My Uterine Rupture and Placental Abruption (Part 3)

18 Apr

**Disclaimer: I report what I remember as I remember it. I was, however, in lots of pain and heavily drugged.**

I am not educated on how the body perceives pain. I know I didn’t feel the pain at the spot it apparently occurred, my former C-section incision site. A nurse told me when you experience acute pain, your body just knows to respond with feel pain! You could feel it anywhere. I felt the pain of rupture higher in my abdomen.

I also had a vivid experience, and saw two growing arcs of pain, that climbed and climbed then met at a point at the top. And at the top, they broke. I keep trying to explain this to people, but it’s hard because, like the buzzing in my ears, I admit it’s bizarre.

The rupturing, which likely simultaneously caused the placental abruption, did actually almost feel like a contraction, but it outperformed any contractions I have known. It was a pain where you have to holler. One additional event followed, with arcs of pain that built and met then broke. I screamed. And then I knew something had ripped. I reported it as a pop to the nurse, though, and also that I’d gone a little numb. These were of high interest to her; she had me repeat what I said, her eyes wide. She was afraid now, and I knew it.

I looked at Ben’s heart monitor as this was happening, and the digital screen seemed to blink 160 then 0 in a flash. Several repetitive tones and lights began. And the doctor was already beginning a hasty ultrasound.

Neither Drew nor I saw what was on the ultrasound. I remember thinking I couldn’t even lift my head to see it, plus there was an oxygen mask on my face about to get in the way of my vomiting. I knew I was about to violently throw up from the pain (though I somehow actually never did.) The ultrasound was speedy. And the doctor kind and calm. He had a reassuring Southern accent. He leaned in quickly but closely, rubbed my arm and said, so tenderly, Sweetheart, your baby’s heart is barely beating in there. I won’t ever forget that.

Next, he told the nurse it was time for a C-section, and he added, Stat! Stat! Stat! Stat!

A series of things began to happen, things I didn’t see, but things I know because I’ve done this emergency delivery thing before. The code is called, doctors and nurses come hurriedly by the dozens, people suit up, Dad is whisked away—and in the NICU down the hall, where little babies lie, an almost siren wails, rows of lights flash, nurses hastily secure their babies, and they run. They take off toward the birth suites, over a long skywalk, an army of fast-paced tennis shoes to an unknown situation where a baby, a mama, or both, are absolutely crashing.

This part is hard to write. It hurts to know that that’s been my baby crashing, I’ve been that mama, twice now. And to know that Drew has been that scared, alone daddy, twice now. It hurts to be in NICU and hear that sound, see those lights, and watch those nurses run. You just have to swallow hard and look away. To know another baby, another mama and another daddy are having this happen hurts. But you are glad they run because you know they ran for you.

As everyone was running to me from all over the hospital, I was being carried down an elevator to the OR right below. I think I was the first to arrive, and my nurse had a major game face on at this point. She told me to roll to the table, and I told her I couldn’t. It hurt. I was scared. I knew something had ripped. Was it going to rip more?

But she wasn’t having it, and I’m glad she wasn’t. She said something like, You will roll, and you will do it now. We have to move! So I did it, and she told me I was a good girl.

Many people entered the OR, in such a hurry, and introduced themselves at my head as I stared at the ceiling. Soon my doctor was standing over me, and she grabbed my face in her hands and said, Hey. I’m here.

This is when I began to cry. I was so thankful to see her there. I asked her over and over again to just help me. Help my baby. And I knew she would. She had in every single birth before. She never, ever works Thursday evenings. Spring Break wins again.

During all this, Drew had been set outside the operating room door, until a nurse had the bright idea to move him farther away. She knew it wouldn’t be good. So he sat in a hall in a single chair for a long time. On our visits to see Ben in the NICU, sometimes that closed OR door was open, and we could see that chair. Once there was a dad sitting there, alone, again, and it upset Drew badly.

In the OR, as time marched meanly on from the last time I’d seen the baby’s heart beat (it seemed like eternity but was actually not, I guess), I became acutely aware that everything was settling down. The pain had subsided, and uterine activity had ceased. Cessation of uterine contractions is a tell-tale sign of rupture; I didn’t know, but I could have guessed. I did feel a few peculiar sensations that I worry were Ben fighting for his little life. I won’t write what it felt like; I don’t have to write it down to remember. Maybe I felt muscle spasms, I have told myself a thousand times. That happens after an injury. I can’t know, and won’t ever know, but reliving those feelings has been hard.

