As I was put under, I remember thinking “Well this is it. Either I wake up, or I don't"

I met my husband, Doug, through an online dating site. I didn’t realize I was looking for anything serious at the time, however it ended with a proposal in 2015 and marriage in 2016. Doug is 5 years older than me and heavily involved in the music world. He taught the drum-line where I went to high school and I was in the colorguard. We immediately recognized each other’s faces on the dating app and began talking. He lived in Oklahoma at the time and I lived in Michigan, however our timing was perfect. We met as I was graduating from graduate school and I decided to take a job offer in Oklahoma. I took a leap of faith and moved halfway across the country before we ever went on a real date. I trusted my gut and knew he was the one.  Our journey took us from Oklahoma to Florida and eventually back to Michigan to be close to family as we raise our children. 

My husband and I started a family fairly soon after getting married. We were pregnant within months of being married and both excited to have our first daughter.  Like most first time moms, I did not know what to expect.  I followed everything my OBGYN suggested and that included genetic testing. When the doctor called, I immediately knew something was wrong. I had raised Alpha Fetoprotein (AFP) which can commonly cause things like Spina Bifida and low birth weight. I was sent to a Maternal Fetal Medicine doctor (MFM) for further workup. We were relieved that everything looked great on ultrasounds and further testing.

My initial testing had resulted in a false positive.  I was still put into the category of “high risk” and frequently continued to see the MFM to monitor the baby’s growth through ultrasounds. The remainder of the pregnancy went smoothly until delivery. Since I was in the high risk category I was not allowed to go past my due date for delivery. I was induced on my due date and was in labor for 19 hours before the doctors decided I needed an emergency c-section. I was absolutely devastated after so much labor I needed a c-section. In the back of my mind, I was already determined to try for a VBAC if/when we had another child. 

I waited the recommended time between pregnancies in order to enhance my chances of a VBAC.  When we decided we wanted to expand our family, we were lucky enough to get pregnant right away.  This was not my first rodeo with pregnancy and I knew what to expect or so I thought. I declined the genetic testing this time around. It had added so much stress and misleading information during the first pregnancy that I could not do it again. The doctors assured us the majority of defects found in the testing would also be seen on an ultrasound.

At my 20 week ultrasound everything looked great except the placenta. I had complete placenta previa. This meant the placenta was completely covering the cervix and the baby had no way out - an automatic c-section. 90% of women see their placenta move by the time of delivery. The doctors were not concerned and neither was I. I scheduled a follow up ultrasound somewhere around the 25-week mark. The next ultrasound revealed the placenta had not budged at all. Devastation was the only word to describe how I felt that day. The idea of a VBAC was now fleeting (my dream birth plan). 

The next day the doctor called early in the morning, making my heart sink down deep into my stomach. Placenta previa was much riskier than I ever imagined. This was more than just a c-section. I was at risk for haemorrhaging at any point in the pregnancy. As you move into your third trimester, the uterus thins and can more easily trigger bleeding of the placenta. The degree of your placenta previa can dictate the risk. I had a complete previa, placing me into the highest risk category.  If you hemorrhage during pregnancy there is a chance you will bleed out because the placenta is a large source of blood and hard to control. I was told I must deliver by 37 weeks to reduce risks to the baby and myself. 

The next step was the MFM, a road I did not want to travel down again. I met with the MFM within the week. Looking back, I have no idea why I did not bring my husband to this appointment. Perhaps I was holding onto a glimmer of hope or still too naive about the whole process. The news was overwhelming at the MFM. The MFM stated not only did I have complete placenta previa but I was high risk for accreta. Accreta is where the placenta embeds itself into surrounding organs such as the uterus or bladder and a prior c-section is one common cause of accreta. A diagnosis of accreta places delivery even earlier usually between 34-36 weeks. The doctor sat down with me and her first question was “Do you want more children?” I was completely taken aback. She went on to state that I now had a 50/50 chance of a hysterectomy with the additional diagnosis. Additionally, I could no longer work.  I worked very part time at our local hospital as a speech language pathologist. She stated that walking around the hospital all day increased my risk for early hemorrhage.  I sat in my car sobbing. I tried to pull it together to notify my boss as I was already scheduled for the next day and throughout the remainder of the  year. I told her the gravity of my situation through sniffles.  I set up another appointment with the MFM for the following week to check the placenta. I was still holding out hope the placenta would still move (there was really only a small chance at this point in the pregnancy). 

