Mila's Birth Day - 7/21/21

“We need to talk about delivering today.”

The words I hoped I would never hear until our scheduled delivery date on August 2nd. Words that meant our baby would be born almost 5 weeks early. Words that meant something had changed, and my baby’s life could be at risk.

Something had, in fact, changed. I was bleeding again, but it was different this time. After passing the largest clot of the entire pregnancy, a slow continuous bleed paired with light, regular contractions had moved in. My body knew our sweet baby girl needed to get out, and waiting any longer would only make it increasingly unsafe for me and Mila both.

My OB care provider, Dr. Hong, whom I’d seen for the entirety of my pregnancy, had talked me through this birth countless times. We’d discussed the delivery and what it would look like, how we would approach certain things considering my condition, and how we’d best ensure the safety of me and our daughter. I trusted him with my baby’s life, and considering every last bit of “what to expect” throughout this pregnancy had already been ripped away (now including my expected delivery date), having him there meant the world to me….but he was off for the day.

The on-call doctor, Dr. Hemeseth, called Dr. Hong and explained the situation. Dr. Hong jumped out of bed and immediately called me to let me know he would be there in ten minutes. Tears of joy and comfort welled up when I learned that he and Dr. Hemeseth would attend the surgery together to help ensure a safe delivery for both me and Mila.

The chaos in my room picked up as I called my doula to let her know today was the day. Equal feelings of excitement and fear flooded my body. We were finally going to be done with this difficult pregnancy and everything that came with it. But was Mila ready and strong enough for life on the outside?

My doula arrived and they began prepping my IVs for surgery. Because I had placenta previa, I needed to have multiple large-scale IV ports to allow for both medication as well as the potential for blood transfusions in the event I lost too much blood during surgery. (An uncommon but necessary precaution with placenta previa.) My depleted veins paired with the large IVs were making it difficult to insert them. After close to 30 minutes and several failed attempts, my strength was waning.

“I’m not sure how many more of these pokes I can take you guys”, I said, holding back tears.

They brought in an ultrasound machine to see if they could better locate my veins to insert the IVs. After a couple more tries, it was finally in. I think the whole room let out a sigh of relief.

Dan and my doula Kelli zipped up their bunny suits and off to the OR we went. It was a surreal feeling being rolled away from the room that I called home throughout the last few months, knowing the next time I would be back in there, I’d have a baby in my arms.

As we entered the OR, I lifted myself onto the operating table and sat up to receive the spinal tap. The anesthesiologist seemed to be having a tough time getting it inserted. I sat in the painfully uncomfortable prep position hugging my belly as she poked around unsuccessfully for a good 15 minutes. After a few failed attempts, I began to panic. “What if she can’t get it in?!” “What if she has to put me out and I can’t be here for my baby’s birth??!” “Why do these things keep happening to me???” “When will the challenges of this pregnancy end???”

They brought a stool over for my feet to rest on to see if adjusting my position would help. After another couple of pokes, it was finally in. Another collective sigh of relief from me and my care team, and we moved forward to prepare for surgery.

As I lay back and wait for the medicine to kick in, they kick Dan out of the OR to finish prepping me for surgery. I wiggle my toes until I can’t feel them any more. I lay there, alone, arms stretched out wide. I stare at the clock, wondering when the surgery would begin and what moment our daughter would finally emerge. I observe the baby warmer and the many people in the room, all there to help ensure the safety of me and my baby. I hold back tears of relief, overwhelm and fear, as Dan looked on from outside.

Finally, Dan and Kelli re-enter, and Dan places my cold and clammy hand in his. The surgery begins and they open me up to find Mila frank breech with a hand sticking down between her legs. Our silly little acrobat was head-down less than 24-hours earlier at the ultrasound the day before, so I think the whole room was surprised to find her that way.

After some clever maneuvering, Mila is ready to be delivered. Dan stands up and peers over the drape. I watch his face as Dr. Hong pulls her from my body. Although I didn’t get to see her being born myself, observing my husband’s face as he watched our daughter emerge from my body was pretty great. I witness his reactions with joy as she is born into our world.

“She’s perfect!” He says.

They lower the drape for me to see, and then quickly whisk her to the warmer to get her breathing. Dan rushes to her side. The NICU doctors immediately begin clearing her airways of mucus and rustling her up to encourage breathing. I lay there, feeling helpless, as I wait to hear her cry. After what feels like an eternity, I hear the sputtering sounds of a newborn. They keep her at the warmer for a bit to ensure she is stable and regulate her heartbeat.

Meanwhile, Dr. Hong and Dr. Hemeseth continued work to safely clean out and stitch me up. They carefully work together to remove the placenta considering it’s precarious location. As they removed the placenta, they realized I’d also had a placental abruption (where the placenta starts to tear away from the uterus which is extremely dangerous for baby). So it’s a blessing we decided to deliver when we did because it could’ve gotten very dangerous for Mila very quickly.

