Saturday, April 28, 2012

Not again.

I honestly can't believe I am writing this.  We lost the baby.  It feels like the cruelest form of deja vu.  There are a lot of similarities between the our first loss we had in September.  In September shortly after I announced I was pregnant to my work, on facebook, and on this blog I miscarried.  And again that has happened.  I finally felt ready to share our joy and excitement with the world and now we have to share our grief.  This is so hard.  Last time I think what got me through was thinking that it was a fluke, that is was "one of those things" and that we would have a healthy pregnancy next time.  This time I am overcome with the realization that it isn't a fluke something is wrong and that is extremely hard to handle.  Earlier in my pregnancy I was scared to death that something would go wrong.  I was so anxious and nervous but when I got past 11 weeks I slowly started getting excited and I really started feeling comfortable with this pregnancy and really thought things were going to go great.   

I had a routine 16 week appointment on Friday.  For the first time this pregnancy I wasn't anxious about the appointment and my blood pressure was perfect (anxiety had been increasing it every other appointment).  When the nurse couldn't find the heartbeat with the doppler I wasn't even that freaked out, they took me to ultrasound and we immediately saw a precious little face.  I said "wow, he has grown a lot since my last ultrasound" and the room was quiet.  It was pretty obvious quickly that the baby was not moving.  The nurse tried to find a heartbeat or look for movement and then the midwife did too.  Then the Dr. B came in.  I knew it was over but I kept hoping that the baby would start moving and then for everyone to laugh.  Obviously that didn't happen.  Our baby had died very recently.  In cruel hindsight I think it probably happened one or two days before the appointment because I had been feeling flutters and I hadn't for a couple of days.  I wasn't worried because I knew that the baby can move positions and make feeling him or her early on inconsistent.  I have also lost some hair the last couple of weeks - which did make me a little nervous because I noticed I lost hair before I miscarried in September.  But again, I chalked it up to this being a "different" pregnancy. 

After learning the baby died the next thing was to learn the options and try to make the best decision for us.  This is something that I have heard other women refer to and it was as awful of a decision as I had imagined.  With our last miscarriage we didn't get to "chose" what to do as I miscarried naturally and horrifically at home and then the bleeding didn't stop so I had to have an emergency D&C to stop the bleeding.  The doctor said that since I had so much bleeding last time that I had to be at the hospital and therefore miscarrying at home would not be a safe option.  After my experience last time this was a relief to me.  If I had the option of going through the miscarriage at home, I probably would have naturally leaned that way but I would also be petrified of losing blood as quickly as I did last time.  So the options presented to me were to have a D&C on Saturday or to check into the hospital on Saturday and have labor induced.  Again - I naturally leaned toward having labor induced for several reasons but actually giving birth to the baby is a little more comforting to me personally and I would have the opportunity to hold the baby and see if it was a boy or a girl.  But the downsides to that is that it could take a long time and I don't think my husband or I could deal with being at a hospital waiting to deliver our dead child for long.  We both have so much anxiety and sadness over Fisher's birth and then the last miscarriage that I was afraid it would be too much for us to handle. The other downside was that there would be a chance that that I would go through all that and still need a D&C due to bleeding.   If I knew that wouldn't be the case, I probably would have gone through induction but since what happened last time I had a higher chance of needing the D&C anyway. 

I made the initial decision to go with the D&C and Shawn called and set it up for early Saturday morning.  Shawn was also leaning towards the D&C because he was traumatized by the last miscarriage.  I can't say I blame him, but he told me over and over that ultimately it was my choice.  The doctor wanted to do what we decided as soon as possible before I started miscarrying naturally and would have the risk of uncontrolled bleeding again.  After taking a nap I started second guessing my decision.  We were going to find out on Tuesday if we were having a boy or a girl and I really want to know, I want to give our baby a name.  I called and talked to the midwife that would have delivered our baby via VBAC.  I explained to her my reservations and she talked me through both options and told me that since Dr. B was ordering chromosome tests on the baby we would find out if it was a boy or a girl from that.  I also explained my fear of being induced and it taking a long time or ending up with the D&C anyway.  She said she understood and talked me through the different possibilities of that happening.  After talking to her I felt better about going with the original decision to do the D&C.  I also talked to my would-be doula and friend who has been through a similar situation at 18 weeks.  And having her support and understanding helped me be at peace with my decision. 

