My birth story is a bit on the traumatic side (but really, whose isn’t?)…so much so that I am still contemplating whether or not I am willing to brave another pregnancy to have more children in the future.
Anyway, it’s taken me almost 8 months to get to the point where I finally feel ready to share what happened to me…so, here it is…laid out in its gory detail for all the world to read.
Labor officially started just after midnight on the morning of March 28. I had just gone to the bathroom and noticed that I lost my mucous plug (I know – gross!) and then literally within a minute or two I began having strong contractions. They were probably 5/10 in intensity, lasting 45-60 seconds, and coming every 5 minutes. So, I did what any excited first-time mom would do: I downloaded an app (Full Term) and proceeded to spend the next 7 hours timing each and every contraction I had at the expense of getting any sleep (but who could really sleep anyway with constant contractions, am I right?). Unfortunately, my contractions never increased in timing or intensity, and then…rather anticlimactically, my contractions suddenly fizzled out around 7am and labor officially stalled.
I felt emotionally and physically defeated, and I began to wonder if my baby would ever *actually* come. Stalled labor is quite possibly the worst thing that can happen when you’re a week overdue and entering into straight-up crazy territory with thoughts like “this baby is just going to keep growing until my abdomen literally ruptures” and “there is no way this baby is ever coming…there’s just no way this point.” Don’t judge…there is no sanity in the final moments leading up to the birth of your baby.
So there I was…tired in every imaginable sense of the word…and yet inexplicably wired. I attempted to get caught up on some much-needed rest, but felt too wound up to actually sleep. Around 1pm on March 28, I called my OB/GYN and explained what had happened earlier that morning; I was informed that labor would likely return later that evening and to prepare to have my baby within the next 24 hours. Spoiler alert: my OB/GYN was right.
So, I took a long-ish walk with my husband (to be completely accurate, he walked and I waddled…and by “long” I mean mayyyyyybe like 0.25 miles), and by 3pm, I was starting to have contractions again. They were more intense than they had been earlier that morning, but coming at very irregular intervals. I kept waiting for things to speed up, but they never did…instead, my contractions seemed to plateau once they reached the 5 minute interval mark.
By 11pm that evening, my contractions were starting to slow again and I was on the verge of tears fearing that labor was going to stall for a second time. At 11:30pm, my husband urged me to get into bed since my contractions had all but stopped…and I kid you not, the moment my head hit the pillow, contractions revved up and started coming back-to-back with a ferocity I hadn’t experienced earlier in the day.
I looked at my husband and said “This is it! It’s finally time!” and so we grabbed a few last minute items for our go-bags, then got into the car and drove to the hospital.
We arrived just after midnight (if you’ve been counting, this marks 24 hours of intermittent labor), and were rapidly admitted to the L&D unit after a quick check by one of the nurses. I was a little worried that we might be turned away because I had been checked 2 days prior by my OB/GYN and was only 2cm dilated with a posterior cervix. But, in a shocking turn of events, I was 4cm dilated when I arrived at the hospital and my cervix had already begun to tilt into a more anterior position (hooray!)…also, the nurse assured me that there was absolutely no way they were letting me walk out of the hospital without a baby in hand since I was a week late.
Although my goal was to have a completely natural labor (i.e., no pain meds or epidural), my body was in shambles and the sensible nurses reminded me that I should really try to get some sleep before pushing out my giant baby. Again, if you’ve been counting, we are approaching nearly 48 hours since the last time I got any sleep.
My barely functioning brain decided to chuck my birth plan out the window in favor of sleep. And so, around 3am, I agreed to be given a dose of a magical drug called Stadol (generic butorphanol) which promptly put me right to sleep and gave me about 3 hours of blissful contraction-free slumber. When the dose of Stadol wore off, another nurse checked me and said I was about 6cm dilated and that it was now or never if I wanted an epidural. The anesthesiologist was already on the floor giving an epidural to another patient, so I agreed to get one for the convenience of it all.
Boy do I regret getting that fateful epidural.
