Womb to move

Obviously, I wasn’t convinced I was going to die.
I just wasn’t convinced I wasn’t going to.
It all began around week 18…

“You have a low-lying placenta,” my obstetrician said, wiping the gel off my belly. “Probably nothing. We’ll get a better look at your big scan.”
That was two weeks away.
It turned out to be the last two weeks of pregnancy I’d ever get to enjoy.
I settled on to the bed at Women’s Imaging for what would turn out to be the most unsettling ultrasound I’d had.
And I wasn’t a stranger to pregnancy drama.
Early bleeds, gestational diabetes, super huge heads.
I’d worried over everything.
I’d worried over nothing.
And my boys were both fine.
“You have complete placenta previa,” the sonographer said. “C-section for you I’m afraid my dear.”
Ugh.
Master Nine’s birth had been less than perfect.
Induction, gas, epidural, ventouse, retained placenta, surgery.
Undeterred, I took pregnancy yoga ahead of Lil Fatty’s big entrance, even convincing myself I could actually ‘laugh’ my way through it.
But he very quickly became an emergency caesarean.
I’d barely begun to experience the disappointment of another c-section when another word popped into the discussion – ‘accreta’.
“I’m not going to Google it,” I declared to Learner Dad on the way home.
But alarm bells had been ringing in my head from the moment I’d heard it.
Accreta.
I knew that word.
And I knew it wasn’t good.
That night, I Googled it.
‘High risk’, ‘heavy bleeding’, ‘haemmhorage’, ‘hysterectomy’, ‘life-threatening’, ‘transfusion’, ‘rupture’, ‘catastrophic’, ‘maternal morbidity’, ‘maternal mortality…’
Maternal mortality maternalmortality maternalmortalitymaternalmortality…
‘Accreta’ is diagnosed when the placenta is too attached to the wall of the uterus.
There were two more serious varieties – ‘Increta’, where it actually penetrates the uterine wall, and ‘Percreta’, where the placenta eats right through the uterus, often invading other organs, such as the bladder and bowel.
Rates of all three have been increasing in conjunction with the rise in c-sections.
My scan had been on the Thursday.
I wasn’t seeing my obstetrician until the following Wednesday.
On Friday I rang his rooms in a panic.
“Ok, let’s see,” the midwife said in a calm, almost patronising tone. “Don’t get all worked up now. I’ll just scan through your report. Here we go. Placenta previa, suspected percreta…”
Her voice faded away.
She knew she’d told me more than she should have.
“Don’t panic. And don’t get on the internet. The doctor can talk you through the results. In the meantime, you must come straight in if you have any bleeding whatsoever…”
But I wasn’t really listening.
‘I’ve got the worst one, I’ve got the worst one,’ was all I could think.
The percreta was, at this stage, only a possibility.
One thing that was still certain was I had placenta previa.
Previa means the placenta is covering the cervix, giving baby no access to the main door.
This condition also put me at risk – of sudden and heavy bleeding.
I researched both conditions exhaustedly.
I joined Facebook support groups dedicated to them.
Overwhelmingly the women with percreta had had hysterectomies.
Women with previa had occasionally lost babies to premature delivery.
Some talked of months on hospital bed rest and then months in neonatal intensive care units.
They wrote about bleeds so big they’d left the bathroom a crime scene, of late night panicked emergency calls, of being flown from rural towns to big city hospitals by helicopter.
But, despite all the near-death drama, I was a little encouraged.
These were all stories of survival.
Although I had a lot of support around me, only these women knew exactly what I was going through.
Like me, they’d pulled down their pants fearfully every time they went to the toilet.
Or dashed in panic to a toilet every time they thought they felt wet.
They’d had insomnia. And steroids.
They’d faced countless ultrasounds and MRI’s and many a grave face.
They’d sat up late in bed writing goodbye letters to their children (yes I really did this) – just in case.
And they’d tried to contemplate their kids’ lives without them in it.
Everyone’s biggest fear – and I was no exception – was of being put to sleep and not waking up.
The mortality rate (which most of us had frantically searched for at some point) seemed to range from 2 to 5 to 7 to 10 per cent.
A lot of the data was dated.
My obstetrician said much of it emanated from the 1970s, when accreta was largely undiagnosed.
When women did often die.
The fact I was diagnosed and being closely monitored put me in great stead.
But I still felt bleak.
I counted the weeks away with relief.
24 weeks – we called it V Day (for viability).
28 weeks, 30 weeks, 32 weeks, 34.
Sometimes, late at night, I wished I’d just have a bleed and be done with it.
It would force my doctor’s hand and the whole damn thing would be over with.
But I made it to my scheduled delivery date of 35 weeks and four days.
Not one bleed.
My baby girl was born at a healthy six-and-a-half pounds.
Along with her, they extracted my poor spent uterus.
The placenta had eaten its way through, coming to rest alongside my bladder.
I’d be making no more babies.
At age 37 and with two boys and a girl that didn’t seem a huge sacrifice.
Regardless, it was no longer my choice.
These days I look back on my pregnancy and Floss’ birth and wonder if I was being dramatic.
Then I read the posts of my poor diagnosed friends on Facebook and I remember.
When you’re the extremely hormonal home to a human life and the walls are starting to crack, nothing is unreasonable or irrational.

