They took her.
I was cut open and hastily re-stitched; paralyzed by a spinal block; bags of my own blood prepared and ready to transfuse if necessary, though apparently the physical danger to me was now over. The operating room was cold and sterile, glints of hard stainless steel, no friendly faces. My kind and efficient ob-gyn was tense and grim, the normally jovial Irish brogue of the doctor assisting her was quiet. The c-section had been unbearably uncomfortable, to put it mildly. The sensation of an anvil pressing heavily on my chest, compressing my lungs. My arms outstretched out and restrained, a flat crucifixion. An oxygen mask on my face.
They took her five weeks early. In my second trimester, I had been told after an ultrasound that I had placenta previa. My memory is hazy, but I remember not feeling all that concerned at the time. The Women’s Care practice of which I was a patient had formerly had midwives, with whom I’d worked when pregnant with X three years before. That pregnancy and birth had been “normal” if constant ER visits and hospitalizations for chronic, severe migraine can be considered normal, which of course it can’t. But X had been born beautiful and healthy after a standard, relatively short labor. Dr. B was present at the birth because neither midwife was available, and there was meconium in the fluid so X’s nose and mouth had to be immediately suctioned, but all was well. I was able to hold her and nurse her right away. All of us were in the same room together at all times. I was surrounded by family and it was a joyous occasion and my 6 pound, 7 oz perfect cherub of a baby was so pink and pretty with her dark eyes and wisps of hair. I had gone in around 9 am, and by 9 pm, my cozy and comfortable hospital room was filled with a circle of our friends from the coffee shop where we worked. They brought dandelions and chocolates. My lovely friend Megan had tears dripping down her face. There was so much love, and warmth, and joy.
So I trusted that same Women’s Care practice with my second pregnancy, and Dr. B and the other doctors there, despite the fact that the midwives had departed and were not replaced. My migraine disease responded to the increased hormones as it had before. This time Imitrex was generally considered to be safe for use during pregnancy, so I had more options for treatment, though I was often forced to seek additional help at the ER and hospital. When I was told about the placenta previa, Dr. B explained that the placenta was growing between the baby and the cervix rather than on one side, which meant that if it didn’t move up there was no chance of a natural delivery and I would have to have a c-section. I was okay with this. I was put on “light pelvic rest” which meant I shouldn’t lift anything over 20 pounds and told that I should call if there was any bleeding. I don’t think there was any particular urgency or danger implied. I was also told that my baby, which I already knew was another little girl, was breech. That news was delivered with the same tone. I walked out happy. She was doing fine. I thought, well, I have a three year old. I’m going to have to pick her up sometimes. I even thought, maybe I might prefer to have a c-section. I was conflicted about that, but I didn’t feel any trepidation or overt worry. I didn’t obsessively google placenta previa. I followed the pelvic rest instructions, usually.
The placenta did not move. Zo was growing at a steadier rate than X had in utero, and was already around 5 pounds in early Febrauary when the c-section was scheduled for March 17. I thought about buying a silly onesie that said “Baby’s First St. Patrick’s Day.” I worried a little about the c-section, but thought, how bad could it be? I liked having a certain date marked on the calendar, especially since X had been a week late. Sometimes, when going grocery shopping, I’d quickly lift little X into the cart. Despite the horrible persistent migraine pain I felt strong and immune to danger, especially the type of danger that could threaten my life or the baby’s. I should have done some research. Maybe I didn’t want to know.
Click here to read about placenta previa.
Three hours ago I woke gasping from a terrifying nightmare, probably brought on by the experience I wrote about in my last post: driving around an unfamiliar area with my daughter strapped into her booster seat behind me, blinded by level 10 pain, already having vomited, searching for a safe place to park. Zo alternating between reassuring me and plaintively asking if I was going to die. Panicking, unable to take her in my arms and calm her fears, unable to calm my own. In my dream I had lost Zo after picking her up from a strange prison-like school with many obstacles between my car and the line of children and their belongings. I had her by the hand, pink shirt and ponytails, smaller, still preschool size. And then I didn’t. I didn’t see her anywhere. And I began to scream, her name (which in actuality has three syllables) over and over, desperately. All the children had pink shirts and ponytails, but none were her, and the obstacles loomed up everywhere, and then I couldn’t breathe. I signaled frantically for all of the adults to help me, I couldn’t find my daughter, my baby, she was gone, and I couldn’t even breathe. She was gone. She was taken from me and I couldn’t keep her safe, or even myself safe, or properly communicate. My flailing hands, my pounding, terrified heart. My baby.
