Story of my Learning About BT

My story does not involve loss of life, a near-miss, or surgery, and it is complex, spanning my entire reproductive, and perinatal experience. I struggled for such a long time, and actually still do, to a lesser degree, with feelings of guilt surrounding the fact that I felt traumatized by my experience, and that its impact on me has been so profound. But a quote I recently discovered by Viktor Frankl, has been so helpful in how I think about trauma. The quote, from man’s search for happiness, draws an analogy between human suffering, and the behaviour of a gas that is pumped into a chamber. The gas completely fills up the chamber, no matter the size of the container, which is helpful in considering trauma as a complete all-consuming impact on the mind and soul, regardless of it’s perceived “size”. This analogy helps me understand that all trauma is valid, and deserving of compassionate space, and support. It burdens the mind, body, and soul to such a profound degree, it is all-consuming, and it all matters.

My Own BT Experience

While I don’t feel able to share specific details about my entire experience (and also don’t have awareness of all of the details surrounding the birth), I can freely and openly share about it in more general terms. I experienced infertility issues before spontaneously becoming pregnant, which happened after a “chemical pregnancy” following unsuccessful rounds of fertility treatments in late 2019. I hadn’t even identified or processed the loss of that embryo as a “loss”, until exploring things further in therapy much later, but it’s impact and burden on my mind and soul were extremely significant.

While I was pregnant, I never quite felt how I had expected I would. I felt anxious, completely preoccupied with worry, and terrified that I would somehow lose the pregnancy, or even that it wasn’t real, but a result of the hormone therapy somehow. I also welcomed my son in the late spring of 2020, during the first wave of the pandemic, so for much of my pregnancy, severe health anxiety and constant risk assessments, along with my shattered expectations of what pregnancy would look, and feel like, further traumatized me. The entire perinatal experience was so devastatingly isolating, and especially during the first year postpartum, I suffered from severe depression and anxiety symptoms.

The actual birth of my son is where my story gets further complicated still, but in general terms, I felt traumatized by obstetric violence, provider neglect, and a complete lack of informed consent, during a rushed forceps delivery with an episiotomy. There were so many masked and face-shielded professionals in the room at my feet, I don’t know who they were, or even what their titles were, I know I was told that my sons heart rate was rapidly decelerating, but I didn’t know what that meant or if he (and I) were ok. Through circumstances beyond anyone’s control, my husband was unavailable to me during much of the birth, which again felt traumatizing through isolation, and I felt like I had no voice and no information about what was happening. Only afterwards I found out I had had a forceps assisted delivery, an episiotomy, and later in my shared recovery room (an environment which was horrifying to me during that first-wave with no vaccines and little information about the virus) we discovered that my newborn son was experiencing rapid breathing, and had some excess fluid in his lungs. 

We were so isolated in that room. With no information. Hours and hours alone with little to almost no updates at all, and never from the same professional provider. When could we leave? Were we all gonna be ok? Is something terrible going to happen? Is my son ok? Will he need to go to the NICU? Also, WHAT THE F just happened in that delivery room?!? We stayed in our recovery room on the L&D floor for 3 days and 2 nights. I still don’t fully understand why. I knew they initially said they wanted to monitor my son’s breathing, but where was that monitoring? We were largely ignored during the recovery stay, and left completely alone on that third day until finally being discharged by another new face, in the late evening. I knew I was not at all feeling ok, but I also knew within the depths of my soul I had to get my son home. We were not safe here and we had to get out, I remember thinking.

In the early weeks and months postpartum, I was obsessed with checking on my son and hearing his breathing, watching his chest and belly as he breathed, obsessing over the monitor as he slept. I constantly thought I heard him coughing or wheezing or gasping, I felt completely neglected and isolated, and I needed so much more support (and an assessment toward treatment!). I have begun the process only recently, of obtaining my personal health records from the hospital where I gave birth, although that in itself has been such a headache of a process to make any headway with. But I am appreciating the fact that I am ready to better understand what happened during my son’s delivery.

As I wrap up my story, or the version that I am able to share at this point in time, I do want to share that I am receiving treatment for my mental health (for me that includes medication), I do feel hopeful, I am NOT OK some days, and I accept that someday is not forever. I hope this story helps to empower anyone else who is feeling a sense of guilt surrounding their feelings about their experience. Also, I hope anyone reading this understands that all Birth Trauma is valid, that it deserves so much more support, and that there can be hope.

