Wednesday, January 12, 2005
I couldn't wait until my appointment with the midwife in 2 weeks so I opened my 19 week ultrasound and the report indicated that my placenta was completely covering the internal os. I kind of knew that this meant I would more than likely have to have a caesarean, but I wasn't too phased about this (at this point anyway!)
At my 22 week appointment with the midwife, Renae, she informed me that she'd have to refer the report to the doctor. I told her I'd already read the report and knew what it entailed. Renae was absolutely wonderful, told me to ease off activity, to engage only in "gentle sex" and should I bleed at all to report to the birthing unit immediately. It all seemed a bit full-on, I thought it was just a placenta - what's the big deal??
Well, 3 days later (22+3wks) I woke at 5.00am to find myself bleeding and in a mad panic we raced to the birthing unit of Bankstown Hospital where I was told it wasn't a big bleed and that I'd have to stay in hospital overnight. Overnight turned into 3 days then I was released. From that point on, sex was cut out completely and I wasn't allowed to do any heavy lifting or vacuuming etc.
I remained in really good health until I reached 29+4wks when I was out at a sporting event and started bleeding heavily. I was quite embarrassed to be lying on the ground behind the grandstand with a cafe umbrella shielding me from the dozens of people who had come to "see what was going on" - an announcement was made that the races had to be halted as there was a "pregnant girl in distress behind the grandstand". So I was taken by ambulance to the Birthing Unit of the hospital again.
This time there was more concern from doctors and midwives. I was given steroid injections to help my little girls lungs develop in case I needed an emergency c-section. My hospital didn't deliver before 34 weeks so there was some concern that I would have to be transferred to another hospital if the bleeding didn't ease - but thankfully it did. Another 3 days in hospital and I was released on the proviso that there was someone staying with me 24/7 in case I had another APH episode.
A day and a half later, another 1.30am drive to the Birthing Unit with another APH. This one was small, but still scary nonetheless. I was given 2 cannulas in case I had to go to theatre straight away. The doctors came in and advised me one more APH and I would be transferred to Liverpool Hospital as they had a NICU and this was the third bleed and I couldn't continue to have bleeds as it was too risky for both my little girl and myself. The bleeding stopped pretty much straight away and I spent another 3 days in hospital.
I was given another ultrasound to see if the placenta had moved at all, it hadn't and I was told that my dates were off by 1 week, which pushed me back to 29 weeks again.
I was feeling very much on edge from this point onwards, as the bleeds were occurring without warning, without any strenuous exertion - in fact, they seemed to happen when I was sleeping. So I walked at a snails pace, I sat down in the shower, I lazed on the lounge all day in an effort to take the weight off the placenta. Then, 10 after my last bleed I again awoke with bleeding.
We rushed to Liverpool Hospital and once we'd finally found our way to the Birthing Unit, we learnt that the bleed was "old" and that I should go home after 24 hours. This 24 hour time frame was increased to 48 hours after consultation with the VMO, and following the high risk meeting on the Tuesday morning I was informed that I would have to stay in hospital until I reached 34 weeks, which was a fortnight away. Needless to say I was very upset, and determined to leave. I toyed with the idea of discharging myself, but then I realised that it was important for the sake of my baby to stay. I was advised that I could transfer to Bankstown Hospital once I'd reached 34 weeks.
That weekend I had another APH episode, this time it was a large gush and I was prepped for theatre. I was absolutely terrified that my baby was going to be born so early - even though I had the steroid injections and there was a NICU I just wasn't ready. The male midwife seemed incredibly concerned with the amount of blood I lost and was continuing to lose (i'd soaked the sheets, my legs were covered and it was all over the floor), but the registrar said it was only moderate - citing in the notes it was approximately 50mL - although she never saw the actual loss. I was contracting off the charts every 7 minutes and was offered pain relief but didn't need it.
That night it was difficult to sleep as the realisation set in that there was a serious risk to my baby with each bleed, and the next bleed could bring us closer to the Operating Theatre, and the NICU.
The following day I had another APH, this one was quite large again, but not as heavy as the day before. Once again I was strapped to the CTG machine and my little girls heart rate was monitored. At this stage I was having some mild contractions. The doctors said that they would not give me any medication to stop the contractions as the baby was now in charge and we would go by what she wanted to do. I was to have another ultrasound at some stage in the coming week to check my placenta and the baby's growth.
The ultrasound was wonderful, although quite painful. It was the first time I'd left my hospital bed in 11days. It was amazing to see my little girl moving around and sucking her thumb. I spent that afternoon in bed staring at my photo of my baby, who was now 4lb 4oz or 1950g.
