34 weeks with Emelia: Preeclampsia

I went radio silent on this blog for a few weeks, didn’t I? I’m OK. I’m good. But we have a lot to talk about. So grab some coffee (or wine, no one’s judging here), sit down and get comfortable, and make sure you hold me accountable to tell this whole story (in segments, not all in one post. Again, we have a lot to talk about.).

Let’s go back a few weeks. The last weekend in September, I needed to double my blood pressure meds. My blood pressure had elevated again significantly. I was nesting like crazy. And you guys, I think on some level I knew this pregnancy would be ending early here before the 38 week induction date. I was having a lot of anxiety that this baby would be coming soon and the risk of preeclampsia seemed to be looming a lot closer than was initially on my radar.

On October 1 (34w3d), I took Olivia to the allergist (she had been having hives and we needed to rule some things out and everything turned out to be a non-issue, but she’s now listed as being allergic to an antibiotic she was on) and managed to take a nap while she having hers, something that was sacred to me. And I had this gnawing feeling about the baby. She wasn’t moving as much as she usually did. I mean, she was moving, and doing kick counts always came out OK, but still. Something felt off all day. I didn’t say anything, because I didn’t want Chris to think I was freaking out about nothing, but there were in fact, a few days that week that just felt off to me with her movements. I had been having some very mild headaches off and on for a few days, but at an appointment that previous Thursday, they had run HELLP labs and I was negative for preeclampsia, even with the headaches.

Later that day, I checked my blood pressure and it was significantly elevated, say 145/94. At this point, I was on Labetalol 400 mg twice a day and waited again to check it until an hour after my evening dose. 160/101. Fuck. Fuckity fuck fuck fuck. The headache was still there, pretty consistent now. I called my doctor. He told me to take another Labetalol 200 mg and call him in 45 minutes if it didn’t come down.

I waited the 45 minutes. Actually, I waited an hour just to be sure and it was still around 160/101. This wasn’t good. I called him again, knowing what he was going to say. I needed to come to the hospital to be evaluated. So by now it’s about 10:30 and Chris called his sister to see if she could come by to stay with Olivia so we wouldn’t have to wake her up. I packed the last few things in my hospital bag (but not everything, because I really didn’t think I’d be staying there—just going to be evaluated and maybe changing up the meds again). We were on the road around 11:30 that night and arrived at the hospital just after midnight. My doctor had called ahead and they were expecting me. I got my bracelet and we were led to a room. Not a triage room, but an actual room, which didn’t slip past me and in reality sort of worried me. They took my blood pressure (high of course) and checked my reflexes. Preeclampsia makes you have hyper reflexes and sure enough, I watched my legs kick out spasmodically when the hammer hit my knee. They hooked me up to a fetal monitor. Lab came in and drew blood and Chris and I were alone for a bit. I had my labor dress in my hospital bag, so I wore that instead of the hospital gown. I wasn’t wearing one of those for this birth. I texted my doula to let her know what was going on.

It didn’t seem long before the nurse came back. I think there were a few of them in there. actually. My assigned nurse spoke.

“Your labs came back positive for preeclampsia,” she said, “We need to start you on magnesium. They’re coming in to start an IV.”

I licked my lips. “So the baby…”

She put her hand on my leg. “We need to deliver the baby.”

My mouth went dry. My chest felt tight, I was 34w4d. “OK,” I said more in a whisper than anything. Before I knew it I was hooked up to a pump, an IV in my right forearm near my wrist. A guy from ultrasound came in to do a biophysical profile. I had a flashback to when I was in the ER at 11 weeks, another man doing my ultrasound, another man without the compassion and warmth I’ve experienced with women. I asked if he could turn the screen toward me so I could see.

There she was, but she wasn’t moving around. She had a fist up by her face. She was still head down. He got his big movement, and one other movement, but was waiting for a limb movement, so we were watching and waiting for her to move her fist.

“Come on,” he said lightly and started poking the US wand into my belly, the image on the screen jiggling around. He laughed and continued jabbing me, but Queso wasn’t moving. I wanted to punch him and honestly, I should have said something, but I was quiet, thinking back to the fact that she wasn’t moving like she usually was. Even at my 33 week US, it took the tech a long time to get her to move and she didn’t pass that portion of the BPP.

The guy moved on, getting other measurements, pressing so hard into my C-section scar I gripped the sheets. (The previous two other men with their US wands did the same thing during the transfer and at 11 weeks and you guys for real, no man is ever allowed to do my US ever again) and then went back to focus on her head and fist.

“We’ll get her to move.” He jabbed again, over and over. I felt sick. Over and over he smiled and jabbed and finally I snapped at him to quit it.

“Oh there we go!” This was fun for him. She raised a pointer finger and then her pinkie, in a rock on gesture. I wished she would have flicked him off. Asshole. Anyway, she “passed” if you call forcing her to move passing, and wheeled his machine out.

