Saturday, April 28, 2007

The Aftermath

Despite the quick timing, I'd have to say that, overall, my birthing experience was pretty good. The aftermath was not so good.

As soon as Katherine was born I put her to the breast and she sucked like a champ. I don't know how much time passed (maybe 15-20 minutes?) but at some point the midwife asked me to work on pushing out the placenta. Something about her tone of voice made me aware that things were, once again, not going exactly to plan. After a while of trying (there again, I don't know how long) the cord detached from the placenta. Not good. What happens next is not for the squeamish or faint of heart. Basically she had to reach up into the uterus and try a "manual extraction": she reached up in there and tried to detach it from the uterine lining and pull it out. Mine happened to be attached at the very top of the uterus. I am not exaggerating the following: she was in almost up to her elbow. Did I mention I got a second degree tear from the birth? This was not fun. In fact, it was much, much worse than any of the labor and delivery. After a while she said she was going to call in the OB on call because it was looking very much like I would require a D&C to get it out. Of course, in an effort to spare me surgery, the OB also tried a manual extraction. My doula didn't get to help out with labor but she was a huge help getting me through this.

In the end it was decided to do surgery. The midwife sat down with me and explained that there was a good chance I would end up requiring a hysterectomy. I guess when a placenta is stuck and they finally detach it, there is a very high risk of uncontrolled bleeding, in which case the only thing to do is remove the uterus. I told her I was fine with whatever they needed to do so long as I was around to raise my kids. In the recovery room the first thing they told me was that I did not need a hysterectomy and that everything was fine.

I'll spare you a blow by blow of the next few days. Suffice to say that everything was not really fine. Here's the OB's theory on what happened to me: In order to repair my septum they basically scraped tissue from the top of the uterus. I remember the fertility doc saying that it "thinned out" on the top right side quite a bit but shouldn't be a problem. When I got pregnant, the placenta attached to the scar tissue (which I understand is quite common). The placenta probably grew into the uterine wall a little too much, embedding itself in the scar tissue. When it finally detached, it left behind a small tear in the uterus and that tear allowed blood and air to escape up into my abdomen. It also left me severely anemic. A normal person has a hemoglobin level of 12-14. Within 12 hours after my delivery my hemoglobin was hovering around 7 and the next day it had dropped to 6. I agreed to a blood transfusion and within a day I was feeling like I might make it through the experience. Throughout my days in the hospital I had some pretty intense belly pain and was on some strong IV pain meds. I'm still pretty sore.

The thing I worried most about through all this is my ability to breastfeed. My milk is just now starting to come in but we have been lucky so far in that Katherine has not lost too much weight, nor is she showing anything but very, very mild signs of jaundice. My SIL (aka pediatrician) is not concerned at all and is not even suggesting I supplement her. I think it's going to work but that is still my biggest fear right now.

My second biggest fear is this hole in my uterus. The OB thinks that as the uterus shrinks down in size, the hole will seal itself off. As long as the uterus never stretches to pregnancy proportions again, the hole and corresponding weak area of scar tissue should never pose a problem. Theoretically. I am supposed to have a follow up appointment with him in about 3 weeks. I've been doing some serious thinking about whether or not I should just go ahead and have a hysterectomy once I'm all healed up from this ordeal. The whole situation makes preventing another pregnancy that much more vital and a hysterectomy would certainly solve that problem. Strange how this blog started with me wanting so desperately to get pregnant and now I'm worried about that very thing happening again.

Thanks for everyone's comments and well-wishes. I am still following all your blogs and will continue to follow the stories, hoping for a BFP for everyone.


Christina said...

Wow, what an ordeal! I'm so glad you're OK after all of that, and that none of these complications affected your daughter.

Anonymous said...

What a miserable "after" experience! I'm so sorry you had to go through that. I'm glad you made it through and now you can concentrate on raising those beautiful girls of yours. :)

Summer said...

How scary all that must have been. I'm glad to hear you are on the road to recovery.

Trista said...

I'm behind on my blogreading but I just wanted to say that Hope is absolutely beautiful. The aftermath of the delivery was so frightening! And I imagine that it must be incredibly stressful to think of your uterus having a tear in it which may or may not close up on its own.