First Pregnancy

Throughout my first pregnancy I was the model patient for my provider, overweight yes, but otherwise without complication, until of course I wasn’t. To this day I wish I had realized what labor and pre-term labor was and I wonder IF only I had gone in sooner.

Food Poisoning?

It all started on a Sunday, July 15, 2018, while my husband worked on the room that would be the nursery. He still had 10 weeks before it needed to be done, although I’d hoped we would be further along in the process- there were still no walls. I had been plagued by nausea and terrible swelling the whole pregnancy, started wearing my husbands shoes at 10 weeks, so when I was nauseous and had a sore back I didn’t think anything of it. I spent the day napping and coloring in bed. My husband got me up for a bike ride with promise of ice cream. Thankfully he ended up with a blister when we were only a quarter of the way into our 12 mile bike ride and we turned back. Getting off my bike I felt a stab of pain in my belly but it went away as quickly as it came so I brushed it off and we drove to go get our custard. I didn’t really stop to think about my discomfort until we were going to bed around 10pm. I tossed and turned for about an hour before deciding it must be our mattress causing my discomfort, back pain. We moved to the other bed and I continued to toss and turn until I felt cramping like I had food poisoning and was going to puke or poop my brains out, which I did for the next two hours pacing through hall between events. Finally at 2 am the pain was unbearable and I had noticed that I lost my mucus plug during my multiple trips to the bathroom (not that I knew what that was at the time) so we called the on-call OB who agreed with my assessment that it didn’t sound like labor but to come in to get checked.

We’re having a baby!

We arrived at 2:30am. We were brought up to the L&D triage room to be assessed. The OB was pretty sure I had a kidney stone or bladder infection. They set me up on the monitors, found baby’s heartbeat but had difficulty keeping him on the monitor because he was low. Meanwhile, no contractions were registering and I was in constant pain, not waves. The OB asked to check for pre-term labor “a simple swab test, just to be safe” but he quickly decided that was not what needed to happen and was frankly a bit flustered. After a quick back and forth with the nurse he said “nope I’m just going to measure her” to which I jumped in with “ we already know the baby is measuring big and my mom was fully effaced and 3 cm dilated the last two months with me, so I wouldn’t be surprised if I’m partially dilated”. He looked up and said to me “no you’re fully dilated”. It was 2:55am.

The next thing I knew the tiny triage room was stormed by every L&D nurse free at the time to start IVs, get magnesium and antibiotics (no one checked my allergies), steroid injections, etc. in as fast as possible. All while the doctor looked at me and repeated “Don’t push!”. The NICU nurse arrived quickly with the isolate, but nothing was set up because no one had warned the NICU until they discovered I was fully dilated. Meanwhile, I was made to lay down something I hadn’t done since midnight and that’s when I finally felt the contractions right on top of each other but in distinct waves and the whole while I keep hearing the doctor say “don’t push” to me and “are you ready yet?” to the NICU team. There was a lot of conversation back and forth as the doctor still couldn’t tell when I was having contractions but I focused on not doing the one thing my body so wanted me to do, push.

Finally at 3:45 the NICU team was ready and introduced themselves, the RT was my sister-in-law’s mom Susan, so I said “Hi Susan! It’s Sarah” because that’s the polite thing to do right? With permission to push I did and it was in no way relieving. My water broke mid push and showered the doctor and the triage room floor to ceiling such that the curtain was dripping when we were alone after the delivery. After 3 contractions at 4am we found out we had a son, we hadn’t know the sex before that. I saw part of him for 10 seconds and only really remember the Dr. commenting “easily a 14-pound baby at term” (I still feel guilty for the minor blessings of not delivering such a large boy at term) before he was whisked away and just as quickly as everyone had arrived they were gone. Those, what were likely only minutes, felt like hours as my husband and I sat in shock that we had a son and worrying that he may not survive. I don’t remember this but the worst part for my husband was when the Neonatologist walked in saying “I’m sorry…” something about how it took longer for him to come talk to us than he wanted. 

About 3 hours after he was born I finally got to see my son. He was small and covered in tubes and wires, on a ventilator. Everyone complemented me on how well I handled it all, but then I’m usually the rock and the strong one for everyone else so that’s what came naturally to me. While inside I screamed every time someone congratulated me, I couldn’t understand why we were celebrating my failure and his tentative hold on the world.