The anesthesiologist (well-respected with >30 years in the field) strode into our room offering me and my husband a perfunctory greeting, then proceeded to rattle off his many accomplishments in what we believe was his awkward attempt at making us feel more comfortable with the procedure he was about to do. He then had me sit with my legs dangling off the side of the bed while he positioned himself behind me and prepped my back in a sterile fashion, which was followed almost immediately by him giving me local anesthesia that was mercifully quick and painless.
All of this went exactly as I imagined an epidural would go. But, then this happened:
As the anesthesiologist placed the epidural into my back, he said, and I quote: “Oops. That’s not supposed to happen.” Wait, what the WHAT?! When I asked him what was wrong, he informed me that I am a “shallow stick” and he accidentally put the needle in “too far.” He was apparently seeing clear cerebrospinal fluid (CSF) leaking from the needle, indicating that he had punctured my dura mater. He reassured me that my epidural would still work properly, but warned that I *might* get a complication known as a spinal migraine in about 24 hours. I vaguely remember him offering some sort of brief apology, but also reminding me that this was a well-known risk of having an epidural.
I didn’t think much about the botched epidural again for several hours. Labor progressed and, as promised, I didn’t feel any pain from my contractions. I could tell I was having them, but did not feel any discomfort. As my cervical dilation increased, so did my urge to push…and let me tell you, that is one heck of a strong urge. Finally, around 1pm, my OB/GYN arrived on scene and gave me the green light to start pushing.
I had read lots of mommy blogs in the weeks and months leading up to this moment. I knew that you had to push as if you were bearing down to have a bowel movement. I knew that this phase took a lot of energy and many moms reported that they grew worrisomely tired partway through, and some ended up needing to be converted to a C-section when their heroic pushing efforts did not yield the desired results by a certain point.
But I naively believed that I was strong. And that pushing would be the least of my worries. I admittedly hadn’t gotten more than about 4 hours of combined sleep over the last 52 hours or so, and I was definitely NOT in good physical shape. I used to be a Division I rower in college, but sadly I did not keep up with any form of exercise post-college, particularly during pregnancy. My peak activity level during pregnancy consisted of waddling to the fridge to grab ice cream, then shoveling said ice cream into my mouth.
Anyway, I entered into the pushing phase with a mix of excitement and trepidation, and an overly confident expectation that I would rock this leg of the journey (thanks to my very distant past as a has-been athlete). I began pushing and, at first, there was no pain…just wave upon wave of contractions coursing through my body, urging me onward toward my prize. I was full of an energy I didn’t recognize, and I let it fuel my motherly powers of perseverance. I pushed and I pushed and I pushed some more.
But I couldn’t feel any progress being made, had no sensation of a baby coming through the birth canal. So when I asked my OB/GYN for an update and she informed me that she could see my baby’s head beginning to come into view…I had this crazy notion that I was being lied to in an effort to make me continue pushing. Although my thoughts were almost certainly not coherent at this point, I recall having the distinct revelation that my baby was never going to make it all the way out. I didn’t believe a word my OB/GYN was saying to me, and I was ready to pull the plug on the whole pushing thing and opt for the C-section even though this was the one outcome I knew I wanted to avoid.
Discouragement settled over me and I began to feel twinges of pain with each contraction. When I did a quick mental assessment of my energy level, I could feel my strength wilting before me like a flower under the blazing light of the sun (or, in my case, the glow of about 3 overhead surgical lamps). I was about an hour into pushing, having changed positions several times, when I began to whimper in my most pathetic voice ever that I couldn’t do it. I needed to give up. I needed someone else to rescue my baby from my exhausted body.
But just then, something extraordinary happened. My amazing husband, who had been dutifully placing cold washcloths on my forehead and gently massaging my back with lavender oil, did something I will forever be grateful for: he conquered his fear of looking “down there” and assessed the situation for himself. And when he told me that he could see the top of our baby’s head, this was all the reassurance I needed to keep pushing. I knew my husband was telling me the truth, and I dug down deep and found that inner Division I athlete that had been dormant for the last 10 years.
