OUR [complicated] BIRTH STORY
Some of those close to us know about the complications that led me to 5 months of bedrest (6 of those weeks were in a hospital), an unexpected delivery at 32 weeks, and an additional 5 weeks in the NICU for our sweet, baby boy.
But most people don't know about any of it. And I'll even venture to say that some people close to us probably don't understand the full extent of our entire story. We didn't share what was going on with many people, and during that time I took an extended leave of absence from social media... And really, the internet. I didn't feel like publicizing what we were going through. I didn't want people to know we were struggling, and I certainly didn't want to advertise about our [very] complicated pregnancy with the possibility that something truly terrible could have gone wrong. Now that we're on the other side of it all, I feel like it's finally time to share.
I also want to preface this post with an obvious statement that I am not a doctor or medical professional. This was purely my story, my experience, and what I have learned during my journey. Please do not interpret any of the following as medical advice, and if you're reading this and going through a tough pregnancy yourself, I pray that you are surrounded by a well-educated medical staff that can help bring your babe safely into this world. So with that said, if you're truly interested, and want to invest a little time (I apologize in advance, as this is not a quick story), I'll gladly tell our son's birth story. So here it is, poured out of my heart, in tiny digital letters for you to read:
It all started with our miscarriage really. Yes. A miscarriage. Even as I write those words, I don't really believe it happened. But it did. And we were covered with an insurmountable amount of grief. I intend to share much more about that experience as well, and even though it's where this story begins, I believe it deserves space and explanation all on its own. As the doctors told us, we needed to keep trying. And we did. Finally, we were given the news that we were expecting, and we were given the due date of April 3rd-- the same day we had lost our first to miscarriage, only a year before.
At 17 weeks, the complications began. One Sunday evening, I felt my water break. I knew it was too early for any of that, so we rushed to the hospital and after several hours of monitoring, we were admitted. Over the next three days, I had tests and more tests, medicine, IVs , and what felt like scan after scan to check fluid levels and to make sure baby was comfy in there. It all came to a head on the fourth day. One of the tests came back with some unfavorable results and my OB came in to walk us through it.
She told us the outlook was grim: it looked like I was leaking amniotic fluid, and because I was only 17 weeks, it was about 7 weeks shy of being able to use medical intervention to save the baby. She told us it would ultimately be our decision as to what to do, but she wanted to give us all the facts, plain and simple first:
If we kept on with the pregnancy, this baby would not be the same baby we saw on a scan only a week earlier. Babies need amniotic fluid to grow, develop, eat, and survive; not having enough causes serious complications for the developing child. If we kept going despite that, we needed to know our child would be severely deformed and would likely be disabled on multiple levels.
We also needed to know the danger I would be putting myself in if we continued. If I caught an infection (which was a major possibility since my water had broken), not only would they have to terminate the baby, but if I then became septic from that infection, my uterus would need to be removed and I would never again be able to have children. So while the choice was ours to make, I don't know how much of a choice there really was in any of those circumstances. So our OB prepared us for the worst. But before we would make any decision, we would have one last ultrasound to confirm the diagnosis.
The wait for that ultrasound may have been the longest of anything I have ever waited for in my entire life. I prayed and prayed and prayed. I of course cried, how could I not... but was then told not to cry because it supposedly puts stress on the uterus and could cause me to leak even more fluid. Okay. So don't cry. That sounds easy enough with the information we were just given.
Finally, we were taken in for our ultrasound and as they wheeled me in, I prayed for a miracle. Not just any miracle, but a miracle to keep this baby in, for him to be healthy, and for my body to heal itself from whatever trauma it had endured to put me in this predicament. The perinatolgist named Dr. Tiff, looked at the scan and couldn't believe what she saw. Not only was there enough fluid in there for our little guy, but my fluid level had increased by an entire centimeter within 6 hours! I don't think the doctor knew what to say. She repeated another test herself, and managed to say, "at this time I cannot recommend you terminate the baby". Even though that may have been the most clinical answer we could have received, it was nothing short of a miracle to us.
