Change of Plans
I woke up on Sunday morning to go to the bathroom. It was early and I expected to return to bed for a few more hours before we’d hear Theo talking in his crib, ready to get up and greet the day.
On my way to the bathroom I knew something was wrong. I was in no pain, but it felt as though my water was breaking as I walked. I am 32 weeks pregnant so I was immediately petrified that this was happening too early. As soon as I turned on the bathroom light I realized that it wasn’t my water, I was bleeding profusely. I had actually been bleeding throughout the night but because I was laying down it had pooled inside of me and all came out in a gush as I walked. I called RJ into the bathroom and realized how bad it actually looked by the expression on his face. We immediately called the midwife who, upon hearing the details, said we needed to get to the hospital right away. I called my mother who I knew would be at my door in 5 minutes ready to be there when Theo woke up. I got in the shower to rinse off and for the first time it occurred to me what could really be happening. I began to pay close attention, trying to see if I felt her move. Not a minute later she jumped around, letting me know she was ok, though this didn’t calm my fears.
My mom was at the door minutes later, telling me everything was going to be ok, and that it was a good thing she slept in her clothes last night.
When we arrived at the hospital it appeared as though I was in early labor. I was feeling contractions, pressure in my back, and was 1 centimeter dilated. They moved us from triage to a room. A resident for our doctor came and performed an ultrasound to see the baby’s position in case I were to deliver. She was head down and as he was preparing to leave he turned around and said, “mind if I have another look?” This time he looked for the position of my placenta and said, “it is very low, we will have to look into it a bit more.” After a 3rd ultrasound it was determined that my placenta is fully covering the opening of my cervix. This is called Placenta Previa. There are several levels of this condition ranging from the cervix being partially covered to fully covered. When it is fully covered a vaginal delivery becomes impossible. This condition occurs when the embryo implants low in the womb, and the placenta develops in the same area. Often it resolves itself by moving upwards as the uterus grows. Women who find this condition early in their pregnancy are given high chances that they will still deliver vaginally. We would have found this at a 20 week ultrasound, but as our insurance doesn’t cover it unless it is deemed “medically necessary” we decided not to have one. Our midwife practice supports my mentality that the less intervention the better, and that mostly, whatever happens during pregnancy is out of our control. In this case, I am relieved to not have known at that time as I would have spent the past few months in a state of worry and fear — not knowing if it would resolve itself, what kind of delivery I need to mentally prepare for, or if it would cause me to bleed like it did on Sunday morning. A 4th ultrasound later that day showed that our daughter’s growth is right on track. She is 3 pounds and 11 ounces. I was administered the first of two steroid shots to develop her lungs so that, whenever the time comes, she is ready to be born.
The Placenta Previa is unlikely to resolve itself at this stage of pregnancy and we were told what to expect from here on out. The condition usually causes several incidences of painless bleeding (though not always). These bleeds occur when, for various reasons, a small part of the placenta detaches for the uterine wall (to my maternity nurse friends, correct me if I’m wrong). The first time a woman bleeds from this condition, a hospital stay is usually required, but it often resolves itself on its own. The placenta re-attaches where it needs to, and bleeding and associated contractions stop. In my case, this happened several hours after I arrived at the hospital, though I and the baby remained monitored for a full 24 hours. Most doctors require women who’ve experienced their first major bleed to remain in the hospital indefinitely because a 2nd bleed is anticipated in the coming days or weeks. This bleed has a harder time resolving itself and usually ends in the decision to deliver the baby via c-section. Our amazing doctor, who owns the midwife practice, explained that there isn’t much I can do to prevent a second bleed and after I received my second steroid shot for her lungs, allowed us to go home — knowing that it is the best place for us to be. I am not on bed rest, and my activity is not exactly restricted. I do have to spend the next few weeks taking it very easy, keeping my stress level low, and staying hydrated in order to prevent contractions which can cause the placenta to detach from my uterus leading to a second bleed.
At this point, we are mentally preparing for two different scenarios.
