Birth and Pregnancy Matter: Part III
B&P Matter, Part III
Arrival Story
Note: I first drafted this post on April 25, 2022, almost five years to the day after our daughter was born, and one day before our son was born. I had a whole evening alone in a hospital room with no WiFi, so it seemed as good a time as any to reflect. Of course, after that second baby entered the world, it has taken some time to edit and publish this post.
April 2017, one week before my due date, I had a prenatal wellness visit. At that point in the visit schedule, I saw a different ObGYN each time; the philosophy of the practice was to get to know all of the doctors, because you never know who might be on call when baby arrives. (And, as it happened, my ObGYN was in Hawaii when I had my baby.)
I was surprised when the receptionist asked me for a urine sample; it was not routine to give one at this practice. She explained that the doctor I’d be seeing that day was “old-fashioned” and liked her patients to provide one, but if I couldn’t go, not to worry. I couldn’t go, and didn’t worry. Would it have changed anything if I had? Maybe, maybe not.
The visit went as expected, everything checking out just fine. I can’t remember if I mentioned my ribs hurting, or if I downplayed it as another one of those aches and pains of late-stage pregnancy. As anyone who has made it to the third trimester will tell you, discomfort is a constant state of being; it feels as if your body has simply run out of space to house both the baby (or babies!) and all of your internal organs.
The next day was Saturday, and by then my rib pain was so bad that I couldn’t stand upright. I positioned myself in multiple ways on an inflatable exercise ball. I tried watching a movie (A Man Called Ove) to take my mind off of the pain. I called around looking to schedule a massage but had no success. I thought a bath might help, but the last time I tried to take one in our first-floor tub, I caused a minor flood due to poor caulking around one of the face plates. So my husband went down to the basement tub that we never used (for good reason) to give it a good scrub.
A Swedish film about a depressed widower: guaranteed to keep your mind off of what ails you!
I called my doula to update her on how I felt, just as she had advised me to do in those days leading up to the birth. “I think,” she said, “you should probably go to the hospital. Just to check everything out.”
My husband emerged from the basement, sweaty and tired. He had completed a long run that morning, prior to cleaning the bathroom. I promptly informed him that I wouldn’t be taking that bath after all, and that we needed to go to the hospital, just in case. We brought the overnight bag—also just in case. We knew that first babies tended to arrive late; and had assumed this one would. I thought the doctor might refer me to a physical therapist; there was talk of a shot that could help relax the muscles around my rib cage, giving me some pain relief.
But the problem wasn’t my ribs. It was my liver.
In a day, I had gone from normal, healthy pregnancy to Elevated Liver enzymes and Low Platelets: a condition that goes by the terrible-yet-accurate acronym HELLP. The H stands for hemolysis, which I just looked up, and means “the rupture or destruction of red blood cells” which sounds bad, as of course does the phrase “life-threatening,” which is often appended to the condition. I said above that the urine test the day before might have mattered—while HELLP is considered to be on the preeclampsia spectrum, a sufferer may or may not have protein in the urine, which is a telltale sign of preeclampsia.
Before I go any further, please note that I am NOT an expert on HELLP or preeclampsia and I may get some facts or terminology wrong. This account is based on what I recall from my experience five years ago, and what I have learned from casual reading, which is not the same as actually doing research (though I always try to look for reliable sources). And frankly, it’s disheartening how much of our own health remains a mystery to us. I don’t know—and never will—everything that happened in those first twenty-four hours in the hospital, and how much my life, and my daughter’s, were truly at risk. For example, on my discharge papers, it said my diagnosis was “acute fatty liver”—which, in addition to sounding gross, is a condition that is similar to HELLP but isn’t exactly the same. I’d been told I had the latter, so what exactly had happened to my body?
I spent a lot of time in my last post talking about the systemic issues around pregnancy in the US, and here’s another anecdote: preeclampsia affects approximately 1 in 25 pregnancies in the United States, yet the Preeclampsia Foundation—which is dedicated to supporting preeclampsia patients, expanding education, and conducting research for causes and cures—recorded a meager $1.5 million in revenue in 2020. (Thinking the pandemic could have really hit the organization hard, I went back to the 2019 financial report: $1.4 million in revenue.) Maternal mortality rates continue to rise in the US—despite being preventable!—and are one of the highest of any developed country. It is not much of a stretch to come to the conclusion that American society as a whole can give a f*ck about the health and welfare of pregnant people.
“It is not much of a stretch to come to the conclusion that American society as a whole can give a f*ck about the health and welfare of pregnant people.”
