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A gift from above: The birth of Sebastian C-Section

A gift from above: The birth of Sebastian

"At this point, I was exactly 27 weeks—three weeks past the age of viability, but I was still one week shy of a 99 percent survival rate if our baby were born."

Those close to us know about the complications that led me to five months of bedrest (six of those weeks were in a hospital), an unexpected delivery at 32 weeks, and an additional five weeks in the NICU for our sweet, baby boy.

24WeeksBut for the most part, we didn’t share what was going on. (During that time, I took an extended leave of absence from social media … and really, the internet.) I didn’t feel like publicizing what we were going through. I didn’t want people to know we were struggling, and I certainly didn’t want to advertise about our (very) complicated pregnancy with the possibility that something truly terrible could have gone wrong. Now that we’re on the other side of it all, I feel like it’s finally time to share.

I also want to preface this with an obvious statement that I am not a medical professional. This was purely my experience, and what I have learned during my journey. Please do not interpret this as medical advice. If you’re going through a tough pregnancy, I pray that you are surrounded by a well-educated medical staff who can help bring your babe safely into this world. With that said, I’ll gladly tell our son’s birth story. So here it is, poured out of my heart, in tiny digital letters for you to read …

It all started with our miscarriage. Yes. A miscarriage. Even as I write those words, I don’t really believe it happened. But it did. And we were covered with an insurmountable amount of grief.

As the doctors told us, we needed to keep trying. And we did. Finally, we were given the news that we were expecting. My due date was April 3. I don’t think Jonathan nor I could believe it. This was THE SAME EXACT DAY we had lost our first to miscarriage a year before. I should have known right then and there that this child would certainly be a gift from God, but I think it took us having to experience this pregnancy as a whole to truly find that answer. It’s only in light of the end that the process makes sense.

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At 17 weeks, the complications began. One Sunday evening, I felt my water break. I knew this was far too early and that we needed to get to the hospital immediately. After several hours, the nurses were concerned enough that they admitted me. I don’t know if you have ever had to stay in the hospital, but let me tell you, I think one of the scariest moments of that ordeal might have been when I was first admitted. The fear of the unknown seemed far greater than anything that could possibly lay ahead.

Over the next three days, I had tests and more tests, medicine, IVs hooked up to me and what felt like scan after scan to check fluid levels and make sure baby was alright. It all came to a head on the fourth day. One of the tests came back with some unfavorable results, and my OB came in to talk us through it.

She told us the outlook was grim: It looked like I was leaking amniotic fluid. Because I was only 17 weeks, it was seven weeks shy of being able to use medical intervention to save the baby. She told us it would ultimately be our decision what to do, but she wanted to give us all the facts, plain and simple:

If we kept on with the pregnancy, this baby would not be the same baby we saw on a scan only a week earlier. Babies need amniotic fluid to grow, develop, eat and survive; not having enough causes serious complications for the developing child. If we kept going despite that, we needed to know our child would be severely deformed and would likely be disabled on multiple levels.

We also needed to know the danger I would be putting myself in if we continued. If I caught an infection (which was a major possibility because my water had broken), not only would they have to terminate the baby, but also if I then became septic from that infection, my uterus would need to be removed. I would never again be able to have children. So while the choice was ours to make, I don’t know how much of a choice there really was in any of those circumstances. So our OB prepared us for the worst. But before we would make any decision, we would have one last ultrasound to confirm the diagnosis.

The wait for that ultrasound felt like the longest I have ever waited for anything in my entire life. I prayed and prayed and prayed. I cried—how could I not? … But I was then told not to cry because it supposedly puts stress on the uterus and could cause me to leak even more fluid. OK. So don’t cry. That sounds easy enough with the information we were just given.

Finally, we were taken in for our ultrasound, and as they wheeled me in, I prayed for a miracle. Not just any miracle—but a miracle to keep this baby, for him to be healthy and for my body to heal itself from whatever trauma it had endured to put me in this predicament. The specialty doctor, a perinatologist named Dr. Tiff, looked at the scan and couldn’t believe what she saw. Not only was there enough fluid in there for our little guy, but my fluid level had increased by an entire centimeter within six hours! I don’t think the doctor knew what to say. She repeated another test and managed to say, “At this time I cannot recommend you terminate the baby.” Even though that might have been the most clinical answer we could have received, it was nothing short of a miracle to us.

