I'm a small-town Minnesota dietitian and triathlete.
I help endurance athletes reach their performance and body composition goals through a flexible eating style.
Welcome back to part 2 (of 2) of my unexpected, crazy-ass birth story. If you’ve read part 1, you know that I was admitted to the hospital with very high blood pressure and earned myself a ticket to be induced at 36 weeks and 3 days. Now as the induced labor progresses my memory of everything gets very hazy so I’m providing you with information that my husband had also shared with me afterward that happened that I was unaware of.
Here we go, part 2:
I get checked into labor and delivery, fill out the birth plan paperwork (birth plan = mom and baby go home healthy and I want an epidural) and I am gifted nurse Dawn. I loved all my nurses, but Dawn was especially awesome. I get visited by all the doctors, the anesthesiologist, the nurse anesthetist and a whole bunch of other people to talk about the plan. I had a very serious talk with my husband instructing him that when the baby arrives since he/she will be heading to the special care (level 2) unit and won’t get to stay with me that he had to go with the baby no matter what was happening to me. He argued only briefly saying he was going to want to stay with me, but I adamantly told him that no matter what the baby was going to have a parent with him/her. I just couldn’t stand the thought of our new baby being alone.
At this point, the contractions are very easy to handle, especially when I was standing up so I did a lot of walking around the delivery room, but the docs wanted my cervix to be dilated more before starting me on the pitocin (induction drug). So they had me use a foley ball. Have you ever heard of this? I hadn’t. It’s essentially a little balloon that they insert into the cervix and it has a long tube connected to it that fills the ball with saline to manually dilate my cervix. Every so often they tug on the ball and eventually once I reach 4cm dilated the ball will come out. If you’re cringing at the thought of this, you’re right on. It was so effin’ painful. There are not enough curse words in the world to explain how much it sucked. My contractions went from easy peasy to a nightmare and then some in a matter of 15 minutes. I couldn’t handle it, and asked for the epidural. I didn’t care about being brave or tough, that folly ball did me in and I knew the epidural was going to be my savior. And it was. That anesthesiologist gave me a great epidural. I was now confined to the bed, but I didn’t care. It was glorious.
Eventually, the foley ball came out, and they started me on pitocin. My blood pressure was still a little high, but it had come down a bit since when I had arrived that morning. They were taking blood every couple hours to monitor my levels. It got to the point that they were concerned enough to put me on a magnesium drip to prevent seizures (a risk that comes with the high blood pressure) and they warned me that it makes you feel really really crappy. So this is where things start to get a little hazy, but I remember that we waited and waited and waited for me to dilate further. I stayed at 4cm forever. It wasn’t until about 4 am the next day that I reached 7cm (I remember feeling so relieved to be making progress) and they were telling my husband about they were concerned about my blood work. My platelets and hemoglobin were dropping pretty quickly, and my liver enzymes were elevated. Not good, and he was getting worried… And he was texting my parents (who are nurses) and they were starting to panic as well.
By 6am I was 10 cm and they were prepping me to start pushing. My new nurse Leigh (who was pregnant herself and a freakin’ rockstar) was there with the doctors to help me do some “practice pushing”. I think of it as a warm-up stretch to the real deal. We transitioned to the real deal pushing. With the epidural, I didn’t feel any pain but I could feel some pressure to push against. It was surprisingly harder to push than I had expected. I started sweating and I got SUPER thirsty. Between every push I had my husband give me a drink of water. I was crazy thirsty. Push. Drink water. Push and sip more water. I honestly only pushed for maybe a half an hour, it didn’t take long. I was very in the moment, so I don’t even remember people coming into the room once the baby was about to arrive.
I found out later via my husband that there were 16 people in the room, including myself and my husband. Why so many? Well the neonatal team was there because I was delivering a pre-term baby. Due to my high-risk status with my blood pressure and lab work, I had the entire OB team including the chief of OB (standard protocol in those situation). So it was all hands on deck in case things went south. I was in good hands for such a scary situation.
At 7:05 am, baby was delivered. Funnily enough, we didn’t know if we were having a girl or a boy and part of the birth plan paperwork was to designate the person who will announce the gender of the baby. We honestly didn’t care, so when I got admitted we had asked the staff in the room to “call dibs”, well no one really thought we were serious and it was never really decided how that was going to be announced. So when they laid baby on my chest no one said anything, and it took me a few seconds to remember that I should probably ask what it was (keep in mind that I am sooooo out of it at this point, the magnesium drip that they were giving me through the IV turned me into a zombie mentally). One person said, “take a look” so I lifted the baby and said, “it’s a boy?” and about at the same time someone randomly from the back of the room goes, “it’s a boy!” Such an odd, and yet funny part of our boy’s arrival into the world.
