Pregnancy

My pregnancy started out fairly typical. I was tired and I had morning sickness that needed to be treated with Zofran, but once that was prescribed I generally felt great weeks 10-17. I am a nurse and spend a lot of time on my feet. I also spend a lot of my time outside of work at the gym (it’s where I met my husband). I consider myself physically fit but at about 17 weeks pregnant I  began to notice that I was getting really short of breath walking up the stairs and going on walks with our dogs. I thought this was odd since my bump wasn’t really taking up a large amount of real estate or pressing on my lungs at this point but just attributed it to being pregnant. Then, one day at work while completing a basic (non-physical) task, I started to feel very short of breath. When going to check my oxygen levels I found that my O2 was perfect and that instead, it was my rapid heartbeat causing the problem. A few coworkers convinced me to head downstairs to the ER to get checked out and I ended up getting admitted to the hospital. I was terrified that there was something wrong with my baby, but I had an ultrasound and an entire cardiac workup including an echocardiogram, chest CT and coronary artery CT. We were both given a clean bill of health, but I was diagnosed with PoTS (postural tachycardia syndrome) of pregnancy. This meant that with quick position changes (ie: sitting to standing) for the remainder of my pregnancy I would have heart palpitations. Though annoying, I was able to avoid this with slow movement and increasing my hydration. Aside from this, my pregnancy progressed normally and both myself and my baby remained healthy heading into delivery. Due to Covid restrictions, my hope of having family as a support system during labor was squashed. The further my pregnancy progressed I realized that I wanted some type of support, and through research ended up landing on hiring a local doula. 

Needle Phobia

I have a long-standing needle phobia and anxiety related to IV’s or shots of any kind (weird since I’m a nurse-I know). I always knew that I would have a hard time getting an epidural, especially after watching one be placed during nursing school. I spent tons of time researching hypnobirthing, practicing affirmations, and discussing an epidural free birth with my doula and husband. It was more than just a fear of the needle, I was convinced that if I had an epidural something terrible would happen. I told more than one person that I was sure if I had an epidural that I would end up with a complication (paralysis and infection were at the top of my list of perseverations). I called my best friend and said that there was no way I was getting one and I just had a bad feeling. I was so dead set against having an epidural that my OB scheduled a call with the head of anesthesia to quell my fears. I left the phone call unconvinced. 

Labor

Fast forward to 39 weeks 6 days, I am at my 40-week appt and my doctor schedules an ultrasound due to my increasing (but still normal) blood pressure and the amount of fluid I’m retaining. I had gained 6lbs in a week and was having severe edema to my lower legs as well as my hands. Late-term ultrasounds are notoriously questionable at predicting size of baby (can be off by +/- 2lbs) but my US tech predicted my son would be 9lbs 5oz. Due to my birth size (10lbs) and my husbands birth size (10lbs 3oz), I felt pretty confident that this scan was accurate and began to get very anxious about the size of my baby. My OB suggested an induction that evening, but I declined as I wanted as little intervention as possible. As the days went by, I became increasingly uncomfortable and agreed to an induction at 41 weeks. I got to the hospital on a Wednesday evening and was anxious but also excited to meet my baby. The doctor on call ignored the induction method my OB had ordered and instead suggested we try a cooks catheter. Aka they stick a thin tube into your cervix and then inflate it and attach it to tension. It’s supposed to mimic the baby’s head putting pressure on your cervix and help with effacement and dilation. Well, after 3 failed attempts, a large amount of blood, and a dose of morphine the provider was unable to place the device. My nurse seemed horrified and was apologizing to me profusely, saying that this procedure normally takes just one attempt. I asked her if there was something else we could do, and the provider reluctantly ordered the cytotec that my OB had originally planned for. I continued with irregular but frequent contractions for the next 24 hours. My water broke on its own at about 11:30 Thursday night. The contractions were strong due to the multiple doses of Cytotec. I was laboring with the aid of nitrous oxide and spent some time in the jacuzzi. After 6 hours of almost continuous contractions, we did a cervical check and I was disappointed to find that I was only 2cm. Despite my fear, I requested an epidural. To my relief, it was placed quickly and with no complications and my pain almost immediately disappeared. My epidural was sufficient in reducing my pain, but to my surprise -and joy- I still had really good control of my lower body and was able to move both my legs. I spent the next 16 hours changing positions about every 30-45 minutes with the help of my doula, nurses, and husband in an attempt to spin my baby into an optimal position.

