Ivy's Birth Story, The Coda

This is the story of my hospital stay, following the removal of a retained placenta. You can read Ivy's birth story here.

* * *

The first night was very surreal and lonely. The midwives and our doula, Kerri, left the hospital around 7:00 PM. Rob called my parents to tell them that the baby had been born, and that we were in the hospital. Westley spent the night with Rob's parents, with plans to come by the next morning.

I was so relieved to be with my little girl again, but I felt physically awful. Dizzy and tired, and filthy. But I had Ivy next to me. She was a wonderful distraction. At some point, Rob stripped her down to just her diaper. We cuddled skin-to-skin all night long. I couldn't really sit up to breast-feed her the way I wanted to, so I tried the side-lying position. It didn't work very well because Ivy was so little and so new to breastfeeding, but I had colostrum and was determined that she get it. It was impossible to get a good latch, though, and she quickly turned my nipples to hamburger meat. (By the time we got home, it felt like the baby's mouth was full of razor wire every time she nursed.) After everything I'd been through, there was no way I was not going to breast-feed, even if it was agony.

I didn't really sleep that first night—I just stared at Ivy. Occasionally, I sang to her. When the nurses were first hooking me up to the various lines that would tether me to the hospital bed for two days, I ignored them and kept my eyes locked on Ivy, singing whatever sprang to mind: "Baby Beluga," "Give Yourself to Love," "I Got You Babe" (which I really need to learn properly). I wanted to block out as much of the hospital as I could and just be with my daughter.

Ivy seemed almost relieved. She struck me as incredibly sweet and mellow, but Rob informed me that she hadn't been too pleased with the situation before we were reunited. She fussed on and off from the time the ambulance drove away to the time she was plunked down on the hospital bed next to me.

Rob tells me he held her almost the entire time we were separated. Beth took Ivy briefly to do her newborn exam. Then Beth and Kerri helped Rob get ready to go. Rob moved Westley's booster seat so Kerri could ride to the hospital in the back seat with Ivy. Rob and Kerri didn't know that the paramedics had taken me directly to Labor and Delivery, so Kerri dropped Rob off at the Emergency Room entrance. Rob was looking around the ER waiting area when another man indicated that he was next in line. Then he noticed the bundle in Rob's arms.

"That's a little baby."

"She's about an hour old," Rob said.

"An HOUR?!"

"Yeah, her mom's here somewhere."

"You can go first."

Eventually everyone figured out that I was in Labor and Delivery (it took a while, because I didn't have a patient ID right away), and Rob and Kerri walked over to what would be my room for the next few days. Lynn was already waiting there. Beth and Sara arrived soon afterwards. They waited almost two hours for me. The midwives, who had been in stressful hospital-waiting situations before, kept Rob occupied by getting him to talk about how he and I met. They thought our long-distance e-mail courtship was adorable.

Midwife energy is wonderful. I was sad that they had to leave us. I knew Rob must be exhausted from the stress of the afternoon, so I encouraged him to sleep. Maybe I could rest vicariously through him, since I couldn't seem to wind down enough to sleep. Rob catnapped for a few hours, while I cuddled with Ivy, tried to breast-feed, watched her sleep, tried to relax. I was wired.

I was also freezing. The room was cold, and it didn't matter how many times a nurse came by to turn up the thermostat—I stayed freezing. The blankets were thin, my IV fluid was cold, and I still didn't have any clothes on. I'd been offered a gown but refused it. Wearing a hospital gown seemed more dehumanizing than just being naked under a pile of flimsy blankets, bleeding onto a Chux and a maternity pad that looked like a disposable diaper.

My nurse that first night was named Carolyn, and she was an angel. (With just a few exceptions, all of the nurses I saw were great. And I saw at least a dozen.) Every time I tried to roll over or shift position, blood would gush out of me. If I was lying on my side, as I often was, my bottom leg would end up covered in blood. Every time Carolyn checked my pad, she would clean me up with warm washcloths. Carolyn reminded me of my girlfriends from college. She was around my age, pretty, and very kind without being patronizing at all—but I was still embarrassed. I had to remind myself that wiping the blood off someone's bottom and inner thighs in no way the worst thing Carolyn had ever done in her nursing career.

Trying to sleep was miserable. I knew how tired I was, and wanted desperately to sleep. But in addition to not being able to turn off my spinning mind, I couldn't get physically comfortable. On top of being cold and bloody, I couldn't get in a good sleeping position. The hospital bed was hard and awkward. It bent in a place that I didn't bend. Even with seven pillows, I felt tense and unsupported. I also had an IV (with antibiotics and/or Pitocin) in my right arm, blood flowing into my left arm, a blood pressure cuff on my right bicep, a catheter tube taped to my right leg, and a heart rate monitor clipped to a toe. If I moved too far in any direction, I would jostle something and a machine would start beeping horribly.

