What to expect: preeclampsia & emergency delivery

Samina Qureshi is the Registered Dietitian Nutritionist and owner of Wholesome Start. Her nutrition counseling practice is based in Houston, Texas and she provides virtual nutrition counseling sessions to clients across the country. Schedule your FREE 15-minute nutrition session today!

Trigger Warning: This post goes into Graphic detail about my journey with a sudden severe onset of preeclampsia, an emergency c-section, and loss of life.

YOU CAN'T PLAN FOR EVERYTHING.

I wasn’t ready. But is anyone truly ready for what’s about to come their way? My pregnancy journey was so smooth that there were moments where I would find myself waiting for something out of the ordinary to happen. I didn’t have morning sickness or any other symptoms other than a growing belly and some back pain. Just like many expecting mothers, I was reading through a “What to Expect” type book on pregnancy and had gotten to the second trimester section where I was learning more about my baby's development and the changes my body was experiencing. I hadn’t gotten to the labor and delivery section yet, because in my mind I still had a good four and a half months to get there. You never know what to expect until it actually happens, and that’s why I’m writing this post. What to expect when you have an emergency c-section due to preeclampsia and your baby isn’t able to (physically) join your family. This is the first part of my "What to Expect" blog series. It has taken me a long time to write this, because I’ve had to navigate through the whirlwind of emotions that come and go throughout the healing process. For me, telling my story and connecting with families that have gone through similar situations has been tremendously helpful. Hearing your story and experiences is what is giving me hope to continue. Each day has its ups and downs, but I firmly believe we are stronger together, and I appreciate hearing from each and every one of you.

THE BEGINNING OF THE END.

My husband and I were holding off on making a social media baby announcement for as long as possible. We waited until after the 20th week (half-way mark) of my pregnancy. During our most recent (22 week) OBGYN and ultrasound appointment the baby’s growth was on track, and we weren’t worried about anything regarding my health or the baby’s health. My blood pressure was slightly elevated but not concerning, so our doctor told me to monitor it and to contact her if it was ever consistently elevated for more than 24 hours. Over the next couple weeks, I monitored my blood pressure every morning and afternoon, and I never had an elevated reading. We shared our pregnancy with our family and friends on social media on the 23rd week of my pregnancy and on our following obgyn appointment (24th week) we had an unexpected turn of events. During our 24-week ultrasound we were notified that my placenta had thickened since my last appointment, and the blood flow to the baby was basically nonexistent. For the past couple weeks, I was in the dark and was not aware of what was happening inside my body. I had no physical signs of anything going wrong. With no blood flow going to our baby we knew that things were not normal. After we learned about my placenta, we were notified that our baby's growth was restricted, and he was now in the less than 1 percentile range.

During this check-up my blood pressure was elevated and my obgyn recommended that we stay in the hospital for a few hours to be monitored. This was very strange to me because I hadn’t had an elevated blood pressure in the previous couple of weeks and wondered why it was elevated all of a sudden. We thought it could be due to the scary news we had received about my baby’s growth but the doctor still wanted us to be monitored. My husband and I had plans that weekend, we were going to visit his family out of town and celebrate a holiday with all our family and friends. I had purchased a new outfit that fit my growing belly and was super excited to meet everyone who hadn’t seen me since I became pregnant. Unfortunately, we weren't able to celebrate as planned but our baby's health was our number one concern. We knew at that moment that something more serious was going on and decided to listen to the doctor. Upon being checked in to be monitored, I was asked to change into a hospital gown. This was the first indication that I wasn’t going to be able to go back to work that day let alone go on a weekend trip.

I was immediately set up to be monitored. The nurse took a blood sample, my blood pressure was being taken every hour, and I had to collect a 24-hour urine sample to check for proteinuria. Talk about being stressed. I didn't know how serious this was other than my blood pressure was higher than normal, and the blood flow to the baby was limited and restricted his growth. I thought that my blood pressure would eventually go down after a couple of hours but it stayed high the whole time I was there. After 24 hours, my blood pressure still wasn’t stabilizing, my urine sample came back with elevated protein levels, and my liver enzymes were elevated (not at extreme levels, but elevated nonetheless). These were all signs of preeclampsia with severe features. I was told that my health and my baby’s health was in extreme danger and that we needed to take action.

A SEVERE SITUATION.