After reviewing the test results herself, our OB concluded that I had PPROM (Preterm Premature Rupture of the Membranes), which she thought was most likely a small, high leak in the amniotic sac which had managed to seal itself up.
PPROM occurs in fewer than 3 percent of pregnancies, and is usually accompanied by other risk factors that can attribute to the condition (none of which were applicable to me). Rarely, the break in the membranes heals and the leakage of amniotic fluid stops on its own, which is what had happened in my case. I read somewhere that 90% of PPROM cases result in delivery within 7 days of diagnosis, and diagnosed in the first trimester are given a <1% chance of sealing up.
Our OB prescribed two weeks of strict bedrest at home. I cried when I was admitted to the hospital, and after 5 days with ALL the ups and downs, I was now crying that I had to leave. The hospital was safe; and I knew if something were to happen, we were in the best hands possible. It took some major convincing (and prayer) to feel like home would be a better option.
Two weeks of bedrest at home came and went without a hitch. We were scheduled for an additional ultrasound to check fluid levels one last time and I passed without any issues. Thanksgiving, Christmas, and New Years all flew by, and I was actually looking forward to returning to work on January 3rd, after being out of the office since the 15th of November.
On Sunday, January 2nd, I woke in the morning with what I was sure were contractions. I thought it best to stay in bed and see if they would go away on their own. After about an hour, no such luck. I got up to go to the bathroom and had some severe complications. Back to the hospital we went.
The previous time I had gone into triage, I was monitored and then admitted after about 5 hours. This time, it took the nurses all of 15 minutes to assess me, check baby, and wheel me down to a labor and delivery room to be admitted. Whatever was going on was very serious and I needed to be in close proximity to an operating room in case I was to deliver.
At this point, I was exactly 27 weeks gestationally: three weeks past the age of viability, but one week shy of a 99% survival rate if baby was born. High risk started there... And the issues kept coming. I was put on bed rest, hooked up to an IV of magnesium sulfate to stop the contractions, and was visited by our on-call OB that prescribed other medication to stop labor as well. I was also scheduled immediately for an ultrasound.
A few hours later, Dr. Daneshmand, head of Perinatology for San Diego (and the co-founder of Miracle Babies), wheeled us up to the fourth floor for our ultrasound. After a thorough examination, he gave us our diagnosis:
Vasa Previa. As defined by What to Expect When Your Expecting as "a condition in which some of the fetal blood vessels that connect the baby to the mother run outside the umbilical cord and along the membrane over the cervix. When labor begins, the contractions and opening of the cervix cause these vessels to rupture and can cause fetal death." I'll be the first to say that this is an extremely broad explanation of the condition.
From there, I had further complications, some associated with Vasa Previa and some just because I was really just lucky:
Abnormal placenta growth.
In a normal, healthy pregnancy, the umbilical cord grows out of the center of the placenta. In my case, the cord had instead grown abnormally out of the side. The placenta, being the baby's only life support in the womb, cannot function properly and cannot correctly sustain the baby during the pregnancy with such an issue.
This means that as the baby and placenta grew, the placenta managed to split into two parts and was held together by tiny, fragile stands connecting the two pieces together. This was extremely dangerous; if any of those strands ruptured, it would essentially mean the baby would suffocate to death within minutes.
Velamentous Cord Insertion (VCI).
Since the umbilical cord grows out of the side of the placenta instead of the middle, it is able to traverse down the birth canal and get stuck in between the baby and the cervix. This is a problem on its own, but it causes (if you can believe it) further complications. The umbilical cord is strong, and is surrounded by a super tough jelly that protects the cord from being torn or crushed in utero. When velamentous cord insertion occurs, this jelly disappears and the cells of the umbilical cord implant themselves into the amniotic sac. This leaves the cord highly susceptible to damage. Any damage to the cord (my water breaking, contractions, basically... labor of any form) means rapid fetal hemorrhage or suffocation, and ultimately death for the baby.
Blood clot on cervix.
Which had ruptured, causing a partial placenta abruption (and what they think initially brought me in).
