I had my son by C-section in 2006. Joey was a little giant, 10 lbs. 2 oz. Reason for the section was shoulder dystocia and cord prolapse. My recovery was pretty uneventful, but I still thought that if we had another child, I’d like to try for a VBAC.
I had several miscarriages between the births of my children, and consulted a reproductive endocrinologist at the University of Iowa (we lived about 45 minutes away from there in a small town called North Liberty.) One of the tests I underwent was an ultrasound to check if my C-section scar was a contributing factor. It looked good, so good that the tech called it “the most beautiful scar she ever saw”.
They found that the reason I kept miscarrying was most likely due to low progesterone levels, not anything as a result of my section (the only other uterine procedure I had was a D&C because of a miscarriage). I was given the go ahead to try one more time.
I got pregnant with my daughter in the summer of 2009. My doctors carefully went over my file and told me that they thought I would be a good candidate for a VBAC if I wanted one. Even though I had a difficult pregnancy (I had lost Victoria’s twin at 8 weeks, she had been diagnosed with a congenital heart defect at 20 weeks, and I had gestational diabetes that was difficult to control satisfactorily, even with insulin), they still offered me the chance to attempt a VBAC at the University Hospital, based on that ultrasound report about my scar and their opinion that it was highly unlikely that I would have another child with cord prolapse.
We scheduled a C-section for March 7, in case I didn’t go into labor naturally, so we could have the NICU ready for my daughter’s needs. I went into labor naturally, however, on the evening of the 4th. I stayed at home until my contractions were about 5 minutes apart, then we headed to the hospital.
My doctors had told me that they were not going to give me Pitocin, which was fine with me. They told me that it could increase the chance of rupture. Before I could get an epidural, they had me sign a bunch of paperwork. I remember one of the sheets talked about uterine rupture, but said the risk was small. They would not let me proceed with a VBAC unless I signed it, so I did. And I waited.
I got moved to a primo spot (I could see the football stadium from my room’s window ~ which is a huge deal to UI fans.) I quickly progressed from 3 cm to 8, then to 9. We expected her to come any moment.
Then we stalled out. I was stuck at 9.5. Breaking my water didn’t help. I asked my doctor for one more hour, but had no progress. We agreed to wheel me down to the OR for a repeat C-section. We were all pretty tired, and we wanted to finally meet this little girl.
At first it went pretty much like my first C-section had. There was a light mood in the OR. We told them what her name was going to be, we waited a bit for the NICU staff to arrive (so they could get their first really good look at her heart), and we waited for my husband to get suited up. The doctor said she was making the incision, and there was happy chit chat.
Then about two minutes later, it went silent. I looked at my husband. He didn’t seem to know what happened either, but when we looked at the doctors and nurses they all looked pale.
My doctor spoke first. Clipped tones, slightly louder voice, no nonsense, precise Indian accent. All business. Everyone moved quietly, efficiently.
My baby girl was lifted high for me and my husband to see. “She’s beautiful” my doctor said, then handed her off to the NICU staff. Still no talking, other than a call for a certain clamp or other surgical instrument.
Me and my husband knew something was wrong. No idea what, though. It had to be bad. Everyone in the room was pale and holding their breath but us.
Then someone said the word “rupture”.
I looked at my husband. English is not his native language, but he understood it before I did. I have never seen him look that scared before. I hope I never do again.
Oh shit, I thought, as it slowly sunk in. Was that the only glimpse I was going to get of my daughter? She was….is….beautiful.
Someone asked my husband if he wanted to go to the NICU with Victoria. I told him to go. He refused. I then ordered him out, and said she needed him more. (Actually, I thought there was a good chance I was going to die and I didn’t want him to witness that.) He reluctantly left. I wasn’t sure if I was ever going to see him again.
The doctors continued to work. I started silently praying, and occasionally dry heaving. I started shivering so hard my teeth chattered, and was beyond grateful when they brought me a warm blanket. On occasion the anesthesiologist asked me if I could feel any pain. I couldn’t. I did feel sleepy, though, and fought to stay awake. I was scared to close my eyes. I knew as long as I was awake I was alive.
I heard someone talk about my ureter. I guess I looked confused, because the anesthesiologist told me that they wanted to be sure it was not cut while they were putting me back together. I wasn’t going anywhere until they were sure it was working correctly.
It was. I saw some color creeping back into the doctors’ and nurses’ faces. Someone said “closing up.” The anesthesiologist told me I would be feeling some pressure. I kept visualizing my guts being stuffed back inside me. Someone told me that they were able to save my uterus. I wasn’t going to die, after all.
When my daughter was delivered, I looked at the clock over my doctor’s shoulder. She was born about 5 pm. It was now closing in on 7. Two hours of this. I couldn’t believe it.
Finally, the doctor left the room, and I felt my gurney backing up. They were wheeling me out of there. There must have been ten doctors and nurses coming along with me to my first recovery room, just off the OR. I guess I started to feel a little giddy then. Couldn’t believe I came that close, and was still here. I’d get to see my husband, my daughter and my son again.
I arrived at the first recovery room. Had a nurse standing by, with what looked like six flat screens. She was supposedly tracking other patients in there. I noticed she kept asking me about my family, and my life, and other little chit-chat questions. I guess all my signs looked good, and an hour later I was sent to the regular maternity ward.
First time I was alone in hours.
I started wondering what the hell just happened to me, and was my baby ok. I was exhausted and finally passed out for a bit.
I heard a nurse come in, and I asked her about Victoria. She was fine, she said, and asked me if I wanted to see her. YES!!!