Preeclampsia is a complication during pregnancy marked by high blood pressure in women who have previously not had issues with high blood pressure. It can occur at any point 20 weeks after gestation. (For reference, pregnancy is a total of 40 weeks and 20 weeks is the midway point.) There is no known cause that can be pin-pointed, and I had no previous health issues that could have predicted this outcome. Preeclampsia is one of those conditions you can't plan for or prevent, it just happens to some people and “some people” happened to be me. It is not only dangerous for the baby, it can be fatal to the mother as well. The mother can have multiple organ failures and even result in death. The only known cure for preeclampsia is delivery, but that doesn't mean the mother's health will automatically bounce back to normal immediately afterwards. When we first spoke to the doctors, they mentioned that many women with preeclampsia can carry on with their pregnancy if they are monitored closely in the hospital until they are closer to their due date. It is recommended to monitor and treat the mother in the hospital for as long as possible so the baby has time to develop to a stage that would be better for its survival upon delivery.

In case I had to deliver early, I was given steroid shots to help my baby’s lungs develop to increase his chances of survival. Unfortunately, my situation became more serious, and I wouldn’t be able to be monitored for much longer. My blood pressure was not stabilizing and my liver enzyme levels were worsening. The medical team decided that I needed to be induced to deliver in the next day or so, and I was started on labor inducing medication. Within about 12 hours there was a change of plans. I no longer had the option to have a natural birth, because I had a placental abruption, which is when the placenta separates from the uterine wall before delivery. This is another serious complication during pregnancy because the placenta can no longer provide oxygen or nutrients to the baby and can cause heavy bleeding in the mother.

THIS IS IT.

As I was lying in bed, I felt a gush of liquid run down my legs and hit my nurse button in a panic to let them know I think my water just broke. The nurse came in and noticed it wasn’t my water that had broken, it was an alarming amount of blood, and it wasn’t stopping. I had a placental abruption with major bleeding. I was losing blood and fast. At this point the medical team rushed in and within seconds they said this was an emergency, and I had to have a c-section right away. At this moment, I remember feeling extremely calm. I knew that nothing was in my control and that I had to put my trust in the doctors and medical team. I was repeating a prayer in my mind and knew that this was the end of either my life, my baby's life, or both of our lives. I looked at my husband holding my hand and told him I loved him and they rushed me to the operating room. For any of the spouses/partners reading this post-- this part was likely harder for my husband than it was for me. I was immediately put under and don't remember a thing whereas my husband was left in the room I was bleeding in and didn't know if we would make it through the surgery. I can only imagine how scared he felt during this waiting period.

Less than an hour went by, and the last thing I remember was my pregnant belly being cleaned and a mask being put on my face. When I woke up, I had no idea what happened. I didn’t know if I was alive, what happened to my body, if I had delivered my baby, or if my uterus was still in my body. If I wanted another chance to carry a baby in the future, my uterus would still need to be in tact and in my body. Many times with a placental abruption, the uterus gets pulled out with the placenta or can be damaged during the c-section. My mind was foggy as the anesthesia was wearing off but I remember the neonatologist coming up to me to tell me that I had delivered my baby via c-section, my uterus was still in tact and my husband was with the baby in the room beside me.

Before I got into the room, my husband was with our son the whole time as the doctors tried to resuscitate him three times. Since he was so tiny (under 500 grams), and his lungs were so underdeveloped that he wasn’t able to be intubated. As I was rolled back into the post-operating room, our baby took his last peaceful breath, and he passed away. Our families held a funeral service that honored our beautiful baby boy. I'm so happy my husband had the opportunity to spend time with our baby during his last moments of life when I wasn't able to be there for him.  

I didn’t write this to get sympathy but to share the realities of life that are not openly discussed. Preeclampsia didn’t happen because of something I did. There was no preventative measure I could have taken to change what occurred. This is a huge point to remember! As women, we tend to take the blame and even blame ourselves for what our bodies are sometimes unable to withstand. There are certain things that are out of our control, but that doesn’t mean we can’t continue moving forward. Our bodies are amazing, and this life is too short to spend it criticizing your appearance, restricting your enjoyment, or blaming yourself. It is not your physical appearance, ability, or body size that determines your health or worth, it is your daily choices and actions. My goal is to help you break free from blocks that keep you from feeling your best both physically and emotionally.  

If you'd like to continue reading about my postpartum recovery story please stay tuned. I'll be sharing another blog post about how I am getting through the physical and emotional recovery that goes along with having a c-section, preeclampsia, and losing a child. In the meantime, please feel free to reach out to me via the comments below or contact me for support. I am so grateful to be given another chance at life. I will not take any day for granted and will continue to work towards what I value -- helping people make food work with them instead of against them in managing their health.