Knowing Now What I Wish I Had Known Before

They say hindsight is 20/20.  It seems unfair.  Knowing what could of been done or should of been done differently is some days what makes it hardest to keep putting one foot in front of another.

My tragedy didn’t just happen last summer.  It began back in the early 2000s when I was pregnant with my oldest.  My first 8 months I had gained 18 pounds, in the 4 weeks prior to his birth I gained just over 35lbs.  My body was so swollen.  I knew it wasn’t right.  I went in to be seen time after time.  I was seen throughout my pregnancy, and prior to it as we went through infertility treatment, at John Hopkins.  I was naive, I thought they were the best.  If they said I was okay, I must be okay.

I was at the hospital 3 times in the week prior to my water breaking at 39 weeks at home.  The resident who saw me the 2nd time wanted to admit me.  He saw the swelling and pitting, I was dilated to 3 cm.  However he was not allowed to admit me.  Despite the fact the pitting was so bad and I had been having extreme headaches for 2 weeks.  The hospital guidelines were that you had to have at least 2 of the 3 preclampsia indicators; those being swelling/extreme weight gain, high blood pressure, and protein in the urine or you had to be dilated to 4 cm.  His attending physician made this call not to admit me without ever laying eyes on me or examining me himself.

The resident sent me home with a 24 hour urine collection.  I came back the next night to drop it off.  The following morning my water, by the grace of God, broke at home.  When I got to the hospital and into the L&D department that is when chaos started to ensue.  It turns out that the protein in my urine was extremely high and someone had failed in their job to call me with the results and get me back and admitted ASAP.  By the time they had me admitted when I arrived after my water breaking they realized I had been very right and they had been very wrong.

I continued to labor.  About 4 or 5 hours into laboring at the hospital they informed me they needed to give me an epidural because my blood pressure was very high and they thought the epidural would help bring it down.  Following the epidural my blood pressure went higher.  They then decided to put me on a Mag drip, along with a Pitocin drip as the Mag by itself would slow labor.  I had everything I didn’t want done to me done.

I eventually after 10+ hours of labor at the hospital made it to 10cm.  They then had me push.  I pushed for over 2 hours.  My son was sunny side up and after each contraction and push he would go right back up to 0 phase.  The epidural did little for the pain because it was back labor because of his positioning.  Also, because of the epidural, I was not allowed to labor in a position that would help him naturally be able to descend better on my feet because you can’t stand with an epidural.  The whole time I kept saying, well at least next time…  My labor nurse was dumbfounded by me.  She told me that not once had she heard a patient say there would be a next time during actual pushing.

After over 2 hours went by of pushing I was not doing well.  They rushed me to the operating room and did an emergency c-section.  They allowed me to briefly see my son.  He opened up his big blue eyes and stared right into mine and a love that I had never known the fierceness of before was instantaneous.   They then took him away and made my husband leave as well as I was fading fast.

I went into DIC (disseminated intravascular coagulation) on the operating table, nurses call it death is coming.  Everything was bleeding, my body was in shock.  My urine was completely red so they ran sterile milk through my bladder to make sure they had not nicked my bladder.  No, they hadn’t, it just turns out I was that far gone.  Eventually I woke up in the L&D department.  The next few days are very, very fuzzy with few memories as they had to keep me on the mag drip to help my blood pressure go down so I wouldn’t go into seizures.

My husband, that wonderful man, literally nursed our son.  He helped him latch onto my breasts while I was basically completely out of it.  He changed diapers, burped him, bathed him, all the things I had waited so long to do.  Our friends who were there at the hospital got to hold my son before I did.  That’s a bit hard to bear still.

Two days later my mom arrived.  My mom who was a nurse, including a labor and delivery nurse.  She said when she saw me she could barely recognize me.  Unfortunately for me, she was the entire country away because we were stationed in MD at the time and my family is from the west coast.   I wish she had been nearby.  She would of known what to do and how to make a doctor listen.  I wish I had been advocated for as being a first time mom I took the different doctors I saw words as gospel.

It was all ok though, I believed, because my son was ok and I thought I had learned some valuable lessons.  Turns out I hadn’t learned enough.

In 2004 the American College of Obstetricians and Gynecologists (ACOG) issued new clinical guidelines regarding VBACs.  When I became pregnant with our 2nd son I was told that a VBAC was not an option at the hospital I was near due to ACOG’s new policy change.  I fought with my OB, I begged, I pleaded, and he refused.  I understand that he couldn’t perform a VBAC because they had threatened already to not insure him if he did anymore.  What I don’t understand is when he knew how strongly I felt about having a chance of trying to have a natural birth and hopefully avoiding a repeat c-section why he didn’t advise me that I could go else where.  That I could be seen by an OB in a neighboring city that had 24/7 anesthesiologists at the hospital.  He could of told me that would be an option, that there was an option available to me elsewhere.  He didn’t.

I once again was naive and did not search out options and facts for myself.  I took another doctor’s word as absolute.  I had a repeat c-section, one I vehemently did not want to have.  By the way, I could of not scheduled a c-section and gone to the hospital once I was in labor and they would of had to keep me as a patient, legally.  I wish I had known that as well.