After reviewing the test results herself, our OB concluded that I had PPROM (Preterm Premature Rupture of the Membranes), which she thought was most likely a small, high leak in the amniotic sac that had managed to seal itself up.

PPROM occurs in fewer than three percent of pregnancies and is usually accompanied by other risk factors that can attribute to the condition (none of which were applicable to me). Rarely, the break in the membranes heals and the leakage of amniotic fluid stops on its own, which is what had happened in my case. I wasn’t able to find exact statistics for how often a seal-up happens after a rupture, but from what research I did, I gathered it was far more likely for the baby to be delivered than it was for the membranes to seal up.

Our OB prescribed two weeks of strict bedrest at home. Although I cried when I was admitted to the hospital, after five days with all the ups and downs, I was later crying that I had to leave. The hospital was safe. I knew that if something were to happen, we were in the best hands possible. It took some major convincing (and prayer) to feel like home would be a better option.

Two weeks of bedrest at home came and went without a hitch. We were scheduled for an additional ultrasound to check fluid levels one last time, and I passed without any issues. Thanksgiving, Christmas and New Year’s all flew by, and I was actually looking forward to returning to work on January 3 after being out of the office since November 15.

On Sunday, January 2, I woke in the morning with what I was sure were contractions. I thought it best to stay in bed and see if they would go away on their own. After about an hour, no such luck. I got up to go to the bathroom and (if you’re squeamish, skip this next part) had what I can only describe as a massive bleed. Back to the hospital we went.

The previous time I had gone into triage, I was monitored and then admitted after about five hours. This time, it took the nurses all of 15 minutes to assess me, check baby and wheel me down to a labor and delivery room to be admitted. Whatever was going on was very serious, and I needed to be in a delivery room in close proximity to an operating room in case I was to deliver.

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At this point, I was exactly 27 weeks—three weeks past the age of viability, but I was still one week shy of a 99 percent survival rate if our baby were born. High risk started there … and the issues kept coming. I was put on bed rest, hooked up to an IV of magnesium sulfate to stop the contractions and was visited by our on-call OB that prescribed other medication to stop labor as well. I was also scheduled immediately for an ultrasound.

A few hours later, Dr. Daneshmand, head of Perinatology for San Diego (and an absolute saint of a human being), wheeled us up to the fourth floor for our ultrasound. After a thorough examination, he gave us our diagnosis:

Ultimately, I was diagnosed with Vasa Previa, which meant some of the fetal blood vessels that connected me and my baby ran outside the umbilical cord, along the membrane over the cervix. Once labor starts, contractions and the opening of the cervix can cause these vessels to rupture, which can in turn put the baby’s life in danger.

From my understanding (and my experience with the incredible nurses and doctors), I found that for me, Vasa Previa could be broken into three tiers:

Tier one of Vasa Previa was essentially the growth of an abnormal placenta. In a normal, healthy pregnancy, the umbilical cord grows out of the center of the placenta. In my case, the cord had instead grown abnormally out of the side. The placenta, being the baby’s only life support in the womb, cannot function properly and cannot correctly sustain the baby during the pregnancy with such an issue.

Tier two in my case, was caused by a bi-lobed placenta. This means that as the baby and placenta grew, the placenta managed to split into two parts and was held together by tiny, fragile strands connecting the two pieces together. This was extremely dangerous; if any of those strands ruptured, it would essentially mean the baby would suffocate to death within minutes.

Tier three was what was called velamentous cord insertion. This is where the abnormal placenta comes back into play. Because the umbilical cord grows out of the side of the placenta instead of the middle, it is able to traverse down the birth canal and get stuck in between the baby and the cervix. This is a problem on its own, but it causes (if you can believe it) further complications. The umbilical cord is strong, and is surrounded by a super tough jelly that protects the cord from being torn or crushed in utero. When velamentous cord insertion occurs, this jelly disappears and the cells of the umbilical cord implant themselves into the amniotic sac. This leaves the cord highly susceptible to damage. Any damage to the cord (my water breaking, contractions, basically labor of any form) means rapid fetal hemorrhage or suffocation and ultimately death.

