Grief and Going Back to Work

Tomorrow is the last day of my last maternity leave with my last baby. While I was given Lyla, I left a part of myself back at the hospital literally and metaphorically. Lyla is very beautiful and content, she giggles and smiles so much and the way she looks at me makes me feel very loved despite her tiny size. Today I grieve the 3 I have lost, the ones I had yet to have and the end of a special time with my baby girl.

Accreta Confusion

At the 20 week scan, the tech did the ultrasound and the doctor came in to review the results with me. She noted I had placenta previa which is where the placenta covers the cervix but at this early in the pregnancy, it would likely move and not be the issue. Her words were “the issue is what the placenta is showing near your uterine scars.” The uterine scars were from the D&C and the uterine septum resection. Sometimes the placenta will attach to the uterus where that scar tissue has formed, a condition called Placenta Accreta which occurs in 0.2% of pregnancies. She had seen increased blood flow in the area of the scars and may indicate attachment of the placenta to the uterus. After delivery of the baby, the separation of the placenta from the uterus can cause massive hemorrhaging and only a hysterectomy can stop the bleeding. She asked me to come back in 8 weeks to monitor the placenta. Never once did she put a name to the condition, all she could do was tell me not to google it. I was shell-shocked and walked out of the office. Matt works at Georgetown so I asked him to meet me after. I couldn’t even spit it out without the tears rolling down my cheeks. A hysterectomy at 36? The appointment left so many questions.

Those 8 weeks were a torment. I scoured journal articles, medical sites, Facebook groups, anything I could get my hands on to understand the condition. I requested an earlier ultrasound but my doctors noted there would be no value in having one done sooner. I went into a little depression at that time and I couldn’t cope with the pregnancy. I reached out to others on Facebook in a similar situation but that only fueled my worry and my need to have a definite answer of do I have Placenta Accreta or not. I connected with another woman who was a similar age as me, had a 2 year old son just like me and had suspected Accreta just like me. We messaged back and forth talking about the scariness of it all and how we worry about our sons if something were to happen.

At the 8 week mark the ultrasound showed no signs of Accreta and the follow-up MRI showed nothing either. One of the doctors read the results to me and as I was asking him questions, he walked toward the door and had one foot out. It was like my worries and concerns were so inconsequential to him even though I would only take a few moments of his time. I requested another doctor in the practice to give me a call to discuss and she had a similar tone of indifference. I then sought a second opinion and he also felt I did not have Accreta. He commented on how unlikely a uterine septum resection was very minimally a risk factor for Accreta. I had a lot of anger at MFM for the way they handled the situation, the long lag time in between visits and the way they essentially blew off my concern. As the weeks progressed, it became easier to let go of the anger and found relief that I would have a normal delivery.

My induction was scheduled on Wednesday, May 22nd. Since I am over 35, I would need to deliver within a few days of the 40th week so they let me pick a day for the induction since my cervix was “ripe.” The morning was smooth, I had a wonderful nurse and she got me the okay to have a pretty hearty breakfast. Around 9 they started the induction process and I basically got to hang out in bed, eat breakfast and watch TV. If you have a toddler, you’d understand the joy in that. The labor progressed well and by mid-afternoon I was having full on contractions. The epidural didn’t work so well on one side of my body so I felt much of the birth experience which wasn’t what I signed up for but I powered through it. I gripped onto the railing, took deep breaths and looked at my husband for the strength I needed. I was shaking from the pain but with each push I could feel her coming and when I was able to touch her head, the joy you feel gives you a renewed energy to keep going so that you can hold that tiny baby in your arms. And finally she was out and on my chest. I felt pride and love and such a connection with this hairy little girl we made. Then the doctors moved on to the next part of labor, delivering the placenta. It was a bit of time before the doctors and nurses started talking about the placenta. Even though my uterus was contracting, the placenta wasn’t coming out. They continued to have me push but I was so enthralled with my little girl, I wasn’t worrying, there was still time for it to come out. After 20 minutes, maybe 25 minutes the placenta came out. I had pushed and I think my doctor tugged a bit on it to help it out. That’s the moment where things started to change.

Introduction

I have a need to tell this story, to get it out because some days it feels like it’s swallowing me up. Becoming a Mom began 5 years ago and ended on May 22, 2019 when I had emergency surgery to remove my uterus and cervix to stop a massive hemorrhage. I lost over half my blood volume and needed 5 blood transfusions. It was worse than many experience but not as bad as some women have suffered. In these 5 years, my husband and I have conceived 5 babies but today I am the mother of two beautiful children. 

The OR

There were a lot of little moments that run through my mind from the point I delivered Lyla to when I woke up in the ICU but the defining moment was when the D&C didn’t stop the bleeding and my doctor said I needed a hysterectomy. I don’t know if it was minutes or seconds but I asked her in a daze from the anesthesia and possibly from the blood loss if it was absolutely necessary to remove my uterus. She leaned over me on the operating table with her surgical mask covering most of her face and kindly but firmly said that she must. There was a look in her eyes, a kind of resolve because she knew she needed to do it to keep me alive. I’d held it together until that point, not crying, reassuring Matt in the Labor and Delivery room but it was in that moment, when she looked me in the eyes that I felt so scared. I put my hands over my eyes, over my face and I sobbed. I sobbed because I realized I was losing so much blood. I sobbed because I have two beautiful children that need their mommy. I sobbed for the children I wouldn’t have. I sobbed for Matt because I love him with everything in my soul. I sobbed on the operating table in a room with 10 - maybe 15 people swirling around the room preparing for my surgery. Someone, maybe my doctor, asked if I wanted to see Matt and all I could do is nod with my hands still covering my face. I wonder what it looks like as a doctor and nurse to see that. When Matt came in his facial expression was one I’d never seen before in the 11 years I’d known him. I stopped crying and I told him he needed to call our moms and get one of them here as soon as they can, that we needed them. I thought about all the work of caring for the kids while I recovered and knew he’d need help, that I’d need help and he nodded or maybe said something to that effect. I know we said loved each other and I don’t know if I cried again but the last thing I remember was him walking out of the room. I think the anesthesia fully set in at that point because that is my last memory of being in the operating room is seeing Matt walk out and being alone on that table.

After Shocks

I have nightmares of bleeding, I have nightmares of losing my baby and no matter how much rationalization or distraction I employ to heed off these disturbing thoughts when I awake, they stay with me throughout the day. The same is true with my hospital stay. For a while there, I’d relive the ICU days over and over again thinking about what I should have or could have done differently. It took so much time and energy to convey to the doctors the pain I was in and something in my mind wants to blame myself for not doing enough or saying enough or something.

I’m scared. I’m angry. I’m so beyond anxious that it feels like it is eating me whole. I have been adding up all the events of my life. Some days I add up all the good, all the people I have been blessed to have in my life. Other days I add up all the bad, all the disappointments, all the hurt from those that didn’t show up or those that caused pain and of the pain and loss of the becoming mom. Some days I mourn my uterus and want so badly to have another child. Other days I am so overwhelmed by my childs’ needs that I think I am not worthy of this, that I am not a good Mom and that I am not warranted to feel loss or mourn what I have lost because I can’t even handle what I have.