This is the postscript to my earlier blog ‘Preparing for the worst’. For those of you following the journey of my third pregnancy here is what happened in the last couple of months:
After the ultrasound at 29 weeks I decided to not focus on the potential negative outcomes of having Placenta Accreta. I mentally prepared myself for the worst but decided not to dwell on it and to focus on the potential positive outcomes. I figured that worrying about it isn’t going to make it any better so I just started being more grateful for what I currently had and what might go right when it came time for the birth.
At 33 weeks, like my previous two pregnancies, the baby engaged very low, which is always a pleasant feeling…not! When I went to see my Obstetrician about two weeks later he started sounding more positive. He said “the fact that the baby has engaged is a good sign. If your placenta was still sitting very low and attached to the previous Cesarean scars the baby would not be able to engage – the placenta would be in the way”. I walked away on a high, feeling more positive than ever.
At 36 weeks I had yet another ultrasound to check on the likelihood of Placenta Accreta. It confirmed that the placenta had indeed moved further up my uterus but was still showing signs of Accreta. However, what it was showing was only a mild form of Accreta and only in a few small patches. Again, I walked away feeling more positive and when I saw my Obstetrician two days later he said he was happy to just approach the birth as a standard Cesarean and if problems arose he would deal with it at the time. I still had to sign consent forms to have a hysterectomy and blood transfusions if necessary but my Doctor really seemed to think they wouldn’t be necessary. On top of that, he told me that I would be awake for the birth – music to my ears!!! I was so grateful at how so much had turned positive in the previous few weeks. I could now relax and just enjoy, as much as is possible, the last few weeks of pregnancy.
However, during this meeting with my Obstetrician after all this positive talk he went very serious and quiet while reading through some paperwork from the ultrasound. I let him read and digest it, curious to know what brought this on. He said “how would you feel about doing the operation next Friday?”. I was a little stunned as I thought there was no reason to bring the operation forward. He continued “I ask because if you look at the results from each of the ultrasounds you can see on these charts that each time the baby’s growth is slowing down. At your last ultrasound the baby is only measuring in the bottom 10th percentile. That measurement in itself is fine but the fact that months ago the baby was measuring around the 50th percentile and then around the 25th percentile, I’m concerned that maybe your placenta isn’t very efficient and maybe your baby would be better off coming out earlier.” I didn’t see this coming but after talking with him I decided to go ahead with the earlier date. He advised me to have two shots of steroids in the lead up to the birth to help mature the baby’s lungs which I did follow through with as well as more blood tests to check how my Pancytopenia was travelling – turned out to be only mildly deficient – nothing to stop me from having an epidural or spinal block, so another confirmation that I would be awake for my baby’s birth, yay!
So the big day arrived. I remember sitting on the cold operating table, holding DH’s hand while they put the spinal block in – not a pleasant experience. Then I remember laying down feeling all sorts of strange sensations while doctors worked on my body, including hearing something similar to a chainsaw for a long time! I thought to myself ‘why would anyone choose to go through this when you have a body designed to do it another way?’ It always feels unnatural and somehow wrong being on an operating table and it hits you how much trust you put into medical staff. DH got really interested this time in watching the operation take place over the blue screen they put up between you and the business end of the op. I could feel his hand shaking all through the procedure – I’ve never seen him like that before. He would occasionally sit back down next to me shaking his head saying “this is a major operation!” He seemed so grateful for all that I had gone through and was going through for us to have one more baby.
Then the beautiful moment arrived, they pulled down the blue screen and showed my Doctor pulling our baby girl out of my abdomen and handed her to me briefly before taking her away for cleaning up and helping her breathe – she still had quite a lot of fluid in her lungs and breathing wasn’t easy for her. The doctors and nurses proceeded to work on the placenta and were pleased to see that even though the placenta was attached to the uterus in one spot it actually peeled away relatively easily, so no need for a hysterectomy or blood transfusions! I was so relieved. They closed me back up and when our daughter was stable again they brought her over to me for our first proper cuddle!
We named her Alexandra, a name we’ve had picked out for many years, and her middle name is Jane, named after a very dear friend of ours who passed away last year after a long battle with cancer on and off for 14 years. Alexandra stayed in a humidicrib (isolette) for 48 hours due to the fluid on her lungs and to help stabilise her temperature. Whenever she came out I did a lot of skin-on-skin with her which she loved and so did I.
As the last ultrasound predicted she is small – only 47cms and 2.7kg (5pound 15oz) and she looks like her skin is a little big for her but she has quite an appetite and guzzles down expressed milk or formula with gusto, unlike my other children! I have a lot of trouble breastfeeding – all the nurses and lactation consultants were telling me I was doing everything right but it’s still incredibly painful for me and my nipples get damaged very easily despite proper attachment. But I’ve given it a good go in hospital and know that now I’ll be doing half breastfeeding, half formula feeding for the next month or so and I refuse to have mother guilt over that. I’m doing the best I can. It’s easier to accept this as it is not my first baby – I’ve been there, done that before!
Two days after the birth the headache I had got significantly worse and a nurse realised very quickly that it was the headache associated with epidurals/spinal blocks. Because it was a Sunday I got back into the operating theatre within an hour or two and had a procedure known as an epidural blood patch. This is where you have another epidural procedure but they also take out some of your blood from your arm and insert it back into your spine to close the hole where spinal fluid is leaking out causing a headache. So that was a fun way to start a Sunday morning! The headache disappeared straightaway which was brilliant, I was so grateful!
So now that I’m back at home with my beautiful baby girl I’m just focused on trying to recover from the operation as well as taking care of our gorgeous girl. So my days are filled with me being elated one minute, in a pool of tears the next (I’m not emotional when pregnant, but I’m a mess afterwards!) and trying to manage the pain in my abdomen – every step can be agony, as well as getting in and out of chairs, sofa and our bed. I’m still taking a form of morphine for the pain and it is now the 7th day since Alexandra was born! It takes a long time to recover from a Cesarean – it is not the easy way out!! (There is no easy way out of childbirth)
I’ve been feeling guilty that I was never as sure as my husband was about having a third child. I was more focused on the practicalities of it but now that she is here – she is so precious and so beautiful – it’s like falling in love again – I cannot imagine life without her. Welcome to the world and our family baby Alexandra!