Tuesday, July 16, 2019

Our Preterm Labor Story - Baby Born at 21 Weeks

*Warning, this post deals with pregnancy loss*

I’'ve hesitated to write about this because pregnancy loss is a hard subject, but I haven't found many stories similar to mine, so if writing it out helps one person searching for information, then this will be worth it.

Last I wrote on this blog, I had an early miscarriage after trying for two years to have a second child. My husband and I had decided that we were content with being a family of three with our son, and that our TTC journey was over.

Fast forward to March 7, 2019 and I find myself unexpectedly pregnant. My RE had told us that we had a 1% chance of conceiving naturally, so finding out that I was pregnant was the surprise of a lifetime. Because my tubes are so damaged, I was immediately concerned about an ectopic pregnancy. My OB wouldn't see me until I was 10 weeks along, but they were willing to do a beta, which came back at 115, but they wouldn't do a repeat beta. Thankfully my RE is amazing and was willing to have me come in around 5 weeks for an ultrasound. At 5 weeks we saw the start of a gestational sac in my uterus, and nothing wrong with my ovaries or tubes. At 6 weeks we saw one baby with a heartbeat. 7 week ultrasound looked good as well, and I got released from my RE. Thursday, April 25 I had my first OB appointment at 11 weeks. Baby was measuring right on track and both of us were doing great.

I had another OB appointment at 15 weeks where the ultrasound tech guessed that baby was a girl. At that appointment I was referred to a maternal fetal medicine doctor because of a concern my OB had, but everything looked great at the MFM appointment, and baby was confirmed to be a girl.

June 26 I had my 20 week ultrasound and an early gestational diabetes test (I had gestational diabetes with my son, so we wanted to catch it early this time around if I was going to have it again.) Baby girl looked wonderful, cervix looked long, my GD test came back negative.

Monday July 1, I had a bit of pink tinged discharge when I wiped. I called my OB's office and spoke to a nurse who said it sounded normal, to take it easy the rest of the day, and to call if it turned to bright red blood. Tuesday, the discharge had increased, so I called my OB and asked to be seen. The only available appointment was at an office 40 minutes away, but I decided it was important enough to go. I was taken to the ultrasound room right away where the ultrasound tech began with an over the belly ultrasound. Baby girl looked great, had a strong heartbeat and enough fluid. The ultrasound tech then switched to a trans vaginal ultrasound and became concerned. She asked me to stay lying down while she got the doctor. When Dr. T. came in, he looked at the ultrasound and told me that it looked like my bag of water was bulging, I had a small hole in my bag of water, and that I was 4 cm dilated. I was in preterm labor.

Dr. T. wanted to keep me at the hospital next to this clinic, but I knew that wouldn't work with my husband working almost an hour away, so I chose to drive back to our home town hospital. My husband met me there and I was taken directly to labor and delivery.

I was hooked up to the contraction monitor, given an IV, and baby's heart rate taken with a doppler since she was too small to be monitored with the over the belly monitor. A different OB, Dr. L came in and told me that the plan was to keep me lying down with my head lower than my feet in hopes that my bag of water would fall back behind my cervix, and my cervix could be stitched closed. I was also given medication to stop the contractions I was having.

I was 21 weeks and 2 days, and the ultimate goal was to keep me pregnant until at least 23 weeks so that I could be given steroid shots for baby girl's lungs. At first we were told I was going to stay in the hospital until 23 weeks, and then I would be moved to a different hospital that had a NICU where I would stay until I delivered. A few hours later, Dr. L told us that our insurance wouldn't pay for me to stay in the hospital until I reached 23 weeks, so I would be sent home.

Later that night, Dr. T came in and told us again that I would be staying in the hospital. We were very confused about all of the back and forth about the plan, but decided to take things day by day. I sent my husband home to be with our son and to sleep, and I settled in to try to rest.

The next morning, Dr. L came in and again told us that I was going to be sent home. She said that insurance wouldn't pay for me to stay, and the hospital wouldn't do anything special for me that we couldn't do at home. At this point, it was a waiting game to see if strict bedrest would keep me pregnant for the next week and a half. I was given the instructions to come into the ER if my contractions picked up, or if I had bright red blood.

I was sent home that afternoon and settled in for what we hoped would be a couple of weeks of lying around. I was allowed to get up to use the bathroom, but besides that, I was stayed horizontal. I fell asleep around 9 pm and woke up again at midnight with horrific back pains. My back had been sore all day due to the uncomfortable hospital beds, but this was worse. I tossed and turned for about an hour to try and make the back pain go away, but no matter the position, it just got worse. I woke my husband up around 1 am because I was getting scared. I knew I needed to stay on my back, but I couldn't handle the pain. I wasn't having contractions, and I wasn't bleeding, so we weren't sure if I needed to go back to the hospital, but we decided to anyways. In my head I thought, "if they could just give me something for the back pain, I can stay on my back again and we can keep baby girl safe."

While my husband was waking up our son, the back pain increased. I couldn't sit down in the car on my way to the hospital, it hurt too much. I started feeling like I needed to push, and right as we pulled up to the hospital, my water broke. As I got out of the car to get into a wheelchair, I felt our baby girl be born. I told the ER nurse what had happened, and he ran me up to L&D while my husband parked the car with our son.

I was taken into a room and put on a labor bed. As soon as my pants were taken off, our baby girl came fully out and the umbilical cord was cut by Dr. L. Our baby girl was taken over to the warming table to be looked after, but she was too small to survive. During all of this, my husband and son had come up to L&D and some amazing nurses offered to take care of our son so that he didn't have to be in the room with us. My husband was by my side as the nurses tried 5 times to start an IV, and while we waited for the placenta to come out. Finally they were able to start an IV and Pitocin was started to try and get my body to push the placenta out.

Dr. L ended up having to leave around this time and Dr. T was called in, I think around 3 am. Dr. T tried so hard to manually take out the placenta, which is the most painful thing I've ever had done to me. He got most of it out, but was worried that there were pieces still inside, so he opted to do a D&C to make sure everything was taken out. While I was in surgery, my husband called friends to come take our son so that we could have the day to mourn and figure out what our next steps were.

We held our baby girl before I went back to surgery and again after it was done. She was so tiny; 12.9 ounces and 11 inches long. She was absolutely perfect and healthy, for some reason my body just didn't want to hold onto her.

I stayed in the hospital for 24 hours so that I could get multiple doses of an antibiotic to make sure I didn't get an infection. I spoke to Dr. T before being discharged, and he apologized for what happened. He said that I should have never left the hospital, and while staying may not have changed the outcome, at least it wouldn't have happened at home/in the car. He also said that he didn't know I had been discharged until he got the call saying I had come back in labor. I have a 2 week postpartum appointment with him in a couple of days where I hope to discuss what could have caused this to happen.       

It's been almost two weeks since our baby girl was born on July 4. Two weeks of mourning and going over the "what ifs". We will never truly know why this happened, or if we could have done anything different, which has been the hardest part. Physically I'm healing, but mentally and emotionally it's been really hard. We've had good days and bad days, and our family motto has become "take things one day at a time."

It's been a roller coaster ride of emotions these past few months. From being happy as a family of three, to learning I was pregnant, to wrapping our heads around becoming a family of four, to mourning the loss of our daughter. I have no idea if another pregnancy is in the future for us, but right now, I just want to focus on healing myself and loving on my little family.