I never thought during pregnancy about the possibility or scenarios of post-birth complications. I was too anxious about childbirth itself and focused on managing that and creating as positive an experience as I could. I had an unmedicated natural birth immediately followed by an uterus evacuation or curettage under general anaesthesia to stop heavy bleeding. Pieces of the membranes and placenta had stuck in my uterus after birth. I spent two nights in ICU and got a blood transfusion. I wrote about my birth story here.
Once we were allowed to go home, I thought all was over and behind us. I thought it was only a matter of taking the many iron supplements I was given upon discharge and paying attention to my body and emotional state while I recovered my strength. Besides the usual other things one needs to take care of following a natural birth, I mean. I was definitely weak; going up a flight of stairs or carrying the baby for longer periods left me breathless and exhausted. I certainly never contemplated the possibility complications could linger on and turn into something worse further down the line.
Everything seemed to be going fine. The midwife did not detect anything out of the ordinary during the follow-up meetings during the first two weeks after birth. I was puzzled at first and concerned to an obsessive point after a while about the ongoing bleeding (lochia). It wasn’t heavy, nor brightly colored, nor painful or anything, but I could not understand why it was still going on if the uterus had been cleaned. I was told everything looked normal. In around two weeks or so it had gone down to some brown-red spotting, which sounded like within the range of normal… but it went back to a red constant diminished flow. It bothered me terribly. And it went on like that until I decided to advance my check-up with the gynae at 5 weeks post-partum.
An ultrasound revealed two bits of something were left behind in the uterus. I was told another uterus evacuation intervention was needed. That caught me completely off guard and I was under shock. Several dates were suggested to me and I initially opted for the later one. I needed time to process it all. It was a quick procedure that would have me out of my home for 4-6 hours, all included. The nurse explained to us the administrative procedures; depending on the date chosen, different hospitals were involved, with different anaesthetists, different payment methods and rules about keeping baby with me. I went home crying… I felt so much resentment and impotence; I was upset. I shared this with our midwife, our mommy friends from the hypnobirthing class, with my best friend. They all had kind words of support for me.
My mom, who was still visiting, was very much in disbelief and angry. Between my husband and her, they convinced me to undergo the procedure the following day. What was the point in delaying it? Just get it over with as soon as possible. My husband went back to the gynae office and arranged everything. The next day, at 13.00h I was to be at the hospital to complete the necessary forms and make the upfront payment. Gynae charged no fees for this, but we had to pay for using the hospital facilities.
We had to cater for the baby’s needs during my absence. He was staying home with grandma and he was sure to need at least two feeds. I had never needed nor considered pumping breastmilk before and it was hardly the time to start then. I quickly scouted around for formula recommendations, just in case, and went out and bought a box and a bottle. I sent a message to my direct boss to tell her about the procedure. I figured being in a foreign country for work reasons and with the institution having a duty of care, it was wise to let them know, just in case.
Next day, I breastfed baby just before leaving for the hospital, to make sure he would only be given the minimum of formula possible. We got there about an hour before the scheduled procedure. The administrative procedures went quickly. We were then taken to a ward; I changed into a hospital robe and waited. The anesthetist came by to have a chat about my medical conditions and finally, I was asked on a wheelchair and taken down to the theatre. I think I went down with tears in my eyes. My husband was not allowed in the elevator, but he went down the stairs; I saw him again briefly when coming out of it. I remember lying down in the theatre; there were only three people there: anesthetist, gynae and a nurse. I got a prick and a wire again in my hand and I heard them chit chat for some seconds before going under.
When I regained consciousness, I was drowsy and in pain; I had such a heavy body. I could only speak with difficulty. It was a completely different sensation from the first time around, when I had felt better than ever. My husband was with me; we were alone in a different hospital ward. I told him it hurt. He explained that the procedure had gone wrongly and I had just had abdominal surgery. I was shocked. I started crying with sobs, which only made the pain in my abdomen worse. He held my hand and hugged me.