The first scenario is our “best case” and is what we are ultimately asking God for. In this scenario I do not have a second bleed before I reach 36 weeks. Because it is dangerous for me to go into labor on my own, if nothing happens between now and then I will go into the hospital for a scheduled c-section. I am 36 weeks on December 18th and at that point our doctor and midwives are confident she will be healthy enough to be born without needing any time in the NICU. This is our ideal situation. We are not upset at the prospect of a cesarian birth. We only hope that this experience can be just as positive for us and our daughter as our first birth was for our son. We made conscious decisions about how to bring him into the world and feel that he received every advantage because of them (though trust me, we know there is no “right” way to have a baby). After some research I am confident our daughter can receive the same advantages. For this reason we are hoping for a non-emergency situation in which our hopes for a “gentle” c-section where we experience the same bonding time as a new family as we did with our son.
The second scenario comes with different outcomes, and is stressful to consider. In this case I have a second bleed at some point between now and 36 weeks. Because this could very well be our reality I will not be alone at home from now until she arrives. If I have a second bleed I will call an ambulance and hopefully arrive at the hospital in enough time to have a c-section that is still a non-emergency. Even in this scenario we could very well have a “gentle” cesarian and a healthy baby girl. However, it could also turn into an emergency event in which I am put under general anesthesia and won’t have the privilege of spending the first few moment and hours with my daughter. This is my greatest fear. I also fear her having to be in the NICU. I know that if she needs it, is the best place for her to be, but I have high hopes of establishing a successful nursing bond with her as soon as she is born and the earlier she comes, the less likely that will be. This was so important for me and Theo and is ultimately, one of my greatest prayer requests. I do understand that a successful nursing relationship isn’t fully dependent on those first few hours, but it is what I’m asking God for.
At this point there are many unknowns. We are now spending our time preparing for every one of these options. Writing a cesarian birth plan, packing our to-go bags, considering what we will need for an extended hospital stay, mentally preparing to be separated from our son for longer than we’d like, setting up the house for her arrival, buying diapers, and all of the other little things that come with bringing a baby into the world. I was only just started to think about these things as I thought I had at least 6–8 weeks before she came. Now I need to be prepared for her to come at any moment. We are excited and scared.
We know that many other couples have faced this common complication. It is my hope that providing these details helps us to understand what women in this situation really need in terms of support. Often women experience this things very individually, without communicating their reality to those around them. This is just one of several things we’ve experienced in relation to having children that we wish we would have known more about before, and that, now having experienced it in some part, we hope to support others experiencing it in the future.
Praises:
RJ has Sunday and Monday off from work each week. Were I to bleed on a day he was working he would have been long gone before I went to the bathroom.
My placenta is covering the cervix, but is on the back of my uterus which makes a c-section very safe. If it were on the front of my uterus there would be no option for delivery that wasn’t life threatening.
I never made a very conscious decision regarding which practice we would use for my OBGYN care. Thanks to my mother I fell into Reading Women’s and Birth. They have been the most amazing and supportive group of people throughout both of my pregnancies. Dr. Cammarano and all of the midwives constantly put me at ease and make me feel like we are in the best hands possible.
We’ll be holding our daughter on Christmas. We know she should cook a bit longer, but the idea of meeting her sooner rather than later is ultimately exciting.
Prayer Requests:
That I don’t bleed again and that we are able to welcome our baby girl on December 18th with a gentle c-section experience. That she won’t need any NICU time at this point and we are able to have the same amazing post-birth experience we did with Theo.
That, if I do bleed before then, I am able to get to the hospital in enough time, and my bleeding isn’t too severe, for us to still have a non-emergency c-section. That if RJ is working he is able to make it to the hospital in time.
That, over the next few days I am able to prepare enough for her arrival to remove that stress-point from my brain. Something that isn’t typically stressful for me has become quite daunting.
That our hospital stay is a positive experience. I have had previous experience in hospitals and while I love Reading Hospital and their staff, and I feel very safe in that setting, I am generally uncomfortable being there. Theo was born at the Reading Women’s and Birth Center and we were home 6 hours after he arrived. This was so perfect for me physically and emotionally. I am confident God will give us the same comforts even though I am not in an environment in which I am comfortable.
Thank you for all of the prayers and support so far. I hope this was more informative and interesting, than long and boring. We are staying positive and happy here at home surrounded by people who we know will be there for us at a moment’s notice. We trust that nothing is impossible for God.