Thursday, June 18, 2009

Ruminations and speculations

Today I had my follow-up appointment with my doctor. This is the typical office visit to make sure that I recovered properly from the birth. I realize that I still haven't blogged about the circumstances of Annie's birth, but I think all of you who read this blog know what happened. The summary is that when I was 35 weeks pregnant, I tripped and fell while at work and went to the hospital for monitoring. After about 24 hours of monitoring, I ended up with an emergency C-section. This happened because of 3 episodes in which I had a contraction and Annie's heart rate dropped significantly.

At the time, the doctors feared that I had damaged my placenta when I fell. (It was a slow fall, but I landed directly on my belly). A damaged placenta means that the baby is not getting enough oxygen; thus, it can be fatal to the baby. The only way to tell if there was a placenta abruption is if there is bleeding (which I didn't have), contractions (which I was having but wasn't feeling), and/or change in the baby's vital signs (which occurred when I had one of those contractions). They did an ultrasound and couldn't tell anything from that. When Annie was born, there was blood in the amniotic fluid, which could have been an indicator of an abruption. They decided to send my placenta to the pathologist to see if anything could be determined from that.

Now there may not have been a placenta abruption. But of course, that raises more questions than it answers. The nurses that were taking care of Annie in the nursery speculated that I had not damaged my placenta, but that something else was wrong and that by some stroke of luck (or divine intervention, which is what they thought), I happened to fall and come in for monitoring. Otherwise, no one would have figured out that anything was wrong until it was too late.

Today, I talked to my doctor and learned that the pathology report was inconclusive. Apparently, the only way that pathologists can conclusively determine if an abruption occurred is if they study the placenta directly after it is delivered. Usually, they don't get it until an hour after the birth, and by then it's harder to determine. Interestingly though, the pathologist noted that the placenta was abnormally small (in the 5th or 6th percentile) and that the blood supply to a small portion of the placenta appeared to have been insufficient or cut off. The doctor thought that these factors could have caused the problems that led to Annie's early delivery as well.

I guess we'll never know. I have felt horrible about the circumstances of Annie's birth, particularly when she was so little and had to sleep in an isolette at the hospital with all these tubes and sensors hooked up to her. It was not the way I wanted to give birth. But I guess it could've been a lot worse. Maybe somehow it was meant to be.

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