C-section

At 10:30 pm on Friday after 48 hours in the hospital, a cervical exam was completed, I was found to be 90% effaced, 8cm dilated, and 0 station. I had been in labor for about 24 hours and on a Pitocin drip + epidural since around 6 am that morning. I had been 8cm for >4 hours and was diagnosed as ‘failure to progress’. I was told that although my son’s and my vitals were normal it was recommended I have a c section due to the length of my labor and lack of progress. I was exhausted (mentally and physically) and starving after not eating anything but honey sticks and broth for 30 hours. After lots of tears and discussions with my husband and doula, I consented to the cesarean. I was disconnected from my Pitocin drip at approx 11 pm. I was terrified of the surgery and openly crying. My doula had been with me for 24 hours and at one point we made the decision that she would be my +1 for the c section due to my husband’s queasiness (he almost fainted during the epidural placement and wasn’t sure he could attend the surgery). At the last minute, he changed his mind and decided that he wanted to be in the OR. My husband was escorted down the hall to get changed into his surgical scrubs, and I was wheeled to the OR in my hospital bed. At this point, I was instructed to transfer myself to the operating table, which I found odd since my lower body was numb and heavy due to the epidural. Once I was laying flat on the table I began to have severe back pain, what I know now to be ‘back labor’ due to the OP (sunny side up) position of my son. During this time the anesthesiologist was prepping me for surgery and conducting sensation tests, all of which I reported I could feel. It was then determined that my epidural had become dislodged. The anesthesiologist told me that I needed a new epidural. This caused me to have a panic attack. It was difficult for me to even ask for my first epidural where I had the support and presence of my husband and doula. At this point, I’m all alone in the OR with an entirely new birth team as it was just shift change. I declined the second epidural and asked if I could instead have general anesthesia. I sat over the edge of the OR table having really strong contractions. The epidural was difficult to place due to my fluid retention from being on Pitocin and IV fluids all day. Again I stated multiple times that I wanted general anesthesia and that I could not do this as the anesthesiologist fished around in my back trying to place the spinal. I was told ‘yes you can’ and ‘that will not be good for your baby’. It took over ten minutes but finally, the epidural is placed and I am laid back down on the operating table. The anesthesiologist continues to prep me for surgery and goes back to conducting sensation tests. I continue to report full sensation to the right upper quadrant of my abdomen. I am told verbatim, ‘this is very far away from where your incision will be’.  My husband is brought into the OR. I have the strong sensation of my son’s head crowning and ask repeatedly for someone to check to make sure. No one performs a cervical exam. At this point I have been disconnected from Pitocin for more than 2 hours, yet was having active labor of my own and my previous exam showed that I was in transition. Instead of performing a cervical exam and assessing new medical information that could have potentially STOPPED me from having a c section altogether, I was told ‘this is normal’ and that it was because my son’s head was ‘engaged very low in my pelvis’.  Despite all of my attempts to communicate the amount of sensation I had, the surgery began. The surgeon’s report states that I did not complain of ‘real’ pain until the incision was made on my uterus, which is a lie. I remember screaming, ‘I CAN FEEL EVERYTHING!’. At this point, I am begging, flailing my arms and pleading for them to stop. No one stops. Instead, I am pinned down while the surgery continues. I beg for them to put me under general anesthesia, I ask them why they won’t stop. No one answers. 

Once in recovery, I speak with the OB who advised me that they made the call to proceed with the surgery despite my pain due to the risk of administering anesthesia to me and having it affect the baby. She also says pausing the surgery could also be a risk for hemorrhage.  My son was delivered at 1:25 am (9lbs 4oz and 21.5 inches long), at which point the above mentioned risks would no longer have been an issue. I remember seeing him held up over the drape and having one brief second of relief from the pain. Also the fleeting thought, ‘he has so much hair!”’. Though my son was born, I am operated on in this manner, with full sensation, until 1:31am when I was finally intubated and put under general anesthesia for the remainder of the surgery. During these 6 minutes after my son was born I was aware of nothing else except for the agony I was experiencing. Unbeknownst to me, my husband fainted and was laying on the floor of the OR. He then got up and returned to the area where he had been dressed in surgical scrubs.

The physical pain I went through has been so hard to deal with, but I find the things I am having the most difficulty with are the things I missed. The golden hours, the first skin to skin, the taking in our new baby boy in awe together. Instead, I am separated from my husband and baby and don’t get to meet him until almost 2 hours later. One nurse was thoughtful enough in the chaos to find my phone on the floor where my husband dropped it and take pictures. They are bittersweet to look at and remind me that I was not there for those moments, but I am so thankful that they are there for me to look back on.

Postpartum

Immediately after my delivery I was in shock, trying to process my joy over the birth of my baby but so traumatized from my delivery. I had been so worried about a complication from my epidural, but this was a scenario I didn’t anticipate and could never prepare myself for. I had a hard time talking to anyone in the hospital and requested a ‘do not disturb’ tag for my door, but that didn’t stop what felt like 1000 providers and hospital administrators coming to apologize to me. People who are not a part of my birth team kept coming into the room to ask how I was and check on me. Having to retell the story of my birth to a new person every hour left me in tears over and over again. Patient advocacy came to my room and let me know they would be investigating my birth.

