Meet Kate! (In her own words)

Hi. I'm Kate. I'm 30 years old and my husband, Ryan, and I are having our fourth BOY! In the beginning of this pregnancy, we had so many folks swear we were having a girl. But I just knew :) Jesse, our oldest, just turned 6, Charlie is 4 ½, and Oliver is hardly old enough to be a big brother at just 13 ½ months old. I have Placenta Accreta and Placenta Previa and am lucky enough to be 31 weeks along and still (mostly) going about daily life at home.

My Accreta story goes way back. Well, at least in my mind it does—mine is a story of one intervention leading to many and setting the stage for the entirety of my birth experiences. I would like to share this birth history which now has me feeling like the poster child for why multiple c-sections can lead to scary & bad things. I thought I had forgiven myself and the doctor that induced me for how my first birth ended up, but now I've been dealing with new stages of...grief? anger? I don't even know how to describe it. You'll have to bear with me because I am rather long winded. But I'll try to at least stay organized!
Kid #1 (Jesse)--I had a totally healthy pregnancy.  I was nice & miserable for the last trimester (who isn't!). I do have some pre-existing conditions that generally put me in the more-than-normally-miserable category. I have two fusions in my back so my pain there is pretty awful once I get nice and round.  Towards the end of my pregnancy I admit to complaining to my doctor about how miserable I was.  All I knew was that other moms around me were being induced left & right, so why wasn't I?  At appointments close to my due date I was "almost 3" cm, 90% effaced (don't remember what station).  Based on the Bishop's scale, I was really favorable for induction.  So at 40 weeks and 2 days, I was induced with pitocin. After about 6 hours, pretty much nothing had happened in my cervix so my doctor said it was time to break my water. There was no discussion of...maybe this isn't going to work, would you like to go home and wait? (Once water is broken, the baby has to be delivered in the next 24 hours). I was not able to have an epidural because of my back fusions, so once pitocin was going along with the water broken, it was horrible horrible horrible.  I endured that for about 8 hours (of course, stuck in the bed because of the pitocin) all the while being checked every couple hours. I never made it past 4 cm. The doctor came in late that evening to say that we could wait until morning if we wanted but probably things weren't going to be any different.  I wish I had been stronger and waited just in case, but in tears I said I couldn't do it anymore so let's just go ahead with the c-section.
After Jesse was born, I was really upset about my choices that had led to the c-section. Why was I pushing my doctor to induce?  Why couldn't I have just been 2 weeks more patient? WHY HAD SHE DONE IT so early for a first time mom with no medical reason? I regret so much that I was not the kind of informed patient that I later became and therefore had advocated against the induction instead of asking for it. But I honestly believe that doctor should have told me that first timers DO generally go overdue and it was better for everyone if I waited. I trusted that doctor and expected her to make the best decision for my care. I do not believe that she did this when she set my induction date for so close to my estimated due date. This single intervention led to so many more and is truly the root of where I am today with Accreta.

So then I learned a ton about VBAC and I was SO committed to being successful with #2. I did hypnobabies VBAC program, along with the regular program. I was going to do whatever it took.

Kid #2 (Charlie): When they tell you you are a good candidate for a VBAC, they may or may not be forthcoming about all the "rules" and things that have to fall into place for you to do it. The first big thing is you must go into labor on your own. The second thing for many many practices is that they want you to go into labor BEFORE YOUR DUE DATE. There are probably other rules too, but these were the ones that got me. I didn't go into labor (believe me I tried every possible natural labor induction technique, and multiple times) by my due date.  The new doctor (I had moved since my first was born) had said he was VBAC friendly, but had been pushing me to schedule the RCS "just in case" from 36 weeks on—for 39 weeks!  He clearly didn't really have much faith in the VBAC. So once I hit the due date he was ready to section me right then. Since by this time I was more informed, I pushed and said I wanted to go 42 weeks.  At the 41 week appointment, my fluid was a little low, but still within the normal range. He gave me the "you're putting your wants for a vaginal delivery over the health of your baby" speech, sent me into tears, and pretty much forced me to schedule the section for a few days later. I had a scan the day before the c-section which showed perfectly healthy fluid levels (actually better than the scan a few days prior), and I tried again to reschedule the surgery for 42 weeks but I was told no. I suppose I could have gone against medical advice but of course had something actually been wrong with my baby I would never have forgiven myself. I then had an uneventful repeat c-section at 41 weeks 3 days.

After this birth I was even more upset because I knew that though there are some doctors out there that do VBA2C I was not in a good location for it (I had searched high and low for the VBAC friendly doc and look how far that got me). Also my husband, though he had been supportive of the VBAC, was not feeling the same way about the VBA2C.  He was worried about chances of rupture and I couldn't blame him.

