him so we can bury
him." He looked confused... and sympathetic... and he returned the
baby to the counter and left.
At this point, my bleeding picked up again. All of a sudden, my door
flung open and two young OB residents walked in. "I'm Dr. Shields and
this is Dr. Hunter. We're going to examine you." Dr. Shields, the
female OB began to do a pelvic exam. Oh, man, did that hurt. I've
never had a pelvic exam hurt before. I could tell she was trying to
remove some clots. "Here, you try," she said to her partner. Dr.
Hunter, the male resident, tried doing a pelvic. It hurt even worse. I
began screaming. "You're hurting me!" I yelled. Oh. my. gosh. It hurt
so bad. They called a nurse in to give me "something for pain." Before
I could consent, they put the narcotic dilaudid into my IV.
Immediately, I began to feel terrible. I felt this heaviness creep in
through my veins until I felt like I could not move my arms or my
head. It started getting hard to breathe and I felt totally flushed
with this "warm heaviness." I told them that it made me feel
miserable... but at least I couldn't feel pain anymore. They continued
with their exam and removed several clots from my cervix.
Apparently, the dilaudid had another affect on me: it made me very
HONEST. I began getting very loud. I told the OB residents that "I'm
not a baby when it comes to pain... I had a natural birth last year
and my baby was 9.5 pounds!"
They asked me who my private OB was, and I told them that I saw a certified nurse midwife. They must have also
asked me if I had had any previous surgeries because they knew about
my cesarean. It must have clicked in their heads that Khristeena
attended homebirths, because all of a sudden, Dr. Hunter began to
lecture me.
"Were you planning a homebirth??? With a previous c-section??? That is
incredibly dangerous!!! It is a much better compromise, if you want a
natural birth, to give birth in the hospital with a midwife."
"She already did that, last summer" I overheard the nurse interject.
He continued: "I personally know two patients that were close to death
because they tried to VBAC at home... "
I could not believe that he thought it was appropriate to LECTURE me
on homebirth right now!!! Me, of all people! I am probably THE MOST
informed patient he will ever have when it comes to homebirth and
VBAC. I have read SO MUCH on the subject in the last year. Believe
me... I know what the risks are.
Well, I had had enough, and the dilaudid began to make my mouth start
working! "Well, Dr. Hunter, I am "close to death" right now!!! And you
have the audacity to lecture me about homebirth?? INAPPROPRIATE!!!
It's because of people like YOU that I never want to give birth in a
hospital again! I had a very traumatic induction and c-section in a
hospital three years ago and I HATE hospitals! I'm an OB nurse and
attend births for a living and I've seen things that residents do that
make my toes curl! I am not pregnant anymore and I might not ever have
more babies, but if I ever do, I will NEVER GIVE BIRTH in a HOSPITAL
If you know me... you know that this was very unlike me to say these
things. I don't know what happened after that, but the residents
ordered a bag of pitocin to help contract my uterus down, and then
they left the room. It was probably about 6:00 or 6:30 at this point,
and I remember just wishing every time the door opened that it would
be Khristeena. I needed someone there with me that cared for me and
that knew what was going on.
I hit my call button. Every time I pressed the button, the lady asked
me to repeat myself. They could never hear what I was saying! And even
when they did, it took FOREVER and several reminders in order to get
help. What was the point of having the stupid call button if it didn't
work??? I asked for someone to come in and get me a pair of socks (my
feet were freezing) and some maxi pads... after my pelvic exams, the
residents left me just sitting on chucks pads with no pad or
underwear... and I was just bleeding onto myself. I was a total mess.
Unfortunately, the sweet nurse who first took care of me went home at
shift change. After what seemed like forever, a new nurse finally
walked in a dumped a bunch of sponge bath supplies on my side table.
"You can clean yourself up when you're ready" and then she walked out.