Three months ago, Suzanne Mazzola gave birth to her fourth child.
Like me, she had placenta percreta.
Like me, she made it to her scheduled delivery date of 35 weeks.
Like me, she had a healthy baby.
Unlike me, she never woke up.

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The real midwives of maternity

His name was Chris.
He had grey hair, a beard and kind eyes.
He was my midwife.
Besides Learner Dad, he was the most important person around when Li’l Fatty was born.
I’m not talking about labour.
I went straight from induction to caesarean so the doctor was the only person I really remembered from that experience.
I’m talking about recovery.
Some women can’t get out of hospital fast enough after having a baby.
Others are literally sent packing, dragging their dummies and diapers behind them.
Me?
I was kind of in between.
I quite liked being taken care of yet, having been a patient only in the public system (with its shared rooms and average food), I went home a bit sooner than I needed to.
One of my reasons for almost staying was Chris.
You think of midwives, you think of babies.
But, when it comes down to it, the midwife is really there for you.
Baby’s out, baby’s breathing, baby’s fine.
In my experience, the midwife is all about mummy.
When your room is full of visitors, all eyes on bub as he or she is passed around the room, it’s the midwife who is all eyes on you.
He’s the one who can tell you’re in pain.
Or tired.
Or needing to be left alone.
It’s an intimacy unlike any you’ve experienced: not even your own hubby will regularly poke around the pads in your undies checking for blood loss; or help wash your naked, war-torn body in the shower; or regularly remind you you really need to poo.
Then there are the nightingales.
They’re the midwives who glide around your hospital bed at night, gently checking your vital signs while you peek at them through the slits in your eyes.
They lower your bed, slip you painkillers and gently take bub from the crook of your arm to pop back in his crib.
And then, sorry to break the spell here, there’s the early morning midwife bitch.
She’s the one who strolls in and moves the crib (with baby inside) up against the wall, as far away from you as possible.
She’s the one wanting you to get out of bed to get him.
The bitch who’s trying to stop you getting a blood clot.
You’ve heard of the baby blues?
The floods of tears that come three or four days after you’ve delivered your baby?
Mine came the moment I left the hospital.
The moment I stopped being nursed so I could go home and nurse someone else.
Admittedly the tears only lasted the short ride home, whereupon I happily and eagerly re-entered the real world.
A world that now included Li’l Fatty.
But although mine was one of the dozens of tired and teary new mum faces Chris must see every day, I’m not sure I’ll ever forget his.