First Time Meeting Micah

NICU Stay

We had a relatively short NICU stay, 40 days, but leaving the hospital after 3 days and still never having held him was soul-crushing. Having to induce lactation (I never was very successful), feeling guilty and pressured to provide the only thing he could have initially, and navigating the postpartum period I never learned about because we didn’t get to go to our class and I hadn’t gotten that far in my pregnancy book, was so hard. Seeing him intubated, hearing he had an infection, hearing he had a brain bleed, was frightening, but worse was seeing other babies and feeling guilty that he was doing better than some, while jealous of other moms who got to hold or feed their babies or even go home with them. I’m still sorry for the thoughts I had about the full term mom whose son was large, I was so mad at how she panicked when the alarms were going off because her son was mad and hungry and she wasn’t on time to feed him, meanwhile she was bookended by a mom with a kid on a ventilator and a mom with a kid on an oscillator who knew which alarms to pay attention to by that point. Regardless, even a short NICU stay is traumatic and I know how awful it is to be in a room on the L&D floor hearing other moms with their babies – I’m so sorry to that mom and others, like the pregnant woman in the hall or the friend who didn’t have a NICU baby. I don’t wish my experience on anyone but I did at the time and do wish it never happened to me.

I spent approximately 12 to 16 hours a day (6 am to 10 pm) in the NICU with mine and 5 other babies in our little bay. There were a few nurses in the NICU who supported me and cared not just for the babies in their care but the parents too. One (Craig, dad to 3 NICU grads himself) even pulled my husband aside and told him to keep me away from the NICU even if only for an hour. He saw the writing on the wall that I was headed for a major breakdown.

Coming Home

Coming home was also difficult; not going back to work and staying home 24/7 because he was medically fragile, losing the support of people who had become family during our stay. All the appointments, we had home nurse visits, weight checks, ROP appointments, and more. I even had a county health nurse shame me for not breastfeeding him, meanwhile, I was lucky to produce enough milk for one of his 10 bottles a day. It was overwhelming and lonely. Most people thought that once he was home everything was fine and he was a normal baby. I felt so alone. It took me until he was nearly 6 months old before I started to put the pieces back together and bond with him in a way that was not just focused around fear. Even now, I wonder if I hadn’t been made to feel like the pain was in my head or that I wasn’t really sick in the past, I might have gone to the doctor sooner. But, then I think that if I’d gone sooner they probably would have sent me home and missed the pre-term labor anyway.

Today he is happy and healthy even with lingering respiratory issues and, like any 3 year old, refuses to sleep. Even so, he is and always will be my Mighty Micah.

Second Pregnancy 

Following my experience with Micah I was nervous to have another child because we had no (and still don’t) explanation for why he arrived 10 weeks early.

As an aside, I’ve found writing my story with Ezra more difficult, maybe because it’s fresher, or maybe because it wasn’t his life but my own that was on the line.

We found out we were expecting again when Micah was about one and a half (Thanksgiving 2019). This time I was determined to know as much as I could about what to expect in terms of complications and how we were going to try and get me to term. I never considered that complications might arise during my postpartum period.

I had ultrasounds at 8 and 9 weeks and then every other week from 12 to 24 weeks then weekly starting at 28 weeks. I took weekly progesterone to make my uterus “a happy home” from 16 through 36 weeks. I was at a higher risk (20%) for preeclampsia due to my white coat syndrome (is it surprising that I have anxiety with/around doctors/medicine?) so I had to monitor my BP 2x a day and take baby aspirin. My first appointment with the MFM I had a BP of 120/100 and he nearly put me on BP meds then and there.

COVID

When March 2020 came along I was at 20 weeks and stressed by the constantly changing protocols and not knowing how care would continue if I were to get COVID or just be symptomatic. My appointments couldn’t just go virtual and I was worried that any change in my care plan would result in a second preterm birth.

Because of COVID and the new protocols, I ended up going 25 weeks never seeing my own OB (who did by chance get to deliver Ezra) and not knowing who I would see until I arrived at my appointments. The OB I saw at 21 weeks decided I didn’t need to see an OB until 28 weeks when I would have my glucose challenge, but I was already seeing the MFM doctor at 22, and 24 weeks so I didn’t worry too much about it.

Gestational Diabetes 

At 28 weeks I ended up failing the 1 hour challenge and subsequent 3 hr test. I was officially diagnosed with GDM (increasing my risk for preeclampsia among other things). The next 10 weeks I worked to control my blood glucose with diet and exercise. I had to walk for an hour after every meal to have an acceptable blood glucose while on a low carb high protein diet, hungry ALL the time especially for brownies and ice cream. Regardless, I ended up needing insulin over night and it seemed like every week the dose was increased. Nothing I did made a difference. It was hard when the only thing I could try to control was uncontrollable.

Once I reached viability I started to break down the rest of my pregnancy into little goals to be pregnant just one hour more than I was with my first. Then to reach 32 weeks pregnant and avoid our hospital’s “small baby protocol”. Followed by making it to 35 weeks and avoiding automatic NICU admission at our hospital. Then term at 37 and then to hit 40, something I’d originally thought would be impossible.

Induction: Labor & Delivery

Because of my risk for preeclampsia and the diabetes it was recommended I be induced at 39 weeks. We gave our son every opportunity to come before his eviction date but he wasn’t interested in leaving on his own so I was scheduled to be induced at 39 weeks 5 days. When I was admitted I was 3 cm dilated and he was at -3 station. Induction was delayed a bit so I could get some insulin: I ate before arriving at the hospital since I knew I wouldn’t be eating after.