Kid #3 (Oliver): I did not rule out the VBA2C... but after more searching for a local doctor, the closest we could find was about 45 minutes away. And my dear husband was just really not comfortable with it.  That was what helped me to decide not to go for it. I couldn't do something like that without knowing he was fully on board. I did however, insist that we go all the way to 40 weeks before doing the RCS.  Having never gone into labor, I wanted to give my baby a shot at choosing his own birthday, and I also wanted to be totally sure he was ready when I delivered. Again, no labor for me, and I had the RCS at 40 weeks 2 days. Before my OB (finally I had an OB I really liked, if only she had been the one with me for Kid #2, who knows, maybe it would have happened!) cut my uterus open, she had my husband come around the curtain and apparently you could see little Oliver right through my uterus. She explained this is why she hadn't been a fan of the VBA2C idea, I would have likely ruptured.  At least I felt validated in my decision to not do it. I came out of the surgery fine but in recovery, started hemorrhaging. There was some discussion of a hysterectomy if the bleeding couldn't be controlled, but medications handled it and though I spent a few extra hours in the recovery room I was able to then resume the normal course of postpartum activities, and I had no further complications. I did not require a transfusion though they had prepped me for it.

And that brings me here... to kid #4 (Eliot):
At about 9 weeks along during this pregnancy I experienced a terrifying gush of bright red blood. At that time I was diagnosed with a subchorionic hematoma. I do wonder now if it was a symptom of the developing Accreta. The first time I heard the term “Accreta” was during my 20 week ultrasound when they also diagnosed me with complete placenta previa. My OB explained, as gently as she could, what Accreta was, how it could develop, why I was at risk for it (the 3 prior c-sections coupled with previa) and that they would be monitoring me closely with ultrasounds. A month later, when the 24 week ultrasound showed no placental movement, I was referred to the nearby MFM specialists. Its been about 6 weeks now since I was diagnosed with Placenta Accreta. At my last check up, almost 2 weeks ago (at 29 weeks), they believed my Accreta has not exited the uterus, so, no percreta. I have my next checkup in just a couple of days and they will be doing weekly ultrasounds after that. My practice uses level 3 ultrasounds and they didn't believe they would benefit from doing an MRI, so we are trusting that and sticking with the ultrasounds. They have scheduled a cesarean hysterectomy for 34 weeks and 1 day on July 17 with 2 rounds of steroids for our baby starting 48 hours prior. I was desperately hoping to go further, but the MFM felt very strongly that the risks of keeping little man in outweighed the benefits. I have also been warned that any bleeding prior to the 34 week mark could change things. I have been SO lucky and blessed that I have not had any big bleeds (since the early one). I am thinking perhaps my stubborn and unchanging cervix has at least given me this one benefit!

When people talk about the risks of c-sections, aside from the general risks of major surgery, Accreta/Increta/Percreta is THE big risk they are talking about.  I wish the Accreta speech went along with the “risks of induction” because my experience leaves me feeling that they are all so intertwined. Oh how I have always regretted that early induction with Jesse and now, regret doesn't even begin to describe it.

Obviously, I cannot go back and change that birth experience. And, who knows, perhaps the exact same thing would have happened to me at 42 weeks.  But at least if I had gone to 42, I would know that I truly had done everything in my power to allow my body to do its thing before messing with it.

And, I am hoping that by sharing my experiences I can at least help other pregnant moms realize that even though we are really used to c-sections, the consequences can be much greater than a scar.

C-sections are life-saving interventions. Heck, mine will save my life this time (if it didn't last time). But we as women need to be patient, strong & trust our bodies. We were made for this. Sure things happen and praise Jesus we have interventions when they do. 2-3 weeks waiting for labor to start naturally can feel eternal when you are a first time mommy at the end of a miserable pregnancy. But it is well, well, worth it. Instead of talking constantly about that due date, add 2 weeks to it and make plans based on that. If you're prepared to go over & past your date, it won't be so bad if it actually happens. Due dates are not birthdates or deadlines!

My situation is not as risky or complicated as Jennie's, I feel like a wimp whining about anything I am going through on her blog after all that she has been through! My doctors are prepared for the worst in the operating room but they expect things to remain controlled with the hysterectomy and for that to be relatively straightforward. I cannot believe I am 30 years old and having a hysterectomy. My emotions have roller-coastered every step of the way as I am realizing what I and my newest little boy are missing out by being separated by NICU instead of experiencing his first few days together. Even the least form of this complication makes for major struggles for mom & baby with an early delivery. I am gearing up for weeks of pumping, praying that my placenta will stay contained so that my recovery will not be a further obstacle, worrying about my other boys at home and how I will manage back & forth to NICU for however long it will be. I spoke with a neonatologist at our hospital today, and took a tour. While everyone I encountered was encouraging, supportive, knowledgeable, it was a shocking environment for me—a mama used to big strapping almost 10 lb babies who come out latching like pros and rolling over within their first couple of months! I cried (somewhat uncontrollably) when the neonatologist told me that it was very, very unliklely I would be discharged without Eliot. Of course I knew this before going in, but hearing it officially hurt more than I thought it would.

I am ever so grateful that the Great Physician is in control of this situation. We have been blessed with so many prayers. We get prayer cards in the mail and each time I am just so thankful that we have been provided with such a net of support. I remember the first Sunday after my diagnosis attending our church service and having our pastor preach from Isaiah 41...the title of his sermon being “Do Not Fear, He is in Control” … how thoughtful of him to write his sermon just for me that day! (Kidding, but you know what that feels like, don't you? When the lesson just couldn't be more topically appropriate for you?) So I'll leave you with one of the verses that continues to comfort me in my last few weeks of waiting.

Isaiah 41:10 (English Standard Version)
”Fear not, for I am with you;
be not dismayed, for I am your God;
I will strengthen you, I will help you,
I will uphold you with cmy righteous right hand.”



THE END :)