'I Thought It Was Just a Bad Reaction to My Epidural': A Mom's Request for Her Medical Chart Years Later Led to Answers She Didn't Expect
"Relax," Nurse Kelly says again. She places a pillow in my lap and tells me to flop forward onto it. I don't have much of a lap left; I'm a week past my due date. My legs dangle over the side of the hospital bed as Kelly splays open the back of my gown. I can't relax, despite her encouragement. As the anesthesiologist's needle pierces my back, my shoulders are tensed up to my ears. When it's done, I lean back gingerly and exhale, hopeful that relief from 13 hours of pain will soon take hold.
And then every monitor begins beeping. I see my mother's tired but reassuring smile turn into a look of concern. A tide of medical professionals crests against my hospital bed. I'm lying down, looking up, my world now confined to a circle of faces. Doctors, nurses, my mother. She squeezes my hand.
It's 1:41 p.m., and I am still nine hours away from giving birth to my first child. My husband isn't here. After a cervical check revealed I was likely still many hours from delivering, he went home to take a nap, with assurances that he would return before the big finale.
Despite attending Lamaze class with me every week, he hadn't turned out to be much help when push came to shove, so to speak. He is young: 23. We are young. This pregnancy wasn't planned. I'm still in college. We got married five months ago.
Shocked by my anguish during labor and paralyzed by his powerlessness to alleviate it, he has awkwardly receded into the background over the course of the day. And so, as I swiveled on a yoga ball or rocked in the hospital's rocking chair, half delirious with fatigue, it's been my mother's shoulders I've held. It's been her ears I've groaned into during contractions.
I put so much time and effort into choosing an obstetrician: consulting friends, reading reviews, posting on mommy message boards. My prenatal care has been compassionate and attentive, but the doctor from my practice who was on call when I was admitted to the hospital is a man I've met only once. Throughout my stay, he has seemed to swan in occasionally to check my cervix and give orders to the nurse. When he announces the possibility of a cesarean, it's Nurse Kelly who forcefully insists that I'm progressing fine for a first-time delivery. She is the one there for me when I need her. And right now, I really need her.
Something has just gone wrong, though no one has told me. Only many years later can I piece together exactly what happened, with the help of the medical team's notes in my chart. I requested this chart recently—I had to pay for it, as is common practice, even though it is information that belongs to me—because I was eager to understand something that had always eluded me: Had I, had my baby, come close to dying that day? For years, all I knew was that I'd had "a bad reaction" to my epidural. That wasn't enough. I wanted to know more. So, even though I'm not a medical professional, I pored over my chart, looked up every term, and researched everything that had happened to me and to my son, because no one had ever bothered to tell me.
Patient just laid down after epidural placed. Pulse down to 80's.
My baby's pulse, not mine. His 80 beats per minute is paltry; normal is around 140. A fetal heart rate this low can result in death in as little as three minutes.
Abdomen noted to be hypertonic. Pit stopped. BP 90's/40's.
A hypertonic abdomen means I'm experiencing an unending contraction of the uterus. My belly is rock-hard, its continuously tensing muscles squeezing my son and restricting his blood flow, causing his heart rate to drop. "Pit" is short for Pitocin, the drug used to intensify contractions and speed up labor. The hypertonia is likely a side effect.
I don't recall being asked if I wanted Pitocin. I doubt it was presented as a choice. I remember the doctor simply declaring that I was not progressing fast enough, and so it would now be administered. Up until this Pitocin hurry-up, my labor pain had been manageable. The drug has made my contractions unbearable, torturous. The drug was what led to my epidural request. Can prolonged labor be dangerous? Sure. But so can a cascade of medical interventions, particularly those that can endanger both mother and baby.
Because at that moment, the epidural begins to cause my blood pressure to plummet. My typical pressure readings hovered around 110s over 60s during pregnancy, so a dip to 90s over 40s is significant. A drop that size can cause dizziness and fainting. If blood pressure remains that low, the brain and other organs will fail to receive an adequately oxygen-rich blood supply. The result can be death.
As it turns out, a dip in blood pressure is a somewhat common side effect of an epidural; it occurs in roughly 14 percent of patients. No one told me this—not my doctor, certainly—and no one told me about the potential for Pitocin-induced abdominal hypertonia. Had I known the risks, I might have turned it down. Had I known how painful Pitocin can make contractions, I would have categorically refused it.
O2 placed. Patient rolled to right side—left side.
An oxygen mask is fitted over my nose and mouth, then the medical team struggles amid the wires, tubes, and my huge hard belly to tip me from my right side to my left. No one explains why. I've become a passive object in the room, to which no one speaks.
Next, my hospital bed is tipped backward at a steep angle, my feet sent high in the air with my head nearly grazing the ground, as though I'm on a seesaw and my partner has just leapt off. No one explains this either. I see drugs being injected into my IV and nurses staring at the vital sign monitors. I don't know which drugs. I don't know what the nurses are looking for. Just as in every medical emergency portrayed on TV, my mother gets shunted aside in the flurry.
All I can see now are ladybugs. The hospital's ceiling is crawling with dozens of them, their little black spots mirroring the speckled ceiling tiles. I'm hallucinating because not enough oxygen is reaching my brain. Ladybugs are symbols of good luck.
If I'm dying, it isn't as scary as I've imagined; it's almost serene. My vision blurs and my hearing goes fuzzy and the world continues to shrink. I've fainted before, but this is different. I'm fading, caving in on myself. It feels like when you're sure you're moving backward, but it's actually that the train next to you is going forward. A stillness that feels like motion.
This is short for terbutaline, a drug used to open the airways of asthma patients. At the time, it was also used off-label to stop preterm labor, since it can relax uterine muscles. However, it increases heart rate and the potential for serious maternal heart problems, even death. In 2011, the FDA warned against its use in pregnant women. But it is 2007 and my heart needs a jump start, so that need outweighs the risks.
Decel lasted ~ 5 mins & return to baseline 145-150's. Uterus soft. Will monitor closely.
Part of that close monitoring is the placement of a small clip attached to a wire (called a fetal scalp electrode) inside me on my baby's head, to get a more accurate fetal heartbeat reading. Meanwhile, I am slowly regaining consciousness. Light replaces darkness. My world comes back into focus. My mother weeps.
When my husband returns a few hours later, refreshed, I tell him what little I know about what transpired in his absence: Something very bad happened, and though no one has said so, I sense that both I and the baby had been in real danger. He is dumbfounded and deeply apologetic for leaving.
Finally, it is time to push. I know this because I can feel it, because my epidural is beginning to wear off. After a very long hour, our son makes his entrance. Eight pounds, 5 ounces of squishy pink wailing. My husband, not I, gets to soak in those first few magical moments of bonding. My agony continues as my doctor stitches up my third-degree sideways labial tear without anesthetic.
Our son is 12 now, his head coming up well past my shoulders. He has a little scar on the top of the back of his head where the scalp electrode was placed, a circle about the size of a ladybug where no hair grows. Whenever I see it, I'm reminded of how that day, instead of both of us dying, the coin flipped the other way. It doesn't for everyone. But we were lucky. On that day, he was born, and I was reborn as a mother.
This article originally appeared in Parents magazine's May 2020 issue as "A Birth Story I Never Expected" Want more from the magazine? Sign up for a monthly print subscription here
Parents.com investigates the nation's maternal health crisis and what can be done to lower the risk for thousands of expecting mothers. Read more here.