Around 2 am I got my first dose of the steroid shot which would help mature Queso’s lungs as much as possible before her delivery.

I started feeling the familiar effects of the magnesium, which I can only describe as feeling completely wasted. Luckily, it didn’t seem to be as bad as it was with Olivia (good thing too, because, spoiler alert: I was on it for five days straight) and I didn’t see double or anything, but it was still hard to focus on things. As the mag flowed in through my veins that night, I started feeling Queso’s movements more. Nurses were in constantly doing blood pressure checks, every 30 minutes and it was around 6 am before we could get some rest, which was a joke and both of us didn’t sleep all night. Chris was texting my mom and his sister updates. I was thinking about Olivia and the fact that I wasn’t leaving the hospital without giving birth. And my baby was going to be in the NICU. I had fucking preeclampsia again. I barely could mentally survive my last hospital delivery and now I have to do it again.

At least, unlike last time, my blood pressure started coming down on oral meds only. In fact, I only needed 100 mg of Labetalol twice a day and my pressures hovered around 135-138/85-88 so I call that a win.

My doctor came in to see me around 7 am, but he had been calling the shots and communicating with the nurses all night. I remembered he was supposed to be on vacation on October 1-15th, but here he was. He told me all babies here at this hospital born before 37 weeks had to be sent to NICU, as per their protocol. But he thought my baby would do well. I asked if she could still be placed on my chest after delivery and he said if all went OK, that I should be able to hold her for up to an hour. He told me we could start the induction process tomorrow with the cook catheter bulb and told me what I could expect then. He checked my cervix and I was dilated to 2. He told me according to the monitor I was having contractions, so he was feeling good that we could do this VBAC.

Around 9:30 am, the neonatal nurse practitioner came in to talk to us about what to expect during delivery and when she’d go to the NICU. The more she spoke, the more my heart sank.

“They said I should be able to hold her after she’s born if everything OK,” I said.

“Maybe,” she told me.

“I mean, my doctor said like an hour.”

She frowned and shook her head. “No, not an hour. Maybe a few minutes.”

She left and I cried.

Chris and I hung out in the room the rest of that day. Luckily, I was allowed out of bed with help, so I could still get up to the bathroom by myself as long as a nurse was there or Chris brought me. Besides feeling shitfaced, I didn’t have any other effects, which I was grateful for.

But there was a lot of PTSD. There was a lot coming back to me with Olivia’s birth. The magnesium. The blood pressure. The IV in my arm. The nurses constantly coming in to assess me. They were all really great. But it was a lot to deal with.

Queso started moving and squirming around, becoming her more normal movements and I brought this up to my nurse.

No, she told me, I wasn’t being paranoid. The baby was feeling the effects of the preeclampsia. She was stressed by what my body was doing.

I debated going to bed that night you guys, instead of calling my doctor when my blood pressure was high. After all, I had an appointment scheduled the next morning, and they could assess me then. It freaked me out that I almost ignored that intuition that something wasn’t right. Always trust your instincts. Always.

I remember that first day in the hospital as just full of bouts of crying, feelings of dread, the panic I kept having to swallow down because I couldn’t move well. They wanted to place a second IV as a saline lock. I already had an IV running, the BP cuff, the O2 monitor, the inflatable calf things to prevent blood clots, and the fetal monitor. It was suffocating. It was experiencing trauma all over again. I didn’t want this second IV restricting my one free arm. I didn’t know what was going to happen to the baby once she came. This was turning out to be the worst-case scenario for me and this was supposed to be my healing birth experience. This was what I practiced for, paid for, and prayed for. I saw a chiropractor, acupuncturist, I was doing Hynobabies. All of it, all of the preparation I was doing for this birth seemed to be crumbling around me. I don’t know. I just remember crying a lot that day. My doula came to visit in the afternoon and that helped so much.

My doctor came in in the evening.

“The nurses told me you were having a hard time,” he said gently. He said I was on Effexor before—did I think I needed to go back on it? I didn’t know how to explain this wasn’t depression—this was a wicked case of PTSD from my prior birth.

I had asked about taking something to help me sleep, knowing I had gone 72 hours without sleep during my stay with Olivia and started having auditory hallucinations and my doctor ended up ordering me a morphine shot, Vistaril, and Unisom. They helped, sort of. I kept setting off my O2 monitor with low sats because I wasn’t taking enough deep breaths. The IV pump would randomly go off. My nurse was constantly coming in to adjust the fetal monitor. The lab came in and flicked the overhead light on to get blood to check my magnesium levels.

I got my second steroid shot at 2 am that morning, 24 hours after the first. He wanted to get me to 48 hours after the second shot before delivering, but he’d be happy with 30-something.

I was told Olivia was doing well with my sister in law. She was having a blast actually, and my mom came to get her to bring her to her house that evening.

Thursday morning we started the cervical dilation to begin the induction process.