When I come home, I finally worked up the courage to read through my medical record. I was immediately overcome with rage. In the middle of my operative report and anesthesia notes the words ‘tolerated procedure well’ and ‘patient satisfied with anesthesia care’ burn through me. I call the hospital and let them know that I want the note changed to reflect what actually took place. The head of anesthesia calls me and assures me that my medical record will be revised. I am told that they are doing an internal investigation and case study on my birth within the anesthesiology department. At the conclusion of their investigation, I ask to be included in their findings. During my meeting the head of anesthesia and chief of anesthesia are present. The anesthesiologist who attended my surgery is sitting 4 feet away from me. She tells me she is sorry, and that she thought she could manage my pain with IV meds once she realized my epidural was insufficient. She says that I was in fact in severe distress from the first incision and that there was ‘a marked change in the atmosphere of the OR’ as they began the cut on my uterus. To me this means nothing because I know that I was in agony both before and after this. She says she will change her charting to reflect that I had inadequate coverage throughout my entire surgery. She tells me that the 6 minutes after my son was born until when I was finally intubated was due to her having to ‘pre oxygenate’ me before putting me under general anesthesia (something I’m pretty sure she should have been doing the whole time). She tells me she also wanted to wait for a second anesthesiologist ‘just in case’ I was difficult to intubate. The chief of anesthesia says she should have never began if I had any sensation in my abdomen. I think…’no shit’. Her apology and explanation do not give me closure. They make me angry. 

I am so angry. I’m angry that I wasn’t taken seriously. I’m angry that it seems like the anesthesiologist had a god complex and thought she was ‘good enough’ to medicate me when she knew I didn’t have sufficient epidural coverage. I’m angry that when she realized she actually wasn’t good enough, I had to wait for a second anesthesiologist to come to the OR, adding so many minutes to what already felt like an eternity. I’m angry that I didn’t get to hold my baby as soon as he was born. I’m angry that now the thought of expanding my family terrifies me because the thought of a failed VBAC or an elective c section seems unfathomable. But I am also so sad. Sad that I didn’t get to see or meet my baby for several hours after he was born. Sad that I didn’t get to see my husband hold our son for the first time. Sad that instead of bonding as a family with our newborn I was crying in the PACU trying to understand HOW and WHY and WHAT just happened to me. Sad that instead of enjoying baby snuggles my first few weeks home from the hospital I was a shell of myself. Sad that instead of looking back at the day my son was born with joy and happiness, I instead remember it as one of the worst days of my life. I’m sad that I can’t talk about my birth story without feeling like I’m scaring someone who is pregnant or might have a c section. I feel embarrassed that I am the birth story that people share in hushed whispers, ‘did you hear what happened to Carly?’. I think in one of your recent posts you wrote that ‘birth trauma is not contagious’, but it sure feels like it is. Mine is not a story that people want to hear. It’s not fair. I feel like a petulant child stomping my foot saying that. But it wasn’t fair, and it was 150% preventable. I think that’s what makes it harder for me to get over. If only one person had spoken up for me in the OR. If only one person had checked when I said I felt my son’s head. If only one person had paused and given me some options or feedback if only the anesthesiologist administered general anesthesia the second she realized I was in pain – then this all could have been avoided.

People process trauma in different ways. While I want to scour my medical record and go over the situation over and over again, my husband’s process is not as vocal. Though we both suffered trauma that day, being in the OR while I begged for help that he was unable to give is something that he has difficulty talking about at length. I think it is too painful for him to relive those memories and that feeling of helplessness. And while he can’t have long chats about it with me at this point, one of the very first things he did when I was still in the hospital was write down his own account of what happened. Reading his words in a way is more heartbreaking than my own memories. I hate that he entered into fatherhood with so much trauma. Becoming a father is a momentous occasion all by itself with all the changes it brings. On top of adjusting to his new role of ‘Dad’, he also was trying to help hold me together. I don’t think he really knows how much he truly did help me those first few weeks home. Not just with the bottles and diapers. When I couldn’t talk, he let me sit in silence. When I cried, he held me. And while this happened physically to my body, I know that it happened to him too.

Because Mac’s birth was such a difficult day, it wasn’t until a few weeks ago that my husband realized he had taken pictures of me meeting Mac for the first time. Finding these pictures was such a gift. I remember having my oxygen on in the PACU and asking the nurse if I could take it off so that I could kiss my son. Somehow my husband had enough presence of mind to capture these images.

Through dealing with the effects of my traumatic birth experience, I have developed a whole new appreciation for trauma-informed care and for the health care providers who practice in a way that supports all of the big feelings that come with trauma. I will never forget my angel of a nurse in postpartum who I was lucky enough to have 3 shifts in a row. I will never forget the nurse who captured my son’s first moments earthside. I am only 6 months postpartum and I know I still have a lot of healing left to do, but I am hopeful and I am trying- and I feel like that’s a great place to start 🤍

The author:

My name is Carly. I am an RN and first time mom from the Boston area. 