But back to that moment at the hospital. Once my blood test results came in, I was checked in and prepped to have the baby. Nurses told me the risks to me and my baby at that moment were of me having a seizure and/or bleeding out. They would need to start a magnesium drip right away to reduce the risk of seizure, which they assured me would cause nausea and make me feel absolutely terrible. They inserted a balloon catheter to help induce labor, and advised me to rest that night—or as much as I could in between regular checks to take my blood pressure and draw blood. I’d be giving birth the next day.
By the next morning, the situation escalated quickly. My condition had not improved, and the balloon had done nothing to induce labor. At some point, my doula arrived at the hospital, even as it became clear I wouldn’t be pushing and using deep, yogic breaths. The baby needed to come out as soon as possible, and the safest and fastest way to do that would be with a C-section. My husband and I were both suited up for the surgery; we have a few pictures of those moments, courtesy of our doula. My husband likes to joke about how much we spent on her services, but there’s a good chance she saved my life. If she hadn’t advised me to go to the hospital the day before, if I hadn’t had an experienced coach and ally giving me that advice—I may very well have taken that bath, and gritted my teeth and bared it through my “rib pain.” After all, the me of only a day before had never heard of HELLP syndrome, had known I was healthy and definitely did not have preeclampsia or some rare version of it.
After being prepped, I positioned my body into the requisite C-curve for the needle to be inserted into my lower back. I barely remember this moment—it just registered as something I needed to do, and I did it—but my needle-hating husband recalls it vividly. Probably because he could see it happen, and definitely because of what happened next. Some time after the needle/catheter was inserted, he looked over at me and saw the blood. He said (later, not in the moment, because he has high emotional intelligence) it looked like I had been shot in the back. He called a nurse over immediately.
“He said…it looked like I had been shot in the back.”
I was at a the L&D ward of a university-affiliated hospital, not an emergency facility, so it had no ICU or NICU. I know that the ObGYN was on the phone consulting with someone at the “big” hospital; again, I don’t know if she was just consulting, or if there was a conversation about moving me, and I never will know. The reason I looked as if I’d been shot was that the catheter they had inserted had popped out, and after that, a “typical” c-section in which I was awake was out of the question. I would need to be under general anesthesia and my husband could not be in the room.
Another fuzzy memory we both recall from this time: the anesthesiologist in a heated debate with the doctor in the hallway. About what—again, I’ll never know.
Then, I was wheeled out of the room, and my husband was left looking at the empty space where the bed had been. He talked to family on the phone and waited.
Then! They brought him a baby! Our baby: born after 11 AM, healthy, an 8 on the APGAR scale. And because we wanted the sex of the baby to be a surprise, he got to discover we’d had a daughter right then and there, got to hold her, and the doula-turned-photographer got some wonderful snaps of that moment.
Meanwhile, I was in recovery purgatory somewhere, in what felt like the cold, gray, basement of the hospital. It was Sunday, and I don’t recall any other patients in the room with me. I just remember coming to, the grayness of the room, and hearing someone on the phone in conversation with IT about a computer issue. Was the nurse surprised to see me wake up, or did I imagine it? In darker moments, in the months and years to come, I wondered if I was actually in a recovery room, or the morgue. Boo, bitches!
I asked about my baby, where he or she was, were they okay?
Eventually someone wheeled me back to my hospital room. I had IVs in both arms, as I needed a blood transfusion, an iron infusion, and likely some other drugs that I am forgetting. My husband got to introduce me to our daughter, and told me her full name, a full name we hadn’t completely decided on because we didn’t know boy or girl, and because we had gone through an entire March Madness baby name bracket to land on a Final Four (two boys’ names, two girls’). In the end he made the decision to go with my top seed—because really, I earned it, and it’s a beautiful name.
I wish I could say I remember that moment he handed our daughter to me, but I was still in the post-anesthesia fog—and so I am glad we have the picture, because it makes me think I remember, and because I can see how happy I am in that instant.
We all got through that perilous birth experience and I am forever grateful, truly. But a moment like that contains many truths and interpretations. Of course the blanket message that followed, sent to family, friends, and colleagues, read, “Mom and baby are doing well!” because that is the easiest truth to pass on, and for others to digest. No one wants to read, “Mom and baby went through a harrowing experience—but baby’s vitals are great. Mom is slowly recovering physically, but will need years of therapy to work through the PTSD!”
Of course, it didn’t fully register at the time that I’d just experienced major trauma. I was a new mom, and I was thrust into its myriad responsibilities immediately (again, IVs in both arms) with little support. And that is when the hospital truly failed me.
