Placenta Accreta

It’s 8:00 pm on 4/16/2020. 

The nurse looks at the clock and says, “We’ve been pushing for two hours.” She follows with, “Would you like to take a break?”.

“Yes”, Dia whispered, with what seemed like her last ounce of strength. 

We’re approaching the end of what had otherwise been an extremely long day. 

Here’s a quick recap to bring you up to speed:

  • 02:45 am: Dia’s water breaks
  • 04:00 am: Arrive at the hospital
  • 05:00 am: Move to labor & delivery room
  • 06:00 am: Starting to feel pain from contractions
  • 08:30 am: Epidural Inserted
  • 10:00 am: 5cm dilated
  • 01:00 pm: 8cm dilated
  • 06:00 pm: Start pushing

As the day progressed, I would jot down these moments (and many more) with their timestamp in my notes app. I didn’t want to forget a single detail.

Little did I know, I’d end up spending the rest of my life unable to forget what happened next. 

Cesarean

At 8:00 pm, our Doctor came into our room and examined Dia. All day he was hinting towards the possibility of a C-Section birth. 

Between Dia’s mother and sister, they had 4 C-sections across 5 kids. Based on that family history, our doctor was preparing us for the same. 

We weren’t opposed to it. However, we wanted to give a natural birth a fair shot. Two hours of pushing felt like enough.

When our doctor ordered the nurse to prep the Operating Room, there was a sigh of relief. Dia was in pain and it was difficult to watch.

Around 8:45 pm, they rolled Dia out of the labor and delivery room and told me to gather our things. I packed our bags and carried them over to the recovery room. After a few minutes, a nurse came and walked me to the OR where Dia was prepped and ready.

I sat on a rolling stool on her left side. I held her hand and repeated, “everything’s going to be ok” over and over. 

Her head was jostling around from the pushing and pulling on the other side of the curtain. She wasn’t in pain, but she did feel a lot of pressure. 

She was alert, yet loopy. 

Then, all of a sudden, we heard a cry. An unmistakable sound: This first time you hear your baby cry is as distinct and memorable as the first time you hear its heartbeat through the doppler machine. 

Our doctor called out, “Hey Sunny! Look over the curtain and tell your wife what you’re having!”

It was a beautiful baby girl, with a shit load of hair on her head. That’s my daugther.

They invited me over to the cleaning / weighing station. 

They asked me to cut the umbilical cord.

After cutting the cord, they showed me her weight (8lbs, 15oz) and her height (21.75”) - then asked me to go back to Dia. 

I ran back to Dia’s side and told her everything. “The baby is so big!! It has so much hair, but I’m not sure if it’s curly or straight. They let me cut the cord, it was so thick and gummy. Look at these pictures...”

As I was telling Dia what a great job she did, a nurse tapped me on the shoulder. I turned around and she had the baby in a wooden cart. “Let’s head to the nursery”, she suggsted. 

“What about Dia?” I asked.

“Let’s go to the nursery… now.” She insisted. 

I was confused, but I didn’t think much of it at the time. I looked at Dia and just told her I had to go. I kissed her and reiterated what a good job she did and that everything’s going to be ok. 

Will Everything Be Ok?

The walk from the OR to the nursery could have been ten feet or ten miles, I don’t remember. All I remember is looking down at my baby for the entire walk. I couldn’t believe she was finally here.

We arrived to the nursery at 9:30 pm. We were the only patients in the room. They placed Luna under a heat source, ran some quick tests, lathered up her eyes with Vitamin K, and showed me how to put a diaper on her. 

Then they left me alone. 

The next time I looked at the clock, it was 10:00 pm. Where did the time go? More importantly, where’s Dia?

Our Doctor did a good job setting expectations. He said a Cesarean typically takes 45 - 60 minutes from start to finish. 

I told myself I’d wait until 10:30 pm to find someone to ask. 9:30 pm to 10:00 pm went by in the blink of an eye. 10:00 pm - 10:30 pm couldn’t have been slower.

Uncertainty turned into fear.

A nurse walked by and I waived her down. “Where’s my wife? It’s been 90 minutes since our C-Section started and I haven’t heard anything.”

“Let me find out”, she replied.

She went to a phone nearby and dialed someone on speakerphone. As the conversation advanced, she lowered the volume on the speakerphone. She ultimately picked the phone up. Not a good sign.

The nurse came back to me and said, “They’re moving your wife from the Operating Room to the Recovery Room right now.”

That took longer than expected. I asked, “Is everything OK?” 

“I can’t tell you that”. 

WHAT!?!? “You can’t tell me because you don’t know or you’re not allowed to tell me?”

“I’m not allowed to tell you, you’ll have to speak with your doctor.” The nurse knew this answer was insufficient. 

“I need to talk to him right now. How can I?”

“Let me see if they’re ready for you in the recovery room.” The nurse called someone else, came back, and gave me directions to the recovery room. 

I ran there.

Finding Dia wasn’t difficult. There were 3 nurses around her small bed. There were machines on both sides of her. There were two bags hanging from the bed: one full of blood, the other urine. 

The nurses moved around me. Dia seemed fine. She wasn’t all there, aside from a little bit of shaking, she looked OK.

Placenta Accreta

“What happened?” I asked her.

Dia started with “I’m not sure, but everyone was panicking after you left. At first they were asking me weird questions like how did we meet. But then they started yelling at me to keep my eyes open.” 