Bio

Name: Krista Fraser-King

Instagram: @mindcaremomma

Personal blog: mindcaremomma.com

Facebook group: First Time Moms of Covid

Location: Ontario, Canada

Pregnancy Journey

My daughter Julianne was brought into this world at 11:21 pm on Tuesday, March 26, 2019. Just shy of three years later I still get a lump in my throat talking about the process of bringing her earthside. Jules is the light of my life, and although I bask in all of the glory of being a Mama, as I know all too well the overwhelming ache women experience longing for a child of their own, I can’t help but feel relieved to know I am not alone as I continue to process the trauma from a moment in my life I never imagined would bring such feelings. 

My path to conceiving Julianne, at the time I thought was extremely difficult to which now after the proper education, I think it is quite normal. It is the lack of education for women on how to conceive/know their bodies, how pregnancy can be SO hard, how extremely difficult bringing a child into the world CAN be, and how feeling depressed postpartum is NOT uncommon– that brings about these expectations I think we all have for ourselves as soon as we start to try, or unexpectedly conceive. It took me eight months to conceive Julianne, and each month I cursed my body and grew further away from the happiness I wanted to feel. 

I have a video of when we found out I was pregnant. I still watch it to this day, because I remember thinking ‘this is finally happening’, not having any idea what my journey would be to follow. Around week five I became extremely sick, almost borderline HG sick.  I was a teacher at the time teaching Kindergarten, and let me tell you, finding the time to pee during teaching when pregnant was difficult enough, but now finding the time to puke, forget it. My husband and I finally made the decision around thirteen weeks for me to quit teaching, and become a homemaker. I am extremely lucky to have done this so early in my pregnancy. I luckily had a better second trimester when my nausea subsided around sixteen weeks, and I began to breathe. It was around the cusp of my third trimester I found out I had gestational diabetes. 

I had to go on a special diet (oh and I am a vegetarian so super fun to kick the carbs, NOT), I had to prick my finger four times daily, and I had to inject myself with insulin morning and night because I could not control my fasting blood sugar with diet, and exercise. My OBGYN who I do love so much, made the call to induce me at thirty-eight weeks and five days. I looked at my calendar, and this would put me at being induced on Sunday, March 24. My OBGYN was also very reassuring that the induction process would be a breeze, and she would be able to deliver my daughter herself on Monday, March 25. 

Well, the 24th came before I could blink, and soon I was Sitting in a hospital bed signing papers waiting to meet our little girl, and begin the induction process. 

Birth Journey

Now, before I continue my story this is a little disclaimer that some of the events that took place I do not think are common, and my daughter’s birth story truly is what we like to call, a perfect storm. 

I honestly did not make a birth plan. I had a couple of wishes as far as who would be in the room, what music I wanted to play, and that I would accept an epidural. Other than that we went in with clear intentions that we understood things could change on a dime, and we just wanted a healthy Mama & baby. Saying that out loud now, makes me cringe because although we are both physically healthy, I am still struggling mentally as I mentioned before. 

We checked into the hospital on March 24th, 2019 at 9:00am. My induction plan, I was told, was to start with a medicine called Cervidil, which is inserted like a tampon into your cervix to help prepare it for delivery. This happened around noon, I think, a lot of the minor details are still fuzzy to me. I knew around four in the afternoon something was wrong. I was not progressing, and I was in extreme pain. I could not even move my legs for a nurse to check me, and by 5:00pm I was the woman you see in movies who is screaming in pain, and the whole floor can hear her although I was not anywhere close to pushing. Finally, an unbelievable nurse said, “this is not in here right”. To which I replied, “then get it out.” I had to grab my husband with every ounce of my strength as she reached into my raw vagina, and removed the Cervidil insert. I was crying, my husband was crying, and my mother was crying. It was already not what I had pictured. This same nurse recommended I go down to Labor and Delivery (I was currently on an antepartum floor) to receive a walking epidural for the pain. 

Next, after being on the walking epidural, I was comfortable enough for an OBGYN to check me, see how far along I had made it, and then made a decision on how to proceed. She decided to insert a Foley Balloon which I do not remember feeling. All I remember is hitting that green button for more medication every time it shined and passing out over and over. Next, I do remember another OBGYN breaking my water somewhere on Monday the 25th as well as starting me on Pitocin. I don’t remember seeing my OBGYN on the 25th, and I started progressing a bit after this, but it was not until Tuesday morning the 26th that I really started to show progress, and I asked for my first real epidural. I say first because I actually received three. 

