Tuesday, July 20, 2010

Mom to Gavin William
Born too early at 20 weeks, 6 days
January 9th, 2010

Getting pregnant was easy but not simple. We conceived our second son on our first IUI and injectables attempt. I couldn’t believe we succeeded the very first try. My pregnancy went perfectly until I began to notice some mucous discharge on the evening of January 7tn at 20 weeks and 4 days I honestly didn’t think much of it. Never could I have imagined it was the beginning of the end. The next morning I awoke to the same mucous discharge but now streaked with blood. I started to get concerned but headed off to work anyways. At lunch time I called labor and delivery because my Doctor and Nurse were both out that day. Triage said I should come in and get checked.
I thought I might have a urinary tract or yeast infection, something simple and treatable. The following is my birth story. Written in a time of fresh grief and shock, with some updates from today.
I sadly announce the birth and death of Gavin William January 9, 2010. He was 14oz and 10.5 inches long. I will love him always.

I never thought when I walked into labor and delivery Friday January 8, 2010 that I would be leaving with an empty tummy, broken heart and baby boy in the morgue.

When I arrived at labor and delivery I was considered low risk. Everyone assumed as I did that it was a urinary tract infection or something like that. As a result I waited for quite a while. While I waited for an assessment room I was asked to give a urine sample. At that time I discovered that there was more bleeding then there had been earlier. I let the nurse know and was sent back to the waiting area. When I did finally get into the assessment room the bleeding had increased. It was coming out with small bits of mucous. While I waited for the resident to come and check me it only got worse, I could feel it. I was also feeling some tenderness in my abdomen. My back was aching terribly but I chalked it up to sitting in the waiting room chair and sitting on the stretcher for hours. I never once thought it could be something else, something more sinister. I remember the nurse intermittently monitoring Gavin’s heartbeat. At one point he gave her a big kick. The first and last real kick I felt since I had an anterior placenta.

After a total 5 hour wait the resident came and did a speculum exam, and then a manual exam. She sat down on the side of the bed put her hand on my arm and said to me “I feel a bulging bag of waters and cannot feel any cervix.” I am sure my face just dropped, I know my heart sunk. I knew this wasn't good. The Doctor asked me if there was someone with me. My husband Will was on his way but not there yet. They left me alone to call him. I called my parents too as they had my older son with them. I remember being almost hysterical trying to get the words out “I might lose the baby.” My mother not being the most tactful person said something like things happen for a reason and I had to hang up on her. It was not the supportive response I was hoping for.
The nurse brought the ultrasound equipment into the area and as soon as the image came up on the screen I saw a balloon of waters, I actually thought it was my bladder but it was my bag of waters in my vagina. My cervix was dilated to about 3cm. The resident also thought the placenta also appeared to be low lying, although this did not show up at my anatomy scan. Gavin was breach and doing fine the whole time.
Will finally arrived around this time.

I immediately became very high risk and was placed into trendlenburg position with my feet above my head to take the pressure of the bag and to try to get it to go back into the uterus. I was told I had two outcomes. Either I would stop bleeding and they might be able to push the bag back in to do a stitch or I would deliver the baby. Of course he would not be viable at this gestation.

I was taken to a labour room, silly me I thought I would go to anteparturm. My Doctor who was not on call but happened to be on the floor came to see us followed by the entourage of residents and nurses. He immediately mentioned “chorio.” He was realistic with us, he told us it doesn’t look good that there was only a small chance we would make it to the OR for a stitch. He told us his partner would be on call that evening and that he hoped to see me on Monday.
After being settled into my room with a urinary catheter and a warm pack for my back I began to feel regular contractions, back pain and eventually an enormous amount of pressure. I was given some T3's, then a shot of morphine, and then gas. The only think that took the edge off was the morphine but it was very short lived. I was told that if I got an epidural it meant sitting up. Sitting up meant I would definitely deliver. Of course I declined the epidural.

By 1am on Saturday January 9th I was contracting every 2-3 minutes with the immense pressure. I was sucking back the gas with each contraction. I felt that if I pushed even a little my waters would break. The urge to push was enormous. Many thoughts went through my head. How long will I be able to hold out? Am I a bad person if I push? It’s over I might as well just push. I also prayed. I prayed so hard that I would be able to stay pregnant, that the contractions would stop.

Shortly after 2am while coping during a contraction I pushed just a little and I felt something move down and out....it was the bag of waters. I immediately called the nurse, she came in and I told her the baby was coming. She took a quick look and summoned a resident. The resident came in saw the bag of waters bulging out, broke it and in a few pushes I delivered Gavin at 2:17am. He was born alive, I saw him gasp for life three times. I am not sure how long he actually lived but it was just over an hour before the resident called the time of death. Will and I held him and loved him. We kept him with us for quite some time. He was bathed, hand prints and footprints taken, pictures done, kisses from mommy and daddy and then we said goodbye.
Not one doctor I have consulted is able to pinpoint one single cause for what happened. I had silent dilation, acute chorioamnionitis and a retroplacental hematoma. Each one of these things could have been the cause or as a result of one of the other things. To complicate matters I had a perfectly normal term pregnancy with my first child, with a somewhat complicated delivery.


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