Saturday morning Shawn and I went to the hospital while my mom watched Fisher at our house.  I talked to Dr. B before the surgery and told him that I really wanted to know if the baby was a boy or a girl and he said he understood and would do his best to submit samples for chromosomal studies.   I ended up having a D&E instead of the D&C.  Basically it is a more aggressive procedure they had to do because the baby was too big for the D&C.  I lost quite a bit of blood in the OR (but not as much as last time thank God!) and woke up from surgery feeling horrible.  They admitted me to the Women's hospital and put me on pitocin because they wanted to make sure all of the uterus contents were out and to make sure my bleeding stayed under control.  I was actually glad they admitted me because I don't think I would have been comfortable going home.   While I was on pitocin I had some pretty bad cramping and passed some large clots.  I realized that I definitely made the right decision for me emotionally by doing the surgical procedure as opposed to the induction.  I can only imagine the emotional trauma that would come with hours of that.  After being on pitocin for several hours and being stable, they said that I could go home if I felt comfortable.  By this point I was ready to get in my own house and relax and to see Fisher.  So I jumped on the opportunity. 

Unfortunately just getting home made me feel really bad and weak.  I have been laying in bed most of the evening but have had a little Fisher time here and there.  But so far physically this has been harder than last time.   I am still in shock that this happened.  If the chromosomal studies do not show a problem then we will look at different issues.  It is horrific that you have to go through this at least twice before investigating problems.  I have heard many doctors say they won't look into the problem causing miscarriages until after three miscarriages.  Dr. B. said that since I have had two late miscarriages on babies that appeared completely healthy by ultrasound that it makes sense to investigate further.  I agree. 

I am heartbroken and pretty angry at the world right now.  I love being a mom so much and I have always imagined having at least two children.  I wanted them close in age.  That won't happen now most likely even if we do decide to try again I think it will be a long time.  I am angry that I allowed myself to get excited about this pregnancy.  I am angry that I already felt bonded with the baby and that I had convinced myself that this was going to be a healthy pregnancy.  I hate that I told work and have to go through that uncomfortable situation again. It was so hard on me last time and I can't believe I have to relive that.   I hate that I JUST got passed the due date of the last baby and was past all of those thoughts of how far along I would have been and now I have to go through all that again.  It just seems cruel and unfair.  I am usually such a positive person but I don't want to be that person right now.  I know that life will have to get back to normal and that I will have to carry on but not tonight.

Tuesday, April 24, 2012

Vacuum Injury

Vacuum injury.  That is what it is called in the medical world apparently.  Funny how we have been dealing with this crap for 2.5 years and that is the first time I have heard that term.  But according to an OB that recently reviewed Fisher's records - his injuries are textbook vacuum injury.  He said that the vacuum injury was of course caused by the brow presentation but that even pitocin induced contractions couldn't have caused the amount of damage on Fisher's face.  He said there is no way for a vacuum to cause such an injury except in a malpresentation situation.

I know it doesn't change things.   But having the cause of Fisher's problems laid out so simply, so succinctly is hard.   It would have been so easy to say "No, no vacuum.  Stop." I didn't.  I couldn't.  I didn't have the information and my head knows that I can't blame myself.  But sometimes my heart doesn't listen.  On the other side of the coin - in some ways "vacuum injury" is a little easier to stomach.  In my head I had always imagined Fisher's injuries developing over 22 hours of labor.  Thinking that the majority of the injuries happened over a shorter span is a little better to me.

This has been and continues to be such a long process.  In so many ways it would be easier to stop thinking about it, act like it didn't happen, and move on.  I know that many people could do that and a lot of times I wish I could. But I just can't ignore whatever it is inside me that keeps pushing me forward.  I ignored my intuition while I was in labor with Fisher and if there is one thing I have learned in this whole ordeal is that I will never make that mistake again.

