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During my first pregnancy I spent an awful lot of time convinced that every pain I felt was something wrong and every bit of discharge was amniotic fluid. I googled “leaking amniotic fluid” more times than I would like to admit. I knew hundreds of strangers’ stories of how they were or were not in early labor that time they felt funny.
Of course, every pain was not something wrong, and I wasn’t leaking amniotic fluid at all. I started dialating a few weeks early but only to 2 cm. Then it stayed like that for the next month or so until I gave birth at 38 weeks pregnant. Full term.
So, when during my second pregnancy, I started to feel funny, I blamed it on stress and went on with my evening. (I was in NY at my Grandmother’s funeral. I had driven the 10 hours there the day before, and was leaving the next morning to drive the 10 hours home.) In fact, I went on with my drive home and went to bed ready for my ob/gyn appointment the next morning.
Looking back, I may have known. There was a lot of fluid, that I assumed was urine, being a pregnant lady having to pee all the time and stuck in the car. And my back hurt. It ached. I was super uncomfortable and couldn’t get comfortable. But again, I was pregnant, driving, sitting in the car, for 10 hours. So, I was “sure” it was nothing. When I got home, I went to bed ready for my 22 week appointment in the morning.
It was a normal morning. I was still a bit uncomfortable, but it was “probably being tired and achy from my drive”. I got my son ready for school, he left with my husband and I left for the doctor.
Within an hour I was calling my husband.
The doctor’s appointment was quick. Residents came in to take my history, I told them about the slight back pain and some leaking. “I doubt it’s anything, but…” They left and told the doctor my history. There was less than a full minute before he was in the room going over what I had already told them. It wasn’t supposed to be an internal exam, but because of what they considered symptoms, he decided to do one.
It was the quickest exam I have ever had. Literally in, look, out.
“Ok, you can go ahead and get dressed, then please come next door to my office so we can talk.”
That’s the moment when your head starts to get a bit fuzzy. When the doctor finishes up quickly and quietly, and calmly (too calmly?) tells you to meet them in their office.
In his office he explained that I was dialated, possibly 2-3cm already. He wasn’t positive, because he had gotten out of there so quickly. The reason he had not stuck around to check out the situation? If the fluid (remember the fluid?) was in fact amniotic fluid, it would mean a tear in the amniotic sac. A tear in the amniotic sac means skyrocketing odds of infection. So, best to stay away with instruments and such.
“Drive across the street to the women and children’s hospital, park, and get checked in to the antepartum unit.”
With tears slowly filling my eyes, I was told to call someone (my husband) and have him meet me at the hospital with anything I was going to need. I was checking in, and the doctor didn’t know when I would be checking out.
The next few hours both lasted forever and flew by. Time has a funny way of stopping, or maybe disconnecting from reality, when you are given news like this. Maybe it’s because you are processing so much in your head and heart, while waiting around for answers.
At the hospital, I was hurriedly checked in, since no one knew exactly what was going on. They wanted to get me hooked up to monitors as quickly as possible. I was put in triage and hooked up to monitors, before my paperwork was even complete. My husband arrived before the doctor made it in to more thoroughly go over what was going on.
At the hospital we had a different doctor than I saw across the street for my regular checkup. This doctor was from the same practice, but was on call at the hospital this day.
She came in and went over in more detail what was going on.
I had dialated to 2-3cm. They weren’t going to check to see if I was still dialating due to risk of infection. I wasn’t, however, currently contracting. The magic number for survival rates in premature babies is 24 weeks. A maternal fetal medicine specialist would be in to see us. She was so sorry. The amniotic sac was bulging, and the first doctor was worried that if he examined longer, even if it wasn’t leaking yet, it may burst. The odds were not in my favor.
This is about when I started to detach from the situation. I had tears streaming down my face, but was calm. Maybe I was numb. It was as if I were two people. The one crying and the one sitting there listening to the facts.
The maternal fetal medicine specialist came in. She was sincere and concerned, but had an air of joy and hope about her. She had the perfect demeanor for someone in her position. I could sense the seriousness of the situation, but felt calm and trusting of her. She explained that if we wanted to continue the pregnancy, even though the chance of survival was low, she would do a test (amniocentesis) to check the amniotic fluid for bacteria and see if I was in fact leaking fluid.
If I wanted to continue this pregnancy and was leaking fluid,
I would be on bed rest at the hospital. This still carried risk of infection, and there was still risk that bacteria was already present in the amniotic fluid. If either of these things were true, I’d be induced immediately. If not, I would stay in the hospital until I inevitably got an infection or went into early labor. Our first goal would be to make it to 24 weeks pregnant. This is when the fetus is actually considered viable.
Now, before anyone gets on me…. yes, there have been a number of cases of babies born before 24 weeks surviving. And everyday science is getting us closer to the majority of those born at that gestation surviving. However, statistically at the moment 24 weeks is the turning point, and very few hospitals are equipped to handle babies younger than that.
If I wasn’t leaking fluid, there were some extra precautions we could take. Namely, flipping me over so the fetus and amniotic sac slid back up past my cervix, and sewing up my cervix. If we did this, I could go home and just come back at full term to have the stitches snipped. Of course, I’d have more prenatal visits than usual, and I would be seeing the specialist vs my regular ob/gyn. The chances of me making it to full term would be pretty good though.
My husband and I wanted information and any answers we could get.
So we took the next step and did the testing. The collected fluid was sent out to be tested for bacteria, and a blue dye was injected into the amniotic sac. This dye would let us know if I was in fact leaking fluid. We had a sonogram done. Fluid levels were still ok, the baby was head down (not ideal in this situation), and we could see where the amniotic sac was bulging into my cervix.
All of this testing, just to be in the same place; waiting without clear answers.
Within 20 minutes we had our answer. Blue dye on the pad they had given me.
If we wanted to save this baby, I would be staying at the hospital indefinitely. Best case scenario, until 34 weeks gestation when they would deliver no matter what. When the risks to me start to outweigh the benefit to baby. Through Thanksgiving, Christmas and New Years.
The doctors were more realistic than optimistic. It may all work out, but they didn’t have high expectations of it.
Every day is a huge win, because every day is uncertain.
We had to think about some “what if’s” right away. What if you go into labor before 24 weeks? The possibility of severe handicaps are high in a preemie under 24 weeks gestation. Handicaps that would almost certainly leave her without any quality of life. Do we want to resuscitate if there are complications in a pre-24 week delivery? Do we want extra intervention after birth? At what point do we want intervention? Our heads were spinning as we tried to make the right decisions. We went forward based on intuition mixed with facts from the doctors. We tried to keep emotion out of it, because we didn’t want to be the people that held on at the expense of our child’s wellbeing. At the same time, we weren’t going to give up on her just because the odds weren’t in our favor.
So, I settled into my room.
Ready to wait. We focused on not thinking about the possible outcomes, but moving forward one day at a time. We resigned ourselves to stop using her name, and disconnect emotionally from the pregnancy. It almost felt like when you are finishing a long hike or run, you are only focusing on the next step. You can’t focus on how you are feeling, you zero in on your movements. Not thinking about the end point, but on the steps to get there.
Thats how we decided to go into this journey. Focusing on getting through today and still being pregnant tomorrow morning.
To read more of our story, and other articles on Bed Rest and prematurity, check out Preemie Life