There were complications with each epidural to the point that the anesthesiology team asked my mother if I have ever had a spinal injury (I haven’t). I guess my spine was reacting as one that had something out of place, and it took three epidural placements to get one that worked. After that, I slept, and I slept A LOT. Even though nurses kept waking me for blood sugar levels, or anything else they needed, I tried to sleep, now forty-eight hours past my original induction time. 

I remember around 8:00pm on March 26 the midwife asked me to start pushing. I do remember taking note of the time in my head because I was excited my daughter may be born within the hour. Well, at around nine forty-five, when I was losing steam, the midwife yelled ‘you’re almost there’, to which I replied, ‘You’ve been saying that for almost two hours now’. This is where things start to get really fuzzy for me. 

I remember blacking out, I remember having the conscious thought I can’t do this, and I am done. I remember my husband catching my head as I fell to the bed, and then I remember waking to the sound of his voice asking ‘are you still with us’. I remember looking in the corner to see my Mom bawling, I remember oxygen being put on me, and I remember an OBGYN stating he was going to try a vacuum assist. I don’t remember anything about the vacuum assist, and my husband actually thinks I was unconscious the last time he tried, making a total of three attempts. 

I also know now after three attempts, they do pull you in for an emergency C Section. I remember the room getting brighter, I remember two nurses holding me up for my spinal, and I remember being laid down. I blacked out again. I then remember my husband coming in, and holding my hand. I remember hearing his voice shake, and the anesthesiologist reassuring me I was breathing (I couldn’t feel my chest move, and was anxious I was not breathing). 

Then as if greeted by a warm sunrise on a cold winter morning, the blue shade was lifted before my eyes, and my daughter appeared at 11:21 pm. I remember thinking once more ‘this is finally happening’. They let her touch my face, and I still remember the comfort her touch brought. I remember trying to comfort her right back with my voice. Then I remember my husband leaving my side. 

The next thing I knew I was in a recovery room, looking over at my husband cuddling our little baby girl and a nurse begin to explain to me how to breastfeed (Yup, barely conscious, but let’s learn how to breastfeed.) I don’t remember much of the next twenty-four hours after this. I don’t remember certain visitors ever coming, or leaving. I don’t remember much of the first precious moments with my baby girl. I don’t remember being in pain, or even eating. I just remember being extremely tired. 

Motherhood Journey

Somewhere around the morning of Thursday, March 28th, I remember waking very early to my daughter’s cry. We were successful at breastfeeding, and I spent the entire day learning everything I could about her sounds, her smells, and her touch. I was finally able to start feeling a little more human using the bathroom, and eating take out food. My husband had not left my side in almost five days and was exhausted. I am truly grateful for the human being he is, as I would have never made it here without him. I remember him caring for me, and our baby girl that day like he had been doing it his entire life. I just remember falling asleep that night thankful for my family.

Friday, March 29th we were discharged from the hospital after I begged to leave. I had been there a total of five days, and I was not going to spend another night in the hospital. We learned before leaving that Julianne was diagnosed with Jaundice (this did resolve within a week), and we made her first pediatrician appointment.  

After this, we dove into being parents to our little girl. Late-night feedings, diaper changes, night sweats, pain medication, and getting to know one another. I truly do remember feeling happy. Around seven weeks postpartum I started to dread breastfeeding. I did not connect with Julianne this way, and it just seemed like a chore that caused us both pain. I went to my eight-week postop appointment where my OBGYN was encouraging about not breastfeeding any longer if it was causing me to become depressed.

Around three-months postpartum, I was back in the office asking for a referral for a therapist. I blamed it on being too young, too inexperienced with newborns, or having too many expectations for the shallowness I felt inside, and the overwhelming anxiety. I am thankful to have a therapist who is experienced in postpartum depression, anxiety, and trauma. She made it very clear to me how traumatic my birth was, and how it was ok to feel like I needed to grieve, process, and heal from it. What a strange, yet freeing sentence to be able to finally understand it is OK to need to take care of me in the process of learning how to be a Mama. 

I’m still learning every single day. I have done different types of therapies with my therapist to re-process my traumatic birth, but my journey is not over. My husband and I actually decided to try for another baby in 2020, but were unsuccessful. I was diagnosed with secondary infertility, and because of everything I have been through, when we were presented with fertility treatments my husband said something shocking and much needed. He looked at me with his sweet eyes and said, “Babe, it’s YOUR body. You decide if you want to do this, or don’t want to do this and I will be here with you every step of the way either way.” 