Even on Pitocin (started at 9am) and with my water artificially broken (at 11am) labor felt like nothing or maybe a period, but my blood pressure and blood sugar were all over the place throughout labor. While I didn’t have to have magnesium they did put seizure pads on the bed rails just to be safe. Around 2 pm I went through transition (food poisoning feeling again for me). And by 4 pm after 3 contractions I delivered Ezra. I got to hold him and neither of us had any complications other than high bili, due to being Coombs positive, for Ezra. It was an answer to prayer that I could hold him after birth, room in with him, and go home with him. The stress of COVID, not knowing if I would suddenly go into labor, and controlling my GDM paled in comparison to getting what I so desired for my time in the hospital.

Postpartum Preeclampsia & Stroke

You’d think my story ends there with a relatively un-traumatic pregnancy, labor, and delivery; however, the discharge instructions are actually important when you go home from the hospital.

Five days postpartum (3 days at home) as I was making breakfast and going up stairs to change Ezra’s diaper I lost vision in my right eye. I’m used to ocular migraines and thought that I must just be having a severe one, because again I’ve been trained to write off every symptom as insignificant or in my head. I went outside to pick some tomatoes and while bent down lost feeling in my right hand and right half of my face. I panicked a bit but didn’t want to do anything about it. Meanwhile, my husband checked for other stroke symptoms and I didn’t have any. I decided to take my blood pressure just because, and it’s was 160/90. High but I wrote it off as me being anxious about the loss of vision and feeling. I still sent an email to my doctor because my husband was worried.

The doctor called later that afternoon and asked me to check my BP, it was 200/90 and 180/90 (I double checked because I didn’t believe the first reading). I was advised to head to urgent care or the emergency room to get checked out. I left fully believing I would be home in a few hours, in time for dinner or at the latest bed time. I went to the hospital and the ER/urgent care was busy so I sat and waited for my turn through triage. I was happy to wait because waiting meant it wasn’t a big deal and I was fine. After about 45 min I got called back and my blood pressure was 220/115. I spent no more than 15 min in the ER before being admitted to L&D. When I got to my room right by the nurses station and next to the triage room I’d delivered my first son in, I got in another bed with seizure pads already on the rails. I guess the long ER wait didn’t correlate to being ok.

I was in denial that I wasn’t going home to my boys so much so that I refused to take my shoes off. I wasn’t able to eat since they were concerned I was dangerously close to full-blown eclampsia. I had 5 min head-to-toe checks for two hours, then once my BP was “under control” at 160/90 it was reduced to every 15 min for 5 hours. The next morning my blood pressure spiked again. It was terrifying knowing I’d already had a TIA/mini-stroke. I was also unable to talk to my family. I didn’t bring a phone charger and my phone died shortly after being admitted.

Thankfully my nurse was amazing and helped store my expressed breast milk so my husband could come pick it up to feed Ezra. When he arrived with Ezra in tow all the nurses looked the other way because they said it was cruel and unusual punishment to keep a newborn from his mother “screw the visitor policy”. My nurse advocated for me to get me out of the hospital as soon as my 24-hr magnesium drip finished, instead of the more extended stay that I’d been told to expect. I was sent home on strict bed rest and BP meds because my BP was still crazy but controlled.

I had a second TIA at home but my blood pressure was in the range it was supposed to be so I stayed home, going to the hospital only added stress and anxiety which didn’t help in the least. I had a lot of follow-ups and wasn’t able to walk around the block until nearly 2 months postpartum without my heart racing and my blood pressure either going through the roof or tanking. On several occasions, I had to call out to my husband as I blacked out. I spent most of my maternity leave asleep on the couch or in bed.

The funny thing is I thought we’d escaped all complications and trauma. While I was incredibly lucky to be admitted to L&D instead of the stroke floor and am lucky to have no lasting effects it was so hard on me and my boys, my husband and Micah especially. While my OB is optimistic that a third pregnancy could have no complications I am terrified by the unknown, and we are worried about the risk to my health. I don’t know what the future holds and am still working through my grief with Micah’s early arrival and our loss of ignorance and ability to just go ahead and start trying to get pregnant/have as many children as we want. I am thankful for my boys but so often wish we hadn’t had to go through any of it and that I could still be blissfully ignorant.

My experience has affected my relationships with friends and family, especially those expecting. I am continuing to work on those relationships and finally admitted to my doctor how not ok I am which was a big first step for me. Not yet ready to do anything more than that but maybe in the near future.

My name is Sarah, I am a boy mom to two beautiful boys Micah (3) and Ezra (1). I work as a geologist in Wisconsin. We love going on adventures especially to the lakeshore and woods.