They found someone to push my wheelchair over to the NICU. I know I looked like hell, and even being wheeled over was tiring. But I got to see her around midnight. She still looked beautiful, and they got her out of her bassinet so I could hold her. We made it. Thank God.
The next morning, the nurse got me up to use a walker. I remembered that from my first C-section. I dragged myself down the hall, and would have tried to make it back to the NICU if I wouldn’t have been so wiped out.
Then, the first pair of doctors visited me while I had breakfast. They were two women, in their late 20’s. One brunette, one blonde. They were the first to tell me just how badly I ripped apart.
The blonde doctor told me that the OB was just about to start the incision into my uterus when she watched it split apart before her eyes. I tore all the way into my vagina. When I asked about my original C-section scar, she said that held together. Everything else fell apart.
Then the brunette doctor spoke. They were able to save my uterus, but I should never think about having another child. She said that it was highly unlikely I could carry another baby to term. Any attempt would likely kill us both. They could not guarantee that I would pull through a second time.
We had already decided that Victoria would be our last child, but hearing that was hard to take. I know that doesn’t make a lot of sense. Maybe it is because it wasn’t just me and my husband making the decision any more, but my body hitting the limit of its capabilities.
I got a variation of that second doctor’s speech about five more times before I was discharged four days later.
The doctor who saved my life was able to answer a few more questions when she checked in on me. Maybe her soft Indian accent made it easier to take. She said the walls of my uterus were paper thin, and we were lucky that they held as long as they did. I had lost two liters of blood before she could stanch the bleeding. She had been practicing since the late 70’s, and I was the third rupture she had witnessed.
I didn’t have enough guts to ask her what happened to the other two women, or their babies. I hope they made it through, too.
For the next few months, I concentrated on getting my daughter prepared for her corrective open heart surgery. She was born with Tetralogy of Fallot, and surprisingly the whole ordeal of her birth didn’t affect her one bit. (She’s now a beautiful little four year old imp who loves torturing her older brother, dancing, swimming, ice skating and Hello Kitty.)
I didn’t deal with the rupture until my daughter was almost a year old. By then, she had recovered from her surgery with flying colors, we had moved from Iowa to Florida, and life was starting to settle down a bit.
I started to look up things about uterine rupture and came across some survivor groups. I’ve never met anyone in real life who had a uterine rupture, so they’ve been a source of comfort. I stopped feeling like such a freak of nature knowing there’s other people out there like me and my family.
I’ll never be completely over it. I can’t help but think about it whenever my daughter’s birthday rolls around, for example. I can’t help reliving at least part of that day. I dread the day when she innocently asks me what it was like when she was born….”was it a happy day, Mommy?”
Sometimes it hits me at random moments. Just recently, when I was at Publix, I picked up a bottle of wine. 750 ml., average size. For some reason, I put two more next to it in the cart and said, “That’s how much blood I lost that day.” I sat and stared at it for a while. Couldn’t believe I could lose that much, not have a transfusion, and still drag myself down a hallway the next day.
My husband still tears up and says he thought I was going to die and leave him a widower. He only recently told me that while he was waiting to hear if I would make it, he was wondering how he would raise two small children alone.
No one ever tells you that uterine rupture affects men, too. How could it not? They watched the mother of their child almost die; maybe they witnessed their child’s death. I worked with men, and know how they always want to “fix” things. This is something that they can’t fix, possibly the first thing they can’t do one damn thing about. I know women who would try again, but their partners just refuse. They don’t want to take that risk. Their hearts can’t take it.
One of the hardest things to accept is how many of the women in the survivor groups shouldn’t be there. Most of them were in better shape than I was. They had healthier pregnancies, they were younger (I was 41 when Victoria was born), their children had nothing wrong with them (or at least, nothing as serious as V’s heart condition). I had a c section, and several of them did not. Yet their children were taken, and my daughter wasn’t. I still can’t make sense of that.
I didn’t think when I signed the paperwork that I would be that 0.5% they were talking about. I had no idea how I would freak out over a late period, and start worrying about possibly being pregnant (After all, maybe I’m in that 1% of women who get a tubal ligation and it doesn’t work?). I still have no idea how I’m going to address my daughter’s questions about her birth. What if my daughter, or future daughter in law, is trying to decide if a VBAC is the right choice for her? (I still think it’s a great option, but damn straight I start worrying like crazy when a friend of mine attempts one.) How do you explain that you are happy when other survivors find your group, but you wish there weren’t so many of you in it?
This is why I get angry when I see some half-wit post that uterine rupture is overblown. If you are only concentrating on the number of women who experience it, yes….it’s statistically small. But the effects on the families who experience it are huge, even if everyone pulls through. Shouldn’t that factor into the discussion, too?
I post a little about my story from time to time, usually when a post about HBAC (or UBAC) comes to my attention. I say that a VBAC at a properly equipped hospital is an excellent choice, please reconsider your plans for something other than that.
I get one of two reactions. Either I’m ignored, or someone calls me a fear-mongerer. I’m not. I’m the best case scenario. I pulled through, my daughter did too, and physically, I’m ok. I have a talented doctor, a first rate surgical team and a properly equipped hospital to thank for that. I practiced what I preach, and that’s why I’m here to talk about it.
I’ve not only heard the stories of women who tried HBAC and/or UBAC and fell on the wrong side of that percentage, I know their names and the names of the ones they lost or left behind. They aren’t mere statistics to me. They’re beautiful, brave women and beloved children. They were someone’s everything.
You don’t want to join our club, and we really don’t want more members in it. That’s why I speak up.