STRUGGLING TO HAVE A BABY

Ever since I was young (quite literally, since I had my first period) I’ve wanted to be a mom. It has always felt like the one thing I was meant to do with my life. I was always so careful to use birth control and prevent any unplanned surprises, thinking that it would only take one time to conceive a baby. Turns out, that’s not how it worked out for my husband and I. After a full year of trying (with LH strips, the Ava bracelet, studying my cycle…all the things), we really started to think our time would never come. Who was I supposed to be, if I wasn’t meant to be a mom? We did at home fertility testing that didn’t provide any answers. With further researching, we figured that if the first suggested medical treatment would be an IUI, we may as well try something similar at home first. We used the Mosie syringe system and finally conceived after 13 long, hard months. 

MISCARRIAGE

As soon as we were pregnant, I immediately started researching miscarriages. I had no logical reason why. I felt like I needed to prepare myself. I would have thoughts that I would never meet my baby and could picture calling out of work for a miscarriage but couldn’t picture going on maternity leave. I was so unbelievably anxious. I had gone off of my SSRI for baseline anxiety and depression when we started trying to conceive and at this point the midwives essentially told me I was going back on it. I’m thankful that they did; I think it laid the groundwork for surviving what was to come. The anxiety didn’t ease up. I was anxious enough that they scheduled an early ultrasound for me. I remember a day about two weeks before the ultrasound where I went to the bathroom and immediately thought “something just changed”. I brushed it off as a part of my incessant anxiety. We went in for our ultrasound at 8w4d and found out that our baby had died at 6w6d and that I was having a missed miscarriage. Intuition is a crazy thing. Somehow this still rocked me to my core. We were thankful to have guidance in choosing management options and when we were told we could try to conceive after our first period following the miscarriage. Somehow, the stars aligned, and we conceived our daughter in the cycle after our first period with the Mosie syringe system again. 

PREGNANCY COMPLICATIONS

As a pregnancy after loss, I had anxiety every day and a constant fear of losing another baby. I thought after a clear anatomy scan, I could finally take a deep breath. I was so excited for our 20-week ultrasound for exactly that reason. Instead, we found out our daughter had a single umbilical artery. We had a consult with Maternal Fetal Medicine and went through extensive genetic testing to ensure this wasn’t a small sign of a larger problem. We were thankfully cleared and made a plan for intermittent growth scans to monitor for any signs of intrauterine growth restriction. Maternal Fetal Medicine encouraged me to plan to deliver no later than 40 weeks to prevent the risk of complications, so we went ahead and scheduled an induction at 39w6d. I was optimistic this would be the last complication, until I was diagnosed with gestational diabetes. I was again lucky to have diet-controlled diabetes and not require insulin. I struggled with everything that came up during pregnancy. After our struggle conceiving and miscarriage, it felt like the universe was trying to tell me I wasn’t meant to be a mom. It took a lot of time and work to get through the fact that this wasn’t a sign, just speed bumps on the road to becoming a mom. 

INDUCTION/HOSPITAL ADMISSION

We were scheduled for induction at 39w6d, on June 17th, 2021. We were told to wait for a call from the hospital to be told when to come in. I was so anxious waiting for that call, I just didn’t want to be responsible for noticing when my baby died. It sounds morbid but that was truthfully my fear and my persistent thought. We called in at noon when we hadn’t heard anything. They were so overwhelmed with patients they had that they said there was no way I would be coming in, but offered a non-stress test to check on my baby later that afternoon. I was so upset. My husband and I went for a walk to waste time before the non-stress test. We had multiple non-stress tests before and knew what to expect, so we were happy to at least hear our baby and know she was okay. About five minutes into my non-stress test, numerous staff members came running into the room and had me change positions a few times. Turns out that my daughter had a large deceleration and earned us admission right then. We were on continuous monitoring and waited for there to be enough staff to start our induction. My daughter continued having intermittent decelerations even without beginning induction and I was consented for a c-section overnight that night. They finally started my induction with Cervadil around 6:00 in the morning. The decelerations slowed down throughout the day and weren’t as severe or as long. The Cervadil, unfortunately, didn’t do enough to ripen my cervix for Pitocin. As the decelerations had improved, they decided to utilize Misoprostol throughout the night. The decelerations picked up again but not enough to indicate obvious distress, until the morning. I woke up at 7:00 in the morning to about 14 staff members in my room speaking loudly and moving me around, instructing me eventually to get on all fours and then they lost the tracing on the fetal monitor. Thankfully, the loss of tracing was simply from all the movement and my nurse was able to find it again. This was such a terrifying way to wake up and honestly is not a feeling I’ll ever forget. After everything had settled down, I asked my nurse if I could talk to my midwife team about the risks vs. benefits of continuing with induction versus moving to c-section. The midwives came in and pushed me really hard to continue with induction, despite my concerns. They mentioned a contraction stress test, where they give me some Pitocin to have actual contractions and see how the baby tolerates it, but didn’t think it was necessary. They were using words like “elective” to describe having a c-section which, with a first baby, I didn’t want to choose when maybe it wasn’t the best option. I asked them to involve the OB team, who recommended the contraction stress test as a decision maker. They started the Pitocin, I started to have one contraction I could barely feel, and my daughter went into a huge, prolonged deceleration. They immediately said I needed to go to emergent c-section and we were in the OR in no time. I was so thankful my baby was going to be here safely before anything bad could happen to her. We finally made it to the finish line, it felt like. 

