Difficult Pregnancy and Traumatic Birth {Hyperemesis Gravidarum, Gestational Diabetes, Cholestasis And Induction}

My pregnancy and birth were by no means ideal or what I had planned. But sometimes its more important to hear about the births that didn’t go to plan than the ones that did. If my experiences can help just one person then my story is worth sharing. – Johanna

Ever since I was a little girl I have been desperate to experience pregnancy and motherhood, seduced by images of glowing women tenderly rubbing their bellies and tiny perfect infants.  I knew early in my teens that pregnancy may never be a reality for me – I suffered from severe endometriosis and lost a fallopian tube to a laparoscopy at the age of 17 and was told my chances of conceiving without intervention could be minimal.

Fast forward eight years and there I was with a positive pregnancy test in my hand. I was cautiously excited – despite the unplanned nature of the pregnancy – knowing my chances of ectopic pregnancy and miscarriage were high. In my mind I had won my battle – I had proved the doctors wrong with my pregnancy and could not imagine that anything but happy days were ahead for me. Sadly, my battles were only just beginning.

By the time I saw my baby’s little heart flickering on the eight week dating scan I was already very ill. I was wracked with debilitating nausea and vomiting and having trouble even keeping down water. I was told all the usual things – have small meals, get fresh air, try ginger, eat crackers – but nothing worked. I had been determined that I would eat healthy and not take any medications at all during my pregnancy and was still dragging myself to work to do ten hour shifts in child care. When I finally broke down due to exhaustion and dehydration and let my partner Mark take me to the doctor to get a prescription of anti-nausea meds I cried all the way home. They did nothing to help and I soon made my first visit to the hospital after vomiting blood. They put me on IV fluids and gave me a medicine called Ondansetron (Zofran). For the first time I was able to drink a small cup of water and keep it down so they sent me home with no medication, no advice and two days off work. As soon as the medicine and fluids wore off I was back to my worst and in desperation and fear for my baby’s life I went to a doctor to beg for a prescription for Ondansetron – she told me she wouldn’t prescribe it for me and it was dangerous for my baby and I left in tears feeling devastated and ashamed.

Two days later I was back at the hospital being admitted and was finally diagnosed with Hyperemesis Gravidarum – I was vomiting blood again after days of bringing up all food and liquids and bile, too dizzy and weak to get out of bed without assistance. Food revolted me, smells revolted me – I couldn’t stand the smell of tap water let alone my partner, I couldn’t stand up long enough to shower and I couldn’t brush my teeth without vomiting. I was losing weight rapidly. I had to tell my work I would not be in for the foreseeable future. Mark was working full time and then coming home to nurse me – as well as running our household by himself – I was utterly helpless and some days could not even make it across the hallway to use the toilet without assistance. My Mum came over on her day off every week to take me to Drs appointments and offer what assistance she could with house work etc.

After my admission to hospital I was given a script for Ondansetron. It gave me a little more control over my vomiting but I still vomited most things. I managed to keep myself hydrated with lemonade ice blocks and frozen coke because they were all I could keep down. I cried bitterly when I was alone, scared that I could not provide my baby with the nutrition necessary for it to grow and convinced that the baby would die…or that both of us would. I was pushed into early testing for gestational diabetes due to my high BMI and when it came back positive I felt even more helpless – the only things I could manage to keep down were the very worst things for GD but I had to eat what I could eat or end up back in hospital.

The strain of going down to one income became too much and when the government wouldn’t help us with any sickness payments, we had to make the painful decision to pack up the little home we had made for ourselves, break our lease and go and live with my parents. My symptoms got very slowly better and I began to get a better hold on my vomiting. I was able to expand my diet to more normal foods and keep down water with the help of my medication – even if the nausea was still very prevalent. The damage to my body had been done though and I was suffering from malnutrition, weak, had lost a huge amount of muscle and was in constant pain due to atrophied muscles in my back as a result of all the months of bed rest.

