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Last week I had another ultrasound to determine if it is likely that I may be developing Placenta Accreta. My new Obstetrician had flagged thisas a real possibility a few months ago given my history and the fact that the placenta was sitting around the area where my uterine scar tissue is. Well, the ultrasound showed that it is looking suspiciously like Placenta Accreta. No doctor will say for sure as they keep telling me that it’s one of those conditions you cannot find out the fact until they open you up on the operating table. The placenta is still sitting low where my caesarean and D&C scars are but at least now it has moved away from my cervix a bit so there’s now no risk of Placenta Previa. Also, in the last scan at 19 weeks you could see the blood flow moving easily between the placenta and the uterine lining but that has now stopped. There is quite a gap where no blood flow can be detected between these two. When they enlarged the area on screen you couldn’t even tell where the uterine lining stopped and the placenta began – it looked all meshed together. On top of that I was told that there was an unusually large amount of blood flow in that part of my uterus which was also indicative that something ‘unusual’ was going on there, like Placenta Accreta. So while they cannot diagnose Placenta Accreta definitively, it looks like my Obstetrician will have to have all the necessary extra surgeons, assistants and nurses to deal with all the expected blood loss. I was told it was better to be prepared for the worst and hope that when they open you up it turns out to be normal!

But what is ‘the worst’? It is a possibility – a small one but still possible that I could die from this. So I’m now starting to think about rewriting my will, writing letters to my children and dear friends & family – even though they almost certainly won’t be needed but it doesn’t hurt to realise & write down what people mean to you (just thinking of it I have tears streaming down my face, and damn it – I’m in public, in a cafe!) If I did die I will be so pissed off that I didn’t get to pursue my long-term dreams but more importantly I feel for my children – not growing up with their mother present, and me missing out on seeing them grow up, and my husband having to answer many questions about ‘when’s mummy coming back?’ or ‘what was mummy like?’.

Enough of the morbid thoughts! The most likely ‘worst’ event I have to prepare for is the huge amount of blood loss that comes with Placenta Accreta when they try to separate the placenta from the uterus and it won’t come, therefore necessitating the need for a Hysterectomy to avoid death. I’ve read various personal stories from women who’ve been through this scenario and often they speak of 12 hour operations from the initial caesarean through to the development of the operation turning into a Hysterectomy procedure. Under normal circumstances Hysterectomies are performed when the uterus is its normal size – about the size of a pear I believe. But doing one where the uterus has only just given up a baby could be much more difficult. I need to speak to my Obstetrician next week to find out more but reading stories on the web has certainly been eye-opening and scary. I know I’ve probably read the worst ones as the more mild cases probably don’t get written about! Even so, I’d like to know the worst so I can prepare myself and my husband so we have help ready when it’s needed.

I’ve also been wondering about how I will cope physically once it’s all over. Anyone who tells you that having a caesarean is taking the easy way out of giving birth is talking out their arse! Whether it is an emergency caesarean (after having been through labour) or a planned caesarean you still have to recover from surgery as well as looking after a new born plus your other children. On top of which it is strongly advised you don’t drive for six weeks afterward which makes the school drop off and pick up tricky, especially when you don’t have family or friends who live close by who can do it for you.

A Caesarean Hysterectomy is supposed to take even longer to recover from so that would extend the timeframe for these difficulties. On a vanity point, I understand they cut you open in a vertical line up towards your naval as it is easier to perform the surgery so I don’t know how that would look in the summer (and no, I don’t wear one-piece swimsuits as my boobs aren’t big enough to hold them up – the straps are always falling off my shoulders!). On a more serious note, they may need to put me under a General Anaesthetic again instead of an epidural, which, if you’ve read my previous blog My Journey Through Infertility Part 1 you will know, will upset me a lot as I will miss out on my baby’s birth.

Some people who have been through all this have the added heartache of not being able to have more children. I cannot imagine their grief. I’m lucky in that this will be my last baby, we will not try for number four. Sometimes life is cruel and it’s good to remember that there are many couples out there who’ve had much heartache in not being able to have children or have not been able to have as many as they’d like because of health complications or many other reasons. Even though having a baby should be a joyous time, for some people it is a stressful time and it would be nice if more people recognised this rather than just assuming you are so excited about it all. How about asking how the woman or man feels about it rather than saying “you must be so excited!”, sometimes I feel like saying “well, actually, no. I’m rather stressed about it” just to see the look on people’s faces.

So that is where I’m currently at in my journey with baby #3. Hopefully everything will turn out fine but in case it doesn’t I’ll be prepared as I can be.