Editor's Story, Health, Motherhood
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Bella’s Birth Story + HELLP Syndrome

Every expecting mother plans out their perfect labor + delivery, but for many, the occasion doesn’t unfold as intended.

That sure was the case for Bella & I.

As a first time expecting mother, surely I had it ‘all planned out’. Early in my third trimester, my husband and I went on a labor & delivery tour at the hospital, we attended a birthing class and weren’t shy to be the most question-asking couple there, I even packed my hospital bag way too early and included way too many things.

My wish was for an all-natural birth, but safely taking place at the hospital I knew like the back of my hand.

Little did I know, the condition that would ultimately call the shots in our labor + delivery, was slowly creeping its’ way through my body for months, possibly (I personally think) my entire pregnancy.

See, I had been seen many extra times compared to normal pregnancies, although to my OB dept., my pregnancy was always considered normal. So much so, that my monthly check-ups were scheduled with an RN instead of a doctor.

Though, I did have ‘weird’ abdominal pains starting in the first trimester, each episode bringing me to the ER and then ultimately back home after ultrasounds showed everything was okay.

Then there was month 5. Well, there was a particular week during month 5. One in which a BIG inkling of ‘something is wrong’ showed up (when looking back upon our journey).

My husband and I were on vacation in the Andes Mountains within South America. I woke up a few times every night we were there, gasping for air, with my heart racing, and feeling like I just couldn’t catch my breath. One of our adventures of that trip included going to the top of one particular mountain range, an adventure that we cut short due to the intense upper abdominal pain I experienced once we reached the top. Altogether, we chalked it all up to the high altitude and never thought perhaps something more serious was going on.

Back home, I was on top of all my second and third trimester appointments, ultrasounds, growth scans, blood tests, and other routine checks, like the glucose tolerance test. The only fetal concern throughout that time was from a growth scan. Our little Bella’s stomach was smaller than should be at one point, so we had to have extra scans until she showed signs of ‘catching up’ – which she ultimately did.

In terms of maternal concerns, my heart’s PVCs (Premature Ventricular Contractions) became worse and extremely frequent during my second and third trimester. This is when there are extra, abnormal heartbeats that disrupt the heart’s regular rhythm and cause the feeling of a “flip-flop” or skipped beat within your chest (something I have suffered from occasionally throughout my life). Although PVCs are considered pretty common, the frequency during my pregnancy raised a bit of concern. So ultimately, I had a full work-up done by a cardiologist, including echocardiograms and holster monitoring. The findings were that my aortic valve does not always completely close, causing a bit of regurgitation and then PVCs. Still, this was considered pretty common and there was no real danger to my or baby’s health.

We then got to the point in the third trimester where I had weekly fetal and blood pressure monitoring. Although I had a funky heart rate sometimes, my blood pressure was always within normal range, and I never experienced swelling – therefore, there was never a reason for my doctors to worry about pre-eclampsia or other complications.

Even when my 7-month routine blood work came back showing low platelet levels, the RN whom was following me monthly, responded, “They will check this again closer to your due date, it just means that you may not be able to get an epidural at the time of labor + delivery.” So, I went about my 7 and 8-month pregnancy way and the husband and I anticipated month 9, the last month before we officially became parents. . .

BALANCED LIFE ALOHA - PREGNANCY STORY AND HELLP SYNDROME

I was four weeks away from my estimated due date when I was awakened in the middle of the night by horrible pain.

Although the pain was in my upper-right abdominal area, I thought I was in labor. As a first-time expecting mother, you dream about the moment you finally feel labor begin, and knowing no difference, I thought this was it – so off to the hospital we rushed.

By the time we reached L+D (Labor + Delivery Department) I was experiencing the most horrific pain I had ever felt in my entire life (and I have a very high pain tolerance).

But, no contractions… I wasn’t in labor.

I stayed in the L+D triage for what felt like days! In reality, it was an hour or so waiting for the ultrasound technician to arrive, who would then scan other areas of my abdomen to seek an answer for the pain.

I was irate that I had to wait in agonizing pain, with no answers or relief, for quite a bit of time, waiting for the radiologists to read my ultrasound imaging. I mean, pregnancy hormones plus excruciating pain can really create a woman-monster (oops).

So, at first there was talk about my gallbladder and possible surgery (say what?!). But then the radiologist’s final report indicated that I had a small kidney stone.

I couldn’t believe it. Seriously? I had my head set on delivering this baby! And relief to this pain! Now they were telling me to go home, rest, and take pain medicine?!?!

However, that unresolved feeling didn’t last long. God sent us an angel, a guardian in the scrubs of an OB Resident Physician. He looked through my third trimester blood work and decided to draw my blood for a CBC (complete blood count) before I left, just to make sure. (Remember that low platelet count from my 7-month check-up I mentioned? He wasn’t very happy that it was never followed further.)