Also, please note that our babe was breech, not head-down, for the majority of my bed rest at the hospital.

Now Vasa Previa is extremely rare, occurring in about one in 5,200 pregnancies. It’s even more rare if you conceive naturally (the incidence rate rises in IVF or IUI pregnancies). If it goes completely undiagnosed and a mother progresses to labor, the fetal mortality rate is about 95 percent. So, if I haven’t hit you over the head with it enough, our little boy was in some serious danger.

And if you can believe it, my issues didn’t stop there. To top it all off, I also had a blood clot on my cervix that had ruptured, causing a partial placenta abruption (and what they think had caused the initial bleed that brought me in). The doctors were incredibly impressed. Not only were they shocked that we had conceived naturally, but they had never seen this many complications present in one pregnancy. Great. At least I wouldn’t be the boring patient on the high-risk floor.

So what did this all ultimately mean for me? We found out that day that I would be staying in the hospital until delivery. This time, I had been admitted at exactly 27 weeks. If I could stay pregnant, they would plan to deliver our sweet son via C-section at 35 weeks (anything past that risks labor starting or your water breaking on its own). That meant an incredible eight weeks of bed rest. Let’s just let that sink in for a second. Eight weeks of hospital living, of not going home, not sleeping in my own bed, not cooking or eating what I wanted, not WALKING, not having a baby shower, not getting our baby’s room ready … of not having anything remotely close to a normal pregnancy.

I felt like I was being denied so many things at that point. But I was suddenly reminded that God knows exactly what we need, often times before we do. I remembered when we had been admitted at 17 weeks, and they had talked to us then about being in the hospital until I delivered! I remembered telling Jon that that amount of time in the hospital would be so difficult, and that I knew there was no way I could do the holidays in that hospital. I could not do Thanksgiving, Christmas and New Year’s in a hospital bed. And wouldn’t you know it, the good Lord knew I wouldn’t be able to handle that.

While sitting here writing this, I was reminded of a verse: “And God is faithful; he will not let you be tested beyond what you can bear. But when you are tested, he will also provide a way out so that you can endure it” (1 Corinthians 10:13). He only gives us trials he knows we can handle and overcome. I was home for the precise amount of time I felt I needed—released from my first admittance two weeks before Thanksgiving and re-admitted the day after New Years. If that’s not a promise that there is a God, and that He has our best intentions at heart, I don’t know what is.

Even with that promise, it doesn’t mean that my road during that hospital stay wasn’t paved with trials. I’ll be the first to quickly admit, it was incredibly hard. Probably the hardest thing I have ever done. I’m sure there were days where I was at my absolute worst, and it’s a huge testament to my family and friends, the doctors and nursing staff and especially to my devoted and loving husband, who all helped me stay strong.

I’ll save you the ups and downs of my hospital stay. I don’t have enough time to explain it all here, so I’ll summarize: It was full of some really high highs, like when all my college roommates (including two who were pregnant themselves!) made a trip down from San Francisco to San Diego and stayed with me for two full days! Or having my OB come and visit me EVERY. SINGLE. DAY. (Despite her absolutely insane schedule.) I’d also like to mention that she was a total gift.

My stay was also filled with some really deep lows. All of the drugs and medications I had to be on, the lack of sleep from being disturbed every four hours around the clock for medication or monitoring. Pretty much constantly being in labor for over a month. Or IV day. (I have a very irrational fear of needles. That was the absolute worst, and I’m breaking out in a cold sweat just thinking about when they would need to change out my IV.)

I’m realizing now I could go on forever about all of this, so I’ll get to the point. It all came to a head on Super Bowl Sunday, at exactly 32 weeks. That was the first goal our OB had given us. She said at 32 weeks, our babe would be small, but he would be healthy and anything beyond that was just a bonus. By 9 p.m. that night, I was in full blown labor. I was actively having contractions on the daily, that night they were coming in full force, like every three minutes.