They let him lay on me for a few more seconds and then take him away to be examined. Other than being on the small side, 6 lbs 3 oz (not bad for 36 weeks and 4 days!), he was pretty darn healthy and perfect. I got to spend a short time holding him and I was feeling so tired and scared I was going to pass out that I asked them to take him and for my husband to hold him. Now, my husband had never held an infant before and he was so terrified that I had to demand that he hold him. So as I was getting cared for south of the Mason Dixon line I just lay there and watched him holding our new son, Rory. The neonatal doctor had the baby do a little bit of breastfeeding. I was mentally a marshmallow so the doctor had to hold Rory to my breast and he actually did a great job latching quickly and had a good strong suck and swallow which was a great sign for the pre-term little guy. After what seemed like just a few minutes of breastfeeding they had to take him away to the level 2 special care unit for further monitoring, and I had to stay in labor/delivery for 24 hours on the magnesium drip in a horrible zombie state to be monitored for complications. The nurses brought Rory to visit me only once during that 24 hours and I was able to practice breastfeeding again. We struggled with getting latched and it didn’t help that I had no idea what the hell I was doing. The nurses had me pumping every 2 hours during the day, and every 3 hours at night to get my breast milk supply to start coming in, and the rest of the time I basically tried to sleep though that was difficult with the blood pressure cuff running every 30 minutes and getting blood drawn every hour or two. When I was awake and sitting in bed, I was able to watch Rory via the video monitor in his room that was connected to my room’s TV.
I did attempt to leave my hospital bed and be wheelchaired to Rory’s room once in the evening but I made it 5 seconds in his overheated room and needed to go back to my room as I felt sooooo sick. I was in such rough shape that I could barely get myself back into my hospital bed. I remember telling the nurse, “did you know that about two years ago I did a freakin’ Ironman? And now I can’t even get into this damn bed.” The nurse assured me that I would feel better in the morning once off the magnesium. And I did.
At 7:05 am the next day I was unhooked from the magnesium, got a few other important tubes removed from other areas of the body and was transported to the post-partum ward. By the time I showered, dried my hair, ate lunch I felt amazing. Something worth mentioning that during that 24 hour post-partum monitoring I had pee’d ginormous quantities of fluid. I’m talking 500-800 mL of fluid every single hour for 24 hours – we later estimated that I had likely about 8 lbs of excess fluid in my body at the time of delivery (yikes!).
It felt sooo great to have all that excess fluid out of my body and I was able to go spend the day with my new baby. Rory spent 4 days in special care. A lot happened in those 4 days. It was crazy with all the conversations with nurses, doctors and staff doing all the necessary testing and monitoring and needed procedures. Plus, trying to take care of my healing post-partum body from a hospital community bathroom/shower room. It was some challenging days, to say the least.
Rory’s first few days he was given donor breast milk via bottle in addition to what I was able to give him from pumping and breastfeeding. I was discharged from the hospital two days after giving birth. At discharge, they had given me the diagnosis of preeclampsia with severe features, but I had a post-partum appointment a week later the OB doctor to talk about my labor and delivery situation and she gave me the diagnosis of HELLP syndrome.
HELLP syndrome is pretty rare and is usually considered a variant of preeclampsia. HELLP is an acronym that stands for Hemolysis (red blood cells breaking down), Elevated Liver enzymes, Low Platelet count. The global mortality rate for HELLP is reported to be as high as 25%, with the most common reasons for moms becoming critically ill or die from liver rupture or stroke which can be prevented if it’s caught early.
For a few weeks after I had Rory I felt as if I had PTSD from the entire labor and delivery experience. I was having flashbacks, would start crying or become very anxious. It was a traumatic experience and I really struggled to move on from it afterward. I did a lot of reading on HELLP syndrome to help understand more about what happened and how can I prepare myself for future pregnancies. There was one particular older study that stood out from 1999 that stated of the patients they analyzed “approximately 90 percent of patients presented with generalized malaise (feeling poorly), 65 percent with epigastric pain”. Uhhhh, that’s me in a nutshell. I felt poorly for months and that upper gastric pain is a dead ringer for what was happening to me the week before I delivered Rory.
Symptoms of HELLP can include: headaches, nausea/vomiting that gets progressively worse (may feel like the flu), upper abdominal tenderness and pain, fatigue or malaise, bleeding, edema (fluid retention/swelling) and high blood pressure.
Hindsight is 20/20, and had I known all that general suckfest I went through in my pregnancy was not normal. It was a storm brewing and signals that my body was a risk for something pretty serious. You can bet that if I get pregnant for the 2nd time that I will be on high alert. I’m at a higher risk in future pregnancies. I hear varied stats, but 20-30% higher risk is typical for HELLP and preeclampsia.
I’ve learned an important lesson through all of this. I’ve learned that I’m responsible for my health care (not my doctor or midwife) and I need to be very assertive with my care during pregnancy and after, and I hope that these words may be of help to others as well. Be vigilant, you know your body best and if you feel something isn’t right say so and make sure they hear you (tell them to write what you say in their chart notes!). I am giving myself just as much responsibility as I give my doctor in my health.
Have you or a close friend or family member had HELLP syndrome? Comment below, I’d love to connect!