DELIVERY

I went to the OR, got my spinal, and was prepped for section. I made sure to tell everyone who would listen that I wanted the drape to be dropped when she was being born. That was all I wanted from delivery, to see that my baby girl actually came from me. Unfortunately, anesthesia was busy and the drape was only dropped on my husband’s side. I wasn’t able to see my daughter be born. They took her over to the NICU team who was present as it was an emergent c-section. They invited my husband to go meet our daughter while the NICU team was still tending to her. It turns out, she required deep suctioning as she aspirated a significant amount of my blood and she needed CPAP support to recover from the aspiration. Thankfully she was finally cleared and brought over to me as I was almost done being closed up. I started feeling nauseous and got some anti-nausea medication. My IV stopped working right as they were pushing the medication in, but they said it was fine as the case was over. We were wheeling back to the room and I was holding my baby but something was very wrong. The corners of my vision were turning black. I knew something terrible was about to happen and I told my husband to take the baby. I felt myself get so exhausted, my eyes closed, and I couldn’t open them again. My blood pressure was low and continuing to drop. I was given IM epinephrine to make sure I could make it back to the OR where I could get IV access and further intervention. The charge nurse was pushing my bed through the hallway, said “oh sh*t”, and started running. As we came into the OR, I heard her start yelling that my blood pressure was 40/20 and asking who was going to put a line in. The anesthesia team went to work putting a large central line in my neck, an arterial line in my wrist to monitor my blood pressure, and giving me more IM epinephrine. My blood pressure stabilized and I became minimally responsive (an improvement from entirely unresponsive). I went for a CT scan and finally came back to my room with my husband and my baby hours after delivery. They put her on me for skin to skin and I still couldn’t open my eyes. I kept telling my husband to make sure she didn’t fall. I slowly became more awake and more interactive, but was not awake enough to hold her. I was moved to the step-down unit for the night, away from my baby, before even really getting to know her. The nurses on the step-down unit worked hard all night to get my lines out and get me back to my baby in the morning. Wheeling back in to my room on the birthing pavilion at 6:00 the next morning is a feeling I can’t even explain. It was like coming home, even though it clearly wasn’t home. But it was the room my husband and baby were in. That’s what made it feel like home. 

PROLONGED ADMISSION

I was in the hospital for longer than anticipated. Our daughter was born on Saturday and we didn’t get to go home until the following Wednesday night. I had a blood clot from the line in my neck that was occlusive and required anticoagulation. They came in to my room and told me to choose a medication with daily monitoring that would allow me to breastfeed or a medication with no monitoring that would not. With the separation from my baby at birth and the whole first night, not having any education on the pump or how to use it, and struggling to deal with still being in the hospital, it felt like daily monitoring would break me and I couldn’t breastfeed anyways. I was so exhausted again on Tuesday that I couldn’t hold my baby. After some iron and a couple of blood transfusions, I finally felt well enough to leave on Wednesday. After some convincing and a two-day post-discharge follow up appointment being scheduled, my team agreed to let me go home. 

CONTINUED COMPLICATIONS

I continued bleeding for weeks, but was on blood thinners and didn’t think anything of it. The week of my six-week postpartum visit, I started passing large clots (again) and soaking through a pad in an hour. I called the on-call OB who told me that because I was an ICU nurse, I should know when I need to come in and to just go to my scheduled appointment. I called the office the next day and got my appointment moved up. When I saw the OB in the office and told her what was happening, I was so incredibly thankful that she took me seriously. She got me in for ultrasound during my appointment time which showed some sort of collection in my uterus. We made a plan for a D&C the next day after 24 hours off of my blood thinners. They surprised me when they came in my pre-op room to consent me for general anesthesia. I understood the fear of decompensation but was again blindsided. The D&C made me feel better immediately. My bleeding stopped two days later and I had so much energy. They found retained placenta which was likely the source of a number of my problems. I went through some severe PPD/PPA at about three months postpartum. I asked for help and required additional medications to stop myself from thinking that my baby would be better off without me. Thankfully, my PCP listened and found the exact medication for me. 

WHAT THIS MEANS FOR THE FUTURE

They still aren’t sure what happened to me. The best guess is peripartum hemorrhage (during delivery) with formation of a large uterine hematoma while I was decompensating complicated by sudden cardiovascular collapse. The DVT was considered provoked and hopefully won’t occur again. We found the medication that worked well for my PPD/PPA so if it happens again, I’ll know exactly what to ask for for help. My daughter had a single umbilical artery, a short umbilical cord, and an exposed loop of vasculature. The exposed loop of vasculature is likely why she couldn’t tolerate even a single contraction without having her blood supply cut off. Maternal Fetal Medicine plans to do a detailed scan looking closely at the umbilical cord of our next baby when the time comes to ensure we do the best we can to prepare for complications. I am planning on having scheduled c-sections for future deliveries. I think the fact that my baby would have died if I had gone into labor on my own has terrified me enough to not want to risk it with any future pregnancies. The Maternal Fetal Medicine team is ecstatic about that decision, to say the least, and told me I likely wouldn’t have even been offered a VBAC. Theoretically, all of these complications were flukes and shouldn’t happen again. Theoretically.

