I planned a homebirth but ended up with a preterm emergency induction and crash c-section due to severe preeclampsia + HELLP syndrome. My baby had intrauterine growth restriction (IUGR) and weighed less than 5 lbs. He was in better shape than I was, and only spent 3 days in the NICU. There are substantial long-term health risks for both mom and baby following severe preeclampsia, and my anxiety about this lingers.
I had no control in this scary medical situation. I surrendered myself to the medical establishment the minute we walked in the hospital. My goal throughout my pregnancy was to be present for the labour and birth; the magnesium sulfate I had to be on made this almost impossible. No one took the time to explain why we should do something or if there were alternatives. Most people were professional, but only took care of what was medically necessary. For example, when it became apparent that a c-section was urgently needed, no one said anything to me. I heard them talking to each other and figured it out. I was in the OR and on the operating table before anyone spoke directly to me about the situation.
November 13th – 35 Weeks + 3 Days
I checked my blood pressure (BP) weekly the whole pregnancy. At 35 weeks it was above 140/90. I texted my homebirth midwives, but was unconcerned. Everything stayed normal for two days, until I got two high readings in a row. I had no symptoms, other than decreased urine output, but I knew that my homebirth dream was gone.
The midwives suggested testing for preeclampsia, and I ultimately connected with a hospital RN who was skeptical, but said to come in. Blood and urine tests confirmed that I had mild preeclampsia requiring an induction at or before 37 weeks. The OB gave us the option of getting steroid shots for the baby’s lungs and I received the first of two shots.
We were in shock. Not only would I have to give birth in a hospital during COVID instead of at home, but I would be induced preterm because of a serious pregnancy complication. I was so worried that I was going to die, but I had hope that we’d make it to 37 weeks.
November 16th – 35 Weeks + 6 Days
I finally connected with my OB and scheduled the induction for six days later. Our homebirth team prepped us for a multi-day induction and suggested that I contact my OB again to ask for the GBS test so we’d have the results in time.
November 17th – 36 Weeks
I got the GBS test and asked to do the labs again. By the time we got home, the first lab results were back. My liver enzymes had gone from 17 U/L to 554 U/L in four days – well outside the normal upper limit of 40 U/L. My stomach sunk, and I turned to my husband and said, “That’s not good. Can you get my phone in case the OB calls?”. He had barely handed it to me when it rang. My OB confirmed that this was now severe preeclampsia and that we needed to start the induction right away. I hung up the phone, laid down on my bed and cried. This was not what I wanted. I was so scared that I was going to die.
We arrived again at the hospital. They ran labs and a new OB came in and checked my cervix. It was closed, 40% effaced, and baby was at -3 station. She said my labs were stable and our only option was an induction starting with misoprostol. She also started a magnesium sulphate IV to prevent seizures, with the side effect of making me feel like I had a fever and the flu. She told us briskly how serious the situation was (“devastating” and “catastrophic”). I shared that I would like the birth to be as unmedicated as possible. She replied skeptically that they recommend I have an epidural.
We tried to create a cozy, relaxed environment to encourage the induction process. The BP cuff went off every 45 minutes, and the RN returned every two hours to refresh the magnesium, every four hours for Misoprostol, and every six hours for labs. They were limiting my fluid intake, which seemed extra cruel since I felt so hot and thirsty from the magnesium.
November 18th – 36 Weeks + 1 Day
11 am
We gave up trying to sleep and ordered breakfast. Our food arrived during shift change and the new RN said she was going to take my BP as soon as we were done eating. This RN had a “Military Nurse” flag on her badge, and her demeanor reflected that. She was extremely brusque and expected me to follow orders.
11:30 am
I started to feel period-like cramp contractions. We were excited that I was starting to feel something. The RN took my blood pressure and it was 168/95 – she said I needed BP meds and that I couldn’t leave the bed afterwards. I stood up to go to the bathroom first and my water started leaking. I went to the bathroom and a stronger contraction hit, requiring me to hold onto the wall.