I pushed with a vengeance I didn’t know I had. The room suddenly filled with about 7 nurses and a second OB/GYN (I later learned that this was because they were concerned my baby might get shoulder dystocia as she was projected to weigh about 10 lbs based on ultrasound measurements). With the very last drop of energy that I had, I gave two final pushes…and that was it. At 2:37pm, after 90 minutes of pushing, my baby girl made her debut. My husband cut the cord and Ellery Metta was placed on my chest. I was beyond tired and couldn’t sit up to hold her, but I tilted my head down and kissed her soft head.
And this is where things get a little hazy for me.
I don’t remember having a chance to really see my baby before she was whisked away by a nurse. I began to panic: was my baby okay? What was wrong? And that’s when I felt it. A giant gush of hot liquid. My OB/GYN was still at the foot of my bed and had a concerned look on her face. She proceeded to press down on my sore belly and once again there was another gush of hot liquid.
The flock of nurses returned to my bedside and kept telling me that everything was okay…even though I knew it wasn’t. Then I felt the absolute worst pain in my life, like someone had taken a searing hot knife and sliced through my abdomen.
The pain almost made me black out. And all I could think was “shouldn’t all the pain be over now?” All of the mommy blogs I read told me that labor and delivery officially ended when the baby was born and the placenta was delivered. The hard part was getting the baby out, and the easy part was the placenta. And my placenta had come out whole shortly after my baby was born…so what on earth was all this commotion about?
The look of concern on my OB/GYN’s face darkened and the nurses around me all had an undeniably somber quality to their gaze. I soon pieced it all together and realized that I was hemorrhaging. Those gushes of hot liquid were my own blood. Pouring out of me. In the not-so-distant past, this would have been the kind of situation that caused a woman to die from childbirth. And the gravity of this realization was not lost on me, even in my hazy postpartum state.
That searing hot pain came back time and time again as my OB/GYN frantically tried to scrape my uterus with her hand, looking for possible placental remnants. Fun fact: your uterus does NOT want to be touched right after it’s given birth.
So my uterus was literally screaming in agony as my OB/GYN did manual maneuvers to try to stop the bleeding. And if you’re asking how in the world she was reaching her hand way the heck up there (“elbow deep” as my husband would say), it’s because I was torn wide open. Yup. My giant 9lb 8oz baby and her extra large head did not come out gracefully. I had a third degree tear, meaning that it stretched all the way through my perineum and involved a portion of the anal sphincter. Look it up. I dare you.
Anyway, I was lying there helplessly hemorrhaging, feeling repeated violations to my tormented uterus, wondering if I might die soon. And eventually I just couldn’t take the pain anymore. So I mustered one last ounce of strength and sat upright and screamed at my OB/GYN. I can’t remember my exact words, but the gist of it was “get the F@CK out of my uterus!!!!!!!!”
Being the wise doctor that she is, she quickly exited the scene and booked me into the OR where she could safely continue her maneuvers while I was under sedation. Before I was wheeled away, I asked my OB/GYN what the best and worst case scenarios were. Without missing a beat (time was of the essence here), she said “best case, you have retained placenta and your bleeding stops when I remove it. Worst case, I have to do an emergent hysterectomy.” And that was it. My husband and I held hands, exchanged tearful “I love you’s,” and parted ways, not knowing if I would come back sans uterus and our dreams of having more children would be surgically removed.
My husband had to describe the next part of the story to me as I really wasn’t aware of what was going on around me at this point. He said that just as quickly as the delivery suite had flooded with extra staff, it was suddenly empty. And he was left holding our brand new baby girl in his arms, surrounded by the graphic aftermath of childbirth. He says this was the closest he has ever felt to living in a war zone: the walls were spattered with blood, and the floor was covered in debris with various degrees of his wife’s bodily fluids. He told me later that he didn’t think someone could survive the degree of blood loss that was left behind in the room around him. And since he was left utterly alone with his thoughts, my husband had one of those soul-searching moments with God. He prayed and called our pastor to ask for support. I share this last bit only to highlight the seriousness of the situation as my husband is not one to call people for help…let alone call our pastor.
I’m not sure when I was rolled back to my room, but it was sometime after 5pm. And I thought to myself “The worst is over now. They are going to give me my baby and all will be right with the world.”
Oh how wrong I was.