At my 20 week scan we found out we were expecting a little girl and by about 22 weeks my vomits had decreased to one every few days – unless I exerted myself in any way, got too tired or got upset. I was still unable to contribute to the household in any way and spent my days lying in bed watching TV. I was very grateful that I was seemed to be coming out the other side of the hell I’d been going through with HG and my GD was totally diet controlled (I’m still not convinced the state I was in when the test was done didn’t produce a false positive) – things were looking up!

I was 32 weeks when I again started to feel something was wrong. I had been improving in tiny steps and filling my time writing my birth plan – I was planning a birth totally free of induction or drugs. I became incredibly itchy, to the point that I wanted to rip my skin off and I was crying. I was diagnosed with Cholestasis of pregnancy – a condition involving the liver which meant that my baby was at a much increased risk of stillbirth and would have to be induced before 38 weeks and had to spend the night in hospital for monitoring because my test results were so bad. I couldn’t believe it! Why did these things keep happening to me? I had been through such pain and suffering already and had been focusing my energies on making up for my terrible pregnancy with an amazing, intervention free birth….now that was being ripped away from me too! Around the same time I was informed that the glandular fever I’d had the previous year had not in fact resolved itself as I had been told and had in fact been active and present in my blood throughout my whole pregnancy!!!!

At 34 weeks I was admitted to hospital again – this time I was struck with excruciating pain in my back, so bad that I was screaming and wild. I spent 6 nights in hospital with a massive infection in my gallbladder and on IV antibiotics. The doctors were very concerned by my body’s lack of immune response – despite the seriousness of my infection I never once got a fever which showed that my body was not trying to fight the infection at all.

I made it to my personal goal of 36 weeks, managing to enjoy my baby shower – which we had long feared I would not make it to. Then my liver began to show increased distress despite the 8 tablets a day I was taking to try and keep my body working and my induction was scheduled for November 21^st – I would be 37 weeks and 2 days.

The day of my induction I was filled with conflicting thoughts. I was excited to meet my little girl although I would not be having the birth I had planned. But as much as I did not fear the actual process of birth, I had trouble believing that things would go right for us given all the road blocks that had been thrown in our way during the pregnancy.

We arrived at the labour ward at 5pm and Mum, Mark and I settled into the room armed with many bags of things to sustain us through the long night ahead – 12 hours with a foley bulb in if I was dilated enough or perhaps the same amount of time with cervadil. They examined me, ready to try and place the foley bulb and found I was already 3cm dilated! The midwives and Drs were happy and excited saying this never happens for a first time Mum at my gestation. They decided to send me home and have me come back in at 7am rather than break my waters and have me labour through the night. The Dr gave me a stretch and sweep and we went home and tried to relax – it felt like an anti-climax but I was also excited thinking that perhaps I wouldn’t need any interventions. My body could do this! Despite my best efforts that night, I didn’t go into labour and my waters remained intact. When I got up in the morning I had started to lose some of my mucous plug and became excited that perhaps I had dilated even more overnight.

Back at the labour ward and a check revealed I was still only 3cm. I was disappointed but determined. The midwife ruptured my waters with a great deal of effort and to my great disappointment there was meconium in them. This changed the whole birth plan right away – I was no longer allowed to labour without any augmentation – I would have to go straight onto the hormone drip. I asked if they could keep it on a very low level and they agreed. When my contractions began it was 10am and I handled them well, walking around the room and bouncing on the birth ball. I had to consent to monitoring because of the drip but had organized to have to wireless monitor – it was a struggle from the start. It was supposed to make it easier for me to move around but every time I moved it kept cutting out and finally I had to have the wired monitor on as I continued to bounce through contractions on the ball. Every time I stood I was losing amniotic fluid in big gushes but my contractions which were coming every 2 minutes were ‘too short to be effective’ and they turned up the hormone drip. I began laboring on hands and knees on the bed which felt very good but in this position none of the monitoring would work and the Drs came in and told me I had two choices – lie still so the monitoring worked or consent to internal monitoring. I chose to labour on my back to spare my baby from having her head punctured.