This is the separation of the placenta from the uterine lining. The placenta is part of your baby’s life support system, transferring oxygen and nutrients to the babe. When the placenta separates from your uterine lining before labor it can interrupt the transportation of oxygen and nutrients. Less than 1% of pregnancies will experience a placental abruption.
The doctors were incredibly impressed. Not only were they shocked that we had conceived naturally, but they had never seen this many complications present in one pregnancy. Great. At least I wouldn't be the boring patient on the high-risk floor. I'm a visual learner, so for all of you out there that read the previous paragraphs and don't have any idea of what I'm talking about, I've included a diagram below to better illustrate exactly what Vasa Previa is, and how VCI works. My condition was a combination between the two images below, and please note that our babe was breech, not head-down (of course) for the majority of my time during bed rest at the hospital.
Now Vasa Previa is extremely rare, occurring in about 1 in 5,200 pregnancies. It's even more rare if you conceive naturally (the incidence rate rises in IVF or IUI pregnancies). If it goes completely undiagnosed and a mother progresses to labor, the fetal mortality rate is about 95%. So our little boy was in some serious danger.
So what did this all ultimately mean for me? I think it goes without saying that me, but more specifically baby, were in some serious trouble. We found out that day that I would be staying in the hospital until delivery. This time, I had been admitted at exactly 27 weeks, and if I could stay pregnant, they would plan to deliver our sweet son via C-section at 35 weeks (anything past that risks labor starting on your own). That meant an incredible 8 weeks of bed rest. Let's just let that sink in for a second. 8 weeks of hospital living, of not going home, not sleeping in my own bed, not cooking or eating what I wanted, not WALKING, not having a baby shower, not getting our baby's room ready... Of not having anything remotely close to a normal pregnancy.
I felt like I was being denied so many things at this point. But I was suddenly reminded that God knows exactly what we need, often times before we do. I remember when we had been admitted at 17 weeks, and they had talked to us then about being in the hospital until I delivered! I remember telling Jon that there was no way I could do the holidays in that hospital. I could not do Thanksgiving, Christmas, and New Years in a hospital bed. And wouldn't you know it, the good Lord knew I wouldn't be able to handle that.
While sitting here writing this post, I was reminded of a verse: "And God is faithful; he will not let you be tested beyond what you can bear. But when you are tested, he will also provide a way out so that you can endure it." (1 Corinthians 10.13) He only gives us trials he knows we can handle and overcome. I was home for the precise amount of time I felt I needed - released from my first admittance two weeks before Thanksgiving, and re-admitted the day after New Years.
Even with that promise, it doesn't mean that my road during that hospital stay wasn't paved with trials and tribulations. I'll be the first to quickly admit, it was incredibly hard. The hardest thing I have ever done, hands down. There were days where I was at my absolute worst, and it's a huge testament to my family and friends, the doctors and nursing staff, and especially to my devoted and loving husband, who all helped me through it.
I'll save you the ups and downs of my hospital stay. I don't have enough time to explain it all here, so I'll summarize it this way: it was full of some really high highs. Like when all my college roommates (including two of them who were pregnant themselves!) made a trip down from San Francisco to San Diego and stayed with me for two full days! Or having my OB come and visit me EVERY. SINGLE. DAYUMN. DAY (Despite her absolutely insane schedule).
My stay was also filled with some really deep lows. All of the drugs and medications I had to be on, the lack of sleep from being disturbed every 4 hours around the clock for medication or monitoring. Pretty much constantly being in labor for over a month. Or IV day. Oh my sweet Lord BabyJesus, IV day. I have a very irrational fear of needles. That was the absolute worst, and may be breaking out in a cold sweat just thinking about it. *Massive emotional shudder*
I'm realizing now I could go on forever about all of this, so I'll get to the point. It all came to a head on Super Bowl Sunday, at exactly 32 weeks. That was the first goal our OB had given us; She said if we made it, our babe would be small, but he would be healthy and anything past that gestationally, was just a bonus. By 9pm that night, I was in full blown labor. Now where I was actively having contractions on the daily, that night they were coming in full force... Like every 3 minutes.
