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Ophelia's Birth Story: Emergency C-Section at 33 weeks

Updated: Jun 5, 2023

I was very lucky that I got pregnant on the first month of the first time we tried. I was young and healthy, and assumed that this meant that everything would be straightforward and normal. And it was, until it wasn’t. I had the usual ‘morning’ sickness in the first trimester, our 12 and 20 week scans looked good, and I felt great. We were planning a homebirth and attended the typical antenatal classes, preparing for our uncomplicated, natural birth. At my 28-week midwife appointment, my midwife measured my bump

(fundal height) and felt that I was measuring smaller than I should be, therefore wanted me to go for a growth scan to check baby. It took a week to get a scan appointment, and once we had our scan our normal, uncomplicated pregnancy quickly became high risk and stressful. During our scan they felt that baby was measuring small – roughly around the 2nd centile – and were hugely concerned as to why this was. We spent the next 4 weeks in and out of hospital as they did multiple scans, tests, and monitoring to try and figure out what was happening. They couldn’t find any reason for why baby was so small, and because of this, they wanted to continue monitoring us multiple times a week. This turned out to be both a blessing and a curse. A curse because it was really stressful, put a lot of pressure on me, and impacted my emotional and mental health hugely. It was a blessing because I ended up developing preeclampsia and HELLP syndrome, and if I hadn’t of been going in for monitoring, it could have ended very differently.

On Friday the 13th I went in at 33 weeks pregnant for monitoring. All my checks came back positive, but they took a blood sample to check a few other things. I was sent on my way with an appointment on Monday for a growth and doppler scan. We had a great weekend with friends, and on Monday I made my way back to the hospital for what we assumed would be another round of routine checks. My in-laws had stayed over the night before, and as Rich had to go into work, my mother-in-law came with me for a

chance to see the baby. This turned out to be such a blessing in disguise.

Baby was looking good during the scan, and I was feeling really positive as we made our way to the assessment unit to finish the checks. They took my blood pressure and it was quite high, but as I’d just come from a scan, they wanted me to wait around for a bit to see if it came down. They also retook my bloods, as they had concerns from the tests they had ran on Friday. Whilst we were waiting, a group of students came in and as baby was breech, the midwives asked if I’d be happy for the students to palpate my stomach and have a feel. I said of course! The students weren’t told baby was breech and it was so fun watching their faces as they tried to figure out where baby was.

Eventually, a consultant came down and explained they wanted to admit me for 24 hours of monitoring due to my blood pressure, and to see if medication brought it down. I was moved up to the ward and my mother-in-law went to find us some lunch as I called Rich. He was at work and didn’t answer, and I spent the next 2 hours trying to get a hold of him! My MIL came back with some sandwiches, and I put a list of things to get from home together as we ate. We had just nicely finished when a group of doctors came rushing in. They explained that my blood work had just come back, and that it was showing decreased liver functions as well as low blood platelets. I didn’t know what any of that meant and sort of blanked and said ‘No, I’m just here because my blood pressure is a bit high!’ They explained that my blood pressure was high because I had preeclampsia and my liver and platelets were being impacted by a condition called HELLP syndrome (H – haemolysis, EL – elevated liver enzymes, LP – low platelet count), which can be a very dangerous complication of preeclampsia. It’s all a bit of a blur, but I remember telling them that I felt absolutely fine, that they must have got the wrong person because there was nothing wrong with me. I later learned that, although rare, pre-e and HELLP can present without the ‘usual’ symptoms they tell you to look out for, such as headaches, blurred vision, and swelling. So although I was feeling fine, my body was (quite quickly) shutting down. I was told that the only treatment was delivery, and that a c-section was booked for 7pm that evening! This is where having my MIL there was a god send. Having a medical background herself, she was able to fire out questions and get clarity on the situation, whilst I sat there trying to process. I still hadn’t been able to get in touch with Rich, and I was very much freaking out.

Due to the severity of the HELLP syndrome (despite me still feeling fine), I was not allowed to go home – even briefly – to get any stuff (not that my bag had been packed at all!) and was immediately moved to my own room on labour ward to prep for the section. Although delivery is the only treatment for pre-e and HELLP, one of the things that they give you to help manage symptoms is magnesium, via a drip. Magnesium helps to reduce the swelling in your brain, in the hopes that it prevents one of the most dangerous effects of pre-e and HELLP, which is seizures. Although necessary, the side effects of magnesium (other than preventing seizures) are not very pleasant – hot flushes, dizziness, feeling like you’re floating out of your body. I went from feeling completely fine to being prepped for surgery, hooked up to an IV and feeling terrible very quickly; it felt like I had whiplash and I felt SO overwhelmed by it all. I'd eventually been able to get a hold of Rich, and as we had a few hours until the scheduled section, the plan was for him to go home from work, grab a quick bite to eat, and pack a hospital bag for me.

Side note ladies – don’t let your partner pack your bag. Somehow, despite seeing my underwear every day, I ended up with pants from the bottom of my drawer that hadn’t made an appearance in years! 🤦‍♀️😂

Rich got to the hospital at around 2pm, and we settled down to wait for the few hours till our section time. We used this time to update a few people, as well as settle on a name – something we thought we'd have a lot longer to do!

