LeRoy's Arrival Story

This week is Birth Trauma Awareness Week so I thought I'd share the story of LeRoy's early arrival, as writing it down and sharing is helpful in processing it. His delivery was certainly not what I expected going into pregnancy and even right up until it happened. 

He's a somewhat small 3 month old now, but a generally happy one

First, some background on my pregnancy: 

On our five year anniversary I found out I was pregnant. We couldn't do our normal anniversary dinner out due to covid and instead went for a hike nearby while cautiously (it was super early, the line on the test was faint but there) talking about the pregnancy and potentially taking our kid hiking some day. 

I was pretty grateful to be working from home as the first trimester required daily naps for a period. We were "team green" - not finding out the sex prior to delivery. Mike couldn't come to any ultrasounds until the 3rd trimester due to the fall covid surge, though he was able to video chat for the 20 week ultrasound. The pregnancy was fairly normal up until 28 weeks. 

My last pregnancy "week pic." After this week, things got stressful and I missed the pics.

At my 28 week appointment, my first in person in a while since I was low risk and minimizing unnecessary in person visits due to covid, my blood pressure was so high in clinic that my midwife sent me to Regions (actually, Abbott, because Regions was full, but I'll always remember she said "I'm sending you to Regions") for monitoring. I felt perfectly normal, however, and it took me a second to realize that meant I was going to a hospital. After a few hours of monitoring, my labs - looking for preeclampsia indictors - came back normal and I was sent home. But, I was diagnosed with gestational hypertension and had to adjust my mindset from my preferred "natural" childbirth to a scheduled induction at 37 weeks. That came with a high risk designation and changing to an OB rather than the midwife.

I ended up having two more hospital admissions before delivery, one fairly uneventful except for it being late at night and then a stressful, overnight visit at 30+3 that was a bad experience at Regions. At 30 weeks my BP and one lab was trending high enough for my OB to indicate I get steroids to help baby's lungs in case of early delivery. It seemed like just a precaution. I was seemingly on a trajectory towards preeclampsia, but with no indication of how fast that could happen. That's the annoying thing about preeclampsia - it can be very gradual or very fast.

Week 30 was spent monitoring my BP at home and constantly worrying about it spiking again. I dreaded having to go back to the hospital. Until pregnancy I'd never been admitted to a hospital, I'd never been poked and prodded so much and had never felt so restricted. Then, as I'd feared, at my 31 week appointment, my BP was very high.

Delivery admission

I didn't know it then, but this hospital admission would be the one where I delivered. I pushed back on going in for monitoring, fearing an OB who'd be interventionist (we had a bad experience with one like that during my overnight admission). Baby looked great at the ultrasound that morning and I again felt fine, making me even more reluctant to go. The idea of delivering this early was just overwhelming and upsetting. My concession to going in - to Abbott this time as I knew Regions didn't deliver before 32 weeks and I didn't care to go back there - was stopping home for lunch and to listen to Mike's thesis defense. Right before we headed in I got blurry vision, though it went away fairly quickly.

At the hospital, I had regular blood draws as usual. But, my BP wouldn't come down even with oral medication. I still felt pretty fine, albeit annoyed and stressed, until I got a headache and the doctors wouldn't give me Tylenol (I forget why but believe it would interfere with something). Finally, it's after 7 pm - I was admitted at about 2:30 pm - and I'm hungry but the cafeteria is closed and now I'm told I can't eat. This is when Mike says he knew something was up and I was going to deliver. I was rather distracted by that headache at this point. 

Delivery

Later that night, my labs came back with very elevated numbers indicating severe preeclampsia and decreased liver function (emerging HELLP syndrome). My blood pressure was still not down and we knew that magnesium was the next indication to help my BP and to prevent a seizure. But, having heard horror stories about magnesium's affects, knowing it meant delivery was likely soon and still wanting an outcome where I'd "just" be hospitalized until I hit 34 weeks, I really questioned the magnesium. My OB was on call but not in the hospital so she talked to us via phone about how bad my labs were and how they needed to deliver ASAP to avoid long term damage to my health. 