What? Clean myself? I could barely move!!! Not only was my body in
shock, but I was still under the effects of the dilaudid. I could
hardly move my upper body. There was no way I was going to be able to
get up, fill the basin with water, and then sponge myself off!
IMPOSSIBLE. I was totally incredulous that she would just leave me
like that.
Finally, there was a knock on the door. I knew it must be someone I
knew because none of the hospital staff ever knocked. It was
Khristeena! I immediately felt more relaxed. "Oh honey, I'm so sorry
this happened." She gave me a hug. She had made me some super strong
raspberry leaf tea and had me begin drinking right away to help tone
my uterus. It tasted so good. I had been so thirsty (sign of shock).
Khristeena kept looking around the room and it was at this point that
I noticed, too, just how messy things were. There were bloody chucks
pads everywhere. My bloody shorts were just sitting on top of the
garbage can. They couldn't even put my clothes in a belongings bag? I
became acutely aware at this point that I was just soaking in puddles
of blood. My skin on my legs and hips felt saturated and started to
become irritated from being so wet. I still never received a pair of
socks and my feet were FREEZING. They have never felt so cold. I could
barely move my toes.
I waited and waited for a pair of socks. I literally felt like I had
frost bite and my toes were going to fall off. Isaac wrapped my feet
in a towel and Khristeena began to massage them. She told me that my
feet weren't getting very good circulation. It was at this point that
I realized how dire my situation actually was. I began to fear that I
might even lose my feet!
No one came in with the socks. No one came in with a pad. Meanwhile, I
was just sitting in puddles of my own blood. It was so humiliating.
Khristeena- God bless her servant heart!- found the washcloths and
basin and gently began to wash me. She was so gentle and so sweet. She
removed all of the bloody blankets and chucks pads and helped me to
regain some dignity. She helped me sit up so I could drink some more
tea. She helped put a maxi pad between my legs. The chaplain, Sister
Brenda, found me some socks, and Khristeena put them on. I could
finally relax a bit. My IV started beeping, then. I hit the call
button so that a nurse could fix it, but of course no one came in.
Khristeena examined the pump, hit a button, and it stopped. "What did
you do to stop the beeping?" I asked.
"I hit start" she whispered. All this time I was sitting there
bleeding and should have been receiving this important medicine and
fluids, and the nurse never hit start??
My bladder was full again. I hit the call button and a nurse
reluctantly came in with a bed pan. I sat on it and tried to pee...
and I couldn't. Everything was so swollen. I tried to relax.
"Khristeena, turn on the water faucet!" Didn't help. "Maybe there are
too many people in here..." The chaplain left. Khristeena then filled
a basin with warm water, but it on my side table, and stuck my hand in
"This is an old college trick," she said with a wink.
Well... it worked! We all had a good laugh.
I started to ask Khristeena about my new nephew. Khristeena had been
up all night at my sister-in-law's labor and birth. What a crazy day
for her, too! I can't imagine what it must have been like for her to
go back and forth between two sisters... one with a new baby, and one
who lost her baby.
I told her that I didn't like the male OB resident and that he had
lectured me about homebirth. I told her how rough he had been with me.
I could tell she was sad for me that I had such poor care, and she
apologized for not coming sooner. I was just so glad she was there
with us now!
At some point, the triage nurse from Saturday came in. She asked who
Khristeena was and Khristeena said "I'm Sigrid and Isaac's midwife." I
loved that! She truly was there for both of us, and I'm so grateful.
I asked the nurse for a breastpump. Oh, man, did she look confused! I
explained that I was still nursing my 13 month old, and that I didn't
want to get engorged and develop mastitis on top of everything else
that happened to me. "You can get pregnant while breastfeeding?!" She
seemed so surprised. I was shocked that she didn't know this! I just
assumed it was common knowledge!
"Yes... you can. This is the second time I got pregnant while nursing."
"Aren't our bodies just amazing?" Khristeena added with a little
chuckle in her voice.
I never did get that pump... until I asked about 5 more times for it
hours and hours later.

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