Every few hours, someone came in to check my blood pressure—75/40, or thereabouts—empty my catheter bag, and feel my belly. In the very early morning, when it was still dark outside, Rob and I tried to watch Winnie the Pooh on his iDevice. I cried, so we stopped. I was glad when "real" morning rolled around, complete with sunlight coming through the windows. Something about those late-night checks made me more acutely aware of the "hospital-ness" of it all.

(I was glad to be in the hospital, insomuch as I knew I needed to be there. But the loss of the uncomplicated, peaceful postpartum period I had imagined stung. I often wondered if I would feel differently about camping out in a hospital bed with tubes in my arms if I'd planned a hospital delivery. There's no way of knowing, really.)

I was so thankful to have Rob with me. He kept Ivy swaddled and in clean diapers, and brought her to me when she started making the furrowed-brow hungry face. I cried often, and he just nodded along with my hormone-flooded joy-sorrow. Rob even slept with Ivy a little. At one point, I got scared that something was wrong because Rob was snoring and I couldn't see the baby. He was mildly offended when I woke him up—"She's here. She's fine."—but he understood my paranoia. I was more than a little on-edge.

The second day in the hospital (the only full day) was the most surreal. Rob's mom arrived with Westley around breakfast time. Grandma got right to work holding the baby.

Westley admired Ivy, but mostly just helped himself to the roasted potatoes on my food tray. I ate potato-spinach squares, which Rob and Kerri had been thoughtful enough to bring from home. They were supposed to be for eating while I was in labor, but as it turned out I had no desire to eat in labor.
People came and went all day. Shortly after Rob's mom left, my parents arrived with more food and supplies from our house. They spent a good chunk of the day at the hospital with us, which was a wonderful distraction for Westley. I kept wanting to help entertain Westley, or care for the baby, but there wasn't much I could do from the hospital bed. Every time I tried to sit up, I saw spots. I kept watching the clock, watching the blood bag, trying do do the mental math: would I be going home this afternoon? This evening?
I had to have another adult with me at all times to care for Ivy. Since she was never admitted, the baby was considered a guest of the hospital. That really just meant the nurses wouldn't care for her. Since I wasn't able to take care of her on my own, someone had to be with me all the time. Rob and my mom took turns holding Ivy, while the other attempted to amuse Westley.
The most notable aspect of Day Two in the hospital—and my hospital stay as a whole—was the stream of medical professionals who came to my room to tell me that I had almost died.

One at a time, the people who had been in the OR with me stopped by to say hello: the anesthesiologist (Mr. "We don't get spinal headaches here"), the oxygen mask guy, the obstetrician who'd had her hands inside my uterus, the obstetrician who'd been running the ultrasound machine to make sure the first obstetrician got all placenta chunks out. They all told me their version of the horror story.

* * *

"Remember me?" Oxygen-Mask Guy asks.

When I say yes, I do, he looks rattled and says, "You had a close call yesterday."

The anesthesiologist describes the bleeding as "buckets of blood." He's much less grouchy with me. In fact, he seems a little shell-shocked. It's clearly a relief for him to see me sitting up in bed, sounding chipper. I smile and tell him I'm feeling basically OK (because I am). I don't tell him that I'm sickened by the mental image of myself, unconscious on the operating room table, bleeding. Buckets.

By mid-afternoon, I finally piece together a picture of what happened in the OR—and it wasn't just that I "lost a lot of blood" as the doctor had informed me the night before.

* * *

The placenta came out in pieces. It was stuck tight in the left horn of my uterus. At some point in the removal process, I started to bleed...and bleed. Fundal massage and three different drugs later, I was still bleeding with no sign of stopping. (The doctor told me which drugs they used, but I only remember Cytotec.) At one point, the anesthesiologist told the obstetrician that my blood wasn't clotting. The situation was truly life-threatening. From what I gathered, it was pure luck that the bleeding finally stopped and I was basically all right.

More than one person suggested that if I have another baby, I should do it in the hospital.

It was a lot to take in. I struggled to integrate my experience of a powerful, painful, but ultimately joyful home birth with the news I heard repeated over and over again that day: I had almost died on the operating table.

What am I supposed to do with that information? With the idea of buckets of blood pouring out of my body?

I relived Ivy's birth over and over again, relived lying on the floor at home, relived staring up at the bright, round mandala clusters of lights in the OR and extending my left arm to a nurse with a needle.

The bruise, right below my left elbow, was the size and color of a ripe plum. It remained for weeks after I was discharged.