Labor was extremely dangerous for our little one, so the nurses pulled out all the stops. I was given every dose of nifedipine: my normal dose... plus the maximum additional doses. I was given a shot of terbutaline, triggering the "flight or fight" reaction in your brain, but also stopping labor immediately. It has the added bonus of boosting your adrenaline, causing extremely high blood pressure, and some major heart palpitations. I was put back on an IV of magnesium sulfate, to also aid in stopping contractions and protecting our boy's brain if we were going to deliver. Those nurses did everything (and I mean everything) they could to keep that boy inside.
I managed to last another 4 days. At 32 weeks and 4 days, I couldn't keep him in any longer. I was up at 4am answering emails when the contractions started again (yes, if you're wondering, I worked the entire time I was in the hospital, and I'm also totally insane). By 6:30, I was in full-blown labor again and the nurses made the call. They contacted my doctor, and I called my husband - we were going in for delivery.
Both my OB and Hubby made it to the hospital and were in my room by 7am. I was prepped for surgery, and we were wheeled down to an operating room. While the OR was being prepped, Jonathan and I just happened to see two familiar faces scrubbing up for a surgery. Dr. Tiff and Dr. Daneshmand. I couldn't hold it together any longer. Both of these doctors were SO impactful during our stay, and it was one last little detail to our story that had perfectly worked itself out.
Surgery started at 8:11. Almost immediately, my placenta ruptured. It was imperative to get that baby out quickly, and within 5 minutes, he was taking his first breaths. On February 11, at 8:16 am, I heard our son's first cry. Our OB quickly lifted him over the curtain for my husband and I to see him, and was then quickly handed off to the NICU team patiently awaiting his arrival. He was here.
And he was BIG! At 32 + 4, he weighed a whopping 4 lbs. 9 oz. and was almost 19 inches long. A gigantic baby for 32 weeks! I had prayed (given our circumstances) for a healthy, and heavy baby and we were graciously granted miracle after miracle.
Sebastian was born on February 11th, a day specifically chosen for him by the Lord. On a side note, this day happens to also be our dear family friends Steve and Cheri Kuptz's wedding anniversary. And I don't believe this is any coincidence. These two were a major part of our journey while we were in the hospital, they were our most consistent visitors, they were a major source of prayer, and they have been a massive part of our lives since presiding over our own wedding ceremony five years earlier. God had put our support system in place long before we knew we would need it, and we are so thankful for them.
So to be clear, Sebastian's fight wasn't over. He did another 5+ weeks in NICU, which was on its own another incredibly difficult experience that I'll share someday. But for now, I wanted to share my experience of a tough pregnancy in order to give people hope and show that not all pregnancies are easy. Creating life is not a given, and it's something that I would like to call attention to because so often I think we forget. We forget what a gift it is to create new human beings. It's not always simple to get pregnant, to carry to term, or to even deliver that babe safely into this world. Not only do I think that growing a life is a gift, but I also know that there are probably a billion things that have to go right in your body for that baby to arrive safely...and that is a mind-blowing thought all on its own.
But I'll leave you with this: I have come to realize that God's timing is incredibly beautiful. He is always setting us up for His bigger picture. I cannot describe the subtle nuances of our story in any other way than that we experienced a few of the Good Lord's miracles. We are blessed beyond measure to have had such an incredibly trying, and at the same time, absolutely incredible birth story for our son. In hindsight, even with all of the ups and downs, I wouldn't have wanted it any other way. Sebastian is completely loved and adored, and I know with complete certainty that he is meant to be here. He is our little miracle baby, he made it to us, and is our personal reminder to be thankful for this wonderful life. It's something we should cherish-- what a gift we have been given! So thank you. Thank you to our family and friends for your support, for covering us in prayer during our journey, and for loving on Sebastian. And thank you for letting me share our son's birth story - I am hoping you got here, to its completion, and above all, I hope it brought you joy!