Tuesday, August 16, 2011

miscarriage Part 1

I am overwhelmed to realize how close I was to dying on Sunday. I lost about 40% of my blood volume from postpartum hemorrhage after I miscarried our sweet little baby. I am so incredibly grateful that my kids still have their mom. I am so in love with my little family and I praise God that he protected me from fear in the hospital. Our family is stuck in this strange juxtaposition between life and death, joy and grief-- our nephew was born on Sunday, hours before I delivered our miscarried baby, and my niece was born today... just hours before we buried our baby.

I don't know why this happened and I don't seek to know why. In every circumstance, I know that Jesus is with me and before me. He loves me so much, and I know that he will use this season of my life to strengthen and refine me, as He has done so many times before.

I was laying in my hospital bed, getting transfused, and I just felt these "waves of silence" wash over me. Every few seconds, a static noise would fill my ears, and then silence. This continued for over an hour. I couldn't sleep. I just drifted between sadness and gratefulness. The sadness was severe... Is... It is so hard to SO QUICKLY lose a child. Everything happened to fast. To have hopes and dreams ripped away like that is inevitably going to be painful. I lay there feeling so lonely... and then I literally felt Jesus wrap his arms around me in comfort and peace. I am so incredibly grateful for my savior and for that loving embrace that got me through that night.

I have to write a disclaimer that the following account can be graphic at times. This is my story that I'm writing for myself, and I am therefore leaving no details out. I know that this will help me in my journey to recovery as it helps me to process. You are welcome to read, but please be warned.

I had been sick with the flu, so I felt weak to start out the weekend. Isaac came home early on Friday afternoon to take care of me. I had waken up the Friday morning with a severe headache, terrible muscle cramps, fever, chills, and nausea. I could hardly get off the couch. I was a mess. I slept most of the evening. By the next morning, I was praising the Lord because I felt better, and we had a relaxing morning together as a family. Isaac was cleaning up lunch Saturday when I went to use the bathroom. When I sat down, I gasped in shock. The image in my head is one I'll never forget: I was wearing white panties and they were covered in bright red blood. I was immediately brokenhearted because I knew what this meant. I yelled for Isaac: "Isaac! I need you!!! I'm bleeding!!!" I just started sobbing. I was 12 weeks pregnant. I started cramping a little later.

I texted my mom for prayer and then called my midwife, Khristeena. Khristeena told me that I could either stay home and wait it out, or I could go to the ER to get a sonogram to confirm that I was miscarrying. I just had to know. I called my mom and asked her to come stay with Judah and Galilee.

We arrived at the ER at Children's Hospital at about 2:30. This was a terrible experience. The triage nurse, when I told her that I thought I was miscarrying, just said: "well, we can hope for the best!" I told her that I didn't want to hope for the best... why play around with my emotions like that? I knew in my heart that my baby had died.

Another nurse, as she was showing us to our room, asked: "how far along are you?" "12 weeks" I answered. "Oh, how exciting!" she squealed. Obviously, she didn't know why we were there. It was not exciting. It was devastating.

We were put in a little corner room where they had shoved all their spare wheelchairs. Isaac and I couldn't even sit next to each other because there was so much junk in there. Eventually, someone cleared out the room for us, and a nurse started an IV. I was confused. "Why are they giving me an IV? I'm just here for bloodwork and an ultrasound. I have a liter and a half of water in our nalgene bottles here, why can't I just drink?" "This is what the doctor ordered, and it's good for the baby" she answered distantly. I didn't want to argue. I was already completely poured out for the day. The nurse asked if I wanted an IV in my antecubital area or in my hand. I knew my hand would hurt more, but I'd be able to at least bend my arm. I told her I'd like it in my hand. She then proceeded to put it in MY WRIST. This was by far the MOST PAINFUL IV I have ever had. I couldn't move my left wrist at all, and the entire time the freezing cold IV fluids were being infused, I had throbbing pain in my arm. A totally unnecessary and painful intervention. Just another reason why I hate hospitals.