Monday, April 23, 2012

So much to say....

I haven't posted in a long time!  I have had a pretty crazy 2012 thus far and there have been many times when I wanted to write about it, but for one reason or another I haven't. 

The big news - I am pregnant again :)  And SO excited to be into my 2nd trimester!!!!  The main reason I didn't post anything new since January is that we found out we were pregnant in January and it has been such an emotional roller coaster.  Things are so very different this pregnancy than with my first two pregnancies.  Instead of being super excited and bursting to tell everyone - I was scared and wanted to keep it just between Shawn and I for a long, long time.  I did tell a few friends very early and each time instead of being excited it scared me and felt like I had exposed a raw nerve.  Of course my friends are awesome and supportive and loving and just perfect at saying the right things.  It wasn't them, it was me.  We even held off on telling my family for quite a while.  It was just a bridge that was hard to cross this time.  To add to it, the first trimester was anything but easy.  I was sick, sicker than I had been with my first pregnancies.  My amazing team of practioners have been watching things closely and found that my progesterone dropped lower than it should.  So to err on the side of caution I was put on progesterone suppliments "just in case."  I breathed a HUGE sigh of relief when I got past 11 weeks, which was the point where I lost the baby last time.  And again - I am so thankful to have an awesome group of midwives and nurses who took the time to reassure me that everything was ok at that point. 

I have survived a couple of big milestones - first I told my work I was pregnant about 2 weeks ago.  I was so nervous about that but it actually went really well.  I can't express how relieved I am.  Also, I made it past the due date of the last pregnancy.  Ironically, I told work the day before that due date and I think the reaction I got at work made the due date a little easier for me.  So in a weird sort of way, I am feel like that little one was somehow connected to this pregnancy and the big announcement. 

So here we are - I am in my 15th week now, we find out NEXT week if we are having a boy or a girl.  :)  Things are going good - I am off the progesterone, past the sickness phase, and starting to show just a little.  It is actually starting to feel real and each day I find myself just a little more excited and bonding a little bit with this awesome little son or daughter that is devloping inside me.

Lots more I want to write about/document.  We found out Fisher has some teeth problems thanks to his birth trauma, I freaking helped plan and pull off what turned out to be an AWESOME Knoxville Natural Parenting Expo and Great Cloth Diaper Change....but that is all for now :)

Sunday, January 1, 2012

2012. Let's do this.

My plan for 2012.  No excuses.  Just do it.
  • Drink water.  Lots of water and no sodas.  Even diet sodas. 
  • Avoid sugar and sugar subsitutes as much as possible. 
  • Focus on eating whole grains, whole foods, and avoid processed food. 
  • Move it, move it, move it.  Continue exercising, running, and fitting in as much movement as possible with a goal of getting at least 30 minutes of exercise in 5 times a week.
  • Run a 5K with Rachael in February.  After that, run at least 1 5K a month.
  • Plan meals better and go to the grocery store less
  • Wear my BodyMedia armband for an entire year and track food for the whole year.  I think tracking food and exercise for an entire year will be really interesting.
  • Do not focus on the scale.  Focus on how good I feel and know that my body is healthy inside and out.
  • Love myself and my body for what it is, what is has done, and what it can do. 

Saturday, December 31, 2011

Good Riddance 2011

While this year had some great things happen - I have to say I am not going to miss it too much.  Shawn and I had lots of fun with Fisher, we sold a house, and moved to a much better city for us.  We have really enjoyed living in Knoxville and don't miss much at all about Ashland. 
But I will look back on 2011 as a tiring, rough year.  Moving, adding many job duties (and of course no more pay), the stress of finding Fisher a daycare and then not being happy with it and finding him a new one, had my gallbladder out, Shawn had his tonsils out and had several complications, etc,etc.etc.  Of course the most memorable thing for me personally is getting pregnant and then losing the baby.  That was hard physically and emotionally.  I had some stuff go on at work that was hard and some of it is tied into my pregnancy which has changed my feelings about some work related things and people.  So good riddance 2011. 