* * *

I spent all of Wednesday, the day after Ivy's birth, waiting to go home. There had been talk of discharging me that afternoon, but afternoon came and went with no word from any of the doctors on when I might get to leave. I still wasn't allowed to stand up and walk around.

By late afternoon, it was clear that I wasn't going home before bedtime. I had received two units of blood—and I didn't want to wait around for a third. (It took about three hours from the time blood was ordered to the time the bag was empty and some generous donor's cells were safely in my veins.) However, one young obstetrician explained that one more unit of blood could mean the difference between six weeks of extreme fatigue and not. I didn't know if she was right, but I knew there was no way I could be on even modified bed-rest once I was discharged. Rob was going back to work when Ivy was a month old, and I had a busy preschooler to think about. I agreed to one more unit of blood—and one more night in the hospital.

By this point on the postpartum rollercoaster, Rob looked worse than I felt. My mom and I came to the same conclusion: she would spend the night in the hospital with Ivy and me, and Rob and Westley would go home to sleep in their own beds (and hopefully get some real rest).

Having a plan in place boosted my morale. I ate a baked potato and sauteed green beans for dinner (which is what you get when you ask for a gluten-free vegan meal in the hospital) and it was the best thing I'd ever tasted. My mood dipped again when I tried to hug Westley good-bye and couldn't because of all the things attached to my arms. Calling them "robot parts" made it a little better.

Late that evening, a nurse helped me up and I experimented with walking up and down the hall. Most of my difficulty getting around seemed related to spending 24 hours in an uncomfortable bed. My legs were stiff and tired. I was determined to show the doctors and nurses that I could get around on my own, but also determined that I would not push myself so hard as to interfere with my recovery. The doctor and nurse who watched me hobble around determined that I was well enough to have my catheter removed, if I wanted. I chose to have it left in overnight so I wouldn't have to worry about getting up to go to the bathroom, and maybe get a little rest.

My mom walked the halls with Ivy, and rocked her in the rocking chair. I managed to sleep—hallelujah!—and woke up feeling good. Surprisingly good, all things considered. I was so excited to go home, and so worried that without my mom on as nighttime baby nurse, I'd never sleep again.

I got the catheter taken out (I was afraid this would be painful, but it didn't hurt at all), used the bathroom (also not painful, miracle of miracles!), and got dressed in my own clothes. I brushed my hair for the first time in days, and when Rob and Westley arrived, I was sitting in the rocking chair, nursing the baby and eating Cream of Rice like a reasonably healthy person with normal(ish) amounts of blood in her. It was hard to believe that just 38 hours earlier, I'd been waking up from anesthesia.

We finally made it home around lunchtime on my original estimated due date.

* * *

I've thought about my emergency transfer from home and subsequent hospital stay almost every day since Ivy was born. My biggest question remains, Why?

With a bicornuate uterus, I knew I was at risk for preterm labor, fetal growth restriction, and a malpositioned baby. My midwives also knew this—hence the ten ultrasounds I had over the course of 30 weeks. Retained placenta wasn't on anyone's radar.

Placentas are funny things, and it's difficult, if not impossible to determine what they're going to do. The punky young nurse who gave me a Tdap vaccine shortly before I was discharged was the only person who offered up a theory as to what had "gone wrong." My miscarriage had been in my left uterine horn. When the retained tissue from that was removed months later via D&C, scar tissue formed in the left horn. Ivy's placenta may have adhered to that scar tissue—and scar tissue does not contract the way healthy muscle tissue does. I asked Dr. K about this at my postpartum follow-up with her. She said there wasn't a note in my file about where the placenta had been attached. (Some day I want to read through my medical records myself. But I'm not ready for that yet.)

So the answer to why things went the way they did appears to be: Sometimes these things just happen. And sometimes mothers die.

I'm thankful to be alive. I'm thankful that I was able to receive the medical care I needed. But my midwives saved my life. It was their skill and loving, supportive energy that enabled me to "hold it together"—physically as well as emotionally. I felt safe the entire time I was with them. I don't believe it's a coincidence that I started bleeding heavily only after I was in the OR. And had I not been in the care of people I love and trust, I imagine my outcome might have been much worse.

* * *

One last thing...

Many of the doctors and nurses who took care of me in the hospital were very sympathetic, saying, "I know this isn't what you wanted."

I can't imagine anyone wants a medical emergency, but I know what they meant. It's true that I never intended to spend time in the hospital, but in terms of Ivy's birth, I got so many of the things I wanted.

• I went into labor on my own.
• I got to labor and give birth during the day.
• Beth, Lynn, Sara, and Kerri were all present at the birth.
• I felt loving and connected with Rob.
• I didn't tear!
• I kept my sense of humor (for the most part).
• My baby was born at home, in water.
• She arrived in her own time, safe, healthy, and surrounded by people who truly love her.

.....................................