Jack's birth: "I had all the signs of pre-eclampsia"Judith Knott lives in Norfolk with her husband Stuart and her

children Jack, 10, Erika, seven, and Grace, six. This is the story of Jack's birth, which was complicated by pre-eclampsia.

During my regular antenatal checks at the doctors there had been creeping signs of pre-eclampsia. At 34 weeks of pregnancy I was admitted into hospital for complete bed rest as I had all of the classic signs. 

These included extreme water retention. I had put on a massive five stone during my pregnancy and my whole body had puffed up, with swollen legs and ankles, hands and even fingers. I also had high blood pressure, and protein in my urine. 

I had thought it was just something that the hospital staff were over-reacting about, so I was feeling very laid back about it.

I stayed in hospital and the staff monitored me over the next two weeks. By the time I was 36 weeks pregnant, I had put on another stone in weight, and my condition had started to deteriorate. My blood pressure had risen further and I was retaining too much fluid. 

On the morning of 1 February, nearly four weeks before my due date, I was told that it was time for me to be induced. It was the safest option for me and my baby.

At about 8am just after breakfast I was examined and then told that I was already starting to dilate (1cm! Only 9cm more to go). I didn't need to be induced after all. 

I was taken up to the delivery suite, after I had made a frantic phone call to my husband. He seemed to think that I was going to give birth any minute. He sped (adhering to speed limits, of course) up to the hospital only to find that I was not even experiencing any pain yet.

A about 11am, although I had already begun to dilate, the midwives placed an oxytocin drip in my arm to speed things up a bit. My baby was being monitored for any signs of distress. Luckily for me the drip seemed to get my contractions going fairly quickly. 

I was advised to have an epidural. If my blood pressure suddenly rose any further it would place mine and my baby's life at risk. Having the epidural in place meant that an emergency caesarean section could be performed if need be. 

I also had to have a catheter inserted into my bladder, which was very unpleasant. I was wired up to every machine that was in the room. I was feeling thoroughly fed up because my mood had been completely fine until the doctors and midwives had started poking and prodding about!

The afternoon was most uneventful. The epidural did its trick of giving me

complete pain relief and I spent the afternoon watching TV and being checked on the monitors. 

In the late afternoon they decided to break my waters to speed things up even further, which it did. At about 6pm I was examined and found to be 7cms dilated. I then had another contraction and shot up to 10cms! Wow, that was quick!

The epidural had worn off by the time it came to push. After half an hour of pushing, minding the drips, wires, catheters and other niceties, Jack was born at 7.23pm, weighing in at a healthy 7lbs. 

I had a very slight tear but didn’t need any stitches. Jack was fine with no problems at all, a very healthy baby boy. 

Unfortunately, I had to stay in hospital another four days after the birth, waiting for my blood pressure to start coming down. I also had to be on medication for a while to get my blood pressure back to normal. 

After I had Jack I did some reading up on the topic of pre-eclampsia and found out that it's actually much more serious than I had thought. If I hadn't had such good antenatal care, who knows what could have happened.

http://www.babycentre.co.uk/a559460/jacks-birth-i-had-all-the-signs-of-pre-eclampsia#ixzz2u7Zy1Tom

IT HAPPENED TO ME: MY NATURAL BIRTH ENDED UP WITH ME IN THE HOSPITAL WITH A POST-PARTUM HAEMORRHAGEOther than being of the "advanced maternal age" of 33 when I gave birth, no other risk factor applied to me. My wonky placenta was just the luck of the draw.

Jenny Rose Ryan of xojane.com

Um. Did you know childbirth is epic? Maybe you didn't. So I'm telling you now. It's really, really epic -- however it happens. You gave birth in a tub in your living room surrounded by candles and all your loved ones? Epic. You gave birth on an operating table surrounded by all your loved ones? Epic.

Every person who has ever birthed a child deserves a rousing anthem composed by John Williams. If you didn't give birth to your child, you also deserve an anthem, but that's a story for another time. But this isn't even a story about birth. This is a story about what happened to me immediately after. Trigger warning: This is a story of my post-partum haemorrhage. My husband said the room looked like a metal album cover. So, basically, a goat sacrifice.

And this experience (at the end of a 54-hour labor, might I add) just further convinced me of the epic nature of the human birth process and of the essential trust we must give it. And that we all kick absolute ass when we survive it.

Before the room was filled with people saving my life, all I remember is holding my newborn son on my chest as he nursed while the oxytocin flowed through us. Smiling. Looking down at his face. Checking to see if he had all his toes. Relaxing, finally, after nearly two days of contractions that led us to the warm respite of a hospital epidural and away from the cozy tub in the birth center's basement. Relief.

He was here. He was healthy. We could move on with our lives. He was born at 7:39am.

As we cuddled, my son and husband and me, with our doula there giving advice and adjusting his latch, I realized quite some time had passed since I'd pushed him out

and that the obstetrics resident was taking awhile to coax out the placenta. In fact, it had been around 45 minutes, and the placenta is supposed to expel itself shortly after birth.

I knew doctors generally want it to come out within a half-hour of a vaginal birth, but I also knew this team at the hospital where I transferred was friendly to the lower-intervention model I believed in, so they were still giving my body time.

Then, I started to feel dizzy and strangely far away. I remember thinking, irrationally so, that I was being put under for surgery; that's what it felt like. But that dizzy, dissociated feeling -- I later learned -- was shock.

