Tuesday, September 6, 2016

My Complete Placenta Previa Story

When I got my 20-week ultrasound with my fifth baby, I walked into the office completely clueless that what I saw there was drastically going to change the next year for us.

Funnily enough, I almost didn't even have that ultrasound.

Because of traffic and my chronic lateness, I missed my appointment. The receptionist wanted to reschedule and I debated just skipping it entirely.

After all, I'd had 4 perfectly healthy babies already. In my mind the only reason to even do the 20-week ultrasound was to find out the sex of the baby, which we wanted to remain a surprise, so what was the point?

Houston, We Have a Problem (Actually, Two Problems)


Well, I did reschedule, and to my surprise we actually did find two weird things during the ultrasound: a single umbilical artery and a complete placenta previa.

My odds of developing each were respectively 0.5% and 1%, so the fact that I'd managed to do both simultaneously was actually kind of impressive.

The single umbilical artery meant a 25% chance of some serious defects, a 75% chance that everything was fine, and a 100% chance of freaking out while Googling it late at night. In our case, though, it turned out to be absolutely fine.
My Complete Placenta Previa Story --  The craziest 16 weeks in my life was thanks to a placenta that didn't get the memo during my fifth pregnancy. Complete placenta previa is no joke.  {posted @ Unremarkable Files}

But then there was the placenta previa.

"Previa" is a Latin word meaning "right in the freaking way of everything." Placentas are supposed to attach up at the top of the uterus, out of the way and nicely protected, but mine was at the bottom directly over my cervix.

So from now until I had the baby, there was a possibility of me hemorrhaging.

They put me on "pelvic rest" effective immediately, which is like bed rest lite. You can still walk around, but there's no exercise, (yay!) no sex, (boo!) and no heavy lifting (okay, I completely ignored that part because toddlers.)

The other thing about a complete placenta previa is that going into labor on your own isn't even an option. The baby would be trapped and the mom would bleed out if you tried it.

It means automatic C-section.

In Which I Freak Out about Having a C-Section


My midwife was quick to point out that my placenta could move out of the way as things shifted and expanded, so we'd have to wait and see over the next few months.

Meanwhile, even the idea of a Cesarean was really hard for me to digest.

I'd never had a C-section and never wanted one. This whole time I'd been envisioning a drug-free labor and delivery. I couldn't believe it. I was mad and most of all, scared.

I talked to everyone I knew who'd had a C-section. Most said theirs was okay, but when they described the surgery I thought it sounded terrifying, and when they told me about their recovery I thought it sounded absolutely awful.

When I mentioned that to my friend Jill, who had experienced both Cesarean and vaginal births, she said, "Have these women had only C-sections before?"

I nodded.

"It's going to be okay if you have a C-section," Jill said quickly. "But I'm not going to lie to you: it's worse."

I spent the next 4 months alternately crying over C-section related Google searches and avoiding thinking about my impending fate. I was in complete denial, with periodic lucid moments where I wanted to run away screaming "They're going to CUT OPEN MY UTERUS!!!"

Meanwhile, my follow-up ultrasounds weren't looking promising. At my final ultrasound, the maternal fetal medicine specialist took one look at the print-out and snorted "Well, that placenta doesn't even want to move one way or the other!"

My placenta had firmly, stubbornly, and irrevocably hunkered down in the worst possible place, and there was no question I'd be getting a C-section.

The surgery was scheduled for the day I hit 37 weeks, which sounded crazy early to take a baby out, but there was nothing I could do about it. Except worry, which I did with exceptional skill and stamina.

33 Weeks: First Bleeding Episode


Other than the pelvic rest and worrying about the baby and freaking out about the C-section, the pregnancy was totally normal until 33 weeks.

Phillip was home for the day and planning to take our two oldest kids to the art museum and bring a picnic lunch, but in typical Evans fashion we couldn't get our act together and at noon they hadn't even left yet.

The two of us were at the kitchen counter making sandwiches when I felt suddenly, for lack of a better comparison, like I was laying an egg.

My first thought was "Oh crap, I'm peeing my pants!" and you shouldn't judge because if you've ever been pregnant you know stuff like that just happens to pregnant people sometimes.