As both conditions (preeclampsia and HELLP) can deteriorate very rapidly, they continually check your vitals and bloods to make sure that you're doing okay. Unfortunately during the time whilst we were waiting, my latest round of bloods came back and showed that the HELLP syndrome had progressed much quicker than they had expected, and my blood platelets were dropping rapidly and becoming dangerously low. Despite it still being hours from our scheduled C-section time, they decided that they couldn't wait any longer, otherwise there was a risk that I would have to be put under general anesthetic for the section. All of a sudden we had loads of people coming in and out of the room, monitoring me and baby, prepping me for surgery, giving us consent forms and not doing a very good job explaining what was happening in their haste. When Rich tried to ask some questions regarding the c-section, he was told that there was no time to go through it all as 'his wife and baby could die' if they didn't proceed, so to just sign it. It was really scary, for both of us.

Right before they took me to theater, a pediatrician from SCBU came in to talk about what would happen to baby after she was born. He explained that Warwick doesn't usually take babies before they are 34 weeks, but as we were 33 + 4, and there was no time to move us to Coventry (the nearest NICU), they would have an ambulance on stand by who could blue light baby to Coventry if needed. He explained that if baby came out and was crying, that was a really good sign and would probably mean that baby could stay here. If baby came out and wasn't crying and needed help and resuscitation then they would take baby immediately to Coventry and I would follow after I was out of recovery. We had to decide there and then if Rich was going to stay with me or if he would be going with baby. We both knew immediately that he would be going with baby. Luckily, despite being an emergency, Rich was allowed in the operating theater to be there for the birth. I was wheeled in first and prepped with the spinal before he was brought in. I asked if the drapes could be lowered so I could watch baby coming out, but because they didn't know what condition baby would be, they said no to that. If you don't know or if you've never had a c-section before, the first part of the section to get baby out is really quick, usually done in under 5 minutes. Once baby is out it can take upwards of 45 minutes to sew you back up and get you to recovery. This meant that once the spinal was in place and everything was ready to go it was actually very quick for them to get baby out. The surgeon was very good and talked us through it was happening, and as they pulled baby out, the first thing we heard was her crying, and then a nurse saying " wow she's very long!".

Our little girl - Ophelia Riley Dunne - was born at 16:27 on the 16th May, weighing 4 lb and 1.5 ounces.

She was a fighter from the beginning and after a very quick cuddle on my chest, they wheeled her away to SCBU with Rich following. I think it was in the calm and silence that followed their departure when everything really hit me; as they were sewing me back up I started shaking really badly and feeling really nauseous and struggling to breathe. I think this was pure anxiety, adrenaline, and panic as everything sunk in. The anesthetist that was at my head the entire time was amazing. He talked me through all the things I was feeling and helped me to regulate my breathing and calm me down. He also talked me through everything that they were doing during the surgery. After a day of most medical professionals barking orders at us, he was a breath of fresh air. I was wheeled into recovery where Rich was brought to see me and update me on Ophelia. Although she was on a CPAP machine to give her oxygen, she was doing really well and they were really pleased with her. Unfortunately I wasn't well enough to go see her and she wasn't able to leave SCBU to come see me, so it wasn't until early the next morning that I got to properly see and meet her.

If anything, the 12 hours following my c-section were probably the most difficult. Although delivery is the treatment for preeclampsia and HELLP syndrome, it is the placenta that causes the issues and needs to be out for the issues to stop. Your body takes time to recognize that the placenta is out, and will actually continue to deteriorate for a couple hours post surgery before you start to get better. I was post surgery as well as still being on the magnesium, and they had to do hourly checks on me to make sure I wasn't hemorrhaging and that my liver wasn't failing. This included monitoring my blood pressure to make sure

that was coming down as it had been dangerously high as well. It meant that I was in in an extreme amount of pain, as well as being woken up every hour so unable to rest. I was also anxious and worried about Ophelia but unable to see her. On top of all of that, Boris Johnson had done his first of many addresses to the nation whilst we were in surgery, and I came out of surgery to hear about the first set of closures, including hospital visiting. As information is slow to trickle down, my in-laws were able to visit Monday evening - probably some of the last visitors to walk through the doors for almost 2 years! They were able to briefly meet Ophelia, which was lovely because they wouldn't see her (or us) for another 2 months due to lockdowns. My parents (who live in Canada) had been planning on coming over in May after my due date, but boarders closed and air travel stopped and they didn't get to meet Ophelia till she was almost 7 months old.

Because of the unknowns of Covid, it was decided that after 3 days I would be better off at home recovering rather then staying in hospital as was usual. Unfortunately, this meant there was a huge gap in my care as I was discharged from the hospital and GP's shut down and wouldn't see anyone face to face. I needed blood pressure monitoring and my bloods checked to make sure all my levels were stabilising and to make sure there were no lasting impacts, but it was a huge fight getting this (and in fact, did not get it to the level it should have been). I was dealing with this whilst also going back and forth every day to SCBU visiting Ophelia, pumping, and trying to establish breast feeding with her.

Over all, Ophelia spent about 4 weeks in SCBU before coming home. She did amazing, and luckily seems to have zero impact from her birth. Physically, I recovered fairly quickly and easily; however, mentally it took a lot longer. I was eventually diagnosed with Post Partum Depression and Anxiety, and I think a lot of that was the impact from our birth experience. Although there are elements of her birth that needed to happen - like having a c-section - there were a lot of things that could have gone differently, and had they done so, would have hugely reduced the impact on my mental health. As it was our first pregnancy, we had no idea that our voices mattered and that we had choices, and we spent most of our time in hospital feeling out of control and like our wishes about our birth weren't important. Those feelings lingered and played a huge part in our postpartum recovery, both for myself and Rich.

What it showed me is that it's not just about coming home with a healthy baby, but also making sure you, as the birthing parent and partner, feel heard and respected. I went into my next pregnancies with a very different lens and attitude, and it made a world of difference for my next birth. But that's another story for another blog 😉

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