Red Velvet Cake

I will make the cake today- the red velvet cake.  Red for the blood shed for me, for the blood that flowed from my body when Gabe began to breathe on his own, for the 4 units of blood that was transfused, for the LOVE that gave Gabe life and saved ny life and forgave my sins and bled for us all.  The red velvet cake- such a simple yet daunting task for me during this rough time.  But it is what I do,  It’s what i feel i must do.  It is what i want to do.  It is my birthday cake for Jesus.

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post partum blues and near death experience

how do i sort out the post partum blues from the near death experience and the feelings that brought on? i guess it really doesnt matter, but these are my thoughts.  I have mentioned that seeing women in the post partum days is a huge trigger for me remembering my own time of coming back to life in a sense.  The other day, my trigger was hearing a country song, “live like you are dying”.  In it he sings “i loved deeper and i spoke sweeter and i gave forgiveness I’d been denying…”  It was triggering because I resonated with those feelings.  There was something magical about my post partum days where i really did stand in amazement at the fact that I was alive.  I marveled at seeign the world, feeling the heat, seeing the colors.  I wondered at what would have happened if i hadnt woken up.  i was overwhelmed with noise, movement, and emotions but amazed at movement of life and thought in me and my family.  At church we sang Blessed Be Your Name and there is a verse that says

blessed be your namewhen the sun is shining down on my, when the world is all that it should be,  blessed be Your Name on the road thats marked with suffering, when there’s pain in the offering, blessed be your name.

my post-partum-post near death time was marked by a combination of these words: the sun is shining down on me even though there’s pain in the offering.  THere was the physical pain of healing and the emotional pain of the stuggle with doubt and faith.  But i relished the beauty of the sun’s light and warmth, even metaphorically. 

 

reconciling natural birth and medical care

pool room

pool room through Jentle Childbirth

http://www.jentlechildbirth.org.uk/?portfolios=pool-room

that is an amazing place… i hope Jenny’s idea blossoms!  i would have love to gone to a place like that. it seems the perfect combination of natural, compassionate birth with access to the technologies that can aid women or even savee lives.  it would be a dream of mine to bring such a concept to reality in my own town.

natural birth thoughts

midwifethinking.com in her judging birth post makes a great point that some women can have births that end up with c/sections and feel empowered (like me!) and other women can have natural births that are traumatizing. there of course is many combinations in between those senarios. but the truth is that birth in any fashion can be traumatic. pain in childbirth correlates directly to a curse from God so how can we not think there will be inherint danger in it? I missed a few hours of Gabes life, that very first cry, seeing him all yucky and bloody, and the moment that he came from my body. however, his life was saved and my life was saved. I am so incredibly grateful for the moments i have with him and Micah and Anna now. It is amazing to think of the precious, special way God gave each of them to us. as far as birth goes, i want to be able to advocate for women to be able to birth more naturally in a hospital setting where there are emergency procedures in place. its all great for “K” in the video on midwifethinking’s website (an i kindof look in awe as if i wish i could have had that “i just gave birth” experience) but if her baby had had an occult prolapsed cord and had died because they didnt even know there was heart decelerations, and if she had a hematoma that caused her after her baby was born dead to bleed internally when she didnt even know it…well, it wouldnt have been so beautiful now would it.

occult prolapsed cord

Gabe was found in the OP position with an occult prolapsed cord. The following is what i learned about that.

In the presence of ruptured membranes, a cord prolapse can cause an obstetrical emergency requiring an immediate vaginal delivery or a cesarean delivery at the first sign of fetal distress.[
If the umbilical cord presents in front of the fetal presenting part and the membranes rupture, the risk that the cord will prolapse through the cervix into the vagina is significant. Occult prolapse occurs when the cord lies alongside the presenting part.

Cord prolapse occurs in 0.6% of deliveries. The risk is increased with fetal malpresentations, especially when the presenting part does not fill the lower uterine segment, as is the case with incomplete breech presentations (5-10%), premature infants, and multiparous women
http://emedicine.medscape.com/article/262470-overview#a30

A prolapsed cord is a serious emergency and can be very harmful to the baby.
If the presenting part of the fetus does not fit the pelvis after membrane rupture, the umbilical cord can slip past and present at the cervix, or actually prolapse into the vagina.
When the cord is compressed or squeezed, the baby’s supply of blood and oxygen is cut off. The lack of oxygen can lead to severe damage or death if the problem is not taken care of within minutes.
http://www.medpreponline.com/2008/12/obstetrics-umbilical-cord-prolapse.html

broad ligament hematoma hemorrhage

I had a broad ligament hematoma that caused internal bleeding.  It was found during the c-sec and pressure was applied for (medically speaking) “quite a while”.  My husband was told that the outlook was not optimistic.  But the bleeding thankfully stayed controlled and after several hours of close monitoring the danger had subsided.

  • The broad ligament extends from the sides of the uterus to the sides of the  pelvic walls and to the pelvic floor. The function of the broad ligament is to  hold the uterus in its normal position, helping maintain its relationship  relative to the Fallopian tubes and the ovaries.

Significance in Pregnancy

  • Problems with the broad ligament are most likely to occur during pregnancy.  Pregnancy can cause tension in the broad ligament, which can lead to hip or pelvic pain.

