I have been holding off in writing this post for the past week or so because it touches on a topic that sparks deep, unforgiving and breath-stealing fear.
At my OB appointment last week I thanked my lucky stars for not having a brain or heart aneurysm (at least none of which I’m presently aware) because I was confident either or both would have burst. I have been unable to write about what happened because I’ve been scared to death, not sleeping and very emotional. Admittedly, the lack of sleep from the bruised ribs and last week’s anxiety surge coupled with this evil, unrelenting nausea are not helping me be less emotional or more rational. I am trying to do my best (which for the past 5 days has been not all that well). So it goes.
At last week’s appointment I had asked my OB about what would happen with scheduling and whether he recommended sticking with a caesarean rather than being induced if labour didn’t happen early on its own, assuming my placenta has moved the requisite 6 mm by this Wednesday (at 35 weeks) from where it was on April 29th (at 32 weeks). If that happens he said it removes the need for a caesarean at or before 37 weeks to avoid me going into labour and facing the risks associated with that (bleeding to death being the worst case scenario, an emergency hysterectomy being another serious risk).
Last week, my OB said that if I get off of the placenta previa watch and only have my crappy placenta (which has been flagged as being at risk of early deterioration and placenta accrete which could also lead to emergency surgery include hysterectomy but apparently that’s all speculative whereas the previa has been concrete) to worry about, he wouldn’t schedule me to deliver until 39 weeks because (a) he’d get in trouble scheduling a section any earlier if there wasn’t a serious risk like previa driving it; (b) studies show babies benefit from staying in until 39 weeks; and (c) that said, studies also show an increased risk of stillbirth in otherwise healthy women over age 38-40 (that ship sailed some time ago!).
I was so upset, I just shut down. There is no way I trust this placenta to function properly to 39 weeks. In the moment last week however I could not express my anxieties. I was struck dumb. Literally.
Some of those anxieties stem from knowing my Mom lost her baby from her second term pregnancy when the doctors would not listen to her saying she felt something was wrong and wanted to be induced – and so I left the office, called the LP and sobbed so hard I had to go for a long walk before I could return to work (which was pointless since I did not billable work after that morning appointment anyway). Suffice to say I was a hot mess.
If I’ve harboured one unrepentant fear during this pregnancy above all others it is the fear of losing this child. Once we cleared the first and early second trimesters it became a raging nightmarish fear of stillbirth. This fear is potent. It is so profound and deeply seated I cannot tell if it’s driven by intuition (whether a premonition-type thing or otherwise) or merely an overwhelming anxiety. I suspect it is as deeply rooted as it is in part because of my mother’s experience having punctuated my own childhood and having evoked fear throughout my adulthood since I began trying to have children of my own.
What I can say with certainty about my fear of losing this baby – my dear Azulito/a – at this late stage is that nobody, not even my OB or my other caregivers, are saying it’s irrational or unreasonable or not founded in the reality that we all know that my placenta is troubled, that my immune issues elevate the risk of something going seriously wrong at this late stage, and that a family history of this happening is not something to brush away like a family history (maternal) of male pattern baldness (not to say that hair loss in men is inconsequential but it’s not the life or death of your child).
Nobody has tried to tell me that there’s nothing to worry about. Because that would be a lie. My worries are legitimate. The risk is real. And none of that helps assuage my fear or my wish to end this pregnancy sooner rather than later if it means I get to hold a living baby at the end of this journey and not mourn the loss of one whose life expired before the generally applicable expiry date.
Another thing I can tell you about this fear is that it’s a powerful motivator. I would climb mountains, wrestle wild beasts and tear out the eyes and heart of anyone who stood in the way of my goal to deliver this child before it’s too late – whatever too late might be. I have never been more of a mama bear than I have been in my non-sobbing moments during the past week. I would move mountains if I had to. Those of you who’ve been ‘here’ or somewhere like it know what I mean. And I know you’d do the same. I *know* you would.
I would also consume supplements and drink horrible-tasting and devastating side effect-inducing cocktails to bring on a natural labour. On that note, I’ve been lining up the ducks for that eventuality should it become necessary. Whatever it takes.
For now, however, at least until early Wednesday morning this week, I am still considered to be diagnosed with Placenta Previa. I cannot say I want my placenta not to have moved – I don’t really want a caesarean to be honest and most of you will recall I never did. The LP still wishes I’d forego the risks and just choose that path regardless. My OB is letting me decide if the previa diagnosis disappears this Wednesday (so is the LP though he knows I know what he would prefer).
This morning, my OB relented on the 39 weeks requirement and said we can talk about inducing earlier if the previa is determined this week to have resolved itself. I asked if he’d agree to 38 weeks and he said possibly and agreed we could talk about it next week (Wednesday) if the previa is resolved. He also gave me another requisition for blood work to test my bile acids (more fasting – awesome!) in case there is any chance of me developing Cholestasis again (there is a 50-70% risk of reoccurrence). If I do, that would involve an earlier induction or caesarean too. Why? Because the big risk with Cholestasis is stillbirth.
(I know, right?)
I said I was not wishing to be diagnosed with that again even if it meant an earlier scheduled delivery. Thanks but no thanks!
I really like my OB but this roller coaster is no fun. I want someone to hit the emergency stop button so I can get off. I’ve had enough.
As matters stand, I might be delivery via c-section on June 9th. I might be ingesting stuff that in the course of making me sick I hope brings on labour and a vaginal delivery. Or I might be getting medically induced or going through a scheduled caesarean sometime in the week of June 15th. The LP is in trial every day from next week until the end of June and two days this week. The timing could not be more perfect. So it goes.
It is time, Azulito/a. Please come home safely. And soon.