RIP uterus.

Pregnancy and birth are not for the faint of heart.

Women are sold this image of pregnancy and birth as this beautiful thing where we are goddesses on a cloud and every second is nothing but magical. The reality is much different - pregnancy and birth are gritty and dangerous and not glamourous in the least.

Before actually giving birth, I spent very little time imagining how it would actually go. That was partially out of fear and partially because of my combination good luck and good health in which nothing at all had really gone wrong for me at that point (medically or really even life-wise at all). Why would pregnancy and giving birth be any different?

LOL said the universe.

I have been pregnant three times, and all three times have been complicated. In all three cases, I felt like I was failing my babies - my body wasn't giving them what they needed to fully thrive.

pregnancy #1

• Having never been pregnant before, I didn't know what to expect when it came to pregnancy symptoms. I felt terrible until well into my second trimester. For those who have not experienced it, the first months of pregnancy feel like the worst hangover you've ever had, but without the fun that typically precedes a hangover - and this hangover lasts for four months. 
• I developed gestational high blood pressure (bordering on preeclampsia). Among other things, I was under strict instruction to go to the ER immediately if I had a bad headache that would not go away. I have had migraines for years, so this was a tough call. I had a particularly painful migraine at the end of February, so I called my doctor, who told me to go to the maternity ER. I was there for hours, getting serious pain meds through an IV. Much to my relief, I got to go home (I had been threatened with bedrest) and even went to work the next day.
• That was the weekend, and that Monday, I went to an appointment with the high-risk obstetrician. He had read about what happened with my headache and told me he was admitting me to the hospital. "I can't believe they let you go home," he said. I cried.

delivery #1

• I sat in the hospital for three days before they decided to induce at 35 weeks and 5 days. I found out later I was at risk of having a stroke.
• My epidural failed. 
• James was a great cheerleader. He told me I was a goddess and me having a baby was the most amazing thing he'd ever seen. He didn't even pass out.
• Birth was the most painful thing I have ever experienced (and hopefully will ever experience). It felt like my body was being ripped apart. I truly didn't think I was going to make it out alive. I knew millions of women had done this before me and millions would after me, but in the moment, it really felt like I was going to die. 
• Turns out I didn't die. Tiny baby Phineas was born and whisked to the NICU immediately.

So smol.

the aftermath #1

• After delivery, my blood pressure was still high enough I needed to be put on magnesium to prevent seizures. I was not allowed to get out of bed for 24 hours. 
• Phineas had been taken directly to the NICU, so I didn't get to meet him until after that 24 hours had passed.
• Since he was born before 36 weeks, Phineas automatically got a stay in the NICU. He was a "lazy eater" and stayed there for a month.
• Guess what happened about a week after I delivered? That's right: COVID shutdown. My parents, James's mom, and our friends Nate and Taylor got to meet Phineas, but then the NICU closed to all non-parents. And THEN only one parent could be in the NICU at any given time. It was a lonely month of NICU visits where James and I would just pass each other in the parking lot.
• When Phineas finally got to come home, the COVID shutdown was going strong. We were essentially trapped in our house. Friends would come over and look at Phineas through our front windows as we held him up like Simba. James taught school from home while I went back to work to navigate a newly-restricted library. All while being terrified this new disease would kill our tiny vulnerable baby.
• Recovery from a vaginal delivery is a BITCH. One point for C-sections.
• I have had dreams and flashbacks about being back in the hospital having Phineas. I just recently learned this is PTSD.
• Once we were far enough past this time to joke about it, we said, "At least if we have another baby, it HAS to go better than this!" Famous last words.

pregnancy #2

• I accidentally got pregnant when I began a new medication for migraine prevention that made my birth control less effective. Could've used a heads up about that.
• At eight weeks, I miscarried what would have been a little girl. 

aftermath #2

• This will really get to me out of the blue sometimes. Like when I'm having kind of a rough day and see a mom with a daughter and remember I'm never going to have that. 