Because I was on my way to losing nearly half my blood.

I remember saying to my doula, as she took my son away to my husband across the room and a whole lot more people whisked into action to help me, "I feel so overwhelmed."

I thought the dizzy feeling was a panic attack from all the people now in the room. I can get a little like that sometimes.

Then, oxygen mask over my head. Another IV in my arm. People running around. Machines beeping. Gloves snapping. I remember saying, "What are you putting in there?" to a nurse.

She replied, "Some medicine to help with the pain."

I replied, "Is it Fentanyl? I don't want Fentanyl!" And she told me that's what was. And I told her no. That I was lucid and aware enough to know I didn't want it, so they didn't give me any. I didn't want to be sluggish as I shared my son's first hours. I also didn't want him to have those strong medications in his tiny system. I also was a little bit drugged by the oxytocin and the other endorphins that are your body's gift during marathon events.

As the medical team worked, everyone kept telling me I was so strong. 

They would ask many more times if I wanted pain relief because the on-staff OB had her hands in my uterus to manually remove the last bits of the placenta that had attached itself too deeply. Meanwhile, I bled. That's what I was really good at doing at the time.

I remember pushing the button for the epidural repeatedly. The nurses didn't have the heart to tell me it'd been turned off. My abdomen cramps now as my body remembers.

After 54 hours of labor, having hands in my uterus seemed reasonable. It seemed like a thing I could handle.

Besides, at first the remaining spinal medication took the edge off some of the pain. But after awhile, it didn't make a difference. I could feel every tug and pull as she carefully cleared the temporary organ from the permanent one, bit-by-bit and piece-by-piece. I don't think I need to say anymore about that. 

Later, I would learn I had placenta accreta, which is a complication that's very difficult to diagnose before birth, and for which the common response is an emergency hysterectomy, and for future children, a planned Cesarean section. It's a complication that's becoming more prevalent today due to the rising C-section rate, as one of the risk factors is uterine scarring. Other than being of the "advanced maternal age" of 33 when I gave birth, no other risk factor applied to me. My wonky placenta was just the luck of the draw. As the OB worked, I remember looking up at the lights and breathing deeply from my belly. I remember my legs shaking from the pain. I remember my doula asking me if I wanted a shoulder rub. I remember hearing my husband's voice in the corner of the room. I remember feeling hungry.

That's when I knew everything was fine. I was so hungry. All I'd had to eat in the last 24 hours was a bunch of cups of peaches, some Gu and a whole lot of Gatorade. I really wanted a sandwich.

Once I was all cleaned out and stitched up, people came in to mop up the floor. (Like I said, goat sacrifice.) I ate yogurt and Jello. And scrambled eggs with mushrooms and cheese and a gigantic chocolate malt. And a salad.

At about 11, we were transferred to the recovery floor where I ate even more (two burgers, fries, another chocolate malt) and had six rounds of intravenous antibiotics over the next two days, along with a few rounds of IV iron to help build back up my blood supply. Despite losing nearly half of it, I didn't receive a transfusion because my doctors thought I was strong enough to make more blood on my own.

I remember being unable to sleep that first night on the recovery floor because the sound of my heartbeat was birdlike and rapid in my ears. My normal resting rate was around 58. Post-hemorrhage, it was 100. 

My skin, too, had a deathly pallor. I looked like I needed a fainting couch and some smelling salts, like I could swoon from too-tight corsetry at any moment.

Friends came to visit us, as they do with new babies. Everyone said I looked terrible, but I still had a swig of the beer they smuggled in.

Once I was discharged, these same friends brought us red-meat dishes and lots of spinach to our home, and I slowly felt better. For a few weeks, my pulse was still high. But by two weeks postpartum, my red blood cell volume was back up to 31% (normal for women is about 40%) -- where it had been 11 the day I went into shock. 

In all honesty, once I was home in my bed, I felt so much better. The tailbone pain I had for a year (from my son's big-giant-head knocking into it on the inside) bothered me a whole lot more than my temporarily weak constitution.

My story is ultimately one of trusting our laboring bodies. My labor was long and, duh, laborious. And I believe this was my body's message to me to get to a hospital.

I had an informed, experienced team of midwives who watched how things progressed and, together, we responded accordingly. I'm incredibly grateful for their care. I am incredibly grateful that we listened to what my body was telling us and that I transferred before I ended up needing emergency care. It all worked out well.

My husband and I went in with open minds and hearts to the ways things can change during labor and delivery and we all came through. That's really all we wanted.

The moral of the story is this: The only time I want a person in my uterus is if they're saving my life. We all make choices for our medical care that work best for us in our situations. We all deserve an anthem for putting up with those who think it's their business.

http://www.xojane.co.uk/healthy/139:it-happened-to-me-i-survived-a-post-partum-hemorrhage

DUTY REQUIREMENTSJOURNAL READING

SUBMITTED BY: THINA C. TORRES , BSN III

SUBMITTED TO: MS. LUCILA CHAMEN RN, MAN

JULY 2, 2014

DUTY REQUIREMENTSJOURNAL READING

SUBMITTED BY: SENAMEL BALASON , BSN III

SUBMITTED TO: MS. LUCILA CHAMEN RN, MAN

JULY 2, 2014

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