Once the placenta was out, Dan brings Mila to greet me for the first time. Dr. Hong had started to stitch my uterus back up, but then the bleeding picked up and wasn’t stopping. They re-opened the wound to see how bad the bleeding was and determine the best way to try to stop it.

The anesthesiologist had given me everything she could to keep boosting my blood pressure during the surgery, but I had lost over 2 liters of blood at that point, so they decided to give me a blood transfusion.

It was pretty scary at that point because it felt like my body was just starting to shut down. My breathing was slowing, swallowing got harder, I could barely keep my eyes open, but I kept fighting to keep my breaths deep and my blinks short…I was honestly afraid to shut my eyes because I wasn’t sure if I’d be able to open them back up if I did…Dan looked on as the care team discussed how to proceed.

I never could’ve imagined what it would feel like to stare down the potential of death. I ironically recall the dramatic song “Outro” by M83 playing on the speaker in the background as I laid there helpless, fading in and out. I looked silently across the room, where my whole world was just a few feet away from me, wondering what was next for me. My newborn baby girl, the love of my life, all right there across the room…both so close, but so far away.

I focused the little physical energy I had on remaining physically present, but mentally, the dialogue within my mind ran rampant. I wonder how Mila is doing. I question how much more I have left in me and if it’s enough to get through this surgery. I question if I’m ever going to be able to hold my daughter. I wonder how it would feel for Dan to gain his newborn daughter but lose his wife, the mother of his children, and lifelong partner all at the same time. I contemplate what life would be like for him to raise our children alone, and whether my babies would know me as the mother I was and always wanted to be for them.

I’d lost almost half my blood volume, and was fighting to remain present. I knew something was wrong, but I didn’t have the words or energy to describe it.

“I need help,” I pleaded.

They gave me another blood transfusion and place a bakri balloon to help stop the bleeding. I could feel my body slowly coming back to life as they administered the blood. It appeared the bleeding was controlled at that point, so they began stitching me back up. As I prepared to move to recovery, I reached for my nurse.

“Jen, am I going to be OK?” I whispered.

She leaned over to embrace me. “You did so good baby, and you’re going to be just fine,” she reassured me.

I was rolled back to my room where I finally got to embrace Mila for the first time. They placed her on my chest and it instantly took my breath away. My sweet baby girl was finally here, and despite the commotion in the room, I was lost in her world.

I didn’t realize that the doctor and nurses seemed to be concerned about the amount of blood that continued to pool beneath me. As the doctor was inspecting, I continued to lose blood and some significant-sized clots. The doctors and nurses discussed the situation. Was the balloon not effectively controlling the bleeding? Was the drain tube clotted and not draining properly? Was there not enough fluid in it to apply the appropriate pressure? Do we need to replace the balloon? As they observed and discussed the options, they decided to add some additional fluid to the balloon. It appeared that there was no active bleeding, so they packed everything back up, and continued to observe me closely.

“What if this doesn’t work?”, I ask Dr. Hemeseth.

”It‘ll work”, he replied firmly. I’m not sure if he truly meant that firmly, or if he simply said it firmly to convince us all (the universe included) that it needed to work.

I managed to remain stable throughout the evening and by Thursday afternoon, they decided it was safe to try to remove the bakri balloon. After a paced-drainage of the balloon, it appeared that my bleeding was fully controlled. I was cleared to remove the catheter and try to stand for the first time in over 36 hours.

Anyone who’s had a catheter before knows it can sometimes take a while to get things “moving” again. I had a deadline of 6-hours to pee on my own, but after about 3 hours, I tried to stand up to get to the bathroom and was in so much pain, I could barely move. The pressure from my bladder paired with the pressure from the balloon and the tenderness of my fresh surgical incisions, both internal and external, was indescribable. I couldn’t walk, and could barely pull myself to stand.

The nurse came and and suggested a straight-cath, which basically means they would manually drain my bladder to see if that could give me some temporary relief. Writhing in pain, I accepted any potential solution that could help end the suffering. She left to obtain the tools needed. Dan grasped my white-knuckled hand and said “You’re so strong, it’s gonna be OK.”

“I DONT WANT TO BE STRONG ANYMORE!"

I yelled through breathless tears. I was done. I could not take any more. I’d hit my emotional breaking point, and had nothing left to give. I lay there helplessly as the nurse returned to administer the catheter. Thankfully, the relief was almost instantaneous, and so I was again given 6-hours to pee on my own. After several failed attempts, the doctor decided to re-catheterize me completely to give my body some extra time to heal. I was defeated. Nothing humbles you more than not being able to stand, walk, or even pee.

The next day, I was determined to get up and try to walk. Catheter or not, I knew my body needed some movement, so I saddled up my newest fashion accessory and (slowly) worked my way toward the hall.