Once I was back in my room, the nurse sat me up so that I could finally hold my baby…and then my brain went dark. I didn’t know what had hit me, but a pain unlike any other I had ever experienced before slammed into my head as if I had been struck by lightening. The nurse immediately laid the head of my stretcher back down and told me that I needed to lay flat until the anesthesiologist could come back. Why? Because I was having a spinal migraine.
Remember earlier in this post when I mentioned the anesthesiologist said I *might* get a spinal migraine? And that, if I did, it wouldn’t happen for another 24 hours? Well, that turned out to be the most misleading piece of medical information I have received to-date.
Turns out that a spinal migraine (also called a post-dural puncture headache) happens when the highly sensitive pressure system contained within your spinal canal develops a leak and no longer has a high enough pressure gradient to keep CSF circulating at an appropriate volume to cushion the brain. The net effect of this disrupted pressure system is that you develop a severe migraine when you sit/stand, and the migraine significantly lessens when you lay flat (i.e., the CSF doesn’t have to fight gravity to support the brain).
In keeping with its terrible reputation, my spinal migraine went from a 10/10 while sitting up to a 4/10 when laying down. And since I couldn’t sit up to care for my baby, she was once again whisked away by the nurses and spent her first night with them…instead of me. I hadn’t even been able to properly hold her at this point. To say that my heart was broken would be a massive understatement.
I spent the rest of that first horrendous night in the hospital lying perfectly still with cold washcloths on my forehead and taking small sips of Gatorade through a straw (which, notably, my husband had to go out and purchase at a nearby gas station since the hospital only had ice water on hand). For those of you thinking of delivering at a small community hospital like I did, make sure you consider all the little details…like the fact that the kitchen will be closed overnight with no access to special beverages, and the fact that there won’t be an anesthesiologist in the building overnight to fix you up if you get a spinal migraine.
I digress.
Anyway, so the anesthesiologist finally re-appeared the next day around 10am and proceeded to do a blood patch. For those of you who are unfamiliar, this is the corrective procedure that is done when you have a CSF leak. It consists of drawing a relatively large syringe (about 20cc) of blood from your arm and injecting it directly into your spinal canal in an attempt to correct the pressure gradient and introduce clotting factors that can seal off the hole in the dura mater.
The procedure went about as expected: my migraine miraculously went away almost instantaneously…but the sudden force of all that extra fluid in my spinal canal caused brand new pain and disrupted sensation in my lower back and legs. These side-effects are well-known and did not surprise me, but the supportive care I received afterward had an unintended consequence that I was utterly unprepared for.
Let me back up for a second.
If you haven’t read my post about PUPPP, now would be the time to do so. To give a brief summary, I developed PUPPP (pruritic urticarial papule and plaques of pregnancy: aka the dreaded rash of pregnancy) around 37 weeks of pregnancy just after my stomach suddenly developed stretch marks (oh joy). This insanely itchy rash was initially confined to my abdomen, but after giving birth (which is generally considered to be the “cure” for PUPPP), my rash became infinitely worse…and I credit a lot of that worsening to the heat packs that were applied to my lower back and legs after getting the blood patch.
I don’t think anyone could have foreseen the terrible way that my body would react to the seemingly innocuous act of putting a heat pack on my skin. But, it turns out that PUPPP is an extremely heat-sensitive rash. And so, everywhere that a heat pack touched my body, I broke out in new itchy blisters. Before I knew it, more than 70% of my body was covered by PUPPP.
So there I was. Covered from chest to feet (thankfully my neck/head, palms, and soles were spared) in this intensely and RELENTLESSLY itchy rash. No matter how hard as I tried to focus on everything else that was going on around me, my brain kept dragging me back to the itch that was consuming my body. I literally could not concentrate on anything else. It would definitely be safe to say that PUPPP stole an incalculable amount of precious time and memory from me in those first few weeks after Ellery was born…all because my mind could not stop thinking about the constant itch from that God forsaken blistery rash that raged all over my skin.