My therapist and I talk about how freeing that was for me. The expectation of having two+ children was now different, and something I didn’t want. I am different. My trauma changed me, but it did not cripple me. I enjoy every single minute of being Julianne’s mama while learning to love myself in the process. I’ve learned I’m different, but still the same in other ways. Maybe all mothers experience a transition like this. Mine just felt more drastic as soon as I was freed knowing my trauma was validated. Hearing others’ stories of their traumatic births was oddly healing for me as well. I have also decided to apply to a master’s program to get my MA in clinical mental health counseling because if I can help a fraction of the women out there the way my therapist has helped me, I would be forever grateful. To know I am not alone, in how disconnected I became from my birth story, and to know my feelings of grief for my birth story are valid is still comforting to me. I can only hope my story allows for the same sort of comfort for someone else who has been through something similar. 

A Little More About Me 

My family and I live right outside of Orlando, Florida. My husband and I have been together for almost eight years. I have a Bachelor’s degree in Early Childhood Education, and I am applying to Master’s programs for clinical mental health to pursue my true passion later this year. My daughter is almost three, and we have a blast every single day (while she tests my patience). We have a little aussiedoodle named Lady who has completed our family earlier in 2021. I am obsessed with reality TV, Disney World, and jumping rope (favorite exercise). Julianne would like everyone to know her favorite show is Bluey, and she loves mac and cheese (typical toddler.)

 Phoenix. According to an ancient legend, this mythical bird is known for burning to death and rising from its ashes. A symbol of renewal and birth. For four years we spent an adventurous time full of personal growth in Phoenix, Arizona where we would gain inspiration for the name of our second born, Phoenix Kingston-or what we like to call him, P.K. Little did we know, this name would correlate with the experience of our own little miracle boy who rose from the ashes himself.

Prolapsed Cord and HIE
Eating potato wedges. This is the last moment of peace that I remember before my traumatic birth experience. With my second child, I promised myself to opt for a natural birth. I already knew the feeling from my first child. The cramps, the tightness, the lowering, I felt it all. I breathed heavily and in between each breath my husband was fueling me…with potato wedges. I told myself, “I’ve got this.” As I switched positions, my water broke and I was 8cm dilated. This is it, here I go. What happened next was very unexpected. The cord came out first. I had no clue what that meant but there was a pause in the room. In an instant I heard rushing around and my midwife telling me to quickly flip over. This is not how this should be. I was getting ready for the mountain, the ring of fire, the moment I meet my only son. A prolapsed cord is a rare occurrence that needs immediate attention and a very immediate c-section for my son, who experienced a lack of oxygen, blood flow to the brain, and eventually swelling of the brain or HIE. I could sense the nurses and the midwife’s mind snap into a quick rehearsed reaction. They knew this was a medical emergency, they have practiced this situation before. At 8cm and no epidural, I was screaming and being wheeled quickly to the surgical room. My husband was left behind. In between the chaos, I remember letting out moans and screams from the stronger contractions—then I began to cry. I could see a bright light and a scrubbed-up team that I barely recognized now. In between my screams of pain, I stared at the bright light. I quickly asked myself “Will he be ok? Will I be ok? This contraction hurts!” I asked in tears “where is my husband?” It wasn’t until my midwife powerfully said, with all seriousness in her eyes, “Angie, you are having a c-section. I know this is not the plan…but I AM NOT leaving you.”  I had to let go and let God. As my eyes swelled up and my lips tightened, I nodded my head in understanding, like a little girl trying to be brave. It was time to be a good patient. It was time to trust the team and it was time to trust what happens next. My on-call doctor arrived and quickly performed the surgery in her flip flops. There was no time. I am grateful for every second that was spared.  

Anesthesia was far beyond my plan, I like to feel and have issues with losing that sense of control. My son was described as floppy with multiple Apgar scores of one. After about ten minutes of a bag and mask ventilation he spontaneously started breathing on his own. Before that, my husband already began grieving his possible death. I missed this pivotal moment in the story because of the general anesthesia. I woke up fuzzy back in a different room. My first question was, “Does he get to stay here with me?” “Yes.” And I sighed with relief. I was so happy that I did not register that I never held him or saw him when he was born. I never saw them resuscitating him. I never got to console my husband. They wheeled my bed to where he was so I could at least hold him for a short amount of time. When we did skin to skin, I remember crying and just telling him, “We are ok, we are ok” over and over. He stopped crying and he needed me, I could tell. Hours went by and I thought it was finally over, but they came back in my room to tell me my Phoenix had a seizure, and he would be transferred an hour away to the NICU. At the hospital, they began hypothermic cooling therapy to help with his brain swelling. It was storming so instead of a helicopter the NICU ambulance drove down immediately to take him to the hospital. He cried for hours while they wired him and tried to give him morphine. I was not able to feed him due to the cooling process. He was so inconsolable, the nurses placed him in my arms for a few moments and he immediately stopped crying. The nurse quietly said, “Good job, mama.” I felt a small sense of fulfillment, like I was right where I belonged.