It turns out the “scoop had slid” (beautiful euphemism for a doctor making a mistake) and had perforated the uterus. They had gone in through the bellybutton to check whether anything else had been touched; confirming one loop of the small intestine had also been perforated, an abdominal surgery was performed to sew it.
I had been in the theatre much longer than expected. No idea what my husband and my mom thought or felt during that time. My husband is not much about sharing his feelings and instead focuses on what needs to be done; my mom was angry. I imagine my dad, at the other end of the world, also felt quite worried. I was angry, but I was probably more shocked and in disbelief that all this should have happened to me. I believe I was more depressed than anything else.
The first night I went to sleep without breastfeeding or emptying my breasts. I was in such an emotional state that it felt best to rest and delay seeing baby and grandma. The following morning, more than 20 hours after the last feeding, my breasts were engorged, painful and leaking. Baby emptied them and stayed with me during the day. We built a pillow fort on top of my tummy when he breastfed, for protection. Early evenings, however, baby went back home with grandma; we agreed I needed my night sleep to rest and recover this time. I did not want this to affect my milk supply or develop mastitis on top of everything and I wanted baby to have the least formula possible. With the help of the nurses we tried it all: hand expressing; expressing with a manual pump and with an electric pump (both of which my husband went out and bought on the spot). Nurses brought us hot towels to place on the breasts. We managed to get some milk out with the electric pump; the first time we used it, we got 150ml out, the most I ever got by pumping. I emptied my breasts last thing before going to sleep and first thing in the morning (around 5 a.m, when the first nurse came around with tea :O). My husband took it home to baby immediately; he spent the first nights with me in hospital. The hospital had provided us with a family room, at no extra cost.
Around lunchtime I finally saw the doctor. She was sorry for all I had to go through and she explained what had happened, without admitting any fault. It had just happened…But now finally all was in order and there were to be no consequences for my ability to have more children. I was on antibiotics and I was being fed through the tubes. I needed to stay in hospital four more days to confirm that my body was functioning properly, during which I slowly worked my way up from drinking sips of water to having a regular meal.
A physiotherapist, a young, fragile looking but quite strong lady came twice to help me get up and out of bed, walk around and go to the toilet. She showed me how to get up on one side, pulling myself up with the arms on the bed’s handrails, so as not to use my abdominal muscles and feel pain. The first day, I was exhausted only after doing that; I sat up on the bed for a short while with my feet dangling in the air. She also showed me some series of static movements I had to repeat many times a day whilst lying down, to prevent blood clots in my legs. And I did it all, repeatedly; it felt like I was doing something for myself. The second day, with her support, I walked down the hall to the toilet; she went in with me and guided me through sitting down and getting up, always keeping the body in an upright position, no bowing. After that, the catheter was removed and I started doing walks up and down the corridor, longer and longer each day. Now I was in that funny situation of the person in the movies walking slowly, with the support of another person and pushing my drip with one hand.
I needed to have daily anticoagulant injections in my tummy – the mere thought of this was physically painful. Seeing the nurse coming in with the small needle brought tears to my eyes. The first day, the nurse did it in my tummy. I could feel it during and after the shot. The second day, a different nurse came and seeing me so distressed, offered to do it in my thigh instead. It felt so light; I couldn’t feel anything. Therefore, when yet another nurse came on the third day, I asked her if she could do it in the thigh again; it wasn’t the same – it hurt. Doctor had mentioned three shots to me. On the morning of the fourth day, when the nurse arrived with the injection, I refused to have it done. No way I was getting pricked yet again. The doctor had said three shots only; not to mention they had only started with the injections 36 hours after the intervention. Nurses, my husband and my mom’s pleas and attempts to reason with me led nowhere; so, they had to put a note down in my file and that was it.
I hated it all. Plus, the stupid drip would get air bubbles in all the time and the nurses were just so careless at the time of taking the air out. It hurt; the thought of it all and all that was happening. At some point, the drip split the vein and they had to prick the other hand as well. Getting up and out of bed the first time was terribly hurtful. I couldn’t stop thinking – if this is how it feels after a C-section, why would anyone consciously choose one?!