I pulled myself out of the dream as though surfacing through water, drowning. I took a huge breath and realized my nose was completely stuffed up when I hadn’t had a single cold symptom when falling to sleep a mere hour (I discovered) earlier. My daughter’s name was still echoing in my head, the tearing, shattering sense of loss, and I ripped the blankets away to find my six year old Zo sleeping soundly, her light brown bob framing her perfect face, hands tucked under one cheek the way she has always slept since she was born. She likes to sleep with us and often crawls into our bed in the middle of the night. She was right there, safe and breathing deeply.
Talking to J soon afterward, in tears, I realized that the experience at the airport had taken me back to my fear and helplessness and injury at Zo’s traumatic birth.
On Friday, February 13, 2009, X and I were with friends at a crazy bounce house filled building called Monkey Jump. Had I lifted X there, too? Maybe. The warehouse sized room was filled with screaming, careening, children in socks and their weary parents. I wasn’t feeling great. Not with migraine, but with more fatigue than usual, and something else. X had had a good time. Did I take her to my parents’ afterward? Because I think I was home alone when I felt something strange, an internal twang, which compelled me to head for the bathroom though I didn’t have to pee. And there, I found blood. Not spotting, but blood that dripped and puddled on the tile floor. “Call us if you have any bleeding.” Okay. On auto-pilot I sent J a text that I was bleeding, probably the placenta previa, and that I was going to call the doctor as I’d been instructed. When I did so, I was surprised at the response. Even at the sight of the blood, I hadn’t felt particularly alarmed at first (though perhaps I had gone into shock; these particular memories are very clear). This possibility had been handled so casually. Not “you could bleed out,” or “bleeding would indicate the placenta rupturing.” Certainly not, “you could die.” But my call and the news I delivered was handled like a dire emergency. And I did have an awareness of the bleeding… not stopping. Which couldn’t be right. Is this what they had meant all along by “bleeding”? I hadn’t imagined anything like this near deluge. Drips, spots, I’d thought. Were there varying ways you could bleed from placenta previa? I realized I knew almost nothing about what it truly meant to have the placenta pressing against the cervix during pregnancy.
I changed and dug up a large menstrual pad. I lay down and waited for J to come home early from work and take me to the emergency room, which is what we had been urgently instructed to do on the phone. I was surprised and beginning to get very scared, and angry with myself, and angry with Dr. B. Why had I not been made aware that the bleeding which could occur would be a sizable quantity? That I would have to immediately report to the hospital? “Call us” to me meant I could have some spotting and would need to make an appointment and probably stay in bed after that for the remainder of the pregnancy. That is what I’d thought, what the casual tone and lack of explanation had led me to believe, or allowed me to think. Instead it was an emergency, and the hospital, and bleeding which wasn’t stopping. It didn’t hurt. My baby was just over 5 pounds and I was at 34 weeks gestation. We hadn’t prepared the nursery yet, had no bedding, no supplies, though that didn’t even strike me yet as a problem because I was 5 and a half weeks away from surgery, right?
We went to the hospital, where they were waiting for us. I was hastened to a wheelchair and whisked to a comfortable ER room with more equipment than usual. Again, my memory is hazy here, but I was laid flat and hooked up to monitors, where it was determined that I was having contractions. Labor would have to be halted. The bleeding had to be stopped. I wasn’t going to be leaving the hospital. I sent a text to my friend Leah, at work, and asked her to pray for me. I don’t believe in a God that answers prayers but I wanted all the help I could summon. I was terrified.
Of course I know now that placenta previa is an extremely dangerous condition which can cause placental abruption, severe blood loss from hemorrhage, early delivery, congenital malformations, and even death for both mother and baby. I was told none of this. Perhaps my migraine situation had been considered, and my stress level. But what you don’t know can hurt you. And I still believe that it was carelessness and not its opposite which caused my lack of education. In 2009 I was not yet blogging about migraine, advocating for myself, and accepting that I would be chronically ill forever. Now all that has changed. Now I would never accept a diagnosis without asking a lot of very specific questions and doing my own research, as my trust in doctors has been betrayed too many times. This change in my attitude about illness and taking charge of my own body and health was partially because of the trauma of that weekend, one of the most important of my life, Friday the 13th through Valentine’s Day to President’s Day 2009.