My bloodwork came back... and the doctor told me that my HCG level (pregnancy hormone) was normal. [it was 7,000. Now that I've looked it up after the fact, it is a normal level for a pregnancy at about 5 weeks... not 12 weeks. 7,000 was very low for where I should have been]. Now, we just had to wait for the ultrasound tech. It was the weekend, so she was on call and not physically at the hospital. I was told that she had one hour to come to the hospital from the time they called her, but they were having a hard time getting a hold of her. I asked why an OB resident couldn't just come down and scan me quickly? "Oh, they won't do that" they answered. So... I waited... and waited... cramping and bleeding with a stupid IV in my arm. This is a children's hospital... so I heard babies crying the whole afternoon. It took SIX HOURS for the ultrasound tech to get there to scan me. Believe me, I am going to write a strongly worded letter to the hospital about that one.

They made me walk to radiology. The tech started with an abdominal ultrasound. At 11 weeks with my other kids, I remember that my babies were bouncing and leaping in my womb. This baby was very small and not moving. I knew my baby was dead. I could tell the tech was avoiding looking at the actual baby. She quickly took the wand off my belly and told me that she would see much more with a transvaginal ultrasound. I knew something was so wrong... I had never needed one of those at this point of pregnancy before. With the second scan, I saw her quietly measure the baby... 8 weeks 6 days. The baby had stopped growing weeks ago. I was walking around with a dead baby in my womb for 3 weeks. It was almost too much to comprehend. It all made sense now, though... I started to feel much better with morning sickness about 3 weeks before... almost like I wasn't even pregnant.

The tech was very sweet as she said... "I know you can tell what I'm seeing... I hate to tell you this... but I'm not getting a heartbeat." I began to cry with whole body shaking. There is nothing that can prepare you for the knowledge that your baby died. She gave us a few minutes alone. Isaac came to hold me and we just cried together.

When we left the exam room, the ultrasound tech tried to comfort us. "Well, at least you already have children. Not to minimize your situation, but I feel bad for the couples that come in here for miscarriage after miscarriage and don't have any children yet." Yeah... sorry, lady... that doesn't make me feel any better!

We eventually made our way back down to the ER. The ER attending physician came in to talk to us. He had the nerve to tell me that he didn't see a baby on the sonogram... just a gestational sac. WHAT? "I saw my baby!!!" I exclaimed and insisted. He tried to comfort me by telling me that maybe my dates were wrong and I was just earlier in the pregnancy than I thought. He told me that this was just a "threatened miscarriage" not a "missed miscarriage" and that I needed to come in for a repeat ultrasound and bloodwork next week before they could do anything about it. He told me that since my bleeding was light and my cramping not too painful, that I wasn't really miscarrying yet, if I would at all(!!!). Oh buddy-- just you wait and see what happens next!!!! [in retrospect, now that I'm thinking about it... I REALLY think this doctor was reading the WRONG ultrasound to me. It doesn't make sense that he would think an almost 9 week-sized fetus was just a 5 week gestational sac. I wonder if he would have sent me home like he did if he had known. He just told me: "come back the the ER if you bleed more than a pad an hour or if you're in so much pain it feels like your arm is getting chopped off" (!!!!) Very sensitively worded, right?]

My midwife called me just then (the attending had called her before he talked to me) and I whined to her about how he wouldn't just tell me that I had miscarried or what I could expect. She was so compassionate and so sweet. She told me: "Sigrid, I trust you and honor your knowledge of your body. If you are sure of your dates, I believe you. I'm so sorry this happened. Why don't you go home and see what your body does tomorrow. I will call you in the afternoon and we'll go from there."

The nurse came in with my discharge papers which just said to come back if I had heavy bleeding or a fever. I really had no idea what to expect or what I'd be experiencing the next day... The nurse almost left the room before she took out that stupid and painful IV. I had to remind her that I couldn't go home with a hep lock. Honestly... these nurses were just ridiculous. She handed me my discharge instructions and two prescriptions: one for a repeat HCG level, and another for "transvaginal ultrasound for ectopic pregnancy or possible fetal demise" for Monday afternoon. Fetal demise. What a cold way to say that my pregnancy was over.

