the beginning of the end of life as we knew it (part 1 of Elijah’s story)

Please read this first if you are new to this blog. The following post contains graphic details and I pray that nobody be offended.

In my sleep, I turned onto my side and suddenly jolted awake as I realized that something was running out of me. I jumped up and walked to the bathroom, wondering if my water had broken. Then I thought, I have no amniotic fluid, so how would it break? I was shocked to find bright red blood in my underwear and to see the toilet continue to fill up with blood.

I yelled for my husband. He came stumbling into the bathroom. He wanted to call 9-1-1, but I told him to get me the phone and I’d call my sister. It was 1:30 am Sunday (the 6th), but I knew that we had to do something about the bleeding. It wasn’t much more than a heavy period, but I was almost 24 weeks pregnant, so I wasn’t supposed to be bleeding at all.

While talking to my sister, I got off of the toilet. My husband and I started packing our bags and getting things ready to bring the kids to my sister’s house. We figured we’d have to go into labor & delivery at the hospital. Within about 15 minutes, I had soaked through a pad. At that point, I got off the phone with my sister and called my parents (my stepmom is a PA – Physician’s Assistant). My stepmom told me to sit down, so I did. It was hard to watch my husband trying to pack everything that the kids would need for an undetermined amount of time… especially with all of our daughter’s medical supplies, without being able to help him.

I then got off of the phone with my parents and called L&D to explain the situation and tell them I was coming in. I told them about my first two ultrasounds (done at 21 weeks gestation) and what we had been told about the baby (no amniotic fluid, enlarged, non-functioning kidneys, as well as other issues). I also explained how I was scheduled to see Dr. W on Wednesday, the 9th of February for my first real clinic visit with a doctor. At that appointment, we were supposed to get another ultrasound and discuss in depth all of our options, birth plans, etc.  L&D told me to come in and they’d be ready for me. After another quick call to my sister to let her know that we were leaving our house to bring the kids over, we headed out.

We finally got to the hospital around 3 am (it’s about an hour’s drive). My parents were there waiting for us. I was checked in and put into a room. They checked the baby’s heart rate and it was still going strong. In the 150’s. I told them I knew the baby was still alive because I had been feeling movement the whole drive to the hospital.

They also put me on the monitor to check for contractions… and much to my surprise, some mild ones were picked up every 3 minutes. I was having some light cramping, but nothing unusual for my pregnancies. I had mild-moderate contractions (or what feels like contractions, anyway) starting at about 5 months along with my 3rd & 4th pregnancies. A doctor came in and checked me, I was not dilated. She then told me how the “fetus” was not going to survive outside of the womb regardless of gestation age and she highly recommended that we get induced and get it over with. She said that even if the “fetus” were healthy, at 23-24 weeks gestation, they don’t even fight to save the “fetus” when the mother goes into labor or has any sort of complications, they just expect (and let) the “fetus” to die. She had no compassion and did not seem to think of our baby as a baby at all. I was very frustrated with her. She also warned us that the “fetus” was expected to come out with many defects and we may not want to see it. I told her we did, no matter what. She said she didn’t know why I was bleeding, but suspected that I was having slight placenta abruption. She left, giving orders to admit me, place an IV to start fluids, and put me on bed rest with bathroom privileges. So, the waiting began.

I had 2 or 3 more gushes of blood during the night, the last one at about 9 am. During the day, the bleeding was down to some very light spotting occasionally or none at all. I was allowed to walk about in the room. We ate. More doctors came in, they all said they didn’t know why I had been bleeding. They said if the bleeding stopped for at least 24 hours, they’d let me go home. They said if the bleeding continued, I was at risk for hemorrhaging since the placenta could suddenly rip completely. They said that if the bleeding continued, they recommended that we get induced to save me from the risk of hemorrhaging since the baby was not expected to survive outside of my womb anyway. They said that they didn’t want me to go home while still bleeding, since we lived so far away.

I was extremely anemic even while taking double doses of iron and was running a low fever of 100*. Causing more concern for infection for me and/or the baby.

That evening they brought in ultrasound equipment and checked for internal bleeding. My husband and I watched the screen… waiting for a glimpse of our baby. We saw the baby’s profile… so precious and perfect… but that was all we saw.

Unfortunately, without amniotic fluid, it’s almost impossible to see anything at all. We asked the ultrasound technician if he could try and see the gender of the baby. He tried hard, but he said he couldn’t be sure and didn’t want to guess. For most of my pregnancy, I had been sure the baby was a boy since my pregnancy was almost identical to my other boys. Once we found out there were problems with the baby, I started to doubt myself and wondered if the baby was a girl… I’m not sure why. It was so disappointing to not be able to find out. We knew that we would have little or no time with the baby once it was born and I wanted to feel a deeper connection to the baby while it was still in my womb and alive. I wanted to name it and call it by name. I wanted everyone to know who the baby was.

We went to sleep that night fully expecting to go home the next day, Monday. Around midnight, I awoke to more gushing blood. I was so sad. I cried. I missed my children so much. I was so lonely, that even my husband couldn’t comfort me. I just wanted to go home. We hadn’t left our special needs daughter overnight in over two years and never for more than two nights. We had left the other children overnight for much longer, due to our special needs daughter’s hospital stays, but I was just aching to see them again.