Lying still on my back was torture and made the contractions hugely intense. It was now 5pm and I had now been contracting every two minutes for 7 hours but a check showed I was only at 5cm. Having made so little progress made me really disheartened and I was starting to doubt that I could do it. I had clearly stated in my birth plan that the midwives and Drs were not to offer pain relief but Mum and my fiancée Mark could see how exhausted I was getting and urged me to try some gas to take the edge off and I consented around 6pm. The gas relaxed me a lot – made me cheeky and stoned – and helped me focus on the task ahead and regain my confidence. This had an effect on the contractions which started to last longer and every second contraction my body began to push involuntarily which made me feel quite confident that I was making progress. 8pm found me at barely 7cm and the midwife made the decision to turn up the hormone drip making the contractions even more intense. I couldn’t stay still, the gas stopped working, the baby had turned so she was posterior and I couldn’t stop myself pushing during the contractions which was making the lip left on my cervix swell. The Drs came in and told me they were having trouble finding baby’s heartbeat – my student midwife told me later that they were pushing for a C-section at that point – and they convinced me to agree to internal monitoring.

By this stage I had lost control. I had told myself I would be calm and cool but I was screaming my lungs out. Mum and Mark took turns leaving the room for breathers because it was hard for them to see me like that. I was exhausted – I had now been contracting every two minutes on a high level of hormone for 12 hours – and, desperate not to have to have an epidural I consented to pethadine. I really regret this because it was useless, making me sleepy between contractions but doing nothing to help with my pain. Before the pethadine kicked in the midwife convinced me to try the shower, hoping I could stand up in there and get things moving but my legs would not support me, the pain was too intense.

At 12am I was checked again and was 8cm, still thick. The midwife told me that based on my progress so far she would estimate that it would take me three or four more hours to dilate fully. After 14 hours of contracting every two minutes I had a decision to make. I could see my Mum and fiancée having worried discussions over in the corner, I had no more energy, and I had screamed so much my throat was raw. I felt broken and helpless and I knew that I didn’t have another 3-4 hours in me. Mark and I started talking and he told me that he supported any decision I made, that it wasn’t failing, that I had endured so much and fought hard – especially considering my lack of stamina from all those months of bed rest. I felt like a fool, like I had failed. In my head I could see my birth plan with every second line crossed out. An epidural was always something I had been insistent I would never do but at this point I truly felt that even if I made it to 10cm without one I would have no energy to push and would end up with a C-section anyway.

At 1am, after 15 hours I got an epidural and cried the entire time. When the epidural kicked in the room visibly relaxed. I was no longer screaming and Mark and Mum were visibly relieved to see me not suffering any more. With the pain gone my midwife was able to help me maneuver into some different positions and I was able to get a couple of hours sleep while they raised the hormone drip to its maximum. At 3am they brought in an ultrasound to check where baby was and found that she had moved out of the posterior position and was ready to go and a check showed I was fully dilated. I dozed for a while longer and then asked for the epidural to be dialed back so that I could feel the contractions enough to push. At 4am I was ready to push with a mirror in front of me.

At 4.43am after almost 19 hours of active labour, Ella Quinn was born into her Daddy’s hands.

The relief and joy was overwhelming. I held her on my chest and cried hysterically. Mark began to cry too which was something I had never seen before and I have never been more in love with him than I was in that moment.

I began to shake and shiver violently. Ella had some problems initially – she had trouble breathing, then low blood sugars, an infection and jaundice – and spent her first five days in the special care nursery but is now home, a beautiful girl with a mop of black hair who is growing bigger on Mummy’s milk and adored by all around her.

I have my good days and bad days. I have my days where I think, why me? Why did I have the horrible pregnancy, the difficult birth? I have days where I wonder what I could have done differently during my labour to avoid all the interventions I ended up having. I have days when I feel like the huge debacle that was my pregnancy is only eclipsed by the failure that was my birth experience. But then I remember that no matter how I feel about them, my pregnancy and labour resulted in an amazing daughter who is not going to care if I hated being pregnant or if I had an epidural. She is only going to care about how much I love her – and that is something I’m positive I will be successful at.