Cue the giant pity party. Because my first real interaction with Ellery didn’t happen until after the blood patch was done which was around 10:30am…nearly 20 hours after she was born. Read that again. I didn’t get to truly meet my new baby for almost 20 hours. I realize that many moms are probably thinking that 20 hours is nothing when your baby is in the NICU and it’s literally days or weeks before you can meet him/her. But, we only know our own realities, and mine is that the first 20 hours of my baby’s life are forever missing from my memory thanks to a combination of bleeding to death and blacking out from spinal migraines.
And so, while I was desperately trying to soak in all the details of my beautiful new baby girl, PUPPP kept trying to steal my attention back. Those first moments of getting to know Ellery are marred by an itch so intense that I found myself scraping my skin until it bled just to gain a few seconds of sanity with which I could clearly count each little finger and each little toe…feel her soft breath against my neck…take in her sweet new baby smell…hear her adorable new baby coos. All of the things I should have been able to do as a new mom were, in part, destroyed by PUPPP. So to all the moms out there suffering with PUPPP right now, know that you are not alone. I hear you. I feel you. I was you. And it gets better. I promise.
Anyway, the rest of my hospital stay was pretty much unremarkable (aside from the never-ending itch from PUPPP and the new blisters that were constantly bubbling up all over my skin). Lots of family came and went amidst multiple blood transfusions. And by the following day (March 31), I was ready to be discharged.
The sun was shining, the temperature was downright balmy for CT weather in March, and I felt like my health was finally turning a corner. As a nurse rolled me out to meet my husband (thank goodness for wheelchairs when your hemoglobin is only 8 after 3 units of blood), I remember thinking that life was about as glorious as you could ever hope for.
And indeed it was. But sadly there are more hurdles to clear in this never-ending birth saga.
Our first full day at home together as a family of three was April 1 which happened to be Easter that year. And that little detail becomes very important about 8 hours into our day.
My parents came over around 2pm to share some leftover Easter dinner goodies with us…and it was right around that time that I started to get a dull ache in my head. I took some acetaminophen and tried to guzzle as much liquid as possible while I repeatedly told myself that my headache was just a byproduct of severe dehydration and sleep deprivation. But, alas, no matter what I did, the pain kept escalating. By 6pm, it was clear that this was no ordinary headache. If you’re a Jeopardy fan and just yelled out “what is a spinal migraine?!” you are correct. That pesky blood patch had not won the battle after all.
You might be asking right about now what the significance of Easter was…and the answer is this: even though my head felt like it was being crushed by a vice, the itch from PUPPP was even worse. Like so bad that I had to call my OB/GYN. And, of course, given that it was a holiday, it took the covering physician about an hour to call me back. And when he finally agreed to send in a script for a potent topical steroid, he sent it to my usual pharmacy…which was closed…because it was Easter. After a bit of Googling and another call to the covering OB/GYN, the steroid prescription was finally sent to a 24-hour pharmacy that was about an hour away from our house.
My amazing husband picked up the steroid while my parents looked after Ellery and I laid flat on my back on our bed in the darkness of our bedroom…removed, once again, from my baby girl…feeling utterly helpless as I listened to the sounds of other people taking care of my baby. It was like a horrible case of deja vu where my parents were playing the role of the nurses who had cared for Ellery that first night in the hospital when I had to lay flat on my back while they cared for her.
The following morning, we went back to the hospital. Not only was my spinal migraine raging, but my PUPPP was worse than ever and my breasts were beginning to look and feel like giant boulders stuck awkwardly onto my chest. Turns out that nursing is nearly impossible when you have to lay flat on your back and you don’t have any experience with getting your brand new baby to latch properly. So with my new milk supply coming in hot and heavy, I was beginning to worry about getting mastitis on top of everything else.
When we got to the Emergency Department, the staff immediately called the anesthesiology department about doing another blood patch…and, as luck would have it, it was the same damn anesthesiologist who had done my botched epidural and my failed blood patch! And instead of giving me what I would call a well-deserved sympathetic (or even, dare I say, apologetic) bedside manner, I was greeted with a response of “it can’t be a spinal migraine. I’ve only ever had 2 blood patches fail in my 30 year career, and both of those were because the patients went bungie jumping afterward.”
