Wednesday, March 16, 2011

My First Birth - Part IV - The Scariest Event In My Whole Life

So, after a reasonably traumatic c-section, serious blood loss, difficult recovery, and breastfeeding issues, we come to me at three weeks and one day postpartum. I was starting to come back to life, considering breastfeeding as a more viable option, up on my feet, able to care for baby alone. I was even getting a little work done from home. I was still in a lot of pain, but I hadn't needed the Percocet for a while, just ibuprofen. My blood count was coming back up. Things were looking good.

That Monday, I missed my afternoon pumping session, and when the baby got hungry, I decided to try just feeding him directly from the breast to see what would happen. According to my journal entry at the time, "It went OK." I was still unsure, but the decision was soon to be tabled. About three hours later, around 8:00pm, my husband went down the street to get us hoagies for dinner. The baby was asleep, and I was futzing around doing who-knows-what. The previous evening, I had had some uterine cramping that was a much more severe than it had been since the delivery, but it had gone away, and Monday had been fine.

Suddenly, the cramping started up again. I went to the bathroom to see if anything was going on, and I was bleeding more than I had been, which was surprising given that I was already three weeks postpartum. I decided to take some ibuprofen. On my way to the kitchen (we're talking a 1000sq.ft. apartment, so not a long walk or anything) to get water, I felt a gush of blood and instead ran back to the bathroom. When I sat down on the toilet, blood started to pour out of me. Sorry for the graphic detail, but I want you to get a sense of my terror: The usual course of uterine bleeding, whether a regular menstrual period or postpartum bleeding, is a start-and-stop sort of thing. Like, there's a spurt of blood, and then it stops, and then there's more at some point later on. My fellow female readers know what I mean. This bleeding I experienced was not like that. Rather, it was as if someone had turned on a tap or opened a vein. Blood just kept coming.

Remember, my husband was not home. I did not have a phone near me. The baby was in the bedroom, and I could hear him stirring. I didn't know what to do. My only thought was that I should get off the toilet, but I couldn't because my maxipads were too far away and I didn't want to bleed all over the bathroom trying to get to them. I don't think I realized just how serious things were.

After a few minutes, by which time I was trembling with fear and almost in tears, my husband came home with the hoagies. I called him to the bathroom, told him what was happening, and asked him for the phone to call the OB's office emergency line. This was not normal, I was sure. I also asked him to hand me a pad so I could get off the toilet. This was a smart move, it turned out.

I left a message with the OB office's answering service that I was experiencing severe postpartum bleeding. I then got up from the toilet and promptly collapsed to the bathroom floor and lay on my back on the bathmat. I was so dizzy I couldn't stand up. When we saw how much blood was in the toilet, there was no mystery as to why I had collapsed. My husband decided to skip waiting for the OB to call back and called 911 instead. He then called my mom to come over so she could watch the baby when the ambulance came. I remember feeling like my limbs were full of sand, and I kept yawning. My husband thinks I may have passed out briefly a few times.

A police officer came, followed by the paramedics. The paramedics told me I was hyperventilating, and their calm helped me to calm down. They told me to breathe deeply, and the sand-filled feeling subsided. They asked me a few questions, joked with me about how they were missing the hockey game, and loaded me on a stretcher and carried me to the ambulance, where I was whisked away to the same hospital where I had given birth (also the closest hospital). My husband followed in the car.

I was coherent enough in the ambulance to be impressed by how easily the paramedic got an IV started in a moving vehicle, considering the trouble many a nurse had had trying to do it while I was lying still on a hospital bed.

Once in the ER, I was examined first by an ER doctor wearing black scrubs and tended by some excellent nurses. They drew blood and determined my hemoglobin was back down to 8.8, low enough for concern. My OB had called back to my home after we had left for the hospital, and my mom told him we were already in the ER, so he came down to see me, an OB resident in tow. They each performed a pelvic as well and couldn't figure out where the bleeding had come from. Since lying down on my bathroom floor, the flow of blood had stopped - that was probably the smartest thing I could have done, though I didn't know it at the time - because I imagine it put the weight of my other internal organs on the source of the blood and caused it to clot. That's my guess, anyway.

My OB decided to order a CT scan and a unit of blood. They wanted to see what was going on, and they also felt I might need a(nother) transfusion.

The CT scan was a new experience for me and was fairly unrevealing. They saw I had a large clot (about the size of a Cutie orange, or clementine) in my uterus that hadn't been there before, but they couldn't tell where it had come from. They admitted me to the hospital and eventually found me a room.

They had me stay in bed all the next day. They did an ultrasound, which was marginally more helpful than the CT in its image of the clot. Another of my OB's came to examine me and also didn't know what might have happened. Her (and her colleagues') best guess was that my stitches had dissolved before I was completely healed, and a weak spot in the tissues had opened up. She said they hadn't had to readmit a patient to the hospital for postpartum bleeding in years.

My breasts started to feel a bit engorged, and the nurse offered to bring me down a breast pump. I pumped once but spilled the milk on my sheets, then figured it didn't really matter. I had created an association between nursing and this emergency, my mind figuring that since nursing causes uterine contractions, perhaps my breastfeeding attempt earlier on Monday had caused a contraction that led to the bleeding. Who knows.

I stayed in the hospital until Thursday afternoon. They did another ultrasound Thursday morning, and there had been no change in the clot. Since the bleeding didn't restart, they felt it was safe to send me home, as long as I restricted my activity. They also sent a home health nurse to check on my Friday. Everything was fine.

I stopped pumping, stopped breastfeeding, went exclusively to formula. Only about four weeks later, I started feeling very depressed about that decision and tried to relactate, with advice from the La Leche League leader whose help I had previously rejected. My attempt was unsuccessful, although I do have a few cherished photos of me with the baby latched to my breast as I sat on the couch. At least I know I tried, although I also knew that I couldn't pump and nurse 'round the clock, as I would have needed to in order to bring in any kind of useful milk supply after never having established a full supply to begin with and having stopped completely for a month.

I still, over four years later, regret that my older son didn't get as much benefit from breastfeeding as he was entitled to. I no longer blame myself, however, which I did for a long time. For a long time (years), I berated myself for my lack of dedication, my resistance to help offered, and for not educating myself better before the birth. Now, instead, I don't really blame anyone. But I am angry that the "system" failed me, that I was told from numerous sources that formula was just fine and not to feel bad if I didn't breastfeed, and that the lactation consultants and the pediatrician, on whose advice I relied heavily, led me down the wrong path.

I also still have anger that my older son's birth didn't go the way I feel it should have, which led to the scariest moments of my life, lying there on my bathroom floor. But, now I am channeling that anger into something productive - educating other women and offering support so that they can have a better chance at getting the birth and breastfeeding experience that they want. Hence this blog.

It's not all bad news, though. I look forward to my next post, in which I will tell the story of my second son's birth. I think you'll be as amazed at the contrast as I still am.

1 comment:

  1. You are great for doing this, sharing, writing and caring that other mothers-to-be (me!) and new mothers can read and maybe learn from all your experiences (good and bad) :)