I was given medications and admitted to a dark, quiet corner of the maternity floor. The labor and bleeding were stopped, but I was on strict bedrest and barely allowed to move. A catheter was inserted and in order to relieve myself “the other way,” which they needed me to do, I had to use a bedpan while lying down with a nurse present in case the placenta ruptured in the process. It was the most humiliating experience of my life. I couldn’t and didn’t want to see any humor in it. I will never forget the kindness of that nurse and the bond I felt with her, though I no longer remember her name. Years later, she walked into my place of employment and I burst into tears before I even knew why. At least, that day, I was able to tell her what her care of me during some of my darkest days had meant.
**(Update)** Since first publishing this post, my mom has filled in some of the gaps in my memory. Those are added in asterisks.
J and X visited. They brought me Valentine’s Day gifts. The debate began about Zo and whether to keep her “safe” in the womb or to deliver her by emergency c-section immediately to minimize the risk to me. Dr. B had always seemed laid back and was often laughing, so her seriousness and grim demeanor when she would examine and discuss the situation with me were even harder to miss. I was at huge risk. The baby was at huge risk. **The nurses referred to me as a “ticking time bomb.** And Dr. B also didn’t seem surprised that it had occurred. If it was so likely, why wasn’t I told? Why wasn’t it explained that lifting my daughter could actually quite literally kill me instead of simply coming across casually as “not recommended”?
Fortunately Zo was 5 pounds, 5 ounces. I had a special ultrasound which revealed more details and that was truly a joyous moment within the constant terror. I saw her wiggling on the screen, head still down, but healthy, with well developed lungs (I don’t remember whether they used steroids to try to develop them further but it seems like they did). **She did not need steroids, and the ultrasound showed she was taking “practice breaths,” a stage of in utero development indicating fully developed lungs.** It was decided that she could be safely delivered but they wanted to wait as long as possible, and as long as possible turned out to be Monday. I would be exactly 35 weeks gestation, making her “pre-term” instead of “premature.” So I lay flat on my back and waited, terrified and uncomfortable. I did have one more small bleed which convinced the team even more that she needed to come out of there. Dr. B explained that the c-section would be dangerous because just a tiny flick of the scalpel to the placenta could cause me to hemorrhage. The blood was prepared. Another doctor from the practice would be assisting, a pediatrician on hand, a life flight to a Toledo neonatal unit lurking nearby. They seemed far more worried about me than the baby. I think J felt the same way.
I was wheeled to the operating room. J would be joining me immediately before they began. I was so cold. The anesthesiologist was not kind, although I can’t remember in what way; I just remember being nearly naked and shivering as the spinal block was administered to numb me completely from the middle of my back down. I was laid on my back and strapped down. The sheet was dropped in front of my face to block my view as the bustling, tense doctors and nurses prepared. I had had surgeries and lots of medical experience and had assumed a c-section would not be horrible, but nothing prepared me for this experience. Something about the spinal block caused me to feel a huge weight on my chest and I felt I couldn’t breathe. Tears streamed down my face and puddled on the table underneath my head. J came in, dressed in scrubs. “Help me” I whispered. “I can’t breathe.” An oxygen mask was procured and I still felt the blind panic. I asked for anti-anxiety medication and I felt no change after it was administered into the IV. J was behind me.
Surgery began. I heard soft urgent voices and felt more pressure. I knew they had lifted my uterus out and were trying to remove the baby from it without touching the dangerously connected and positioned placenta. She was out. One part of the team whisked her quickly across the room. There was no noise. The doctors were still urgently and carefully removing, replacing, stitching, but the baby. Where. Why. The troublesome placenta splashed harmlessly into a metal basin. I tried to lift my head to see around the sheet and saw brief glimpses of a tiny and gray creature who made no sound. She wasn’t THAT early. Over five pounds. Why wasn’t she crying. The frantic figures in blue took my blue baby away and she was gone.
They took her.
J was given the choice to stay with me or go with the baby. I remember urging him to go. I remember someone saying “It will be okay” and believing them because I had no choice. All I knew is that they hadn’t even shown her to me. I hadn’t heard her cry, and from my pinned down, blocked vantage point she hadn’t looked good.
Mom was with me. I remember thinking she didn’t seem panicky. I remember her being more nervous about the meconium staining at X’s birth. I was wheeled back down the hallway. The tiny, ill-equipped neo-natal room was to the left, where J and the baby were. I strained to see through the blinds blocking the windows. I still couldn’t really move. Terror but then inescapable grogginess. I had been stripped bare and ripped open, quickly put back together, but felt my heart was outside my body and it had stopped beating. Back in my comfortable new recovery room the darkness descended and, mercifully, I was out. **This is only a trick of my self-protective mind. Mom says I never lost consciousness. I was hysterical.**
J’s account of his time with Zo plays in my head like a movie I can’t quite see. I imagine it with beams of light shining from – where? and the nurses like loving angels. All I experienced was a seemingly dead baby being taken away. J saw her struggle to survive, her fight and will to live, and the care of those professionals who had seemed so cold and faceless to me in the operating room.