I went in the bathroom and held my belly and told baby that I wasn’t ready to lose it yet… I needed more time with it, to feel it inside of me. I wanted to go home and be with all of my kids. I didn’t want to make any decisions… I wasn’t ready. I wanted more ultrasounds… I wanted to be more sure of the baby’s condition. I didn’t want to let go of that hope… that hope that maybe the doctors were wrong. That maybe there was nothing wrong with my baby, at least nothing fatal. I was going to carry the baby full term… maybe even schedule a c-section so that the baby’s chances of survival would be higher. We had made plans, despite the confusion… and we were trying to control the situation the best we could.

But, it was never ours to control. Again through Sunday night/Monday morning, I bled. Our hope was being shattered and we were scared. We prayed. I begged God to perform a miracle.. to let things be different.

Once again, I stopped bleeding around 9:30 am Monday. The nurse kept telling us that a Dr. so-and-so (someone I didn’t know) would be coming in to see me. But, when the doctor came in, it was Dr. W, the doctor I had been hoping to see… the doctor I had heard good things about. Sadly, he couldn’t change the circumstances… they were what they were.

I was bleeding, apparently from placenta abruption. I couldn’t go home due to a risk of hemorrhaging. Dr. W felt that the baby’s chances of survival would go down the longer I carried it… due to no amniotic fluid and the baby’s heart being under so much stress. He said that the baby could also squish the cord between itself and my body at any time, cutting off its lifeline and dying. There was no wiggle room inside. Also, because the baby was breech (footling breech, meaning its feet, not butt, were against my cervix), things would only get more complicated the bigger baby got and the longer I was pregnant. He said that my risks would only get higher and the ultimate risk was death for me and baby… and baby’s chances of survival would either stay the same (baby was already expected to die before, during, or immediately after being born) or only get worse as time went by.

He said we were faced with a decision… he said that we could either stay in the hospital and continue being monitored for as long as I was bleeding… and risk hemorrhaging and needing an emergency c-section (which at 24 weeks gestation, would have to be done with a vertical incision because the uterus is too small for a regular horizontal incision, making all future pregnancies high risk and me needing to have scheduled c-sections 4 weeks early. The vertical incision makes the uterus much weaker and unable to go through contracting without ripping apart.)… or we could get induced within the next few days.

He said that getting induced did not make the baby’s chances of survival any less at this point. He said there were risks to being induced, but they were the same risks we would have to face at any point in the pregnancy when having the baby. Because the baby was footling breech, there was a chance that the body would come out (because the feet would start coming out before I was dilated much), but the head would be stuck. Dr. W said he would spend as long as it took (he said it could take several hours) to slowly work the baby’s head out, rather than just pull the baby out (causing trauma to the baby). We told him that we wanted everyone to know that this was our baby and we wanted the best for it… and we wanted to hold it, love it, name it, and bury it properly. We didn’t want to kill our baby. Dr. W assured us that they all felt it was a baby and that we were not killing the baby if we got induced. He said my body was already trying to go into labor on its own and if we got induced, we would just be helping it along and doing it in a controlled setting. Still, it was hard to believe him when I could feel my baby moving inside of me.

Dr. W said that he wanted me to come over to the clinic and get another ultrasound that he would personally look at. So, I was wheeled over in a wheelchair within an hour or so. They did another ultrasound and Dr. W said that he agreed with the previous doctors who had viewed the ultrasounds… baby’s kidneys were huge, and the heart was huge and took up most of the chest (he said the lungs should have been taking up most of the chest at this point), there was virtually no fluid at all, and the baby was footling breech. He felt confident the safest thing for both me and the baby was to get induced sooner rather than later. So, we went back to my room to decide.

We talked and prayed about it all day. My husband felt sure that we should get induced… he felt the risks for me were too high to wait. It was harder for me to feel that way. We made up our minds and changed them several times. We talked to the family. We talked to the nurses. We prayed. It was so hard.

Monday evening, we decided we would get induced. I asked the nurse about starting early Tuesday morning. She called Dr. W and said that he wanted us to wait until Tuesday evening, in hopes that he would deliver the baby Wednesday morning (when he was the doctor on call). It was another hard decision… should we wait another day? The nurse said she would find out which doctor would be on call for a Tuesday delivery. She came back and told us, and it was a doctor I hadn’t liked. So, the decision was made to wait for Dr. W. It was hard to wait with time to think and ponder the outcome. I spent much time in prayer.

Meanwhile, I had stopped bleeding through the day Monday. But once again started bleeding in the night. All day Tuesday, I bled lightly. It wasn’t a lot, but it was fresh blood. So, I was still bleeding. At some point on Tuesday, another doctor we hadn’t met came in. He told us we could go home at any time. He said that my risk of hemorrhaging was not higher at home than in the hospital (we knew that, but being an hour from the hospital, my risk of dying was much higher, right??), he said “People die in the hospital, too”. We thought, Huh!? Is this guy for real? He said that having delivered two of my children at home, I had already faced the ultimate risk (death) and that I shouldn’t be scared of my current situation. He said that I should go home and let my body do the work and I’d probably have the baby in a week or two. He giggled throughout the conversation and acted as though we were being very silly deciding to get induced.

When he left, we were very confused. I asked the nurse, “Is it normal for the doctor to send me home when I am bleeding?”. She said, “No! I was shocked when Dr.__ told me that you could go home if you want. That’s not normal at all!”. She then said that Dr. W is much more qualified and experienced with these types of situations and that she would trust Dr. W over this other doctor. She was very sure that Dr. W knew what he was talking about and the other doctor did not. The nurse later came back and said that Dr. W had called to check on me, so she had told him what happened. Dr. W said that he was very sure that getting induced was the right thing and the fact that I was still bleeding only confirmed it.

So, they planned to start at 2 am Wednesday…