I came home and we put the kids to bed. I couldn't sleep that night. I was so brokenhearted. I was cramping all night long and was physically uncomfortable. I tried to rest... but my mind was going a thousand miles a minute. I kept thinking about our plans for this baby. We were planning on a homebirth/waterbirth. We were going to build a new master bedroom out of our den, so that the baby would have his own room (our old master bedroom). I kept thinking: just how the heck was I was going to go to work and take care of babies again? [I am a neonatal nurse who attends deliveries at a different hospital]. We got a text from our brother-in-law. Isaac's sister was in labor. She was having a homebirth and I had been looking forward to being there with her as a labor support person for the past few months. I was so sad that I couldn't go and I was so sad that I couldn't be as excited for her as I wanted to.

My mind then wandered to how we found out we were pregnant. Our baby was a surprise. My period had been late and so I picked up a cheap pregnancy test at the dollar store on the way home from taking the kids to Fantasy Island one day. Galilee, my then 11 month old, was sleeping, and it was just me and my almost 3 year old, Judah... there was no mistaking it. There was a bright pink line to indicate a positive test. I told Judah "Mommy's going to have a baby! There's a baby growing in my tummy!"

When Isaac got home that day, I showed him pictures of our trip to Fantasy Island [a local amusement park] on our digital camera. I slipped a picture of the positive test in at the end. "Are you trying to tell me something?" he asked. "YES!" I answered. He thought for a minute and then said something that has haunted me for the last three months... "Well, honey... not every pregnancy ends in a baby." I have no idea why he said those words. My husband is not an insensitive guy. I shot him a dirty look, and he realized how inappropriate his statement was. He told me that he was very happy, and that somehow he knew I was going to tell him I was pregnant that day. We sat on the couch and zoned into space, suddenly feeling very tired after that. We began to think about having three children and all of the realities surrounding that concept.

Our baby was a surprise. It has been very difficult this week to not feel guilty about that... It took us a while to really accept this pregnancy and to become excited about it. At times, I saw it as an inconvenience. But, I loved my baby. I dreamed of him every day. We discussed names, our birth plans, the nursery we would create for him. We both loved him so much.

Tuesday, June 28, 2011

Here we go again...


I'm pregnant.


I was trying charting my cycles with FAM, but I'm still majorly breastfeeding my one year old and things weren't that cut and dry. Needless to say... this baby was a huge surprise. When I first found out, I just sat on the couch and stared into space for about an hour. This is my first unplanned pregnancy. It's so bizarre to not have that two week wait before you can take a pregnancy test. To just... have a late period. And tada! You're pregnant. Weird.

Anyway... so I had taken my kids to a local amusement park for the morning. We had a great time-- we rode the train several times, and my almost 3 year old rode all the kiddie rides he could ever want to ride. We had a great morning. On the way home, I stopped at Dollar Tree to pick up some items for my daughter's first birthday party. While I was there, I picked up a couple of cheap pregnancy tests. I was almost positive that they would be negative, but I was frustrated that I hadn't gotten my period yet, and I certainly didn't want to get it at work that weekend. Better just rule this out.

Got home... and a few minutes later I'm staring at two pink lines. DARK pink lines. There was no mistaking it. I kind of just laughed in disbelief. Like... what? I told my almost three year old: "well, sweetie, Mommy is going to have another baby." "Uh, huh. That's nice. Can I watch a show now?"

When my husband got home, I sat down with him and flipped through some pictures on our camera of our day at the amusement park. At the end, there was a picture of the pregnancy test. "Are you trying to tell me something?"

"Yes.... surprise!"

For someone who really didn't want to have anymore kids, he's pretty happy about it. He's been very supportive of his TIRED and nauseous wife.

So... I'm about 7 weeks. Baby will be here sometime in February. We announced the pregnancy at my daughter's birthday party when one of her presents from us was a handmade "big sister" t-shirt.

We met with this fabulous homebirth midwife last week and we really love her. She seems fantastic. She's a CNM and CPM (to honor multiple ways of knowing) and really believes in individualized care with informed consent/right to refuse treatment. That's perfect for me. I'm a young and healthy multip, but I do have that pesky scar on my uterus. :/ Stupid c-section. I'm very very excited about working with her!