BIO

My name is Addison and I’m 27 years old. I work full-time as an ICU nurse. I’ve been a loud advocate for miscarriage support since experiencing it and am trying to do the same with my traumatic birth. I struggled to label it traumatic as I received excellent care and, as a nurse, it feels wrong to dismiss the care I received by calling it a traumatic experience. Over time I’ve come to realize that being separated from my baby, missing the golden hour everyone talks about, missing her first vaccines, and not having my one wish for my delivery met truly did make this a traumatic experience for me. My daughter is almost 7 months old now and my husband and I are hoping to expand our family again in a few months. We are working closely with Maternal Fetal Medicine to ensure it is safe, but we don’t want to allow this experience to change our initial plans for a  large family with children close in age.

A Normal Pregnancy & Delivery
My husband Michael and I learned I was pregnant with our second baby in the spring of 2020, due February of 2021. This being our second time around, we knew what to expect and I felt pretty prepared for what was to come. With my first pregnancy, I had 7 months of morning sickness and a PUPPs rash. Otherwise, it was a healthy pregnancy. My second pregnancy went even smoother without the rash and less morning sickness.

Like my first pregnancy, my second went past my due date. We scheduled the induction for a Thursday morning. I was ready to meet my baby boy and was anxious about the weather, which had been threatening snow all week. We checked into the hospital with high spirits. Little did I know, induced labor would be rougher than I ever could have imagined. Compared to my last delivery in which we ended up not needing to induce, induction was a nightmare. I was in labor a total of 24 hours and 12 of them were unrelenting contractions about a minute apart the whole time. My epidural was hardly putting a dent in my pain. The most the nurse could do for me was a shot of morphine to allow me 1 hour of semi-painless sleep. Michael did an amazing job of breathing through the contractions with me. I found myself relying heavily on him to breathe with me.

 Finally, our doctor came in and told me he was ready for me to push. Luckily I did not have to push for long. Michael started the timer on his phone and by the time 5 minutes were up, my baby boy was in our doctor’s hands. I had the privilege of cutting the cord and then spent the next hour holding him, skin to skin. It was Friday morning – 24 hours after starting induction

From there, things were normal. A nurse helped me into a wheelchair and wheeled me to our recovery room. I remember laughing and cracking jokes with her along the way. On Saturday, we decided we wanted to discharge a day early to avoid coming home in an upcoming snowstorm. Had we waited any longer to induce, there was a possibility of me going into labor during that storm. 

Coming Home

Coming home was extremely emotional. No one could meet the baby for the first time in the hospital due to strict COVID guidelines. Our older son who was 3 at the time was home with my in-laws, anxiously awaiting to meet his new baby brother. My father-in-law helped me into the house across an icy driveway with Michael behind us with the baby. I sat on the couch and watched as my two sons met each other for the first time. I sobbed the entire time, so happy to see my family as a whole.

Unexpected Pain

Sunday was my 31st birthday. My family came over with dinner and we had a low-key night eating and enjoying each other’s company. After they went home I went to bed early Sunday night.

I woke up in the early hours Monday morning with nausea and abdominal cramping. It felt like something had a tight squeezing grip on my guts. The pain was unlike what I experienced in my previous postpartum recovery. I was taking an iron supplement for anemia per doctor’s orders and thought it must have both been agitating my stomach. I pushed it out of my head, attributing it to the many changes my body was experiencing.

Things got worse later that day when my nausea led me to vomit. Alarmed, I called my OBGYN and spoke with a nurse. She also agreed it must be Tylenol and my iron supplement causing my stomach upset. I decided to skip them that night to see if I felt any better.

Tuesday was much the same. I decided to try and sleep it off another day and to call my OBGYN again on Wednesday. Wednesday morning I vomited again. I called my OBGYN and the nurse still thought it was the iron supplement even though I had stopped taking it. She said it could take a few days for my stomach to settle. By Thursday morning I began to experience a low-grade fever. My appetite was also non-existent now and the thought of eating anything made me gag. I was lethargic and could not get off my couch. I called my OBGYN a 3rd time. Upon hearing about my fever, they advised me to go to the Emergency Room. We left our toddler with my parents and our newborn in the care of my husband’s mother and sister. Michael drove me to the hospital.

Back in the Hospital

We arrived around 6:30 PM on Thursday. Michael was not permitted into the E.R. with me due to COVID-19 restrictions. Both of us were reluctant to separate. I went into the waiting room alone. He spent hours in the hospital parking lot, leaving only to get a drive-thru dinner, hoping to take me home soon. Finally, around 7:30 PM it was my turn for triage. I described my symptoms and they immediately prepared an E.R. bed for me. They triaged me as high-priority.