The moment I could eat soups and mushy things, my mom cooked for me some of my childhood dishes: chicken soup; semolina porridge with cinnamon; mashed potatoes with butter and milk; runny scrambled eggs. At least on that account I felt spoiled. My husband brought me Downton Abbey and The Big Bang Theory which kept me entertained when I was not wapping with friends. I am so grateful for all those people who cared for me during those days. The mommies from the hypnobirthing course were so sweet, they got me a voucher to a beauty parlour, to help me forget about it. Colleagues from work also came by; my husband had been in touch about the visiting schedule.
For a while we considered suing the doctor; a South African friend did a quick research and it came out it was very unlikely anything would happen to the doctor. I did not really care about suing the hospital; I was angry and frustrated that two consecutive uterus evacuations were needed and had gone so wrongly..
By the time I got home, the pain had mostly subsided. I remember being given so many painkillers; I took maximum 4-5 pills over the next two days, only when I really needed pain relief. The “staples” were taken out two weeks or so after the surgery. It took me a while to get the courage to look at the scar and I did it very rarely for a time. Almost two years later, it is barely visible and only in the middle section. And anyway, it is below the bikini line. It slowly went from red to pink to blending in with the skin. I didn’t really take care of it, although I had been advised to use bio-oil on it. For many months, I had no sensitivity in the tissues around the scar, it even felt numb. It still doesn’t feel normal, but I can feel much more.
Before the procedure, I had lost around 10 kilos compared to pre-birth me. When I left hospital, I was puffy again and four kilos heavier; which was curious, given I had not been eating much for five days, but probably made sense, with all the fluids I had been ingesting..
I was terribly emotional; felt like crying all the time, incapable of doing much but staying in bed or hanging around my bedroom. I had done everything to avoid a C-section and I had ended up with vaginal tears, two failed curettages and an abdominal surgery similar to a C-section. My mom kept the baby sleeping with her a few more nights and I avoided holding baby while walking or going up and down the stairs; he was six weeks by then and quite bigger than a newborn.
I took the advice of our hypnobirthing coach and called a trauma release consultant, one or two weeks after the surgery. We thought, why not? An amazingly warm and gentle doula paid me a visit and we spent a couple of hours alone together. She listened to my story, allowing me to cry as much as I needed, when I needed, no holding back. She encouraged me to express my feelings, my anger in an imaginary dialogue with the doctor – I did that in Romanian, among strong and shaking sobs. All the time, she was holding, patting and massaging me gently. Until at a certain moment I just stopped crying. After that, I felt much better. It became easier to talk about it and I tried to share my story on every occasion there was a friendly ear around. It took me a long time to be able to talk about it without breaking down into crying. Writing now about it is an exception; maybe because I am dwelling on all the details, on all I can remember.
We had planned to spend my four months of maternity leave travelling around South Africa. We could just as easily take care of the baby anywhere and my husband could work from any place with a decent internet connection. After all that happened, I just wanted to put some distance. It took three months to do all the administrative work to have the baby’s passport and residence in order so that we could travel internationally. When we had everything in place, we went away to Romania for two whole months. When we returned, I had moved on.
These complications made my first weeks with baby more difficult and uncertain than they would have normally been. They affected my emotional state. Before the 5 week appointment with the gynae, whilst in her waiting room, I was given a form to fill in – a form related to post-partum depression. All kinds of orange flags were raised. It became obvious to me whilst filling it in that the outcome would be pointing in such a direction and I felt sad about that. The doctor said I was definitely at risk and advised taking pills. Good thing my husband was with me and he resisted any drug prescription; wasn’t it premature? Have all physical issues solved and then reevaluate and take it from there. I was too down about anything; when she mentioned the risk and drugs, I believe I felt even more shocked that that was happening to me. Just days after I was released from the hospital, we took the baby for his 6 weeks check-up. It must have been obvious on my face, or maybe it was just a routine thing, but the paeds told me to not hesitate to ask for help if I felt depressed.
My husband was a tremendous help, and the trauma release was useful in unlocking my anger. I probably could have used professional emotional support much earlier and possibly for a while longer afterwards, but I consider myself lucky with what I had.