 I sat in my wheelchair and watched in tears as they wheeled him away. The days were long, and my recovery was lonely. We drove back and forth an hour each way every day to see him. I needed to be with my daughter and my son every day so that required a lot of movement for me instead of healing. When we finally brought him home, I became terribly ill and was hospitalized for three days. As I was in the hospital, I was in so much malaise. When they took my blood the lab technician said, “I remember you. You are Phoenix’s mom. That boy is a fighter.” I smiled and closed my eyes. Those few nights without my family were so lonely and I just wanted to heal my body and go home to my babies. I always praise my resilient Summer, who was a one-year-old at the time, and my strong husband for this difficult time in our lives. They are the true underdogs in this story. The days that followed were filled with wonder, worry, and multiple appointments with occupational therapists, neurologists, and pediatricians. I often struggled with questioning myself and wondering if I was keeping track of his progress well enough, or if I was missing something. The worry will always be there, but the ability to remain present with my children took some time. 

Phoenix is now two and a half years old. He was recently released from neurology and occupational therapy. He is so strong, brave, and excels in all his milestones. I am forever grateful for him, the care we received, and having the platform to share my story with other struggling mothers who are stuck in the unknown. 

EMDR Changed My Life 

When we are mothers to a newborn our focus shifts. Our instincts kick in and we become this nurturer and selfless caretaker. We are deep in motherhood. How do we have time to think about what happened during our delivery? He is ok, right? For a little over a year, I cried to myself and had bouts of anxiety, almost blacked out a few times. Silently, I felt I was not allowed to have a reaction; remember he is ok. The sound of surgical tools clanking, beeping machines, and that distinct hospital smell would put me in a trance. I have had panic attacks in inconvenient places. All his cries, every time I was in a hospital, and every thought was not just a vivid memory; I was still there. Trauma does not care if you know there are far worse outcomes. After a lot of research, I signed up to pay out of pocket for a therapist who specialized in Eye-Movement desensitization reprocessing and trauma. I was treated for PTSD. Each session was not easy but every day I threw myself into the arena. Eventually, I would walk in with a big sigh and say, “ok Doc, Let’s do it.” Through EMDR I was not just treated for trauma, but I was educated on neuroplasticity. Our neural networks in our brain can be reorganized and reprocessed. Through this exhausting therapy, I was able to reprocess the past in a healthier way. I felt like I completed a marathon in my head. In return for putting in the work, my thoughts led to me eventually saying “that was awful, stop saying at least and comparing yourself to others.” Thinking of what could have been worse should not be a coping mechanism for big events. What happened was rare, my reaction was normal. After therapy, my brain saw my memories as a movie from the past simply playing and I was not there anymore. I finally saw my son for who he was. A miracle. 

 About The Author

Angela White is a military spouse who graduated from the University of Central Missouri. Her background includes financial services, education, and working for the department of defense. She currently stays home with her two toddlers, Summer and Phoenix, near Destin, Florida where they enjoy many trips to the beach. Occasionally, she assists her active-duty husband on his veteran-based podcast, HeroFront, that encourages fighting the mental health stigma through stories of resilience and success. By being open with her struggles, she continues to help other mothers heal and feel less alone.