So I ran to the bathroom, where I quickly learned that I was not peeing my pants. It looked like I dropped a pitcher of red Kool-Aid on the floor.

Not to be graphic, but later that night Phillip was cleaning up blood that had splashed halfway up the bathroom door.

I knew majorly bleeding during this pregnancy was a possibility so I wasn't panicked, but I was really glad Phillip hadn't left hours ago like we'd planned. For once, our inability to function like normal people was working in our favor!

I called my midwife's office and they said to just go straight to labor and delivery (actually, they first told me to come into the office and I was like, "No, you don't understand, this is a lot of blood.")

The bleeding slowed down and even stopped by the time we were en route to the hospital, which was a good thing because in the back of my mind I'd been wondering how to get in the car without destroying the upholstery.

Hop on Board the Emotional Rollercoaster


I honestly thought the hospital was just going to keep me for a few hours, maybe overnight, and then send me home.

The nurses said I'd bled a lot, but I didn't need a transfusion or anything. They strapped a fetal monitor to my belly and gave me a few painful steroid shots in the bum to beef up the baby's lungs, just in case they had to do the C-section now.

Then they gave me an IV and introduced me to the bedpan. (I received numerous compliments, by the way, on how quickly I was able to pee in a bedpan. Apparently it takes most people forever to relax and just go. But since I had 4 kids at home and had been peeing with an audience for ten years already, I had an edge on the competition.)

Then we waited and watched.

Eventually Phillip went home to collect the kids and start his 3-week stint as a single father, although we didn't know then that it would be so long.

They kept me hooked up to the fetal monitor all night and strapped huge sweaty compression boots on my legs to prevent blood clots. The IV dug into my arm whenever I moved and I woke up every time the boots started loudly inflating. I did not sleep well.

For the next week, everyone I saw told me something different. A nurse told me I'd be here on bed rest for a good long while, then the next day the doctor said I might go home in a few days. A midwife doing her rounds the following morning somberly predicted a C-section within the week. I was a complete basketcase stressing over whatever they told me, and it changed every day.

Eventually it was recommended that I stay in the hospital for the rest of my pregnancy, but if I really, really wanted to do bed rest at home, then I could.

It was an agonizing decision to make. I wanted to go home so badly, but I knew that bed rest just wasn't going to happen at home with 4 little kids.

So I stayed. It was hard because I wasn't (and still am not) convinced that the bed rest served any real purpose. There aren't any scientific studies on whether bed rest is actually effective for placenta previa, and there may never be because what mom is going to gamble with her baby's life just to see?

Bed rest sucks, and maybe I was doing it all for nothing, but at the very least I was in the hospital where I was close to blood transfusions and the O.R. if I should need it, and I guess that was some comfort.

Starts with 'B' and Ends with 'edrest'


With the decision made, they moved me to the postpartum ward, so I was the only one on the floor still pregnant. Brahm's Lullaby played over the speakers every time a baby was born.

I was eventually given "bathroom privileges" (including a quick shower) and even permission to walk down the hall and back once a day.

Bed rest is so bizarre, especially the hospital kind. You have all the time in the world, but you can't concentrate long enough to read a book. I know, I tried.

Instead, I watched a lot of Big Bang Theory reruns. I knitted a shawl for my mom. I, who haven't played a video game since 1998, became an expert at Drop 7 (free from the app store!)

My life revolved around mealtime, since that was pretty much the only thing of consequence that happened all day. Phillip maintains the food was terrible, but he's a food snob. I didn't have to make it so I thought it was great.

My Complete Placenta Previa Story --  The craziest 16 weeks in my life was thanks to a placenta that didn't get the memo during my fifth pregnancy. Complete placenta previa is no joke.  {posted @ Unremarkable Files}
Taken just a few days before the baby made his grand entrance.

People think the boredom is the worst part of bed rest, but for me it was seeing its impact on my family. 

I knew Phillip was practically killing himself trying to do both his job and mine, and there wasn't anything I could do besides call in favors for childcare or meals to everyone I knew.