Before my next MFM appointment, my regular OBGYN called me. I remember thinking this is unexpected, but was not anticipating more bad news. My OBGYN explained that she had conferenced with her whole team (8 doctors) and everyone agreed I was too high risk to deliver at our hospital. Part of the problem was that I was pregnant during the winter and I live in an area with frequent heavy snowfall. The team of OBGYNs logic was that if I bled (life threatening for me), I would not make it to the hospital in time. I now also required a massive team of surgeons for delivery given the new accreta diagnosis and they felt an entire team of specialists would not make it to the hospital in time for an emergency.  It’s worth mentioning that bleeding before the scheduled c-section is very common with placenta previa. I joined a group on Facebook for Placenta Previa and Accreta (bad idea) and saw just how early people delivered due to bleeds. Many women were hospitalized multiple times throughout their pregnancies and delivered extremely early. 

When I answered this unexpected call from my OBGYN, I was out running errands. I called my husband sobbing once again. I live in a town that is 2.5 hours from the closest large healthcare center equipped with round the clock specialists. My in-laws just so happened to live near the big hospital I needed.  My husband and I hatched a plan to move me downstate to my in-laws with our 2 year old daughter. He would visit on weekends. I moved downstate right after Christmas at 29 weeks pregnant. Christmas was not a joyful occasion for me this year. It seemed like the pregnancy was getting more complicated each day and the gravity of the situation was not lost on me. I also had a weight lifting restriction and could no longer safely lift my sweet toddler. My family felt that I could not be left alone with my daughter in case of the very real possibility of a life threatening emergency/hemorrhaging.  It appeared I needed a full time babysitter and my Mom volunteered to stay with us since my in-laws worked full time. Our friends joked we were the real life version of “Everybody Loves Raymond” with our crazy living arrangements. The whole crew  of my  in-laws, my Mom, my toddler, and myself all under one roof deserved a spot at the movie theater with popcorn. 

My Mom kept my spirits bright as I was slowly sinking into a hole of despair. We were singing “Grown Ups Come Back” from Daniel Tiger (PBS) around the clock to help my toddler daughter prepare for my inevitable hospitalization.  When I was 33 weeks pregnant I woke up with a bad bleed. Every doctor that had treated me encouraged me to call 911 if hemorrhaging occurred. The ambulance arrived within minutes. The worst part for me was watching my daughter wave to me from the window as I was hauled off.  My mother-in-law came home to watch my daughter and my Mom met me at the hospital. My husband was on his way, but 2.5 hours from the hospital. I was given steroids to help develop the baby’s lungs  and medicine to try and stop contractions. Every health professional that came in noted their goal was to get the baby to 34 weeks gestation. I stayed in the hospital for a week just waiting to see if I would bleed more. The waiting game was mentally challenging. As one doctor described, it’s like sitting under a sword and waiting for the sword to fall. I was a ticking time bomb with no escape. Every time I went to the bathroom I was triple checking for bleeding. I even woke up in the night checking for bleeding. After a week of complete stability, I was sent home on bed rest.  

I made it to 35 weeks and 1 day before the next big bleed. This was one week shy of my scheduled c-section. This bleed was much worse this time. I could feel stronger contractions and was passing golf sized blood clots. This bleed happened on a Saturday, which meant my husband was with me this time. He took me to the hospital and on the way I was hopeful I would get a new round of treatment to stop the contractions. When we arrived, it was determined I was already dialating and had to deliver immediately. During the two hours I was prepped for the c-section, my labor increased and the size of the clots increased. 

Although literally nothing was going according to plan at this point, I still held out hope I could have an epidural to be awake for the birth of my little girl. Afterall, I wasn’t sure I was going to make it through surgery. The anesthesiologist immediately shot down that idea. I required general anesthesia due to my possible accreta and lost the chance of my husband going to the OR with me. I also required a vertical incision due to the possibility of a hysterectomy.  The OR was cold and I was prepped as much as possible while awake in order to decrease the amount of time the baby would be exposed to the anesthesia, which was terrifying. In the absence of my husband, nurses held my hands and tried to encourage me. Four extra IVs were stuck in me in case I needed blood transfusions. The OR was filled with at least 15 doctors and multiple speciality teams. As I was finally put under, I remember looking at the big OR light on the ceiling and thinking “Well this is it. I either wake up or I don’t.” 