She continued with, “then one person kept saying, Call the Bank! Call the Bank!”. We assumed that meant the blood bank. 

She finished with, “I think Dr. Kuchera just saved my life...”

Our Doctor came by a moment later and started a monologue: 

“So everything’s going to be OK, but we did hit a complication during the C-section. The issue was something called, Placenta Accreta... 

Normally, when you pull the placenta out of the uterus, it peels right off the uterine wall. Like when you peel wallpaper off of a wall... 

Dia’s placenta, however, sort of melded itself into the uterine wall. So when we went to pull the placenta out, it tore the uterine wall and Dia began to bleed out... 

I had to decide between removing the uterus or patching it up. If this was your second kid, I would have removed it, but since this is your first, I wanted to try to repair the damage... 

Thankfully, I was able to stitch up the uterus, but there was a lot of blood loss. 3 liters, which is about 60% of her total volume. So now we are going to load her up with 4 liters of blood, platelets, and a cocktail of other remedies.

I also left a balloon in the uterus to collect any blood we didn’t suction out. That blood will drain itself over the next few days. That’s what this bag next to your catheter is for.”

I only had one question: “Why or how did this happen?”

The doctor replied with a question of his own, “I’m not sure. Did you guys do any surgeries before getting pregnant?” 

I replied, “Yes, we did a polyp removal surgery between our egg retrieval and embryo transfer…”

The doctor said, “That could be it. Maybe the placenta grabbed on to a section of the uterine wall where there used to be a polyp.”

It was enough. I think we were all looking for a simple explanation to understand this complication.

Before leaving, our doctor finished with, “Oh, and it’s a good thing we went the C-section route. If that uterine wall ripped after a natural delivery, I don’t know if we would have been able to get to it in time…”

Recovery

We spent the next few hours in surgical recovery. After the doctor left, I asked if I could go back and forth between the nursery and recovery. When Dia slept, I would go back to Luna and vice versa. After a few trips, a nurse suggested we bring Luna to the recovery room. 

It was a tight fit, but well worth it. Dia finally got to hold the baby. We took our first family photo 🙂

Dia had postpartum preeclampsia, which basically means her blood pressure was really high. It ranged from 170 - 190 / 100 - 110. She’s normally 100-110 / 60 - 80. 

They hooked her up to magnesium sulfate to prevent a seizure. They also gave her a bunch of other drugs. I was too tired to write them down. 

They took her temperature every hour or so because fever was a side effect of a blood transfusion. Her temperature did spike once, but came back down at the next reading.

It’s now 4:00 am Friday morning. We’ve been in the hospital for 24 hours. Dia was making progress. The meds they gave her to reduce her blood pressure were working. The 4 liter blood transfusion was complete. The blood tests were coming back with satisfactory results. 

The doctors and nurses felt it was time to send us to our private recovery room. We brought Luna with us. At this point, Luna latched on to Dia once for about 5 minutes. We tried one more time, but it didn’t really work. So we settled for skin to skin contact until about 8:00 am, when the lactation consultant would become available to us.

At 8:00 am the lactation consultant came into our room and encouraged us to give Luna back to the nursery so they can feed her adequately. I was asleep. Dia reluctantly agreed. Then, Coronavirus…

Coronavirus

Around 08:30am, a doctor came into our room to let us know we were now going to be treated as COVID-19 patients because ONE of Dia’s temperature readings came back above the hospital’s limit.

Within 10 minutes, two nurses came into our room and helped us move to the Coronavirus section of the hospital.

Once we were there, they told us we were not allowed to, under any circumstance, leave the room. When I asked about Luna, they said she’ll have to stay in the nursery until we were discharged. This was a tough pill to swallow. 

Around 1:00 pm that same day, Dia’s OB came into the room to check on her. First, we talked about the surgery and recovery. Then he administered the Coronavirus test, which consisted of inserting a straw-like device into Dia’s nose. The “straw” had to be completely submerged for 45 seconds. Dia said she felt it as far back as her ear. 

Our doctor empathized with us. He told us the fever was a side effect of the blood transfusion. He didn’t believe we had COVID-19, but the hospital policy was firm. 

Before our doctor left, he told us we had the option to deny the hospital’s request to stay separate from our baby. We could bring Luna into our room if we wanted, but she had to stay with us until we were discharged. There would be no going back and forth.

Dia and I looked at each other and we had the same thought. Let the nursery give Luna the care she deserves and let Dia get a headstart on her recovery. I had an additional thought: there’s no freaking way I can take care of this baby alone right now. 

Isolation

We spent all day Friday, Saturday, and Sunday watching TV (mostly Friends), sleeping, eating, and breast pumping. 

We pumped every three hours without fail. 15 minutes on each side would yield 2 to 3 drops of milk. It was painful, but Dia persisted. We’d slap a sticker on the bottle and send it down to the nursery. Our daughter needed to know we were trying. 

We were originally supposed to get discharged on Sunday, but Dia’s blood pressure was still fluctuating. They decided to keep us an extra day. 

We were discharged Monday morning. We met Luna and the nurse who had been taking care of her at the exit door. The nursery prepped a “goody bag” for us: Pacifiers, formula, swaddles, diapers, bottles, etc. I pulled the car around, and we went home.

Two days later, the hospital called and said, “In case you were wondering, your Coronavirus test came back negative.”

Gee, thanks.

Sunny Shakhawala

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