Prior Birth Complications and Trauma

My first pregnancy was relatively uneventful, but we were shocked when I delivered a full-term baby at barely 5 lb. He ended up needing to be transferred to another hospital for NICU care. My doctors said it was probably a fluke. In my second pregnancy, they monitored me a little bit closer, and unfortunately, our baby girl was already measuring small at 16 weeks and I was diagnosed with IUGR (intrauterine growth restriction) and placental insufficiency. The whole pregnancy she continued only growing half what she should have. I was monitored extremely closely with twice a week fetal surveillance starting at 25 weeks, and eventually at 33 weeks I had to be hospitalized for full-time monitoring as the umbilical cord was barely flowing. The doctors induced me at 35 weeks and she was only 3 lb, about the size of a 30-week baby. During that whole ordeal, the thought never crossed my mind that she could have died – that they were doing so much monitoring on her because of that risk. I naively was only worried about how long we would have to stay in the NICU. Thankfully we were able to get her earthside. Looking back on this experience, I can see now with clarity that I was surviving through the trauma of these complications through dissociation and avoidance practices. I never allowed myself to process any of what happened to me. And in hindsight of everything that followed after, I now see that the avoidance of processing this initial trauma only made future trauma more compounded.

 After she was born, my doctors finally admitted that there must be a problem and ran a bunch of tests on me. The tests came back positive for Lupus and a rare blood clotting disorder called Antiphospholipid Antibody Syndrome, which can cause severe pregnancy complications due to placental insufficiency. I was told if we wanted another child, if I took daily blood thinner injections and Lupus treatments then it would take care of the problem and we could have a healthy baby. It felt great to have answers and I felt so confident. I did everything I could to make the next pregnancy successful – I lost weight, was exercising, and we did preconception counseling with our OB plus two specialists to plan out what medications I should use. We were excited.

 Olivia’s Pregnancy – Antenatal Complications

 We conceived quickly, and for the whole beginning of the pregnancy I was thrilled. I took the injections every day – I was excited imagining what it would be like to take a baby home right away and not have to go to the NICU. I was so naive taking for granted that this treatment would work. Unfortunately, again at 14 weeks, our baby girl was showing signs of IUGR. I still never thought anything would happen to her – my second child made it! No one really explicitly told us that IUGR was a leading cause of stillbirth or that we should be worried. At a 17 week scan, her growth was even farther behind. She was literally measuring at less than zero percentile, which I didn’t even know was possible. But her heartbeat was strong, and the umbilical cord flow was still in the healthy range, so I had great hopes for her and big dreams about bringing her home to our family. I started to have doubts when I joined an IUGR support group online- it seemed like every story I could find that talked of a baby as small as her at this early in the pregnancy ended in stillbirth. It was then that I began to fear. My continued trauma had me living constantly in a state of hypervigilance and anxiety. I know now that my traumatized mind was never allowed a moment of rest. And at the time, without awareness and knowledge of trauma and how it was affecting me that spaces like The Birth Trauma Mama has provided me, I didn’t know to seek help. I thought what I was experiencing was normal.

 Olivia’s Birth

At 18 weeks, we went on vacation to visit my husband’s parents in Michigan. I was just sure everything was going to be fine. Our baby girl was really active, and I felt her moving around all the time, including the night before we left. Unfortunately on the plane, I started to bleed, and I realized I hadn’t felt her move most of the day. I hoped against all hope that I just hadn’t felt her because we woke up so early and were running around getting ready to leave. The spotting got heavier, and I started cramping too. In my heart right then I knew something was wrong and I think in my heart I knew she was gone.

My husband’s parents picked us up at the airport and I told them right there in the parking lot that I needed to go to the hospital, that I thought I was miscarrying. Here I was, in another state, away from all my doctors who knew my medical condition and would take great care of me – I knew this was going to be bad. On the way to the hospital, I started having regular contractions.

Hospital Trauma

When we walked into the ER, they asked me my due date. They said I was ONE DAY before their cutoff to be able to go straight to labor and delivery, that instead I had to go to the ER. I started crying profusely right then. Somehow I just KNEW that the ER was not going to be the place I would get the best care. I begged them to let me go to labor and delivery and they said no. I was SO mad at myself for not asking the cutoff first – I could have just said my due date was one day different and had a much better experience. But no, I was faced with no compassion and sent to the ER, in a room with no private bathroom, while in labor. I had heard horror stories of women miscarrying in the ER – I saw myself becoming one of those statistics before my eyes, and with a fully developed baby so agonizingly close to viability. I couldn’t believe we were not given the grace to give birth to our baby in an actual birthing space.  I waited for what seemed like an eternity in that non-private ER room with just a curtain and no door, having full-on regular labor contractions, in excruciating pain with the refusal of pain medication. I had to wait for an ultrasound tech to come pick us up, which took forever. They told me my husband couldn’t even go with us to get the ultrasound – I put my foot down and INSISTED that he go with me or I wouldn’t go, so they finally let him. I had to sit there getting this ultrasound, where they wouldn’t even let us see the screen. But I heard the complete static in the place where I knew her heartbeat should have been. And it was over way too fast – two minutes and we were done. I knew it then and the devastation was already kicking in. But I prayed against all odds that maybe I was wrong. Maybe she was still there. Maybe.

