We all know it is Mother’s Day, and there is so much that we at Share MayFlowers have to say about motherhood, including the whole of preconception, pregnancy, childbirth, and postpartum recovery. We all have a mother who brought us into this world, some of us are mothers, some of us are not, and that leaves many stories to tell. And here is one. It is told honestly and poignantly, without any edits. Just a story of one woman and her motherhood journey. Is it an even portrayal of what the totality of childbirth experiences? No, and that’s the point. Motherhood, pregnancy, childbirth – these are all deeply personal and varied experiences that should always be heard and appreciated from a posture of support and encouragement. I am grateful to Jen, now a physical therapist with us at Marathon Physical Therapy, for trusting us with her story.
Happy Mother’s Day,
“When I was 38 years old I found out I was pregnant with my third child. A mixture of emotions ran through me; terror, disbelief, amazement…did I mention terror? To say that I had had difficult pregnancies is putting it mildly. My history read like something from a horror movie. I had undergone surgery at 13 weeks during my first pregnancy to remove a dermoid cyst from my ovary which was growing rapidly, most likely exacerbated by all the pregnancy hormones. That same pregnancy I endured months of bed rest when I developed preeclampsia in my last trimester. My next pregnancy ended in a miscarriage at nine weeks. Finally my last pregnancy had landed me in the hospital with another diagnosis of preeclampsia, this time with an added twist when I was diagnosed with HELLP syndrome. My two children had been born at 35 and 32 weeks respectively. I had faced the devastation of having to leave my son in the NICU when I was discharged from the hospital after having him and had endured six long weeks at home without him, my heart aching the entire time. I had been told that it wouldn’t be safe for me to have more children and that if I did I would probably deliver even earlier the next time. Getting pregnant again meant I would be putting my own life and the life of my unborn child at risk. Needless to say, my third pregnancy was not planned.
Medical history aside, there was also the issue that I was 38 years old. I had my first baby when I was 27 and my second when I was 29. I knew that having a baby over the age of 35 brought additional risks and worries. What would my husband say? My doctor was going to kill me! With my advancing age I had also learned that I had several large fibroid tumors in my uterus. A quick internet search brought a whole new set of worries about that. Would the pregnancy survive with the fibroids I had? Would my baby be normal? Would I survive this pregnancy? Mustering up all my courage I told my husband and scheduled my first doctor’s appointment.
Unfortunately my doctor’s office had a new policy that patients could not see their doctor for their first prenatal exam but instead had to see the nurse practitioner. I reluctantly went to my first appointment armed with a million questions, concerns and fears. The nurse practitioner confirmed all my fears; this was a high risk pregnancy because of my history and age and I would have to be watched very closely because of the fibroids with frequent ultrasounds to make sure everything was ok. I cried through my whole first appointment probably horrifying this poor nurse practitioner who was just doing her job. Every appointment after that was scheduled with my doctor. No one ever told me I had to see the nurse practitioner again- wonder why?
After my doctor got over the shock that I was once again one of his prenatal patients, he recommended that I have an amniocentesis to make sure the baby was healthy. Due to my age there was an increased risk that the baby could have some sort of a genetic disorder such as Down ’s syndrome or worse. He reasoned that if I was going to risk my life that I should make sure that the baby was healthy first. I had such mixed feelings about this. I knew from being a physical therapist that I could take care of a baby with disabilities if that were the case and that I would want to have it no matter what. I worried that the amniocentesis could cause me to have a miscarriage. I also knew that my husband felt differently. He was scared that he would lose me due to my history and that he may be left to raise three children on his own. The thought that one of them might be severely disabled and he might be without me scared him. With many reservations I scheduled an amniocentesis.
The day before the amniocentesis I began having sharp stabbing pains in my abdomen that would come and go and vary in intensity. Just before the amniocentesis I had an ultrasound of the baby. Just the pressure from the sound head caused horrible pain that left me fearful that something was terribly wrong. Scared to death I told my doctor when he came in the room to perform the amniocentesis what was going on. Turns out the areas that were causing me so much pain were where my fibroids were. I was told that most likely the baby and the fibroid were fighting over the blood supply. Luckily the baby was winning, however that left the fibroids without a blood supply causing them to die and causing me to be in terrible pain. I was told that the pain might worsen to the point I needed pain killers but that it would be temporary and that the amniocentesis was safe to do.