I am sending out 2011 on a positive note though!  My little sister Rebecca came in to spend the weekend with us.  We had a great time last night drinking wine and talking.  Today we went and had lunch with my grandmother, Mamadot.  I can't imagine anyone else I would rather spend the last day of 2011 with.  I am so thankful and blessed to have a healthy, amazing grandmother still in my life at 32 years old.  I enjoy every minute I spend with her and don't take any of them for granted.

Lunch date with Mamadot


Here's to a very Happy 2012 for our family and yours.  May this year bring lots of happiness, love, health, and joy!

Wednesday, December 28, 2011

A relaxing Christmas

It was fun experiencing Christmas with Fisher this year.  He didn't quite understand Santa but he sure understood waking up and having a tree full of presents!  Santa had set up a train table and a wooden train set and Fisher went to town.  We spent the entire day in our pjs - relaxing and playing together.  It was definitely a fun, relaxing day.


I have been thinking off and on about our little baby we lost.  I would be finishing up my 2nd trimester and prior to losing the baby I  was really looking forward to being pregnant at Christmas.  My mom and I had often joked that I missed out getting a pregnant Christmas ornament when I was pregnant with Fisher because I found out I was pregnant right after the first of the year.  I have wished often when looking at our Christmas tree that I had a pregnant Christmas ornament this year.  

Overall, we had a good, relaxing Christmas.  Shawn and I decided not to give each other gifts this year so it was all about watching Fisher enjoy his gifts which is good enough for me. 

Monday, December 5, 2011

The Gray Area

 For the past two years I have tried to reconcile my thoughts and feelings over Fisher's much needed c-section with my desire for a natural birth.  It is not unusual for women to have a c-section and then regret it.  Or to do research and question if a c-section was ever needed in the first place.  I don't fall into that camp.  I wish I would have had a c-section earlier on.  Go ahead and gasp if you are a natural birth advocate, but please read on....

Prior to having my son I did a ton of research on "unnecesareans" and I really felt like if I could go into labor naturally that I would have a vaginal birth.  I was super excited for labor and was ready to let my amazing body do what it was meant to do. I knew prior to having my son that coming into the world naturally would be the best start for him and for me as his new mother.  I knew that from all the research I had done but I also knew it inside.   It just seemed right to me.  I also knew that in the area I lived in this was very,very unusual.  But I wasn't worried because I had a plan.  My plan was to go into labor naturally and go to the hospital and put up with some BS but by avoiding the induction I would ensure myself at least a vaginal delivery. 

Things didn't end up that way though I did go into labor naturally.  I had been in prodromal labor for a couple of days and when my water broke I went to the hospital like my doctor instructed.  I was happy and felt so excited because I felt like I had won the battle.  I went into labor naturally and thus I was going to avoid major abdominal surgery (inductions increase your c-section chances by 50%)!  I was going to have skin to skin contact immediately after my son was born, get to hold him, look into his eyes, and introduce myself to him.  I was going to breastfeed him and cover him with kisses.  And oh yeah - I was also going to have an easy recovery and get back on my feet quickly because that is what I do. 

Things didn't end up that way either.  I get to the hospital with my water broken and in labor and the nurses pretty much freaked out.   The on call doc came in and introduced himself to me and I didn't see him again for about 18 hours and after I had been pushing for over an hour.  During that 18 hour time period where I didn't see him in person - he was ordering all sorts of things to "fix" my labor.  Pitocin, more pitocin, and more pitocin.  At first I declined because I knew that labors can stall out - but after a little longer I agreed to some pitocin. I thought it would be just enough to send me over the edge and let me push that baby out and move on to the next stage!  Ah, but the pitocin wasn't working and Fisher's heartbeat was decelerating.  So the pitocin was stopped for a while and tried again - he seemed to tolerate it better though I still was not dilating.  So more and more pitocin was ordered.  I was very uncomfortable with it, but I was afraid to say anything, because I am not medically trained.  Just some crunchy wildlife biologist who thinks that she is a mammal or something.  During this time I was never examined by the doctor.  He somehow knew what was going on in my stomach from afar.  After all, it was Sunday. 