What seemed like hours of pain and contractions later, the nurse finally came and told us what I already knew – that she was gone. We cried together. I can’t believe how much I cried. But soon the tears stopped when the contractions got even stronger. I had to give birth to our sweet girl, who we named Olivia right there in the hospital.

The nurses and staff were completely dismissive of my emotions. I insisted on being taken to labor and delivery to give birth to her. I just knew that the nurses there would have training in how to help me with compassion and sensitivity to grief. But they kept saying they “paged an OB” and “he wasn’t answering.” They still couldn’t give me anything for the pain for that same reason. I kept asking them to page again – I was pacing around in so much pain from the labor. The PA who was waiting on the OB was clearly clueless – she at one point told me they might just send me home with drugs to “pass everything.” A quick Google search told me that protocols do not call for that when a patient is that far along in pregnancy, especially on blood thinners, as the risk of hemorrhage is way too high. I told the nurse “I shouldn’t be here – I should be in labor and delivery,” to which she replied “it’s really a gray area…” (presumably because my baby measured smaller than her gestational age), to which I replied – “MY LIFE IS NOT A GRAY AREA.” Losing your baby is traumatic no matter what the circumstances, but facing that in the midst of completely uncompassionate, uncaring, and unqualified providers and being at the mercy of a doctor “not answering his page” while facing the tragedy of your life – being in a non-private ER room while in full-on labor with a dead baby – that added a whole other layer of trauma that I can’t even begin to describe.

My contractions got much stronger and closer together, and I felt sure she was about to be born. I started panicking – I was NOT going to let this baby be born in this ER room. She deserved better than that. I deserved more than that. A thought popped into my head – I need to call labor and delivery myself. I grabbed my cell phone and dialed the same hospital I was sitting in, right there from the ER room, and explained what was going on. The nurse I talked to was appalled they had kept me there so long. She profusely apologized, and an OB was in my room within 5 minutes, I was given something for pain shortly after, and I was upstairs in a labor room in another 15 minutes. I was so thankful that the thought to call came to my mind, but wished I had thought of it sooner.

Upstairs, as I had hoped, the nurses and staff were so much more caring and compassionate. They walked me through everything that would happen and treated us with dignity. The room was much more peaceful and I had a private bathroom. I labored for another 30 minutes or so, and then she was born. I was standing and since she was so small, I didn’t have time to call anyone. I caught her myself which was terrifying, but something I’m so proud of looking back, that I was strong enough to do that in the midst of the pain and the screaming tears. We hit the call light and we had about 5 nurses and the doctor in our room in less than 30 seconds it seemed like – they were so attentive and caring. I can’t imagine if that had happened in the ER room – I probably would have had to hold her standing there bleeding for SO long before anyone came if we were still there. But instead, these sweet nurses took care of my Olivia with dignity and made sure I was safe and well with compassion.

I held her after. She was so very tiny from the growth restriction, but I could tell she had the same sweet facial features as her older siblings. She was beautiful. My biggest regret, one that will haunt me for a lifetime, is that I didn’t take any pictures of her. I thought I wouldn’t want to remember how small she was – that was, after all, what caused her death. I thought I would want to remember her by her ultrasound pictures when she was still alive. I had no idea that was something I would want later. So I didn’t, and I declined when the nurses offered to. The reality that I don’t have these pictures to remember her by is something that hurts me every day. They gave me another medication for the pain, and unfortunately, it made me extremely sick. I was vomiting and seeing double the whole time I had with her. Because I was so sick, I didn’t hold her as long as I wanted to. That’s another big regret I have. I have had to tell myself over and over “I did the best I could, in the time I had, with the support I was given.” I was not given the support to know what to do in this traumatic experience I knew nothing about. 

I asked the nurse to take her away way sooner than I should have because of the sickness. I spent that whole night crying in bed, wondering where she was – I knew she had to be in a fridge somewhere, but what did they put her in? These are haunting thoughts you never even imagine yourself thinking. I wish I knew it was okay to ask to see her again after I wasn’t throwing up anymore. I wish they had offered so I knew it was okay.