The kids looked like a ragged, unbrushed band of pirates wearing winter boots with no socks when they came to see me at the hospital, yet I knew he was doing his absolute best just to get them there at all.

And I missed them. On hospital bed rest, you never get to be alone with your husband, and when you do see each other it's just for a temporary visit. As a stay-at-home mom, I went from knowing everything about my kids' day to feeling like their lives were going on without me.

It is no exaggeration to say that hospital bed rest was one of the most emotionally draining things I've ever done.

36 Weeks: Second Bleeding Episode


One day at 36 weeks, just a few days before my scheduled section, I was lying in bed (ha ha, what else would I be doing) when I had another bleed. Nothing like the first, but enough for the nurses to revoke my bathroom privileges and put me back on the fetal monitor.

Sigh.

The OB on call wanted to do the C-section immediately, but I pleaded with her to just wait and see.

I already felt like taking the baby out at 37 weeks was too early; I wanted to give him every extra day I could.

They agreed to watch me overnight, but unfortunately it didn't seem to be stopping and as morning approached I was maybe even bleeding a little more than before.

I'd tried as hard as I could do put it off, but having a C-section now was inevitable.

Even though my Cesarean wasn't exactly a dire emergency, they unfortunately don't have a designation for "slightly urgent, should be done sooner rather than later." There are two kinds of C-sections: scheduled and emergency. And since mine wasn't scheduled, they flipped into emergency mode and everything after that happened very fast.

You can read the details about the C-section here if you're interested (spoiler alert: I hated it.) My baby had to go to the NICU after he was taken out, but I think that was a function of him being early rather than anything having to do with the placenta previa, per se.

(And in case you're wondering whether it's possible to have a VBAC after a complete placenta previa, the answer is yes!)

My experience with complete placenta previa taught me a lot. 

It taught me not to skip the 20-week ultrasound.

It taught me childbirth isn't totally under my control.

It taught me patience as I waited on bed rest for what seemed like forever.

And most of all, it taught me never to underestimate the power of a rogue placenta to turn everything upside-down.

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Unremarkable Files

11 comments:

  1. I should really stop reading stories about childbirth when I am just weeks away from it again.... But this wasn't so bad to read. I know I luckily don't have that problem (4 years post first c-section). but in wanting a VBAC I am 4 weeks from c-section date and baby might be breech. Oh the things you never think of before becoming pregnant!

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    1. That's what I forgot: a disclaimer warning pregnant women not to read it!

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  2. Thank you for sharing your story. I hope others facing the same thing find support from your experience.

    Pregnancy is crazy. It really is a miracle how our bodies work and how we can have babies. :)

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  3. Wow, this is so intense, and I think you are so amazing for making it through this experience! That rascally placenta. Bed rest ordinarily drives me crazy, but I think at the hospital, I would go even more crazy. Seriously, you are amazing for persevering!

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    1. Thanks. I've had the most boring textbook pregnancies, labors, and deliveries for all 5 of my other kids - I really was not expecting any of that. It was kind of a wake-up call that even with all the advances in medicine and prenatal care we've made, so much of pregnancy is still out of our hands and you really do put your life in God's hands each time you have a baby.

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  4. Oh wow! I've only had one friend who had placenta previa and hers was on partial and ended up moving. This sounds like a really rough thing to get your head around and all that bed rest sounds really emotionally draining. I'm glad to hear that you were able to have a VBAC with your sixth, though! :)

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    1. I'm so glad yours did move! For some reason I never even thought or hoped that mine would, but you bet when I got pregnant with my 6th I was praying I didn't have it again!

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  5. Thank you for your honesty. I know that when I was pregnant with my son, I did a lot of late night Googling as well, but I loved accounts like yours, that were straightforward and, again, honest. And the unbrushed pirate children is my favorite visual.

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  6. Wow! I'm so glad you wrote about this. I had a fluky bleeding scare halfway through, but it wasn't placenta previa, though I remember being worried about it at the time. You are such a trooper. I can't even imagine being stuck in the hospital with your kids and husband at home. I would've been a basket case.

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  7. Oh yikes! This would have been scary.

    Being on bed rest would be difficult too.

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