Saturday, May 19, 2012

Survivor Saturday: Nicole's Story

Today I have the privilege of sharing Nicole's story. I ran 8 miles in her honor today. She told me she wrote this story with tears streaming down her face. The emotions of a traumatic birth experience can last long after the body has healed. I hope it helped to get some of that out. I've touched on the emotional aspect of PE, but I think it deserves further discussion. I plan to write more on it this week.

Nicole's Story

I was 26 years old, married, well-educated, pregnant with my first child, and looking forward to a homebirth with midwives.  I had read multiple pregnancy books but felt confident that my pregnancy and birth would be perfect.  At 36 weeks I had my home visit from the midwives in anticipation of the birth.  A few days later, on a Friday, I finished my last shift at work (a stressful IT position) and looked forward to having a few restful weeks before our little one arrived.  On my last day of work I started feeling really uncomfortable and was having difficulty getting my shoes on.

The next morning I had a hard time getting out of bed, and my feet and legs were freakishly swollen.  I chalked it up to the final weeks of pregnancy, and started my day.  I was expecting my three sisters for dinner, a movie, and a sleepover that evening so I had to clean my house and prep food.  I busily prepared for their arrival all day, but started having strange visions of what looked like shooting stars.  I wanted to go to the movie store to pick up the rental, but could not fit any of my shoes on my feet.  I called one of my sisters and asked her to pick the movie up for me as I was not feeling at my best.  Later, I kissed my husband goodbye so that he could spend the night with his parents while my sisters could have a private girly evening.

When my sisters arrived, they took one look at me, and then my legs and feet and immediately expressed their concern.  I told them it was normal pregnancy swelling but, with seven children between them, they insisted otherwise.  They wanted me to go to the hospital to get checked out, but I declined.  We ate dinner and began to watch a movie, but I started to feel really unwell.  My older sister drove me to the hospital in our small town, and I had to wear slippers as even my husband’s shoes would not cover my feet.

When we arrived at the ER, the nurse looked at my big belly and reminded me that this hospital did not have a labour and delivery unit, and that I’d have to go the hospital a few towns over for that.  I laughed and said that I wasn’t having a baby that night and just wanted to get checked out.  She checked my blood pressure and practically sprinted out of the room to get the doctor.  A urine test detected protein.  I had pitting edema.

The doctor told me that he needed to transfer me to the bigger hospital and that I would have the baby that night.  I assured him that no such thing would happen, as I had a home birth planned and my husband was not available.  Detecting a stubborn one, the doctor called the midwives to speak with me.  There was some kind of miscommunication, and the midwives asked him to discharge me and they would check on me the next morning (a Sunday).  Knowing what I do now, I will never understand how this discharge could have happened.  My sister had managed to reach my husband (in this time before cell phones), and he had rushed to the hospital by this time.  We all returned to our house.

The midwife showed up promptly first thing in the morning, and was immediately concerned.  She said I had the highest blood pressure that she had ever seen in a pregnant woman.  She wanted to know if my bag was already packed because I was to immediately get to the hospital.  My husband and sisters panicked a little, and we rushed to the hospital.  Several tests were completed at the hospital, but they had a baby boom that day and the doctor was telling the midwives that he was dead tired and unable to think straight that day.  He wanted to induce, and I insisted on waiting a little while longer for the natural birth I had been dreaming about.  Nobody had clearly stressed the urgency of the situation to me.  I went home.  At this point I had gained over fifteen pounds in a period of two or three days.

The doctor and the midwife further discussed the case that evening, and the doctor indicated that he wanted to call me to come back to the hospital.  For whatever reason, I did not get the call back.  This is entirely unbelievable.  I was advised to rest on my side and not get up.  I returned two days later for a scheduled induction but again the L&D department was overcrowded so I sat in the hallway for hours waiting for my turn in a room.  I was really upset all this time at the loss of the perfect homebirth that I so badly wanted.  I finally was induced at noon, and started pushing by 11:00 p.m.  Pitocin was never required, and the gel alone had worked at inducing the labour.  An IV was hooked up and magnesium sulfate was kept in the room in case of seizure, but never used.  The birth was as natural as possible given the circumstances.

The doctor on call had worked in the Yukon, and was accustomed to working with midwives.  He was happy to sit in the corner reading a newspaper while the midwives delivered the baby, which is a rarity in OB doctors in cases where care has been transferred from the midwives.  At about 1:00 a.m., Ethan Joseph was born weighing exactly 6 lbs.  There were indications that his growth had retarded in utero, but at this time I cannot recall how they knew this.  We were blessed that he arrived when he did.

Tests returned after the baby was born indicated that I had some liver damage, my blood pressure remained elevated, but the edema started to subside.  I wanted to leave the hospital immediately after Ethan was born, but was asked to stay for a short while.  At my insistence, I was released later that evening with the midwives following up the next morning.  It took a while for my blood pressure to stabilize (about two weeks or so seems about right).

I really mourned the loss of the stress-free birth that I had anticipated, and I did experience some post-partum depression after Ethan’s birth.  I had experienced some problems with breastfeeding at the time as well that left me feeling that my body was entirely inadequate to be a mother.  I felt altogether like a failure.  I cried constantly and my husband didn’t know how to help me (his tough as nails wife).  I made connections with an online group of mamas during this time that I will treasure for my entire life, and it was this group of fine women who understood how I felt and helped me through this difficult time.  Ethan gained weight slowly but surely, and he is a strong AAA hockey player these days.

I did not have pre-eclampsia during my second pregnancy, but every time my blood pressure went up slightly, my feet felt swollen, or I was generally not feeling well I felt a sense of panic.  I had a poor experience with a terrible OB that my midwives that had called for a consult when my blood pressure was temporarily up.  That birth also ended up being a hospital birth, but for an entirely different set of circumstances.  Thinking of the circumstances regarding both births can still reduce me to tears sometimes, but I have two healthy children and for that I cannot be more thankful.

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