My fellow fast-walkers would’ve chuckled at the limited speed of my weebles and wobbles. But I got a couple of satisfactory laps in and the doctor agreed that we could try removing the catheter again that night. And finally, in the early hours of the morning, I PEED! I have never been more happy to experience this basic biological process. And considering everything I had been through, this small but powerful “win” offered both relief, and a sliver of hope.

We ended up getting discharged Saturday, but my body was really struggling. I probably should’ve stayed at least one more day in the hospital, but I was just so anxious to go home and feel some sense of normalcy. We’d anticipated this moment for so long, and the chance that it was finally here was clouding my judgment. Weak, exhausted, nauseous and white as a ghost, I inched my way into the car and we headed home.

Thankfully, Mila has been a champ through it all. Her APGAR scores were 7 and 9 out of the gate and all her vitals have been good. She lost about 5% of her birthweight but already started gaining weight back in the hospital. At 4 lbs 15.5 oz, this tiny but mighty little girl is the most adorable little preemie I’ve ever seen.

All things considered, we’re doing alright. Things could’ve gotten way worse really quickly so we are just grateful for the wonderful care team that supported us and the fact that we were able to stay together. Several nurses said “You’re lucky Mila didn’t have to go to the NICU” and “You were one step away from going to the ICU”. Thankfully, none of these things became a reality. And now we’re just trying to focus on healing and taking it easy.

I’m sure there will be many reflections to come from Mila’s birth day, but the three that stick out to me most right now are:

I am stronger than I ever thought possible.

I never would’ve described myself as a “fighter”. But after this experience, I think it is a defining characteristic for me. I fought. Through the pregnancy, in birth and in this postpartum time, I fought. I fought for what matters most, even when it meant abandoning every bit of my own comfort and identity and surrendering to each day as it came. I show up for my loved ones and I will stop at nothing to make sure I am here for my family. For the rest of my life, I will carry this experience with me and I have the privilege to draw on it knowing if I can survive that, I can do anything.

Emotions are an important part of life and are rooted in love.

As a clinically-diagnosed perfectionist/people-pleaser, I’ve spent much of my life downplaying my own emotions and sugarcoating my experiences in fear of making others uncomfortable. Throughout these past couple weeks, I’ve discovered that emotions are a very real, raw and important part of life. They are always rooted in love and deserve to be accepted and shared. Joy, compassion, happiness alongside pain, fear or suffering…our emotions make us who we are as humans and I’m no longer afraid to share this side of my heart with the world, the good and the difficult.

People love me, and it’s ok to accept it.

Self-made, self-reliant or just plain stubborn. Whatever you want to call it, I’ve lived much of my life determined to take care of myself (and my family) and not lean on anyone else to do so. This experience forced me into a position of needing to rely heavily on those around me. For everything from meals to housekeeping to basic self-care (shoutout to my mom for painting my toenails ), I had to lean on others to keep our baby girl safe. I had a laundry list of thank you cards I wanted to write and send, but after several trips to the hospital, I had to relinquish my sense of required reciprocation for these “favors” and simply accept the love no strings attached.

I’m so SO grateful for all who loved on us over the last few months. The meals, the care packages, the check-ins, texts and calls. My parents, who dropped everything at a moment’s notice to care for Calvin and basically cued up the ultimate-toddler-staycation for him. My aunt Kathy, who pretty much became my personal horticulturist during our hospital stays to keep all of my beautiful plants and herbs alive. And my friends and colleagues who sent meals, cards and thoughtful IMs to help support us and keep my spirits up along the way.

And I would be remiss if I didn’t share a shoutout to my care team. As someone who believes firmly in trusting my body and it’s innate ability to function and heal, I was out of my comfort zone when I found myself in one of the most high-risk, medicalized birth circumstances possible. Western medicine doesn’t always lend itself to the mental-emotional-spiritual components of birth, but the care team I had served me as a patient, not a problem to be solved. They consulted with me, and we worked together to make the best decisions for me and my family.

In particular, Dr. Hong, who is a true gem to the medical field. He so eloquently pairs evidence-based medicine with compassion and empathy. He is attentive and always offered thoughtful responses to my questions. His support and compassionate care was so impactful throughout my pregnancy and birth. Anyone who knows me well knows I am passionate about mamas and maternal care, and Dr. Hong is exactly what this field needs. I'm confident he’s made a significant impact on countless mamas' lives (myself included), and I can only hope his presence can bring a transformative impact to this field.

All-in-all, I move forward from this experience with acceptance. Accepting the path we were given, accepting the challenges, and accepting that, for whatever reason, this was meant to be. I am filled with many emotions. But most of all, I am grateful. Grateful to be alive. Grateful to have a healthy baby girl. Grateful for the wisdom this experience has shed on me. And grateful for each and every moment where I am blessed with the health and safety of me and my family.

XO

SS