Immediately Zo was placed under an oxygen hood. Wires attached, IV lines inserted, with little response from a tiny blue baby with no fat on her body to protect her. I believe that the air ambulance techs were rushing inside with their equipment, preparing to rush her to a better equipped facility to the north. J, stunned and horrified, willing his miniature second daughter to breathe, just breathe. I feel like they allowed him to touch her but I’m not sure, and he was so traumatized by the whole experience that I’m not going to ask him right now to re-live it.
“Breathe. Just breathe. You can do it. Breathe.” Talking to her, willing her, knowing it might be no use. Maybe only a minute went by from her removal from the operating room to her placement under the hood and the gasp and flutter as she fought to the surface of her harsh new environment, and while the nurses worked, opened her mouth and inhaled. And without extreme measures, before the reserves arrived, just a little extra help and pressure from the hood and she did it on her own. My baby lived.
J describes the response in the room as a huge burst of joy and near disbelief. Her quick rallying was unexpected. She wasn’t able to cry for some time. Even the poking and prodding, needles and tubes and wires and probes didn’t provoke wailing and protest, but she breathed. She breathed. J sobbed, the nurses laughed, and they did something unprecedented for lawsuit-weary and wary hospitals: they allowed J to take a video of Zo’s first live moments with a small video recorder he’d had in his pocket. They were calling her tough, so strong, a miracle baby. Born blue, then breathing on her own.
The first time Zo cried was when they bathed her.
J brought me the video before they could allow me to see her. He stood next to my bed in tears, and was able to show me the miracle of a breathing baby. She was okay, and I had no awareness of the death and fear and rebirth J had experienced before he began recording; I only had the sensation of that awful operating room and the lack of a baby’s expected cry which had settled into my soul and would never leave. J removed the paper cap which he’d been told to place over his hair. His dark curls had turned about 15% gray since before putting the cap on. He says that as soon as he took the cap off I gasped “Your hair! It turned white!” He was 28 years old. I was 35, and appeared far younger. I date my own more rapid aging to that day as well. We would never be the same.
Holding her for the first time was transformative. I don’t remember how soon she was able to stay in my room with me, but it didn’t take long. **Mom says I got to see her around 2:00 pm (the c-section was at 8).** Her heart and oxygen monitors never sounded alarms other than to indicate disconnected or twisted wires. I was able to nurse and my amazing lactation consultant helped me to pump extra milk in order to supplement her feeding without the use of formula. She would latch, and I would insert a tiny tube into her mouth as well. The fact that we were able to do this was another amazement to the doctors and nurses, who fully thought Zo would refuse to nurse or be unable to demonstrate a sucking reflex.
My young and pretty family doctor, who was struggling with her own chronic illness which would soon cause her to retire from medicine, came to examine us and kept blinking in disbelief. “You can go home,” she said, astonished. “You don’t even need to take a heart monitor with you. Neither of you needs to spend any additional time in the hospital. She’s fine. You’re fine.”
But J and I weren’t really fine. We were joyful and relieved, but damaged.
And the trauma of the recent day when I was again helpless and unable to protect Zo brought all of this back to me in the guise of a terrifying nightmare. But I was able to wake, and see her there sleeping, my strong, tough, spirited miracle child, and I decided to purge myself of the experience in writing for the first time.
They took her away from me and I couldn’t look at her face or follow or even move. But she lived. And so did I.
**In talking with other traumatic birth survivors, including a good friend with the same doctor / hospital whose experience seems even worse than mine, I have learned it is fairly common for c-section babies, especially pre-term ones, to not breathe/ cry because their lungs don’t get exercised while being pushed down the birth canal. Therefore, no matter how it seemed to J and me, and no matter how relieved and happy the nurses were, my 5 lb, 35 week baby was no “miracle,” just a slightly worrisome statistic and one who happened to rebound really well. But I was catastrophically under-informed. I should have been told there was a chance she wouldn’t cry and that I wouldn’t be able to see her right away. I certainly should have been told more about the placenta previa and the danger I was in. In any case, this is my experience as I remember it. And Zo will always be my miracle child.