The silence I began to sense in my body, while the room was very much loud with people readying this, prepping that, told me this was over. It’s just what I kept thinking between my prayers. This is over. This pregnancy. This poor little life. Our dream of a boy. And so I began to relegate myself to it all, to even then begin to process in my own way. I wasn’t crying or screaming anymore; I was submitting.

I began to talk with God, even outloud. I told Him no matter what, we would still follow Him and praise Him. I asked Him to save my baby and save me. I would later learn that people in the OR had been joining my prayers.

Soon, a very particular mental switch occurred. Survival gears began to grind. Since I had a VBAC in 2014 and a VBAC in 2016, both before 39 weeks, spontaneous and not induced (also known as “meant to be”), I had done a fair amount of research over the years on what goes wrong in labor after Caesarean.

And it now dawned on me that I could die. I knew I could bleed too much, or go into shock. I began to look around, wondering, Is it happening right now? Will I begin to pass out? Will I know? I knew that I might not actually wake up from anesthesia. I thought it probably unlikely but within the realm of possibility. It sounds so morbid, and Drew doesn’t like to hear it, but those are the facts and that’s what I thought.

Plus, countless doctors who weren’t even in the room have since told us my life is a miracle, too. Uterine rupture and placental abruption are extreme obstetrical emergencies, causing the mother to rapidly bleed internally. One stat I read said she could technically bleed out within 10 minutes. But I survived without having to have a hysterectomy and only lost two counts of blood.

Once I’d acknowledged that my baby may not make it, survival stepped in. I began to tell everyone in the room that I had three little girls at home, and a husband, and I needed to live. I knew I needed to focus on them.

A young doctor, from anesthesia I guess, was at my head. I told him to tell my girls and tell Drew I loved them. He didn’t argue, didn’t tell me I’d see them again. He just agreed to do it, which I appreciated.

Our three little girls in August 2018

A few times I caught my reflection in something metallic. I could see my round belly, a last glimpse of a pregnancy, of an era even, that ended so abruptly, without warning or permission. I could feel lots of sticks and fluids and hands. I was covered in a strange liquid, which I later realized was Betadine, an antiseptic. I was given antibiotics for a while afterward, since my surgery was unplanned, fast, and therefore carrying higher risks for infection. Outside the OR, Drew had been told not to worry about me; the hospital had plenty of blood products on standby, they said.

I don’t know how much time had passed at this point while I lay there, my body silent but my mind reeling, praying. Time was dragging. I began to ask when I would be knocked out. Is it now? Is it almost time?

My doctor kept asking the room the same things. I’m ready. Let me know as soon as I can go, she kept saying, firmly.

A man put a mask on my face. I thought it was oxygen, and I asked while wearing it if now was the time. Can you hear me? Are you ready? Can you just knock me out now and get my baby?

But in the mask was the gas, and soon I wouldn’t hear or feel a thing. They’ll intubate me, but I won’t know until the sore throat tomorrow. They’ll reopen that faded scar line on my stomach, but I won’t hurt until I wake up.

I won’t know, until they’ll tell me, that they found my precious boy completely outside my uterus, “floating” in the blood of my abdominal cavity, where there is no oxygen, no blood flow, no life. A complete uterine rupture. A complete opening of my old scar. A complete placental abruption. Not even in labor. Which all make for a complete rarity, with no known cause. Those details have been very hard to know. And also that, for many days later, a little tube protruding from Ben’s mouth in NICU was draining not amniotic fluid from his system, but my blood.

This was Ben’s birth. There were no just-born photos. No skin to skin. No inky footprints, no cries.

He was born with no signs of life. No color, no breathing, no reaction, no heartbeat. His APGAR score at one minute was zero. He sure did look like a zero, we were told. And he was also very bloody.

It was 8:41 p.m.

I don’t remember it, the actual time recorded on the certificate, so it’s hard to even say I gave birth. And I don’t remember the surgery or the pain, and his resuscitation and the compressions of his little chest. Seven minutes of compressions seems such a long, terrible amount of time. It seems sad to not remember his entrance; I remember all the others. Still, I won’t grieve not remembering. It’s good I don’t remember.

But how can you never forget something you’ll never remember? It might just take my lifetime to figure that one out.

Read about our recovery and Ben’s NICU stay.

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