Read more:  Broad Ligaments and Pelvic Pain | eHow.com http://www.ehow.com/about_6518589_broad-ligaments-pelvic-pain.html#ixzz1vBW2KG2C

Hematoma of the broad ligament can be a potentially life-threatening condition.  According to eMedicine, common symptoms are back pain, fullness or pressure in  the recto-anal area, an urge to push or dizziness. Women may eventually develop  low blood pressure and anemia.
Read more:  Broad Ligaments and Pelvic Pain | eHow.com http://www.ehow.com/about_6518589_broad-ligaments-pelvic-pain.html#ixzz1vBVijyWM

Broad ligament hematoma is an unusual complication that can occur during delivery, just after delivery or later in the puerperium. Rapid labor, cesarean section, instrumental deliveries, and trauma have been suggested as predisposing factors.- http://www.springerlink.com/content/822047628pw42676/

Traumatic hematomas are rare and may be related to lacerations or may occur in isolation. They include vulvar and paravaginal hematomas in the lower genital tract and broad ligament and retroperitoneal hematomas adjacent to the uterus. Patients with lower genital tract hematomas usually present with intense pain and localized, tender swelling. Broad ligament hematomas may be palpated as masses adjacent to the uterus. All may result in significant blood loss that mandates resuscitation.

Order blood transfusions if blood loss is ongoing and thought to be in excess of 2000 mL or if the patient’s clinical status reflects developing shock despite aggressive resuscitation.

Pay close attention to the patient’s level of consciousness, pulse, blood pressure, and urine output during the course of the management of massive hemorrhage.

Broad ligament and retroperitoneal hematomas are initially managed expectantly if the patient is stable and the lesions are not expanding.[52] Ultrasound, CT scanning, and MRI all may be used to assess the size and progress of these hematomas. Selective arterial embolization may be the treatment of choice if intervention is required in these patients. Use surgical procedures to evacuate the hematoma, and attempt to tie off any bleeding vessels.http://emedicine.medscape.com/article/275038-treatment#aw2aab6b4b4

http://www.jultrasoundmed.org/content/22/1/69.full shows a “Broad ligament hematoma causing hydronephrosis: patient with a falling hematocrit level after cesarean delivery” that was treated conservitively and gradually receeded in a month.  but mine had to be treated agressively because of the hemodynamic state.

OP or Occipital Position

These are classic signs of OP that i experienced:

  •  “Feeling lots of hands and feet in front by the mother’s belly
  • Difficulty finding the baby’s heart tones where you usually would find them
  • Prolonged labor, especially in the pushing stage
  •  ‘Back labor’ – painful contractions felt mostly in the back; common with posterior labors because the baby’s back is pressing against the sacrum (low back); also found with the arm across the baby’s face because the arm is pressing on the mother’s sacrum
  •  ‘Early transition’ – showing the signs of transition (nausea, chills, high pain levels, shakiness, etc.) between 4-7 cm instead of between 7-10 cm
  • ‘Fetal distress’ – baby’s heart rate has problems because baby is stuck and gets stressed; this may also increase incidence of fetal meconium in labor
  •  ‘Early pushing’ – feeling the urge to push before being fully dilated
  •  ‘Anterior lip’ – dilating to about 9.5 cm but a small ‘lip’ of the cervix is stubbornly left
  •  ‘Stuck baby’ – a baby that gets stuck before passing the ischial spines (0 station) and does not descend even after hours of pushing “

There were signs, and there were ways to help. i did rock my hips back and forth and rock on all fours during most of my labor. that is what felt the most natural.

I wonder if the hematoma actually helped him get into the wrong position as it is theorized that a large fibroid would do the same. just my thoughts.

http://www.plus-size-pregnancy.org/malpositions.htm#Common Complications Seen With Baby Malpositions

“No one knows for sure why malpositions happen. As noted above, malpositions may occur because of our modern tendency towards poor posture and unphysiologic positioning. These malpositions tend to be very responsive to maternal repositioning, and often resolve if the mother has sufficient mobility in labor. However, the way most women are forced to labor (on their backs in bed, with limited mobility due to constant fetal monitoring) can make it difficult for babies to turn.

Malpositions may also occur with large and significant fibroids. These may tend to crowd the baby in-utero and force the baby to assume an unnatural position. Sizer and Nirmal (2000) noted that malpositions were more common with big babies; they theorized that it may be more difficult for larger babies to rotate when labor progresses, so perhaps this is why these were the ones that tended to have persistent malpositions that did not resolve on their own.

In addition, women with Symphysis Pubis Dysfunction (i.e., pain turning over in bed, discomfort lifting one leg to put on clothes, sciatica, a ‘clicking’ feeling in the hips/pelvis, difficulty moving apart their legs to get in and out of the car, etc.) probably have a misaligned pelvis, especially in the front where the pelvic bones almost meet. This area is called the ‘pubic symphysis’, and if these bones are out of alignment, they pull on the soft cartilage in between the bones (pubic symphysis), causing a great deal of pain both in front and in the back, and may predispose the woman to a baby malposition.

A misaligned pelvis can cause the soft tissues to pull, twist, or spasm the uterus out of its optimal shape, thus forcing the baby into a less-than-optimal position and making it difficult for the baby to descend properly.”