When it came time for our twins to be born we were in a large hospital.  I spoke to my OB at the time that I really did not want another c-section.  They were twins, they were small, please let me try.  He also refused.  He told me if I came in with one already coming out of me he would cut me open to deliver the other.  I should of ran away when he said that.  I should of searched out to see if there was a group that could help me.

I pause here to let you all know there is such a group.  They are called the International Cesarean Awareness Network (ICAN).  They work with women to help them be able to have at least a trial of labor and VBAC attempt.  If you find yourself in a situation where you had to have a c-section, perhaps an emergency one like my first was, and you also want to attempt a VBAC I want you to reach out to this group.  They have chapters all over.  You can find them online and on Facebook and they can direct you to the chapter closest to you.

Our twins were born at just over 38 weeks via another scheduled c-section.  Our 5th child was also born at just over 38 weeks via a scheduled c-section.

When I found out I was pregnant in late 2015 I was in such shock.  After our first 4 had been all infertility treatments due to my PCOS and Hashimoto’s I was shocked to find myself pregnant over 7 years after I had given birth to our youngest child.  I was much older (think very late 30s) and thought much wiser.

Two weeks after I found out I was pregnant myself and our 5 children, along with my mom, made a cross country road trip.  We had decided our children and I would live near family while we waited for our house in VA to sell and for housing to be available at my husband’s new duty station.  I saw an OB for the first time at the end of my 1st trimester.  Everything looked great.  I didn’t think we would be there for long so I didn’t get into the conversation about wanting to do a trial of labor.  As months drug on and we were still there and no housing in sight so we could join my husband I ended up having to have that conversation with my OB.  He refused, he wouldn’t listen to any of my arguments.  He wouldn’t read the literature I brought him.  Nothing.  I then asked if I had to have a c-section if it could be a gentle one like I had read some hospitals are now performing.  If I had to have one I wanted a clear drape so I could see my son be born.  I wanted immediate skin to skin contact, and I wanted them to wait a minute or two before cutting the umbilical cord.  He refused to even consider giving me that option as it “the hospital policies did not allow for such requests.”  I left and did not return.

I found a wonderful doctor who supported me to a certain extent.  It was a further drive from our home but he was willing to let me have a trial of labor as long as it happened by my due date.   And that the moment I was really in labor I would go to the hospital immediately.  I agreed with him.   He also agreed that if a c-section was performed it would be a gentle c-section.  When he heard my obstetrical history he was saddened and angered by all I had been through and how poorly treated I had been.

The odds of uterine rupture after four c-sections is less than 5%.  The odds of uterine rupture while not in active labor are basically unheard of.  When my uterus ruptured I was not dilated and was not in active labor.  Had I been dilated and in active labor I would of been in the hospital when my uterus ruptured and my son would not be dead.

I can say now that had I known I would be the less than .005% who had a uterine rupture, not in labor, not dilated, and not in a hospital, yes I would have scheduled my c-section at 38 weeks.  But you see, there was no way I could know that.  I had ran the numbers in my analytical mind.  I had weighed the options and the risks and felt I was making the best decision I could for my baby and for myself.  Having Multiple Sclerosis a possibly unneeded surgery would put great stress on my body and set me up for relapse.  That also went into my decision making.  Remember though, I did agree and did have a c-section date set up for my due date.  It had also been over 8 years between deliveries which made the odds of having a uterine rupture even smaller.  I thought I knew everything.

If I were in the same situation again though, having not gone through an uterine rupture I would still make the same decision.  I would however ask to have the window in my uterus checked from 36 weeks on to look for thinning via ultrasound.   It’s only hindsight that can give you 20/20.

It is a sad, sad state our country is in when we say women’s bodies are their own.  We are allowed to do whatever we want with them, including abortion.  But the one situation that we are stripped of our rights where are bodies are concerned is in giving birth to our children.  That is disgusting.  As my OB said, it was my 2nd c-section that sat me up for this tragedy.  The first one was needed.  I would of died without it.  Though had they listened to me and treated what was happening to me seriously and induced me a week or 2 weeks earlier I may very well have not needed an emergency c-section.  Or even if they had tried to turn my son, I still may have been able to push him out.  They didn’t attempt to turn him from his sunny side up position and that makes it harder for any woman to push a baby out of an already small area.

I want others out there to avoid my mistakes.  I want you to advocate for yourself.  I want you to know there are others out there who will advocate for you.  It is your body, not a doctor’s.  You are in charge.  You are the one in control, they cannot force you to have a c-section you do not want.

It may seem crazy that after having an uterine rupture and my baby dying because of it that I would feel this way.  That I would encourage other women not to have repeat c-sections.  I wish someone had encouraged me.  I wish I had known what I know now.  I hope that someone reading this one day will learn from my mistakes, from my not advocating for myself.

Our bodies are made to give birth naturally.  It is Western medicine that tries to tell us they aren’t, our pelvis is too small, lie on your back to give birth, have epidurals so you can’t stand which would be the natural way for a baby to be able to descend out of the birth canal much easier.

I should be holding my son right now.  For the past 45 weeks I have had to live with my mistakes and bear up under the weight of such guilt and what ifs.

I plead with you learn.  Learn about your body.  Learn how to advocate for yourself.  Find others to do it for you if you can’t.  Learn from books that are not biased by our Western conventional medicine.  Learn from my mistakes.