So after hours and hours of pitocin hell I finally get to 10 cm and I get to start pushing. It was elated!   I freaking did it - I put up with all the pitocin and not moving but I was going to push my son out and hold him and that would make it all worth it.  Just give me my baby!

Only it didn't happen that way.  I pushed and pushed and pushed.  I worked harder than I knew I could.   The doctor came in after a while and I pushed and pushed some more.  He said he needed to use a vacuum.  I was just ready to be done.  The vacuum seemed to go on forever.  I knew that pushing a baby out could be hard work and take some time, but I started to get the feeling that something wasn't right.  And then the doctor said he thought something was wrong and I needed a c-section.  At this point I KNEW I needed a c-section.  It didn't make sense to me, I had no idea why in the world Fisher wasn't coming out, I knew it wasn't for lack of trying, but I knew that something wasn't right. So I went to the OR completely exhausted but not deflated.  I had done everything I could do and I knew it.  I was going to finally meet my son.

And then my son was born.  He was born beaten up, bruised, swollen, and was whisked away to the NICU.  The OB explained that he had been brow presentation which is why he wouldn't come down the birth canal - it was geometrically impossible.  And that geometric anomaly caused lots of problems.  Fisher had major facial trauma from his face being crushed against my pelvis with every contraction. See, I wasn't dilating for a reason.  I wasn't dilating because my son wasn't positioned properly to make a decent down the birth canal.   My body IS pretty awesome. It didn't fail me at all.  It knew that Fisher couldn't come out the way he was positioned so it didn't dilate past 5 or 6 cm.  But what my body and Fisher wasn't prepared for was the onslaught of fake contractions.  Pitocin induced contractions that after hours and hours, finally pushed his forehead down hard enough to dilate my cervix to 10 while crushing his face.    And the vacuum - the vacuum continued the assault on my son's head.  Pitocin and vacuums are contraindicated for brow presentation babies because it can cause these injuries. And they can also break a baby's back. Thank God that didn't happen. 

So basically, I am in this weird gray area. I am a very natural birth friendly mama that wishes I wouldn't
have even attempted to vaginally deliver my son.  He would have been so much better off. My son needed to be born via c-section as soon as I came into the hospital with my water broken.   Brow presentations can convert to full face or to vertex but if they don't convert they can't be delivered vaginally 99.9% of the time (a lot of medical literature say 100% of the time, but I have found one or two stories in which a brow presentation was delivered vaginally.  Regardless, it is pretty much impossible).   Because of this most OBs recommend a c-section immediately upon diagnosing a brow presentation.   However, that didn't happen because the OB didn't realize my son was malpositioned. 

So where does that leave me?  It leaves me at a place where I feel like the system failed me.  Many women have a realization after a c-section that the system failed them and they maybe could have avoided the c-section.  I am on the other end of the spectrum.  The last thing I wanted was a c-section, but under the circumstances that was the one thing I needed more than anything else.  Does that make me pro c-section now?  Kind of - I am very pro c-section in certain circumstances.  But what I learned from my son's experience is that what was was lacking was the one-on-one care, concern, and attention by a skilled provider.  See, I had convinced myself that I didn't need a provider that really took time to know me and one that I trusted because I was the one having the baby.  The OB was just there to "catch" it.  Most of the time I think women's bodies are amazing and will do exactly what they need to do to birth a baby.  But there is always those exceptions and THAT is why we pay people to be there for us.  To notice signs that something might not be right.  Not to search for problems that don't exist or to start throwing interventions and drugs at women to have them labor according to a schedule. 

The bottom line is I really don't want any other women to experience what I did.  I don't want any babies to be hurt like my son was.  What I want is for women to allow their bodies to do what they were made to do but when an intervention is needed I want it to be noticed and explained.  I want women to be able to trust their caregivers and know that they are being given information about what is best for them and their baby.   There is obviously a time and place for c-sections.   But there is no time or place to assume that all laboring mothers fit a mold and can be "managed" a certain way.    Nine times out of ten it might work, but for that tenth mother and baby it can be life changing.