Going into my fifth pregnancy–fourth birth–I considered myself an expert level of parent. I have dealt with everything you can imagine, including a child vomiting poop. (Yes, that can happen and yes, it happened in my kitchen!) I have been to every labor and delivery class in Duluth/Superior and the surrounding areas. I’ve watched countless DVD’s and episodes of A Baby Story on TLC, and I have watched the Ricki Lake documentary more times than I care to admit.
Basically, I feel like I could birth your baby for you and know exactly what to do.
What I was not expecting going into my fourth delivery was to die and come back, all because I was allergic to some amniotic fluid this one time.
No Such Thing As Easy
I have had three relatively easy, textbook labor and deliveries. All vaginal births, assisted with an epidural, one was induced, one was nine pounds, one made me a level four tear (do NOT Google that). I had my share of fun in the labor and delivery room so when I went in on August 1, 2016 I expected to have a baby by dinner so I could eat all of the french fries my husband could smuggle in. What I did not expect was for Lucy to be a breech baby. I’d never had a breech baby before I underwent a painful procedure where they attempt to turn the baby around. I have no memory of any of this, but my husband assures me I added it to the “you really owe me” list I keep handy. She was head down by delivery time and we were glad to avoid a c-section.
Just as things start moving along, we discovered that sure, Lucy was head down, but she was now face presenting. The way her head turned made it impossible and dangerous to her for us to proceed with a vaginal delivery so I was rushed into an emergency cesarean. I can easily be angry that this baby just could not follow directions, but the truth is that Lucy saved my life by not following protocol. Had I tried to deliver on the labor floor, I would have hemorrhaged and died right there within minutes. Instead, I died in a surgery room full of the best surgeons, doctors, and nurses St. Luke’s has to offer, during shift change when more bodies were available to work together.
What is Amniotic Fluid Embolism?
Within seconds of Lucy’s delivery I had respiratory failure of both lungs and the right side of my heart failed. Thankfully my anesthesiologist noticed right away and concluded I was having an Amniotic Fluid Embolism, something that happens in 1 in 40,000 births. First recognized as a disease in 1941, AFE is completely unpreventable and unpredictable. It’s essentially anaphylactic shock because of amniotic fluid. What interests me is why did it happen this time? Lots of mothers have amniotic fluid or debris enter their circulatory systems but they don’t suffer this, and why me on my fourth baby? We may never know.
An AFE is characterized by two parts: immediate respiratory failure and cardiac arrest, and then hemorrhaging. You lose ability to clot due to DIC (Disseminated Intravascular Coagulopathy) and you better hope your local blood banks are a popular hotspot for donation because you will go through a lot. Data varies, but it is believed that 40% of women who go through an AFE do not survive. Those who do survive go on to have lifelong medical issues.
The Fight For My Life
I had no idea as I was being wheeled into the emergency room, being reassured by my team that everything was going to be OK, that minutes later I would be fighting for my life. Once the major trauma of the AFE was finished, and I was wheeled into ICU, my family was then informed of my grave circumstances. I wasn’t out of the clear, in fact they couldn’t get my bleeding under control and my husband had to make some tough decisions on what kind of second surgery I would undergo. He opted against a hysterectomy though we were clearly done with pregnancy, and instead opted for a procedure where they essentially use a glue to close or bind arteries that just won’t stop. Fortunately, it worked and I didn’t need a more invasive surgery. I spent four days in the ICU before being transferred to a regular room, where I spent three more days.
By the time I was able to leave it was clear that things weren’t quite right with me. For one, I had no memory of any of it (still don’t), I had no idea who my husband was, was not aware that I had children, let alone four of them. Within a few weeks major depression kicked in and I was given my lengthy list of ailments I would live with for the rest of my life due to significant blood loss and having major organs fail. It would be discovered months later that I also had a stroke, which explained some of my memory loss and cognitive dysfunction.
My hope is that expecting mothers go into birth knowing what could happen, but also know with full confidence that your birth team is equipped with the supplies and knowledge of what to do in critical moments. I may not get my memory back, I may never live without a basket of medications, I may feel like I have the worst flu of my life every day, but I’m alive. And that’s a start.