12:00 pm
I got in the bed asking the RN about side effects of the medication and she dismissed me with a curt response. I asked for the TENS unit and a peanut ball. At this point, the contractions were taking all of my concentration. I felt completely taken aback with how long, strong, and frequent they were, after only having the first cramps a half hour before. They lasted 45-90 seconds, coming every 3-5 minutes. I was scared since this was supposed to be the easy part. How I was going to be able to do the hard part? I felt like a failure for thinking that I could have handled a homebirth.
I was completely unaware of the chaos surrounding me with all my focus on surviving each contraction. The BP cuff on my arm was going off every 5 minutes, and I would try to relax through the contraction and ragdoll my arm whenever I felt it tightening. I was getting annoyed with the people in the room talking to me and touching me – couldn’t they see I was just trying to cope?
I tried to turn to my hands and knees on the bed but got tangled in the IV lines on my left arm, the HEP lock and BP cuff line on my right arm, the wires from the TENS unit, and the wires from the contraction and fetal heart rate monitor. The RN was holding the two monitors to my stomach through each contraction, telling me that I wasn’t “getting credit” for the contractions because the machine wasn’t picking them up.
1:25 pm
The OB came in and checked me, also putting an internal fetal monitor on baby. I was 2 cm dilated, 90% effaced, and baby was at -1 station. All of the staff were excited that I was in active labor.
The OB noticed the baby’s heart rate dipping at the end of each contraction, and said that we might want to start thinking about a c-section. I thought, “Oh thank god – I don’t have to keep doing this.” The second OB suggested moving to the back for more options. With the next contraction baby’s heartrate dropped from 145 bpm to 82 bpm. They rushed over to me and rolled me onto one side, then the other – nothing changed. The OB said, “Call a code C!” (“Emergency C-Section”) and the room filled with even more people. I heard the RN on the phone say “no epidural” – I realised that they were going to want to put me under. They pulled the pillows and blankets off of the bed as they rushed me out of the room. I saw someone push surgical clothes at my husband as they whisked me by. We didn’t get to say goodbye.
1:45 pm
My room was across the hall from the OR. As they moved me I choked out, “I don’t want to be put under general anesthesia.” No one said anything. I took a deep breath and told myself that I wasn’t going to panic, and then we were through the swinging doors of the OR and into the bright white lights.
The RN gave me medication to stop my contractions. They lifted me onto the operating table and I was asked if I’d had surgery before – “no”; when I last ate – “11 am”; what did I eat – “a breakfast sandwich”. The anesthesiologist said, “She has a full tummy. It’s not safe with a full tummy!” I sat on the side of the operating table and the OB said, “We’re going to have to put you under to get baby out in time.” I felt this huge wave of defeat as my last hope for this birth was taken away, and whispered, “Okay.”
Then baby’s heart rate started to pick up again, reaching 110 bpm. They decided to do the spinal and I was given a pillow to curl over. I asked them to hurry.
1:49 pm
I felt a prick in my back and then my lower body felt warm. They laid me down on the table. I stared at the huge round white lights. I asked the anesthesiologist to drop the drape when the baby came out. She promised they would. I felt like maybe it would be okay.
2:00 pm
“Get the husband! Get the husband!” The anesthesiologist called as she put up the drape.
2:02 pm
My husband sat down. The OB called, “We have a boy!” I twisted to look at the anesthesiologist and said, “What?? It’s out??”. They hadn’t dropped the drape or told me what was happening. I had felt nothing. All of my research, effort, and striving to be fully present for this birth, for my baby’s first moments, and I missed it. It happened without me, while I was right there.
My husband was crying – I felt numb. He took a picture for me to see. I saw a little baby connected to wires. Minutes went by in silence. The baby cried once. Thank god. He was alive.
A while later, a cart came into view about 10 ft away and paused. They lifted the mask off his face for a few seconds, and then the cart was gone.
Back in the labour room, a pediatric nurse told us that our baby was doing great – he was breathing on his own. He weighed 4 lbs 15 oz. The nurse took my husband to the NICU.