That decision most likely saved Bella & I’s life.

The CBC came back showing a platelet count of 60(thousand).

*A considered ‘normal’ platelet count ranges from 150(thousand) to 450(thousand)* per microliter of blood*

At that point, the doctors changed their prognosis, the kidney stone was now considered an ‘accidental find’, and we were told that I had a rare, but very serious condition called HELLP Syndrome. …It’s something that has a 25 percent mortality rate.

The pain I was experiencing was not kidney pain, it was actually my liver – in extreme distress. Although I never had high blood pressure or other typical warning symptoms, I did indeed have preeclampsia, but a crazy cousin variant of the complication, with the initials – HELLP. We were told that this was one of the most deadly pregnancy complications, with the most common reasons for mothers to become critically ill or die being liver rupture or stroke (cerebral edema or cerebral hemorrhage).

It’s so named for its symptoms:

H: Hemolysis

EL: Elevated liver enzymes

LP: Low platelet count

My red blood cells were basically getting destroyed and within an hour my platelets dropped even further.

It was game time. I was mentally preparing myself for the seriousness of the situation, so much so, that I no longer noticed the extreme liver pain. I was ready to deliver my baby and survive!

See, the only way to “cure” HELLP Syndrome, is to deliver your baby.

Although it wasn’t my due date yet, Bella was considered developed enough to be born, although we really had no choice otherwise.

So we prepared. I was transported to a L+D room with a view of Honolulu & the Pacific Ocean, where they then placed a balloon bulb inside my cervix to kick-start dilation.

The doctors urged for a slow and steady pushing scenario once labor contractions began. This was because we had to avoid tearing, to also avoid bleeding. For the same reason, I wasn’t allowed an epidural, and a C-section would potentially cost me my life.

See, your platelets (thrombocytes) are the smallest type of blood cell. They are important in blood clotting. When bleeding occurs, the platelets swell, clump together, and form a sticky plug that helps stop the bleeding. If there are too few platelets, uncontrolled bleeding can occur.

By the time I was a couple centimeters dilated, my blood platelet level went all the way down to 40(thousand). I was then put on an IV drip of Magnesium Sulfate to “protect my brain from seizures”. We were told that if my platelet level dropped to 20(thousand) or below, I would need an emergency blood transfusion.

So I signed the blood transfusion consent forms, but made up my mind that I was about to push with all my life and strength to deliver this baby and not allow catastrophe to occur! I COULD DO THIS!

Then the contractions began.

My husband was by my side watching the monitor and warning me when another contraction was about to happen. With every contraction, my blood pressure went up extremely high because of the insane pain I was enduring from being in labor naturally, (no epidural or pain medicine), I felt EVERYTHING.

However, that high of blood pressure was dangerous for the baby. Although I don’t quite remember this part, they had to administer some type of medicine to help stabilize my blood pressure.

Besides the labor pains, I then was dealing with other symptoms related to the magnesium sulfate and blood pressure medicine they were pumping through my IV. I had, not double, but TRIPLE VISION, accompanied by migraines, hot sweats, itchiness and nausea.

Needless to say, I basically pushed with my eyes shut the entire time because of the room spinning symptom. Three hours of pushing and using an amount of strength I never knew I was capable of, and finally… the RING OF FIRE *insert crying-laughing emoji here*.

Bella’s head was finally crowning and that moment felt just as it sounds, like literal FIRE.

I have an image burned in my memory of the moment the doctors pulled Bella’s body out enough for us to see her entirety. Although everyone else in the room looked like they had three heads with my triple vision, there was her.  I saw her clear as day.  In fact, I saw only her. The rest of the world melted away.

Then I realized, she was blue.

& the next 5 minutes were the most terrifying minutes of my husband and I’s life.

She didn’t cry, she wasn’t breathing.

As my husband describes it: doctors, nurses, and specialists came out of the wood-works, as if they magically all appeared at once. They whisked Bella to the side and started to work on her.

Birth asphyxia occurs in about four of every 1,000 full-term births. It’s even more common when babies are born prematurely. I’m sure this had something to do with my HELLP Syndrome and the medicines I was given during the birthing process.

Some causes of birth asphyxia include:

  • Too little oxygen in the mother’s blood before or during birth
  • Problems with the placenta separating from the uterus too soon
  • Very long or difficult delivery
  • Problems with the umbilical cord during delivery
  • A serious infection in the mother or baby
  • High or low blood pressure in the mother
  • Baby’s airway is not formed properly
  • Baby’s airway is blocked
  • The baby’s blood cells cannot carry enough oxygen (anemia)

At that moment, my body just collapsed. I had no more strength, I closed my eyes and did the only thing I had strength for – I pictured myself in God’s embrace, with His arms around me. I prayed.