pregnancy #3

• The pregnancy symptoms were fast and furious. This time, with a three-year-old running around, the level of tired I felt was indescribable.
• After becoming pregnant, I had to stop taking my migraine preventative medication, so I had frequent migraines throughout the pregnancy. 
• Having firmly entered the realm of "geriatric pregnancy" and having been through two challenging pregnancy experiences before, this pregnancy made me edgy. We did the recommended genetic testing, finding out early on our baby was not likely to have any chromosomal disorders.
• Later ultrasounds revealed this baby to have a two-vessel umbilical cord (instead of the usual three) and a low-lying placenta. The two-vessel cord was no big deal on its own, but had it been paired with other abnormalities in the ultrasound, it could have been. If it did not resolve itself, the low-lying placenta would mean a C-section so the baby and I would not bleed to death.
  
• I had to have multiple in-depth ultrasounds because the baby's heart was never fully visible. This was nerve-wracking, but it ended up being perfectly fine.
• While I managed to avoid preeclampsia, I did get hit with gestational elevated glucose (bordering on gestational diabetes). I changed my diet and faithfully poked my finger to test my blood sugar four times a day, every day. I was devastated by this, but the doctors told me it's basically a roll of the dice. You can be super healthy and still wind up with it.
• Because I'd been so close to preeclampsia before, my doctor determined I would be induced at 37 weeks. 

delivery #2

• I went in for the induction, downright terrified my epidural would fail once more. James was an excellent advocate, making sure I got the epidural as soon as possible and alerting the anesthesiologist when I began to feel my legs again. James identified a bend in the line that was the source of the problem, allowing the drugs to flow and me to numb up once again.
• A tornado siren went off after I was induced, so all the laboring mothers were wheeled out of their rooms and into the hallway. My team and I ended up having to go into one of the operating rooms for shelter. Thankfully, it didn't last long, and we were given the all-clear.
• After many hours post-induction, the process was not forging ahead like it should. The baby stopped descending, and his heart rate and breathing got a bit spotty at times. The nurses (OB nurses are saints, in case you didn't know) had me contorting into all sorts of shapes to try and get the baby to move, but it didn't work. The ridiculous thing is that I could not move my legs, so it was up to James and the nurses to hoist them around for me. It was the weirdest feeling.
• I started the induction process at 7am October 3. By 1am October 4, no further progress had been made, and the baby's heart rate and breathing were getting dangerously low. The doctor told me we would have to do an emergency C-section. I cried.
• I was wheeled into the operating room and given a heavy dose of anesthesia - not enough to put me under, but enough to make me super sick. I felt like I was having an out-of-body experience. Was I really here? Was this actually happening? The last thing I remember is seeing James hold a baby up to my face.

Shortly before I lost consciousness.

• I woke up hours later to find myself alone in a recovery room. A nurse quickly arrived to tell me the baby was fine, but I had needed an emergency hysterectomy. "Really?!" I said, wondering if she was talking to the right person.
• Here's what happened. After the baby (whom we named Robin) was delivered, the doctors could not stop the abdominal hemorrhaging. I had been immediately put on higher pain meds before being put under completely, explaining my lack of memory. Once they lifted my uterus out of my body, they realized what happened: my uterus had ruptured. There was a gigantic hole in the back. Robin's arm had gotten stuck in that hole, which is why he wasn't descending like he should have. To save me from bleeding to death, the only real option was a hysterectomy. Poor James had to give the consent for the hysterectomy, because (according to the doctors) I was "too high on ketamine" to really understand what was happening. (When they asked me if a hysterectomy would be ok, I apparently said, "Yeah, that would be great!" which I would have said anyway, ketamine or not.)
• After I had woken up a bit, I talked to the surgeons. When an OB doctor needs to do an emergency hysterectomy, they summon the on-call doctor because apparently this is a two-surgeon job. They were both thrilled - yes, thrilled - to have worked on my uterus. You see, my uterus had no business rupturing. I had no previous C-sections and no uterine fibroids, both of which are known to cause ruptures because they weaken the uterine wall. They had no idea why my perfectly intact uterus would rupture. Neither had ever seen this before, and one of the doctors had been an OB for over 40 years. The odds of this happening were 1 in 20,000. One of the doctors even gave me his cell phone number in case anything else happened. That's probably not normal.