Tuesday, May 24, 2011

"You're in my head!"

My dear friend just had her second baby yesterday morning.

She had a natural and unmedicated birth! YAY!

As she was relaying all the juicy details to me over the phone, she mentioned that I was "in her head" and she kept thinking off all the suggestions I had given to her during pregnancy. I LOVE THIS. Haha. I was a doula from a distance. :)

I've also answered about a dozen e-mails from pregnant friends in the last week. I really love being a resource for birthing ladies! It makes me happy.

Friday, April 22, 2011

Breastfeeding Assistance


When I first started working in the nursery, I wasn't yet a mom. I shadowed a couple of nurses as they assisted new moms with breastfeeding and that, I guess, was enough to make me an "expert." HA! I had no idea what I was doing, but was supposed to go help women nurse their newborns. I feel so bad for those moms! Sorry!!!

New moms deserve someone who knows what they're doing to help them!

How can someone teach about something as personal as breastfeeding if they've never tried it before? How can they encourage it and offer empathetic support if they've never experienced it?

I am so grateful for my births. I've had an induction and c/s, and an unmedicated vaginal birth. I've breastfed both of my kids. I've had mastitis. I've pumped (stupid 6 week maternity leave!). I've nursed during pregnancy. I've tandem nursed. I've had cracked and bleeding nipples. I've cried over low milk supply. I've cried over engorgement! I've leaked in public. I've nursed in public (and been accidentally "exposed" in public... in church, no less!). I've had pumped milk leak all over my purse. I've donated milk. Husband even tried making breastmilk yogurt (lol.. it didn't work...). I nursed my very hungry son every hour to two hours for the first 4 days after a c/s until my milk came in. I was exhausted. I've had breastmilk regurgitated onto me more times than I can remember. I've been through it.

No amount of second hand experience can replace first hand experience. I am young and my adventures in breastfeeding are recent and current. I can relate and sympathize. I love making a difference; I am so grateful.

I found my "kind"

::Smile:: I've gained quite a reputation at work for being mom-and-baby friendly.

The L&D nurses told me last weekend that they love when I come to their deliveries. If a baby comes out pink and crying, I bring extra baby blankets to the side of mom's bed and monitor the baby while mom holds baby on her chest. I let mom hold baby at least 5 minutes. It's really not that long! But... unfortunately... most other newborn nurses want the baby on the warmer before the baby is even one minute old. One of the L&D nurses told me that a baby nurse actually starts tapping her foot if the baby lingers "too long" with the mom. This just disgusts me.

Another bad practice that I am trying to reverse is the length of time the baby is on the warmer away from the mom. Some of the older nurses do all of their charting at the same time as their hands-on care, which practically doubles the time the baby is on the warmer. I've seen some nurses selfishly keep the babies on the warmer until 35 or 40 minutes of age. That's a heck of a long time, considering the baby goes up to the nursery at 2 hours of age for the first bath (another habit that I hope to change one day!). I always try to get the baby back to the mom by 13-15 minutes of age (and that's after the mom holds the baby the first 5-6 minutes). This way, I can keep the baby with the mom as much as I can while also doing all the tasks that my unit expects me to do. I try to be as quick and efficient as I can!

I also always try to give the mom a "sneak peek" of their baby after a cesarean. I remember with my c/s, I didn't see my baby for at least 25 minutes after birth. I saw his picture on our camera and his footprint before I actually saw him. That was a loooong time to wait. I figure that footprints, bands, and meds can wait until baby has been seen, touched, and kissed by his mama!!! As soon as baby is "stable," I will wrap him in a blanket and take him to mom for a minute or two before I bring him back to the warmer to do all my "stuff". Even though it seems like such a simple thing, I believe that this really goes a long way for post-c/s bonding!!!!