The amniocentesis was done on a Friday. I went home to rest for the weekend in pain and fearful that the procedure might cause me to miscarry. I was scheduled to see my doctor on Monday to make sure everything was ok. Saturday night I found myself in the triage center at Brigham and Women’s Hospital because the pain had become so severe that I couldn’t get comfortable. Another ultrasound confirmed that the baby was fine and that the pain appeared to be from the fibroids and unrelated to the amniocentesis. I was put on pain killers and told to rest and see my doctor on Monday as planned. The rest of the weekend I spent feeling nauseous and sick from the pain killers which had made the pain more tolerable. By Monday I was still having pain and was having difficulty eating or drinking due to the nausea. I was sent back to the triage center by my doctor for IV fluids and another ultrasound. Reassured that everything was fine with the baby I was sent home hours later. The pain eventually subsided a few days later and I was allowed to return to work.
Glad that the pain had subsided I attempted to return to my normal life as a wife, mother of a 10 year old and 12 year old and Physical Therapist working fulltime in an outpatient hospital setting. Unfortunately, I ended up having two more episodes of fibroid pain each lasting for about a week, pulling me out of work each time and landing me in bed on pain meds. Around the same time I began experiencing horrible low back and left hip pain which left me in excruciating pain when standing or walking. My last few weeks of work I limped around, taking care of my patients while I suffered with each and every step. Funny thing was I worked as a Physical Therapist alongside a large department filled with other Physical Therapists all of whom were afraid to try to treat my pain for fear of causing harm to me or the baby and fear that something they would do might cause me to go into preterm labor.
My last day of work came at the start of my 25th week of pregnancy. I woke up feeling a little off that day but persevered and went to work anyway. My first appointment of the day was with a new patient. About halfway through this appointment I began to feel very strange. I had a headache and felt dizzy and a little fuzzy. I managed to finish up with my patient and then told the office manager I wasn’t feeling well. She called our rehab director who made me lay down and took my blood pressure. My blood pressure reading was a bit high, 150ish over 90 something if I remember correctly. I was told that I could call my doctor or be sent to the emergency department where I worked. A short while later my husband picked me up and we headed into Brigham and Women’s Hospital to see my doctor. A blood test confirmed my liver enzymes were elevated. This along with the high blood pressure indicated I was developing HELLP syndrome again, a variant of preeclampsia which can cause the liver to rupture if left untreated and can cause seizures or strokes leading to death. The fact that this was starting in my 25th week was not a good sign. The only cure for this condition is delivery of the baby. I knew that having a baby at 25 weeks was not something I wanted to do. If the baby survived I knew it would be a long road and that the baby would most likely have a lot of medical issues and struggles ahead. I was willing to do anything to avoid that. Luckily I truly have the best doctor in the world. He has seen me through the most difficult of times and I thank God every day that I found him. Without him I am positive I would not be here and I would not have my healthy, beautiful children. So I put my trust once again in my doctor knowing that he would do anything he could to help me.
I had thought that home bed rest was horrible with my first pregnancy; that was until I was admitted for hospital bed rest. Away from my husband and children, I longed for the comforts of home. My husband had brought me some clothes, a computer and my kindle but I had a hard time adjusting to the loneliness and solitude. I found it hard to concentrate on reading, distracted by my worries about things going on at home that I had no control over as well as my own health and the health of my unborn child. My husband was left to manage everything at home and take care of our other two kids so there wasn’t a lot of time during the week for him to visit me. The hospital was about a one hour drive from our home, so my family would primarily visit on the weekends for short periods of time between the kid’s activities. I was bored, lonely, and anxious about what was going on at home without me and scared to death of what might happen.
The first week of my hospitalization was extremely stressful. My daily blood work showed that my liver enzymes were getting higher and higher. My doctor was willing to monitor me on hospital bed rest keeping a careful watch on my liver enzymes. He explained that once they reached the number 200 they would have to deliver me because at that point it would be too dangerous for me to continue to be pregnant. The goal was to keep me pregnant as long as possible to give the baby a chance to develop while still keeping me safe. Each day of that first week the numbers climbed getting dangerously close to that 200 mark. My doctor began to prepare me that I was probably going to have to be delivered soon. Then something miraculous happened. Just as mysteriously as the numbers had begun to rise they slowly began to drop down. About 2 weeks later they were back to normal and I was set free back to home just in time for Halloween! I was told to stay on bed rest at home and I had to see my doctor several times per week; but I was free!