8:00 pm
We arrived at the NICU six hours after his birth. I asked to hold him and I was told that he couldn’t regulate his body temperature so he had to stay under the heater. I asked about skin-to-skin and they repeated the same answer. I stuck my hand into the little box and stroked him. They wheeled me to the postpartum room and I told the RN that my face was itching. She said she’d bring some Benadryl but never returned.
I slept restlessly and woke still itchy. I called the RN. A new one was on shift, and she finally brought Benadryl. I slept deeply then.
November 19th – 1 Day Postpartum
My husband visited Baby S a couple of times during the night. He had had breathing issues and would have to stay in the NICU for observation. We went to the NICU and I held him for the first time. His forearm was the same width as my thumb. Later, they finally stopped the magnesium and decided to start regular BP medications.
November 20th – 2 Days Postpartum
I had no privacy. People entered while I cried and told me to relax. Another new OB cooly confirmed I was still at risk for stroke or seizure. I asked if my labour was normal for an induction, and she replied that it couldn’t have been that intense if I hadn’t asked for an epidural. A social worker visited and told me that “It could have been worse.” and “At least you didn’t die.”
That night my BP spiked the highest yet, even though I was on BP meds. We spoke with a different OB and told him that we wanted to go home; that I felt trapped; that if they would just leave me alone, I’d be able to relax and it would go down. He said it didn’t matter why my BP was high; it wasn’t safe for me to leave. He gave me a fast-acting medication and said they’d be back in 15 minutes to check it.
I didn’t want to die. I told them we’d stay. We tried to sleep for two hours before the next BP check. I was terrified that I’d die or be permanently disabled. For two hours I wondered if I would know if I was having a stroke, if I’d be able to wake my husband up, if this was how it was all going to end, and was grateful I’d gotten disability insurance. Finally, the RN came back to take my BP – it’d come down! We cried with relief. I wasn’t going to die that night.
November 21st – 3 Days Postpartum
I was still so scared that I was going to die. No one would reassure me that I would be okay. My husband felt it would help me to have our baby with us, and the neonatologist agreed, so he was discharged from the NICU. I didn’t want him with us. He was safe there. I couldn’t take care of myself and was relying on my husband for absolutely everything – how could I take care of a baby?
November 22nd – 4 Days Postpartum
An OB said we could be discharged. I’m thankful and afraid. We’re told multiple times that I needed to take it easy, to check my BP 3x/day, and that we might need to come back. I was overcome as they wheeled me out. I didn’t think that I would leave the hospital in one piece; I was saddened for the “me” who had come in five days earlier full of hope and determination. I cried on the way home.
1-3 Weeks Postpartum
I was in a fog for weeks, sleeping 16 hours a day and unable to care for myself or Baby S. He was cute and funny, but I didn’t feel bonded to him. It was COVID, so no family could travel to help. We had a night nurse to give my husband a break. The constant fear of my next BP reading haunted me. I started therapy immediately and had visits from my homebirth midwives.
4-8 Weeks Postpartum
I started to feel more human. I could move around the apartment and eat meals at the table. I came off the BP meds, but continued to take my BP daily, fearing it would spike again. I started to feel able to go for very short walks, and no longer had to carefully regulate my energy.
10 Weeks Postpartum
I spoke with a MFM who diagnosed me with “Preeclampsia with Severe Features and a HELLP syndrome variant”. This was the first I’d heard of HELLP syndrome and it retraumatized me. Why did no one tell me this? He implied that I should have had an immediate c-section rather than an induction. I questioned everything I had been told by the OBs. He gave me a 40% probability of a hypertensive disorder in a future pregnancy. We decided this was too much risk and began trying to come to terms with being a family of three instead of our planned-for four.
Now at 15 weeks, Baby S has become a lot more interactive and we’ve really started to bond. There’s a long road ahead, but I’m holding out hope that we’re going to make it to the other side.
The Author
Originally from the West Coast of Canada, Kelsey now lives in the San Francisco Bay Area of the US. She works in local government, and lives with her husband, baby, and feisty rescue dog. When not recovering from birth trauma she loves to cook, hike, and sew. You can connect with her on Instagram at @ke_gi_la (family account) or @kgmakes (crafting account).