The first thing they did after hooking me up to IVs was order an ultrasound. The initial concern was that there may still be a piece of the placenta in my uterus that was causing an infection. They performed an ultrasound on my uterus around 9 PM. Over an hour later results of my uterus showed there was no infection there. The E.R. doctor considered a possible gallbladder attack due to more pain when she pressed on that area. She wasn’t sure though and she told me that she hoped to have answers from a second abdominal ultrasound. If it came to it they may need to perform a CT scan or surgery.

I wasn’t allowed to eat. I was starving and nauseous at the same time which is one of the worst feelings ever. The hunger agitated my nausea even more and I threw up in the ER, one of the nurses getting me a sick bag in time.

Before midnight the ultrasound tech arrived and performed the 2nd ultrasound. Yet another hour or more passed before the doctor came in to discuss the results.

“I believe you may have a blood clot, so we are going to send you in for a CT scan to get a better look at things.”

The words didn’t quite register with me when she first said “blood clot”. I knew little to nothing about them and wasn’t as concerned as I should have been. By around 3:45 AM I went to my CT scan. On the way there, my CT tech explained to me which area of the body they would be scanning.

“They believe the blood clot is in a vein called the ‘Inferior Vena Cava’. It’s one of the largest veins in your abdomen. It collects deoxygenated blood from your lower extremities. This vein is about the diameter of a garden hose.”

The Diagnosis

So far during this process, I was mentally numb. I was going through the motions and placing all trust in my doctors. The CT scan results came back around 5 AM. My doctor entered the room and I called Michael on speakerphone. There was a massive blood clot (Deep Vein Thrombosis or DVT) sitting in my Inferior Vena Cava (or IVC). Clots were in my renal and gonadal veins. They collect blood from the kidneys and reproductive organs. If left untreated the clot would break free and travel through my heart and lungs. This results in death in 25% of cases.

The following moments were surreal. 3 nurses came into my room as well as the ultrasound tech again. I was immediately started on an IV drip for Heparin, a blood thinner. While on Heparin, I would need blood draws every 6 hours to make sure my numbers were correct. At 5:30 AM they performed an EKG while the ultrasound tech scanned my legs for more clots. In most cases, clots of this nature originate there. The on-call OB-GYN also came down to my E.R. room to meet with me.

As the ultrasound tech was scanning my legs, the OBGYN started making small talk with me. My emotional strength finally buckled when we started talking about my newborn. I was missing his first week and that notion weighed heavy on me. I spent the rest of the morning in a constant state of tears. The hardest part of this was that I was completely alone thanks to COVID restrictions. All I wanted was to be home, enjoying those beautiful first days with my baby. I couldn’t be more grateful to my nurses during this ordeal. I was alone and they were as kind and loving to me as my own family would have been. I am forever thankful to those beautiful souls who stood by me.

As I was being prepared to move from the ER to my hospital room, my ER nurse told me I was finally allowed to eat. They administered anti-nausea medication. She raided the pantry for some juice boxes and graham crackers. She also gave me a box of tissues for the endless stream of tears.

Friday at 7 AM I was finally settled in my hospital room. It was my baby’s exact 1 week birthday, and I cried some more. Heartbroken by the fact that I would not be there with him for this small milestone day. To make matters worse, my hospital room was identical to the recovery room we were in after delivery. We were all so happy in that room a week ago, and now I was back in what felt like the same room under sadder circumstances. The doctor who delivered my baby came in to visit me and make sure I was doing okay. He was sorry that this was happening to me and made himself available to me if I needed anything else.

I was so stressed and anxious. Usually, my resting heart rate is in the low 50 BPMs, but after being admitted it stayed at a steady 60 BPM. When Michael was finally able to come to my hospital room to visit me. I hugged him tight and cried into his shoulder. I had only seen him the night before, but it felt like we were apart for days. 30 minutes into his visit, one of the nurses needed to come in and check on me. She had noticed my heart rate dropped from 60BPMs to 50BPMs and she wanted to make sure I wasn’t having a medical issue. I told her no, I was relaxing now that my best friend was finally here. He reassured me that the doctors knew what they were doing. I would survive this thanks to their treatment plan. He remained calm and confident and did an excellent job of hiding his emotions from me. That in and of itself was what helped me settle. It sounds like a cliche, but I truly believe love is one of the best medicines, and this proved it.

Later, I went in for another CT scan around 1:30 PM. This was to check and see if any part of the clot had broken free and traveled to my lungs. The results came back and confirmed a small piece of the clot did travel there, yet I experienced no symptoms. A clot in the lung is called a Pulmonary Embolism (or PE) and it is a leading cause of death in pregnant and postpartum women.

My hematologist explained my diagnosis to me. My blood clots were “provoked” meaning something triggered them. In my case, it was the delivery of my baby. What I experienced was unusual for someone in my circumstances. Blood clots are usually brought on by certain conditions. Pregnant and postpartum women are at the highest risk. Beyond that, there are other risk factors as well: surgery, hormonal birth control, pregnancy after 35, COVID vaccines and illness complications, obesity, smoking, C-Sections, family history, and gene mutations are all known to be associated with blood clots. C-Section deliveries have the highest likelihood of causing a blood clot, and even then they are uncommon, occurring 1 in every 1000 women or a 0.1% chance.