As I already mentioned, labor was extremely dangerous for our little one. So the nurses pulled out all the stops. I was given every dose of my medication: nifedipine, which is actually a blood pressure medication but is also indicated to slow contractions during pregnancy. I was also given a shot of terbutaline, which triggers the “flight or fight” reaction in your brain. It stops labor immediately, but it also really boosts your adrenaline, causes high blood pressure and some major heart palpitations. I was put back on an IV of magnesium sulfate, which also helps to stop contractions and has the added bonus of protecting our boy’s brain if we were going to deliver. Those nurses did everything—and I mean EVERYTHING they could to keep that boy inside.

I managed to last another four days. At 32 weeks and four days, I couldn’t keep him in any longer. I was up at 4 a.m. answering work emails when the contractions started again. (Yes, if you’re wondering, I worked the entire time I was in the hospital, and I’m also totally insane.) By 6:30 a.m., I was in full-blown labor again and the nurses made the call. They contacted my doctor, and I called my husband—we were going in for delivery.

Both my OB and hubby made it to the hospital and were in my room by 7 a.m. I was prepped for surgery, and we were wheeled down to an operating room. While the OR was being prepped, Jonathan and I just happened to see two familiar faces scrubbing up for a surgery. Dr. Tiff and Dr. Daneshmand, the only two perinatologists that had consulted on our case just happened to be prepping for a surgery themselves. I couldn’t hold it together any longer. Both of these doctors were SO impactful during our stay, and I believe it was a little love note from the Lord that we were able to see them both before we delivered.

Surgery started at 8:11 a.m. Almost immediately, my placenta ruptured. It was imperative to get that baby out quickly. Within five minutes, he was taking his first breaths. On February 11 at 8:16 a.m., I heard our son’s first cry. Our OB quickly lifted him over the curtain for my husband and me to see, and then he was handed off to the NICU team who were patiently awaiting his arrival. He was here. He had all 10 fingers and all 10 toes. He was safe. After all that we had been through, he was finally here.

And he was BIG! At 32 weeks and four days, he weighed a whopping 4 pounds, 9 ounces and was almost 19 inches long! This was a gigantic baby for that gestational age. All of our prayers had totally been answered. I had prayed (given our circumstances) for a healthy and heavy baby. And we were graciously granted miracle after miracle.

Sebastian was born on February 11, a day specifically chosen for him by the Lord. On a side note, this day happens to also be our dear family friends Steve and Cheri Kuptz’s wedding anniversary. And I don’t believe this is any coincidence. These two were a major part of our journey while we were in the hospital, they were our most consistent visitors, they were a major source of prayer, and they have been a massive part of our lives, as the two of them were the ones who presided over our own wedding ceremony five years earlier. God had put our support system in place long before we knew we would need it, and we are SO thankful for them.

So to be clear, Sebastian’s fight wasn’t over really. He did another five-plus weeks in NICU, which was another incredibly difficult experience. It’s probably something I’ll write about some day.

I wanted to share my experience of a tough pregnancy, to give people hope and to also show that not all pregnancies are easy. We forget what a gift it is to create new human beings. It’s not always simple to get pregnant, to carry to term or to deliver that babe safely into this world. Not only do I think that growing a life is a gift, but I also know that there are millions, if not billions, of things that have to happen in your body for that baby to arrive safely … and that is a mind-blowing thought all on its own.

 

But I’ll leave you with this: I have come to realize that God’s timing is incredibly beautiful. He is always setting us up for the bigger picture. I cannot describe the subtle nuances of our story in any other way than that we experienced a few miracles. We are blessed beyond measure to have had such an incredibly trying, and at the same time, absolutely incredible birth story for our son.

In hindsight, even with all of the ups and downs, I wouldn’t have wanted it any other way. Sebastian is completely loved and adored, and I know with complete certainty that he is meant to be here. He is our little miracle baby, he made it to us, and he is a constant reminder to always be thankful for this wonderfully beautiful life! It is something we should cherish.

Read more about Katelyn’s adventures a new mom on her blog.

Send us your birth story! Whether you had a home birth, hospital birth, 37-hour labor or emergency C-section, we’d love to read the tale of your little one’s grand entrance. Write up your birth story (click here for tips on getting started) and email it, along with a few photos, to birthstory@pnmag.com. We’ll share it on our Birth Day blog and may even print it in an upcoming issue!