Then I heard her cry.

A 5 lb. miracle, we were certain.

Subsequently, the placenta was passed and I was given internal ‘birth canal’ stitches.  The last steps to our traumatic labor and delivery.

Then they placed her in my arms – a moment I will never forget.

BALANCEDLIFEALOHA.com BELLAS BIRTH STORY AND HELLP SYNDROME

Although I had to stay in that emergency L + D unit for two following days to be monitored, Bella was doing remarkable.

I wasn’t allowed to walk because I was still on a magnesium drip to protect brain until my platelet levels rose to a safe place. We were also told that those who suffer from HELLP Syndrome are at risk from complications still 6 to 8 weeks after birth. Therefore, we weren’t out of the woods just yet.

I was finally cleared to move on to the Mother-Baby Unit within the hospital where we would stay at least another 24 hours for monitoring and tests.

During that time, Bella became jaundice and had to be admitted for phototherapy.

Jaundice is a discoloration of the skin caused by too much bilirubin in the body. Bilirubin is the yellow breakdown product of normal heme catabolism, caused by the body’s clearance of aged red blood cells (excreted in bile and urine). Infant jaundice is a common condition, particularly in babies born before 38 weeks gestation, which Bella was.

During phototherapy, Bella laid in an enclosed plastic crib (incubator) and was exposed to a type of fluorescent light that is absorbed by the skin. During this process, the bilirubin in the baby’s body is supposed to change into another form that can be more easily excreted in the stool and urine.

BALANCED LIFE ALOHA - PREGNANCY STORY AND HELLP SYNDROME

My husband stood for almost the entirety of those 18 hours of light-therapy, holding Bella’s tiny hand. If he let go, she would hysterically cry (daddy’s girl from birth).

Her body responded great to the therapy and at last, we were both released from the hospital.

For the first week at home I got about 7 total hours of sleep, but having our precious daughter in our arms made it all worth it.

BALANCEDLIFEALOHA.com BELLAS BIRTH STORY AND HELLP SYNDROME

If you have made it this far in to the article, I applaud you ;) Although I did describe our pregnancy and birth story pretty in depth here, I believe in the power of our story. I also know the possibility of my journey helping another expecting mother perhaps avoid the allowance of warning signs to slip pass like I did.

According to the Preeclampsia Foundation,

HELLP syndrome can be difficult to diagnose, especially when high blood pressure and protein in the urine aren’t present. Its symptoms are sometimes mistaken for gastritis, flu, acute hepatitis, gall bladder disease, or other conditions.

The global mortality rate of HELLP syndrome has been reported to be as high as 25%. That’s why it’s critical for expecting mothers to be aware of the condition and its symptoms so they can receive early diagnosis and treatment.

The physical symptoms of HELLP Syndrome may seem at first like preeclampsia. Pregnant women developing HELLP syndrome have reported experiencing one or more of these symptoms:

  • Headache
  • Nausea/vomiting/indigestion with pain after eating
  • Abdominal or chest tenderness and upper right upper side pain (from liver distention)
  • Shoulder pain or pain when breathing deeply
  • Bleeding
  • Changes in vision
  • Swelling

Along with all of the indicators I mentioned within my story, I also looked back and realized I had so many other signs of this condition, like occasional blurry vision throughout my third trimester.

Please, be aware of the dangers and signs of such complications, especially first-time mothers. Ask questions, repeat questions, and don’t leave your appointments until you have a full understanding of your pregnancy, check-ups, ultrasounds, tests, etc.

Also, women with a history of HELLP syndrome are at an increased risk of all forms of preeclampsia in subsequent pregnancies. Seeing that I am now in the first trimester of another pregnancy, I was told that I have a 50 percent chance to develop HELLP again.

Though I will continue to pray for the odds to be in our favor, I will also be tremendously diligent with my care throughout this pregnancy & birth journey, so stay-tuned!

x. Heather

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1 Comment

  1. Brittany says

    I love hearing when a mom knows what she is talking about! Having worked in the NICU with a high acuity we actually see this more times then I woukd ever like to see. I will give you a little clue. Thae job of magnesium sulfate is to relax everything in you so to speak, so the reason most like Bella came out not breathing is because that it is transferred across the placenta to her so just like you it relaxes them so much they tend to not breathe. Most of the time if they do not require assitive means to help them breathe they get over it pretty quickly. But when I am called to a delivery of a mom on magnesium sulfate that is the first thing my mind goes to is that little peanut has a good chance of coming out not breathing. Mag is a nasty drug and so is HELLP syndrome so I appluade you and your story because it is not easy being in that situation and its not easy potentially being in it again. Si congratulations on this pregnancy!

    Like

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