On paper, I was at the lowest risk for a blood clot. I met none of the criteria except a recent vaginal delivery. Of all the people this could have happened to, I was the last person anyone would have expected. Blood clots of this nature are rarely discovered where mine was. In most cases, they are in the legs or lungs. We have no way of knowing where my clot began. There were no clots found in my legs.

During my hospital stay, I remained on nausea medication so that I could continue to eat. My doctors told me that nausea and fever were my body’s way of telling me that something was wrong. Everything would subside in a few weeks as the blood clot resolved.

Discharge

After 2 days in the hospital, my doctors told me I was ready for discharge. This notion scared me, as I felt safe and protected from my own body when I was in their care. They would know before I did if something was wrong and could address it right away. I liked being on the heart monitor for that reason. They would be the first to know if my heart stopped. I was afraid that my blood clot would continue to break apart and travel again. I voiced this concern to my hematologist. She jokingly assured me “Well, not to sound morbid but the clot already ‘got’ you. It can’t hurt you now.” She was referring to the PE.

Before we left we would be taught how to administer blood thinners via an injection. If I wanted to continue breastfeeding, I would have to receive my blood thinners this way. At the last minute, I decided that I would prefer to take an oral blood thinner. Injecting myself twice a day with the likelihood of needing Michael’s help felt like too much to deal with. I had already been through enough and did not want to add to it.

Being unable to breastfeed was upsetting. I wanted to do it right this time since I struggled so much the first time around. I knew I could do better this time. This was one of the first of many sacrifices I would have to make from this blood clot.

When I got home, I remember sitting on the couch with my boys, together again at last. We watched “Finding Nemo” and I cried during the credits. I was thankful that I was alive to do something as simple and routine as watching a movie with my children. The music in the credits made me want to dance with my sons and I was so glad I would be around to dance with them in the future. From dancing in our living room to dancing with them even on their wedding days, I wanted to be around for all of it. This close shave with death made me appreciate being able to do those things even more.

Life after a Blood Clot

Today, 11 months later, I am healthy but I will be high-risk for blood clots for the rest of my life. I take an oral anticoagulant, or blood thinner. My Hematologist decided I will take them indefinitely due to the severity and unusualness of my circumstances. Blood thinners stop the formation of future clots so that the body can resolve existing clots on its own. They do not actually “thin” blood consistency. They are not “clot busters”. Side effects of blood thinners are minimal, causing more frequent bruising, bleeding longer if I am cut, and heavier periods. I need to be aware of the possibility of internal bleeding and brain bleeds in the event of serious trauma like falls or car accidents. Special steps must be taken prior to undergoing certain medical procedures. Any future pregnancies will be high-risk pregnancies. I will have to switch to injectable blood thinners if I ever get pregnant again. I am unable to take Ibuprofen or other NSAIDs as they interfere with my blood thinners. Otherwise, I live a normal life.

In some cases, blood clots may never go away and form into scar tissue. Instead, the body will form a new vein to go around the blockage. On the anniversary of my clot, I have scheduled an ultrasound to verify if this is the case with my clot.

I have spent a lot of time over the last year trying to wrap my head around this experience. Many people, including health care professionals, say that it is a miracle that I am here today. Those early days were terrifying. I was afraid of being alone. Afraid of falling asleep for fear that I would not wake up. My doctor assured me that my clot would not travel now that I was being treated, but the fear still weighed heavy on me. The thought always sits in the back of my mind. I wonder if going through induction had led to my experience as well. My hematologist has assured me that it is unlikely, yet that thought still hovers over me.

I have tried to dedicate some of my social media presence to blood clot awareness. Pregnant and postpartum women are in the highest risk group for blood clots yet it’s not talked about as much as it should be. I recall it being an afterthought in some of my pregnancy appointments. I would love to see that change in the coming years. If nothing else, I would at least want my story heard in the hopes that it helps someone else. 

900,000 people in the U.S. each year are diagnosed with blood clots. Up to 100,000 people die from a blood clot in the U.S. each year. I urge anyone who thinks they or someone they know is at high risk of blood clots to explore the many resources available. I recommend starting with Stop the Clot – https://www.stoptheclot.org/.

About me

My name is Lindsay. I live in a small town about 45 minutes outside of Philly with my husband Michael of 5 years, our 2 sons Lucas (4 years) and Logan (11 months), and our dog Panda. I work full time as an Underwriter. I have recently gotten back into horseback riding after taking 2 years off during my pregnancy and blood clot recovery. I enjoy going camping and down the shore. I’ve recently found a love for gardening & houseplants. I am also an avid reader and have challenged myself to read 24 books in 2022. I take every moment I can and take my sons on adventures and excursions – seeing them smile makes me smile.