I lasted about a week at home then was admitted again for the rest of my pregnancy. This time I was slightly more upbeat. I was further along so more confident that, although not ideal, having the baby at that point, everything would be ok. My liver enzymes began creeping back up as did my blood pressure. Bed rest began to take its toll. Getting up to use the bathroom left me weak and winded and I needed a chair in the shower because I couldn’t stand for long without feeling like I would pass out. I began having headaches and blurry vision as well as an achiness in my abdomen on the right side. I realized I was jaundiced when my 10 year old son came into visit me and said he liked my tan. My doctor began to mentally prepare me again that I would need to be delivered soon.
Unfortunately the time came when I needed to be delivered. It was a weekend, I was 31 weeks pregnant and my doctor was off for the next 3 days. Although I wanted to wait for my doctor I was told I couldn’t because my numbers were past that magical 200 mark. My labor was long, torturous and painful. I was induced, put on Pitocin to get the contractions going and put immediately on magnesium to prevent seizures. Magnesium is one of those drugs that build up in your body over time. It literally feels like you are on fire from the inside out and leaves you with a horrible metallic taste in your mouth. As time goes on it causes you to feel weak and uncoordinated. After about 12 hours on it I could no longer walk and needed help to transfer out of bed on to a commode to pee. I could hardly see because my vision was so blurry and even had trouble swallowing and talking. But it did its job and I did not end up having a seizure. I was on that lovely drug for about 48 hours start to finish and was literally counting down the minutes to when I could come off of it.
I had Olivia at 11:02 pm November 15, 2010. She came out 3 lbs. 9 ounces screaming like she was a 10 lb. baby instead of this tiny little thing. I knew immediately she was a fighter and would be fine. Holding her after she was born, I knew she was worth all I had been through. She was here, small, but healthy. Olivia spent the next 5 weeks in the NICU, coming home the week before Christmas. I remained in the hospital for 6 days, waiting for my liver enzymes and blood pressure to come down and for my strength to come back. My liver enzymes at their peak were over 400 so they took some time to normalize. Having been on bed rest for 6 weeks had left me weak, deconditioned and exhausted. The first few days after having her I couldn’t walk by myself any distance and had to have someone with me at all times. I was unsteady and a definite risk for falling, but gradually over time I improved.
Leaving the hospital was bitter sweet. I was longing for home and longing to be with my husband and other kids but not wanting to leave my sweet baby behind. The day before I was discharged I tried to mentally prepare myself. I had been through this before and I thought if I had a good cry before that I would get it all out and not cry when I left. Nice thought right? I made it almost to the lobby when I couldn’t hold it in anymore. I sat in this weird cart like contraption Brigham and Women’s uses for discharges with all my belongings while my husband went to get the car, sobbing my heart out. Someone I didn’t know handed me a tissue. I wanted to be strong for my husband so I didn’t upset him, but I couldn’t help it. There is something so unnatural with not being able to be with your newborn baby.
My experiences although difficult, have made me a stronger person. I appreciate all I have and thank God every day that I have 3 beautiful healthy children and that I am around to watch them grow. I realize that if I lived in another part of the world I might not have been so lucky. I try to use my own personal experiences to help me empathize with what my patients might be going through. I have been a Physical Therapist now for 19 years primarily working as an outpatient Physical Therapist. About one year ago I began working at Marathon Physical Therapy where I have begun to specialize in Women’s Health. I have learned so much over the past year and am thrilled to be a part of their Women’s Health Team spreading the word that there is help out there for women who have been told there is nothing they can do for such things as pelvic pain, constipation and incontinence to name a few things. Looking back on my difficult pregnancies I wonder what do I wish I knew then that I know now. I knew just from being a “regular” Physical Therapist about the effects of bed rest. I knew I would have muscle wasting and be deconditioned and I knew it would take time to recover. I didn’t know that the pain I was experiencing with my back and hip during the time of my fibroid flares could have been treated safely and effectively during my pregnancy by a Women’s Health specialist. I also didn’t know that it is so important to speak up when you are constipated and to never strain. I suffered greatly with constipation throughout my pregnancy. Being on pain killers worsened my constipation as did being on prolonged bed rest. I regularly strained to have bowel movements during that time oblivious to the fact that repetitive straining can lead to pelvic organ prolapse in the future. Constipation is an embarrassing topic that I just assumed was normal during pregnancy. I have since learned that many things that are common while pregnant and after having a baby are definitely not normal and can in fact be treated by a Physical Therapist who specializes in Women’s Health. Incontinence, painful intercourse, pelvic organ prolapse and separation of abdominal muscles are some common problems women face post-partum that can be treated.”