To our delight, we were pregnant by November. Our due date was set for August 24, 2015. As we thought about our birth plan, we decided that we wanted to go the all-natural route. We wanted a non-medicated birth, delayed cord clamping, immediate skin-to-skin, and to breast feed as soon as possible. I began receiving pre-natal care at a birthing center under the care of midwives, and proceeded to have a very easy pregnancy. No morning sickness, reasonable weigh-gain, and high energy. I even worked up until my due date. As I mentioned, I did have some symptoms of HELLP, but I was not concerned about them at the time.
On Friday August 28th, I started experiencing prodromal (early) labor. I had contractions anywhere from every 6 to 30 minutes. It was an exhausting day, and I hardly slept that night. On the morning on August 29th, my contractions were finally 4-5 minutes apart. My husband and I made the trek to the birthing center. There, we were told that I was 3cm dilated and 70% effaced. We settled in to labor for the rest of the day. Around 6:00 or 7:00 PM, my water finally broke. I was 7cm and fully effaced. From there, I proceeded to have a very long and brutal transition that lasted until about 11:00pm. The pain was excruciating, but oddly I can barely remember it. I guess labor amnesia is really a thing. When it was time to start pushing, I remember thinking that the worst was over and I was so close to having my baby girl. Little did I know…
At about 2:00 or 3:00 AM on Sunday August 30th, I still had no baby. She would not move past my pelvic bone. Something unexplainable in me told me that it was time to go to the hospital. My husband (who was the most amazingly supportive birth coach) and midwives tried to dissuade me. They tried to give me an IV for fluids and a catheter to help relieve my bladder. However, it became apparent that I was not going to birth my baby according to plan. I was transferred to the hospital at around 4:00 AM and received an epidural after almost 6 hours of pushing.
I met my doctor at around 5:00 AM. She informed me that my baby’s head was transverse in the birth canal, and that there was very little chance I could deliver her naturally. She noted that I was having very strong contractions and pushing very hard, so Pitocin would not help. She also said that forceps or a vacuum would not help. After pushing for one more hour, we decided that a C-section was our only option.
The next day, I awoke in the ICU recovery room attached to one million machines and a breathing tube down my throat. I motioned to my husband that I would like something to write with, and began writing notes with him in order to piece things together. During my emergency surgery the day before, they found a very large amount of blood in my chest cavity that my body was unable to clot. They attributed this to HELLP Syndrome. I tore some connecting tissue on my liver which contributed to the bleeding, likely because my liver had been enlarged from HELLP. I ended up receiving so many transfusions that they had to replace 100% of my blood twice during the surgery. They packed my chest cavity full of "chest packs," which are basically sponges designed to soak up blood and promote clot building. They concluded the surgery and admitted me to the ICU. I had been in a medically induced sleep for over 24 hours. I was told that I would have another surgery later that day to remove the chest packs. I was able to see all of my family members and write notes with them before the 3rd surgery (we kept the notes, which are quite humorous and sad to read now). I understood what was going on, but was very sedated at the same time.
They had to cut me from the C-section incision vertically up to the base of my sternum for both surgeries, leaving me feeling a bit like humpty dumpty when I awoke from the 3rd surgery in the ICU. At this point, I had the ventilator out, but was still on oxygen – which I would remain on for the duration of my hospital stay while my lungs recovered from the trauma of the surgeries. Also while in the ICU, my baby was able to visit me once. Apparently, this was quite a production that required approval from the director of the hospital and a security escort - I am so thankful to my family for going through the effort to make this happen.
After spending two more days in the ICU, I was admitted to the Post-Partem unit in the hospital. The only plan for my recovery was to have my NG tube taken out (a tube that ran through my nose/throat to my stomach in order to remove all of its contents and prevent digestion), to get up and walk around, and to pass stool. The next 4 days were hell as I attempted to walk and eat. I was unable to keep any food down, and walking was excruciating. I was also under a fog of pain medication and have a hazy memory of these days.