Li’l Brother – Eviction Night

“So how much gel do they rub on to your tummy?” Learner Dad asked, staring at my belly.
We were sitting on the couch at home the night before I was to be induced.
I frowned.
“What do you mean?” I asked. “They won’t give us another ultrasound.”
“No when they induce you with the gel,” Learner Dad said. “How much do they put on?”
I stared at him.
“They don’t put it on your tummy,” I said incredulously.
“They insert it up your vagina and on to your cervix.”
“Oh… right…” he said, frowning as his gaze travelled lower.
I suddenly realised how new this all was for Learner Dad.
I mean, not only do I know how my own body works (sort of) but I’ve also been pregnant and given birth before.
And I’ve been induced too.
Master Seven was 10 days late and either the landlord didn’t want to evict or the tenant didn’t want to vacate because there was NOTHING happening when I finally went into hospital that cold winter’s night.
While common in first pregnancies, induction rates usually drop with subsequent children.
This was good news to me because I really wanted to ‘go natural’ this time.
I had visions of my waters breaking at work and everyone excitedly bustling me into Learner Dad’s waiting car, with little pain or mess involved, and us whizzing off to hospital for a quick delivery.
Or I had romantic notions of waking in the middle of the night and, with a big grin, whispering into Learner Dad’s ear: ‘Honey, it’s time”.
But no, after I was diagnosed with gestational diabetes and an incredibly large fetus, the ‘i’ word was brought into play.
Li’l Fatty was going to be given his marching orders a week before his due date.
Maybe I could refuse?
But then you’re playing a game of Faith in Mother Nature v Faith in Doctor.
Mother Nature had fewer guarantees than the bloke in the coat so there was never a question really as to whose side I was going to take.
D Day began edging closer.
I had the stretch and sweep – anyone who’s had one of those knows from here on in every trip to the toilet means a detailed inspection of the undies and a game of ‘O Mucus Plug Where Art Thou?’
I made super hot curries, drank raspberry leaf tea and power walked across every track Hobart had to offer.
As the days crept by, the tears of inevitability crept in.
I was going to be induced.
Four hours after it began, Li’l Fatty had arrived.
All 4.2kg of him.
So maybe it was for the best.

Doctor, doctor, spare me the news

“Vaccinations can be lethal. They can kill,” my GP said as he prepped Li’l Fatty for his first shots.
I stared at him. I mean, I knew my baby wasn’t going to die, but I couldn’t believe he was airing the possibility.
But then, you haven’t met my doctor – let’s call him Dr Dread.
We were in for Li’l Fatty’s first check up and vaccinations.
Near retirement age, Dr Dread’s an old-fashioned GP who loves to relay stories of near-miss or downright tragedy, stories often prompted by the very condition you’re there to see him about.
Li’l Fatty was duly injected before Dr Dread turned his attention to the check up.
“I remember, back in the day, a woman coming in with her baby for its first check up,” he said.
“Not long after that, she drowned it.
“Having a baby can do strange things to some people.”
I nodded, looking at Li’l Fatty and wondering how anyone could so such a thing.
He measured Li’l Fatty’s head.
“Back in my obstetrics days, we didn’t do ultrasounds then you see, this woman went into labour,” he said, popping Li’l Fatty’s measurements on to a chart.
“The head was so big, it got stuck. The baby died and we had to crunch its head in to get it out.”
Did he just say ‘crunch its head in?’ I thought, trying to blink back tears as I stared at Li’l Fatty’s giant melon.
Satisfied with Li’l Fatty, Dr Dread turned his attention to me and my postnatal examination.
“Have you been doing pelvic floor exercises?” he asked, preparing for the internal.
“Yes,” I replied cautiously.
“My neighbour’s wife did pelvic floor exercises too early after delivery,” he said, shaking his head.
“Air went up her vagina and into her brain. She had a stroke. Died.”
I gritted my teeth as he exposed my innards to the elements.
You’re probably wondering why I chose this half-glass-full kinda bloke?
Well, I first met Dr Dread when I took a very sick then-Master Four to see him and found him more thorough than any other doctor I’ve had.
Weary of doctors who simply make you say ‘ahhh’ and then prescribe antibiotics, I knew this was the doctor for me.
Anyway eventually it was time for Li’l Fatty and I to go.
I bade Dr Dread farewell and headed out the door, happy that at least two of his patients had made it out alive.