The Hardest Thing

Post On Wednesday, April 24, 2019 By Julia Thorn

The Hardest Thing

My first child was stillborn at 23 weeks due to severe preeclampsia.

Maybe everything started around 20 weeks. I was waking up from sleep with pain under my ribs, nausea, and vomiting. It seemed a bit late for morning sickness. I saw my OB, who recommended Vitamin B6 and Unisom; I started feeling better.

My blood pressure at that visit was 126/88.  At exactly 22 weeks my feet started to swell. My husband, friends, and I joked about my “cankles.” All part of normal pregnancy, I thought; although it seemed a bit early for such noticeable swelling.

The anatomy scan happened at 22 weeks and 4 days. My husband and I were excited to find out the sex--it’s a boy! But he was measuring 1-2 weeks smaller than he should be, and the ultrasound tech took too long talking with the reading physician, who eventually came in to confirm the growth restriction. The placenta wasn’t normal, either--she described it as “holey.” This would mean more frequent ultrasounds and additional tests. It was the most difficult day of the pregnancy so far.

My leg swelling worsened as the week went on. At my work as a pediatrician, I took my own blood pressure on Thursday, 9/14/18: 150s/90s. Preeclampsia crossed my mind, so I researched the criteria: elevated blood pressure plus proteinuria. So I checked my urine and, sure enough, it was positive for protein. I knew what was happening. I pictured a weeks long hospital stay to prolong my pregnancy followed by a months long NICU stay. I cried the entire drive home. 

 I explained to my husband what had happened and we agreed I should call our OB to be safe. The on-call doctor told me to come in to the hospital; we hoped my blood pressure would be normal and we would be sent on our way.

My first blood pressure at triage was 180/110. So much for the short visit. 

A high risk OB who happens to specialize in preeclampsia was on call as well. He explained that my blood pressure was dangerously high and they would need to induce delivery.  He told us that not only was our baby small, but the blood flow to his brain wasn’t normal as well. These words started the tears flowing. Our baby wasn’t viable…we were going to lose him. The doctor at least had the forethought to ask if he could use the doppler before we heard our baby’s heartbeat for the last time. 

I was admitted to the hospital and the induction process began. The magnesium and misoprostol medications made me feel worse than the preeclampsia itself. My doctors told me the results of my bloodwork were consistent with early HELLP syndrome, thus confirming the urgency of the induction.  I caught 1-2 hours of sleep between the magnesium checks, medication dosing, and lab draws. I was still so nervous for what was yet to come; I knew I had to steel myself and face the Hardest Thing I would ever have to do.

The next morning, 6/15/18 at exactly 23 weeks, I delivered my baby boy. I couldn’t bring myself to look at him. At least he didn’t cry.

After the delivery, I honestly felt a huge sense of relief. The Hardest Thing was over. My placenta didn’t deliver on its own, so I had to have a D+C procedure to remove it. It took awhile for the anesthesia to wear off, so the full emotional impact of what had happened didn’t hit me until the next day. They kept me another night to monitor my blood pressures, which stabilized off the magnesium, so I was discharged on 6/17/18. It was Father’s Day.

Preeclampsia took my son’s life, and it could have taken mine too, if it hadn’t been recognized early.  While in one way it seemed so transient--my blood pressure and blood tests have now normalized--preeclampsia also changed my life forever.  Now I live without my son, with an increased risk of preeclampsia in future pregnancies, and with an increased risk of cardiovascular disease.  I may have survived preeclampsia but there is still more work to do.  I will beat preeclampsia; I will do it for my son.

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