On Saturday Sept 5th, my sweet baby also fell ill (completely unrelated to my HELLP syndrome). She had contracted entero-virus, which is basically a summer cold. Her fever spiked to 102, and she was admitted to the PICU. This was possibly the lowest moment of my life as I was too sick to care for her and so scared for her life. However, after an MRI, a spinal tap, and multiple blood tests, it was determined that she would not have any long lasting effects from her high fever or the virus. She would spend the next two weeks in the PICU receiving an anti-viral treatment, and was released on September 20th. I was able to visit her almost every day while in the hospital. In fact, this helped contribute to my recovery as it gave me motivation to walk every day that I could to visit her.
By Sunday Sept 6th (1 week after delivery), my condition had started to deteriorate. I began to retain so much water that I weighed 10 pounds over my highest pregnancy weight. This is what the doctor’s called “third spacing.” Basically, my kidneys were not processing any of the liquids in my body. After several x-rays and MRI’s, it was also discovered that I had a small ileus in my bowl due to the surgery trauma – thus the reason why I couldn’t keep food down or pass stool. Finally, my blood pressure and resting heart rate were very high. I was re-admitted to the ICU and received more blood/platelet transfusions. I also had a NG tube and a catheter put back in. I was on complete "gut rest" and not allowed to eat anything except for ice-chips.
3 days later, I had started to stabilize. I was readmitted to the Post-Partum unit, but was given no plan for care. I was still retaining all of my fluids and looked like a human marshmallow. The next day, after a complete melt down, it was decided that I should be moved to the Intermediate Care unit of the hospital and be seen by an Internal Medicine Specialist.
As it turns out, this was an excellent decision and I probably should have been in this unit the whole time. I was being treated like a C-section patient in Post-Partum, not an abdominal surgery patient. After my new doctor reviewed my case, she informed me that I was retaining fluid because of my low platelet count, low red blood cell count, and low albumin (protein) levels. First, I had a paracentesis procedure to remove excess fluid in my abdomen (ouch!) Next, my NG tube was taken out on Thursday Sept 10th. I began receiving an albumin drip, fresh frozen platelets, and Lasix pills to promote urination. In one night, I lost 16 pounds of fluids. I finally started feeling like myself again, and was able to move around on my own for the first time in almost 2 weeks.
By Monday Sept 14th (2 weeks and a day after delivery), I was cleared for discharge. My bowls, lungs, and kidneys were all finally functioning the way they were supposed to be. I had lost 40 pounds in 4 days, bringing me down to 10 pounds lower than my pre-pregnancy weight. I spent the next week visiting my daughter in her PICU room and continuing to recover. One week later, she was released. 3 weeks after her birthday, my husband and I were finally able to take our daughter home.
I have mourned a lot since my HELLP delivery. I did not get to experience the birth I desired, breastfeeding, or bonding with my baby during her first two weeks. Plus, I am still in pain from all the surgeries. However, I keep trying to find the “silver linings” from this experience. First of all, my daughter and I are both alive, and I was able to carry her to full term (something I have learned does not always happen with HELLP). This is the greatest blessing of all. Also, my husband was able to bond with our daughter in a way that he would not have been able to had things gone “according to plan.” My friends and family were so amazingly supportive, and I learned just how much I love and value the time I am able to spend with them. I am now 18 pounds under my pre-pregnancy weight (which isn’t the ideal way to lose weight but hey, I’ll take it.) I committed to breast pumping once a day in the hospital, and have been able to supplement small amounts of breast milk with formula (something I have been told should have been impossible after all of the blood I lost.) We have even started trying to breastfeed a few times a day. While I still have low moments, I am beginning to think of myself as a survivor rather than a victim of circumstance – and this has been very powerful for me. My husband and I have decided to not have more children as the risk of HELLP reoccurring is too high. This decision came surprisingly easy to us, and I have never felt luckier for my little family of 3.
My advice to other women yearning for a natural birth would be to find a supportive OB instead of seeking a birthing center. Had I birthed my daughter in the birthing center, I may have died from blood loss before being able to transport to the hospital. While I still believe that most births are natural processes, you don’t want to run the risk that you are the one in a million who needs immediate medical intervention. Also, listen to your symptoms. Write them down and list them all out together! Perhaps if I had done this instead of bringing 1 new symptom to each appointment, it would have clicked in my midwife’s mind that something was off.