The attending OB and the "high risk" experts on staff were recommending an emergency C-section and we felt powerless. I wasn't particularly fearful for my own health, though I clearly had reason to be, but I knew delivering at 31 weeks was not great for the baby and was focused on that. I was terrified of the idea of both an emergency C-section and delivering at 31 weeks, even though C-sections are common, I'd already gotten the steroid shot and we were delivering at a hospital with a high level NICU. It all just felt so wrong. 

I got morphine along with the magnesium but it didn't help my headache. And, as I'd heard to expect, the magnesium made me feel awful. They wanted the magnesium to have 12 hours to work to help the baby (prevent brain injuries) and at first I feared we wouldn't get that but we got bumped in the emergency line a few times and got pretty close to 12.

The C-section was a bit of a blur. I went in to be prepped first and to get the spinal, which was rough but not quite as bad as I'd built up, and then Mike came in once they'd started. I remember a few details: the 3M drape, the team repeatedly saying my name, gestational age of baby and reason for C-section at the start ("Anna Wagner Schliep, 31, 1, severe preeclampsia and HELLP syndrome" plays in my head sometimes), being freaked out when I didn't hear LeRoy cry, people saying congrats when he was born and thinking that felt super weird, hearing it was a boy and thinking ok, we have a LeRoy. 

The NICU team was next door and took LeRoy right away. Mike went to be with him for a bit while they finished sewing me up, took some pics and heard him cry, or yell really. I learned LeRoy was wheeled past me on the way to the NICU but don't remember it happening. 

In the room next to the OR

Recovery

After a couple of hours in the PACU, where I finally got ice chips and then food (crackers) and notified family, I was wheeled down to the NICU to see LeRoy. Looking back, I have no idea how I fit in that small NICU room, especially with my IV, but they made it work. 

LeRoy grasping my finger

When I got up to my post partum room the nurses asked what I wanted and I said to eat ice cream so they added that to my goals. I ate so much sherbet while there! 

Since I was in a post partum room, I heard babies crying from the rooms next to mine, which was hard to hear. Similar feelings would come up later when we came in and out of Children's daily and saw babies leaving Mother Baby just days after delivery.

I was on magnesium for 24 hours after delivery, which was pretty rough. A fan needed to be at my head at all times. I was so hot and just felt bad. That fan is now mine because of course hospitals can't reuse them. It took a while for my labs to come back down and to find the right blood pressure medication. Eventually, I got strong enough to get out of bed and wheeled down to the NICU and by the last day in the hospital I was strong enough to very slowly walk there myself (well, with Mike's help at times).

After the magnesium, C-section recovery wasn't too bad. Compared to how I was doing emotionally, it felt minor. While logically I knew I wasn't to blame, I had a lot of guilt about delivering so early and it was very hard to see LeRoy in the NICU. Someone in the hospital - likely one of my awesome nurses - must've recognized I was having a hard time because I was referred for a free massage while there, which was amazing.

My pumping journey started while in recovery with the help of the nurses at Abbott/Mother Baby and a lactation consultant in the NICU at Children's while LeRoy got donor milk (such a tiny amount!) to start.

So tired. LeRoy had a pneumothorax on Day 2 and was intubated for a few days.

For how quickly my preeclampsia became severe, it didn't take terribly long for my BP to get back to normal levels at home. I was discharged on medication but only needed it for 2 weeks. 

LeRoy's NICU stay was the hardest 7 weeks I've experienced. I told the OBs afterwards I wished we could've talked to someone from the NICU team prior to delivery to help reassure us or at least talk us through what to expect because we had no idea other than that he'd go there. That might've eased our concern and helped me be more comfortable with delivery. Of course, in an emergency situation that's hard to do.