Nevertheless, the anesthesiologist dutifully stuck a needle in my spine to investigate the matter…and that’s when he said “Oh whoops. Okay. You were right. That’s definitely CSF leaking out.” I didn’t even have the energy to feel vindicated in that moment. But you can be sure that when he did another blood patch and my migraine miraculously cleared for a second time, I made a clear mental note not to let this man touch my spine again.
So now my spinal migraine was gone (and thankfully, it did not come back again as the second blood patch held up)…which was awesome, but it left my brain vulnerable to even more consuming thoughts about the relentless itch from PUPPP and this new problem of extremely tender/swollen breasts.
But here’s where my birth story FINALLY gets its bright moment. And if you’ve read all the way to this point, I commend you. It was exhausting to live through it in person, it’s been exhausting to write about it, and I have no doubt that it’s been equally exhausting to read about it.
Anyway, the ED physician was a kind and caring man who took pity on me and my pathetic state of health. He gave me a dose of IV steroids to help jumpstart the attack on PUPPP and then sent me home with oral steroids to finish the job.
About an hour after being discharged from the ED, we went to the Pediatrician’s office for Ellery’s first appointment. And once again, there was a shining moment of happiness amidst all the darkness of my birth saga. The woman we saw that day was an APRN who also happened to be the office’s designated lactation consultant. To describe her as an angel would be an understatement.
She listened with rapt attention to all the drama that had occurred with Ellery’s birth and beyond, injecting sincere empathy at all the right moments in the story. Then she patiently watched as I fumbled to try and nurse Ellery in her presence, providing constant reassurance about her latch and her access to milk. But I will always be most thankful that she definitively squashed out any worry I had been having over mastitis. She immediately recognized that my breasts were overly swollen and literally rock-hard because of all of the IV fluids I had received in the hospital. She told me that within the next 24-48 hours, all of that excess swelling would recede as my lymphatic system worked to reabsorb all the extra fluid…and she was right!
By the following day, my breasts had found their new normal as milk delivery vessels and had no trace of the rock-hard swelling that had been there 24 hours earlier (don’t get me wrong – my breasts had plenty of rock-hard moments afterward when they would fill with milk, but they never again had the same appearance/sensation as they had when they were congested from all the IV fluids I had received in the hospital).
Ellery was nursing like a champ and I felt a surge of hopefulness that my body was on the mend. The steroids were helping to a modest degree to keep the itch from PUPPP at bay, and even though they prevented me from getting any sleep, I would have taken a thousand sleepless nights over one day of ceaseless itching. The bruises on my body were also starting to fade, and I could feel my energy stores beginning to return as I moved further and further away from the catastrophic postpartum blood loss I had endured.
The weeks slowly crawled by, and each day I grew stronger and stronger. And my appreciation for life and good health became so much more vivid. I was able to focus on Ellery and found great solace in nursing her. In fact, I would credit our nursing bond with providing the greatest level of healing I have encountered thus far…more powerful even than the steroids I was on.
And so, although I faced a mild resurgence of PUPPP several weeks after thinking I was totally healed from it…and despite developing a horrible fungal infection on my arm where the IV tape had trapped moisture (which, by the way, took months to recover from and which I will not bore you with since it’s probably taken you at least 7 hours to finish reading this blog post), I consider myself lucky to have had the recovery I did.
Had I given birth in a place with less access to modern medicine, I might not be around right now to be writing this piece. I am so grateful for the heroic efforts of my OB/GYN, the kindness of the ED physician, and the empathy of the pediatric APRN. I will forever be indebted to these wonderful people as they quite literally saved my life.
And now I would like to sincerely thank you for taking the time to read through my birth saga. We all have difference birth experiences, and I would love to hear about yours in the comments. Whether you were in labor for 30 minutes and your baby basically fell out…or you were in labor for 72 hours and were so exhausted that you had to be converted to a C-section, I welcome you to drop a line below!
In the meantime, as you ponder how to sum up your birth story without going all War and Peace about it like me, I recommend a strong cup of coffee (or a shot of hard liquor) to replenish your energy as the calorie expenditure required to read this ridiculously long post is probably on par with running a marathon…just saying. 😉