Processing the Trauma

In the weeks and months following her birth, I started having extreme panic attacks and anxiety. I couldn’t quit replaying the experience over and over in my head. The extreme desire to find answers and meaning for what happened to me was obsessive. At my darkest point, I stayed up all night long researching fetal autopsy and pathology reports trying to grasp at anything to explain what happened to her. Deep down I knew this behavior was not normal and I shouldn’t be doing this, but I was so shattered that it was all I could do. I stopped sleeping. I don’t even feel like I fully grieved her – I was too busy suffering from the symptoms of the trauma of her pregnancy and birth that I didn’t allow myself the luxury of grief.
I finally realized I needed help. I sought out a local counselor who specializes in both trauma and grief and began EMDR therapy. EMDR was so very hard. I found myself reliving her birth over and over. But as I pressed on in therapy, I found her birth becoming less traumatizing. I found clarity in being able to remember her birth and remember what happened to me without shattering. I realized so many new things about my experience and feeling new things. Realizing that the way I was treated at the hospital – being left alone and unsupported in the very place you came for help – was at the root of my trauma, and was something I didn’t deserve and couldn’t control. But I could take control in processing that trauma and moving towards healing from it.

Years later now, I still feel like I should get back into therapy to make more connections in the way my body processed the compounded trauma of my previous birth complications, and even to explore how unrelated childhood trauma ties into my experiences as a whole. I have much work to do and spaces like The Birth Trauma Mama make me realize that the work is valuable. 

Helping Minimize Trauma for Others, For Olivia

As I was processing my trauma after her birth, I felt a strong pull to do something tangible to prevent other women going through infant loss from facing as much hospital trauma as I did. I don’t want any other mom to have to process both the grief of losing their baby on top of unfair and unsupportive treatment from hospital staff. I want moms to be able to deliver in hospitals with well-trained staff, who are equipped with tangible ways to lessen the trauma for them. To support them in holding their baby and making memories so they’re not haunted by regrets for the rest of their life. To shatter the silence by bringing to light the taboo subject of stillbirth and infant loss that shouldn’t be taboo with how common it is. To give a voice to others. To give a voice to myself.

I read about a device called a Cuddle Cot or Caring Cradle. They are special bassinets for a stillborn baby to lay in that keep their body cool, to allow the family more time to grieve and process before they have to say goodbye to their baby forever. When a baby is stillborn, his or her body begins to change very quickly, and families usually only have a few hours with their baby before the nurses have to take the baby’s body away. The Caring Cradles allow a mother to keep the baby in-room with her for as long as she wishes, even up to days. Although the concept may seem morbid to those who haven’t experienced infant loss, being able to say goodbye to their baby on their own time, and to have plenty of time to make keepsakes such as photos and footprints without being rushed truly helps prevent some of the trauma. Having nurses who learn how to use the Caring Cradles and have candid discussions about how to implement them effectively makes for a more supportive staff. And there is a whole demographic of moms who, due to severe medical complications, may not even be awake when their baby is born. The Cradles are priceless for these cases- allowing mom time to recover medically and still know exactly where her baby is and/or having the baby in-room right away when she recovers. Although I know these devices cannot remove trauma from the infant loss equation, I truly believe deep in my heart that they can make a big difference in limiting that trauma in so many instances. 

Through sharing Olivia’s story and those of many others on social media, I raised $15,000 for a nonprofit whose mission is to purchase these cradles for hospitals. I was able to place three Caring Cradles with that money with her name on them for local hospitals in my state. It is an honor to know that her legacy is helping other families have a better experience. Losing their baby will still be traumatic, it will still be devastating to them, but I pray that it will be a little easier if they have access to a Caring Cradle.

Reaching Out to the Hospital

Afterward, I talked to the lead nurse in labor and delivery at the hospital where Olivia was born. I told her what happened and how traumatizing it was for me. She said it should not have been that way, and that I “slipped through the cracks” because I was from out of town and didn’t have a doctor there. That if I had a doctor there he would have told me to go straight to labor and delivery and called ahead for me. We talked about ways they could change their policies to avoid that in the future. I hope it makes a difference.

About The Author

Catie MacDonald is a mom of four, three on earth and one in heaven. She is an Oklahoma native and recent transplant to Georgia. Catie worked with The Jaxon Kade Foundation to facilitate the donation of the Caring Cradles. The Jaxon Kade Foundation is based on Oklahoma, with the mission of donating a cooling bassinet to every hospital in Oklahoma. You can find them at  jaxonkadefoundation.org and on Facebook and Instagram @thejaxonkadefoundation 

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.