My C section was at 11 am. When I woke up it was dark out and my mom was sitting next to me. I was told I was in the ICU.  I could barely talk from being intubated but whispered to my mom “Is the baby ok?” She assured me the baby was stable in the NICU and on breathing support.  I laid there silently holding my mom’s hand. It was all the strength I had.  I groggily figured out things couldn’t have gone well if I was in the ICU.

I clearly did not have a routine surgery. My thoughts were soon confirmed when the doctor arrived. He stated I had lost almost all of my blood; 4.8 L to be exact (most people have about 5.5 L). He observed that I had actually lost even more than that before surgery as I was passing golf size blood clots. Most people would die from that sort of blood loss in surgery, but when you are pregnant you have slightly more blood.  I’m so thankful that I was at a hospital with a massive blood bank reserve. I also was beyond grateful I was put under. I couldn’t imagine hearing “She’s bleeding out” while on the OR table.  The next news was devastating and is still hard to process today. Once in surgery, the doctors found I had confirmed accreta. The placenta had in fact invaded my uterus. The doctors attempted to separate the placenta and uterus, but that led to extreme hemerroraging. The life saving decision was made to perform a hysterectomy. Here I was at 30 years old with no more chances for children. I am deeply saddened that I no longer have the part of my body that carried my precious children. 

I asked to go visit my daughter that night in the NICU. The doctors were weary of this because I was so weak, but I was determined. I had not gone through hell and back for nothing. I also selfishly wanted to meet my baby before my parents and in-laws. Isn’t the mother always supposed to see her baby first?  My ICU nurse and husband wheeled me to meet her. It took all my strength to make it there in the wheelchair.  I had not prepared myself to see my baby girl hooked up to so many machines. According to the NICU nurse, she was stable. We decided to name our daughter Elliana or “Elli” for short. Her name means God delivers. We felt her name was perfect for all we had been through and survived. 

I stayed in the hospital for 5 days. Because I had lost such enormous amounts of blood, I was warned by the doctors my body was in shock and may not produce breastmilk.  I was so determined to make this work. I pumped religiously and after 3 or 4 days my milk came in slowly! Finally something went the way I had envisioned. I wanted to help my baby thrive as much as she could in the NICU after feeling like my body had failed her completely.  Breastfeeding was important to me. Elliana came off CPAP quickly and required a feeding tube for 2 weeks. She rarely breastfed at the hospital, but that never deterred me. When we got within reach of a release date, we used a lot of bottles  in hopes of expediting her discharge.

After two exhausting weeks of juggling visits to her and finding time to devote to my two year old, we brought our little miracle home. It was hard for me to see the finish line until it arrived. Hospitalizations and doctors had been our lives for months. 

Because of sheer determination, Elliana has become a breastfeeding champ at home. I have slowly begun to recover both mentally and physically. I thank God everyday that I am alive and made it to the survivor side.  I feel like I am a modern day miracle and that my sweet baby is too. Our prayers were answered as so many things could have been worse for us. I could have delivered much earlier, I could have bled more frequently during the pregnancy,  or I could have died. When I went back to my original OBGYN for my 6 week postpartum visit, she was amazed to see how well I was actually doing. After reading the report, she felt I would not have survived if I had remained at our local hospital. She confirmed we had made the right call when we transferred my care downstate. 

Our daughter graduated from the NICU just as talk of COVID and shut downs began. I feel extremely lucky with our timing. I can’t imagine the heartbreak of mothers who could not see their babies in the NICU.  Within a matter of weeks of getting released from the hospital, our state was completely on lock down. Because we have a preemie baby with underdeveloped lungs, we have felt like we are very limited in going out. We will take our time to integrate back into “normal activities.” For now, we are laying low and playing it safe. 

Throughout my entire journey to motherhood, I have learned nothing goes according to plan. I am learning to feel proud of my c-sections. I have battle scars and strength I didn’t know existed. Birth plans do not always go as planned and that’s ok. I am no less of a mother for having c-sections despite the stigma I sometimes feel when saying I had c-sections. My faith and strength have grown because of the trials I have faced. I am blessed to be alive with two beautiful girls. My adventure in motherhood has only just begun. 

Megan - Mom of 2 - Michigan, USA

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