Later that afternoon, I started bleeding yet again, APH number 7. The midwives assured me that it was old blood which had been spooling. Another 2 days later, and I awoke with another APH episode, so once more I was strapped to the CTG. Thankfully my daughters heartbeat was perfect, as it had been in each other instance, which meant she was happy and content and willing to stay put for a while yet.
I was beginning to feel more confident as I had gone several days without an episode of bleeding, however, that confidence was shattered when after 5 days from my last loss, another one occurred 4 days before Christmas. The doctors were advising me that it wouldn't be much longer before I'd have the scheduled caesarean and that much closer to leaving the hospital. On Christmas Eve I was desperate to leave the hospital however, the doctors refused to let me leave - even a day pass was denied to me. So after many tears, some contractions and a restless night's sleep I awoke to have my first Christmas away from my family.
It was an awful day, even though I had visitors, it was still depressing and lonely. Boxing day came round quite quickly, and so did another bleed coupled with more contractions. This bleed was probably the largest and quite painful. At this stage I was very anxious for my baby to be born as the constant bleeds and the stress they cause was taking its toll on me emotionally. Due to the public holidays, there were no Consultants or VMO's working in the hospital, so no decision would be made regarding the date of my caesarean.
I had developed the 'flu over Christmas, and on the 27th, I sneezed which caused another APH, again quite large - this made number 11.
Once the doctors had returned from their holidays, my Registrar Jennifer, informed me that they'd made a decision regarding my caesarean, that it would occur after my next 'significant bleed' which meant enough blood to soak 2 pads. I was terrified hearing this as I didn't want my daughter to be born as an emergency caesarean, it's not at all how I planned it. Upon seeing another doctor, he informed me that my notes indicated that I would be delivered regardless of the significance of my next APH episode. Jennifer said that there were no elective Caesars performed for another 3 weeks and that, in the absence of any significant bleeds, they would like me to hold on until after this time.
New Years Eve came and went while I was sleeping, and on the 2nd of January, 3.30am I had another bleed. Part of me was reluctant to call the midwife because I was terrified of what would follow. I lay there waiting for the cannulas to be inserted, as was standard practice whenever I would be actively bleeding. The midwife didn't put the CTG on my belly, instead she listened with a doppler. She also neglected to write in my notes anything about the bleed I had experienced, which explained why no doctor was sent to review me, and why no cannulas were given to me.
From 3.30 onwards, I lay in bed scared stiff, absolutely terrified because I was not ready or prepared for my baby to arrive. At this stage I was not due for over another month.
When I was reviewed by another doctor later that morning, he was astonished to find that I had not been delivered and that there was no mention of what occurred the night before. The following day, my registrar and VMO visited to inform me that I had been booked in to have my caesarean on Friday, January 7th. I was the only person to be scheduled for that day, and providing there weren't any emergencies, I would go to theatre at 1.30pm. I informed the family and friends that we'd be welcoming our baby on Friday and tried to relax as much as I could for the 2 days until the 7th.
On the Wednesday evening I passed a clot the size of a tennis ball and was strapped to the CTG yet again. This time, baby's heart beat was more erratic, jumping from very high 170+ to under 100 bpm. I was becoming more and more concerned, yet when the doctors arrived I begged them to let me deliver on the Friday.
Once baby's heart beat settled, after 2 or so hours, they were happy to leave me. Thursday morning, my room-mate and I awoke grumpy and tired, and planned on sleeping the whole day through. I thought that by doing this I would be relieved of the anxiety I was dreading about Fridays Caesar. We'd darkened the room and snuggled into our beds when my VMO enters the room and states that I will be delivered that day. I was third on the list and I should expect to go to theatre around 3.30 - 4.00.
I cant explain the emotions I felt at this time, because I was numb. Part of me was terrified, part of me was hysterical and the rest was in complete disbelief that in a few short hours, I would be someone's Mummy. It was all too overwhelming.
I called Ian who left work to be with me . I had visits from the anaesthetist, a social worker popped her head in, and the midwives were especially accommodating of Ian laying on the bed with me, holding me as I shook and cried with fear. I slept some of the day, and stared into space the rest.
At 3.45pm theatre was ready for me and I was taken to the Operating Room to deliver my baby.
I had a general anaesthetic and woke up in agony and itchy in recovery, where I repeatedly asked everyone who walked past me if I had a girl, which I did. The remainder of the night is a blur, thanks largely to the morphine drip. My daughter, Isla Ruby Maddalyn was born at 4.39pm Thursday, Januray 6th 2005 (at 35.2wks), weighing 2585 grams, 49cms long with a Head circumference of 32cms. Despite being early and small, Isla was healthy and went straight onto the ward.
Although the Caesar was the worst pain I have ever know, I look at my little baby now and smile just for her. Everything that I went through, the 49 days in hospital seemed so insignificant and trivial once I came home and started life as a Mum to my beautiful baby girl.