So, anyway, back to the main point of this post. Over the last few weeks, I've gotten into several great discussions in L&D about natural childbirth, breastfeeding, skin-to-skin, and bonding. I've been able to pick out a few fantastic L&D nurses who really are on the same page. I've had some really beautiful births with them. I'm glad that I really stand out as being "gentle-birth-friendly." After spending four years in the newborn nursery, where the majority of nurses have never breastfed and no one seemed to understand my desire to VBAC ("why don't you just have another C/S?" ::sigh::), it's good to know that there are some other nurses who "get it." They understand the birth is such a valuable and important experience for the mother. It's a time she'll never get back. We have to protect that time and treat it as sacred and special.

There are so many practices that I would still love to change in our hospital, but I'm glad my "baby-steps" have not gone unnoticed, and I hope that they catch on! The moms who graciously let us into their birthing space deserve that much from us!!!

Abruption

I read a lot of birthy things. Lots of birth stories, lots of books, lots of articles. I love Ina May. I love Jennifer Block. Peggy Vincent. Marsden Wagner. My facebook news feed is always full of mom and baby related articles. Rixa Freeze and Barbara Herrera feel like old friends sometimes because I read everything they write. And my own personal and professional experiences with pregnancy and birth have shaped me into quite the natural childbirth advocate and attachment parent.

I used Hypnobabies and loved it. I had my "Bubble of Peace" around me and truly believed that birth is beautiful, healthy, safe. I still do believe it is inherently safe for most women. I've already decided that if we have any more kiddos, I'm definitely birthing at home.

However.... every now and then... something happens to keep you grounded.

A mom comes to the hospital at 10 cm dilated, ready to deliver. She wanted a natural and unmedicated birth, and had labored at home all day. When she finally arrived- fully and bulging- she was in so much pain that she could hardly move. Bag of waters breaks- clear fluid- and head began to crown. Baby's head born. Baby is white. Neonatology paged STAT. Baby born... gush of blood. Blood. More blood. Baby is limp. PPV on the warmer. Neo comes and intubates. No time to put ID bands on or give baby meds or do footprints. Baby is immediately transported to NICU where baby is transfused. It takes 7 people to stabilize this full term newborn.

It's scary situations like these that make you go home and hug your kids close and say to yourself: "I am SO SO SO lucky."

There was really not much warning for this abruption. Sometimes things happen in birth... and I'm just so glad for the quick thinking of the staff that night. It could have been much worse. :(

Of course, for 99% of the population, laboring at home would be a good idea. I stayed home with my VBAC baby until I was 9.5 cm. It's a fantastic way to reduce unnecessary intervention. As much as I believe in birth and in its "normalcy," it is still a complex and not completely understood physiological process and there is no way to control or predict how things will turn out.

It's because of stories like these that I always say a little prayer on the way to every birth I attend. "Jesus, PLEASE help this baby come out safely and transition smoothly! Protect and preserve this little life."

Amen!


Breastfeeding Myths

Just read this fantastic article that debunks common breastfeeding myths!


I hear a lot of excuses and concerns at work from breastfeeding mothers and their families. It's pretty hilarious how many times I hear: "How do I know if the baby's getting enough?" Oh, if only I had a dollar for every time I answered that question!!!

I actually had a teen mom's mother (baby's grandmother) say in the delivery room "that's why I hate breastfeeding... It's not like the breast is clear with measurements on the side of it to tell you how much your baby is eating! You could be starving the kid and not even know!" UGH!!! I was so upset inside when I heard that. I had just helped the mom get her newborn latched (she was doing beautifully!) and I gave my usual little breastfeeding introduction spiel about proper latch, milk transfer, frequency, duration, supply and demand, etc... Mom and baby were just so natural together. And then BAM! The grandmother had to completely bash breastfeeding.

Many moms don't get the support they need. I can't tell you how often a mom says "well, my grandparents came to visit, and I didn't want them to see my boob, so I didn't feed the baby in 6 hours." Or, "my uncle's coming, so, can you give me a bottle of formula for this feeding? I don't feel comfortable nursing in front of him."

So frustrating... Your baby comes FIRST! Tell your visitors to wait to visit! Why is everyone coming to the hospital anyway? Can't they wait a few days til you're home??

And what's with everyone wanting to pump right away? Why do moms all think they have to supplement with formula or water? Who is telling them these lies?

::sigh:: Really... breastfeeding is not nearly as complicated as everyone thinks!!!