the aftermath #3

• A recovery from a C-section is no joke - and recovery from a hysterectomy on top of that is REALLY no joke. Ten weeks of absolutely no lifting anything heavier than Robin. That's basically everything. I also felt like I'd been hit by a truck - I had even needed a blood transfusion.
• Because of my hysterectomy, I had to have a whole bunch of follow-ups with my OB. She told me to take recovery very seriously. She said, "I'm not trying to scare you, but if you bust your stitches, your intestines will fall out your vagina." That's what she said when she was NOT trying to scare me?!
  
• If this had to happen to anyone, I'm glad it was me. James and I knew we were done having children, so I certainly had no use for it any more. I feel like I've hit the gynecological jackpot. No periods, first of all - I've already had my period for 20 years, and I probably got out of 20 more years of it. No pap smears, since my cervix went with my uterus. No risk of uterine or cervical cancer. And no risk whatsoever of pregnancy without the hassle of birth control pills, an IUD, etcetera. The only downside is when my pants don't fit, I can't blame my period any more. Now I'm just chubby.
• When nosy acquaintances or strangers ask me when I'm having a third child, I can make them very uncomfortable very quickly by telling them I had an emergency hysterectomy. That shuts them right up. 

takeaways

• The doctors are great, but the OB nurses are the real VIPs. They are with you every step of the way. Anything you need, they are on it. They're the ones who make sure you get pain meds when you need them; they're the ones bringing you warm blankets; they're the ones who hold your legs when you're pushing; they're the ones telling you that you're amazing and you can do this thing. When I had Phineas, I have no idea who the doctor was who delivered him. She showed up at the last minute to catch him. But my lead nurse's name was Taylor. 
• Along those same lines - for the love of Dolly Parton, be nice to your nurses. Both times in labor and delivery, our nurses told us each shift was fighting over who got to take care of us because we were nice to them. Apparently that's kind of rare. I just wanted to win labor by being agreeable, and I guess I did.
• Labor and delivery (and then recovery) is the only time you're going to be treated like the goddamn queen you are, so you'd better enjoy it. It almost makes the pain and suffering worthwhile. 
• These experiences taught me I have weirdly high pain tolerance. After Phineas was born, I had a hematoma that I didn't know about. (I was going to say "TMI alert," but this entire blog post is a TMI, so why bother now?) My doctor poked it and she said, "Does that hurt?" I said, "Ehh." She said, "Every other patient I've had with one of these would have passed out if I had done that."
  
• Both of my children's deliveries almost ended in my demise, so I've got a powerful card in my pocket - but I need to remember to save that for the big things. "I don't want to take out the garbage." "I ALMOST DIED FOR YOU."

It took me until I was 32 years old to decide that yes, I would give motherhood a try. Four years and two children later, my body said, "Ehhh, enough of that." And now I'm short a few organs.

It was my uterus who did the heavy lifting, and it was my uterus who bore the brunt of the damage. To my uterus, I say: thank you for your service. There are two little boys who literally owe you their lives.

In a nutshell, my body wasn't at all cut out for pregnancy. If I had been around and attempting to give birth before modern medicine, giving birth to Phineas would have killed me off - and if I had, by some miracle, made it through that, I absolutely wouldn't have lived through Robin's birth. I will have health complications for the rest of my life from these two: high blood pressure and am now 50% more likely to develop diabetes than I was pre-Robin. I also have a gnarly scar where my second child and my uterus were removed from my body. (Fun fact: Phineas respects me a lot more now that I have that scar.)

No, being pregnant and giving birth is not for the weak. That's why the women have to do it.

(If you would like to see a photo of my shredded uterus, do let me know. I have one that I'm happy to share with you. I'm not going to post it here because it's pretty rough and will not be appreciated by those who are not into the blood-and-guts side of things. But if you are, you'll appreciate the photo. It's wild. The surgeons were so excited about the rarity of the situation they took a picture of it - it reminds me of a fisherman holding up a prize walleye.)