Another Bleed, Another Midnight Trip to the Hospital

Headline: I am okay and the baby is okay. For now.

So there I was, minding my own business, lying in bed wasting time on the Internet when I should have been making progress on my book club assignment, the cat curled up next to me, and it occurred to me that before I nodded off to sleep I should use the bathroom. I'd had a huge glass of water earlier, and who likes to wake up an hour after they fall asleep to go pee? I went, and I looked at the toilet paper, and... no. NO!!! Red blood. A goodly amount of it. And, a moment later, a clot about 1/2" across.

I walked back into the bedroom and was about to look up my OB's number when I realized I knew it by heart. The answering service took down my name and information and put me in touch with a very nice doctor in their practice who I'd never met before. I was oddly, supernaturally calm as I explained what was going on and gave her the ten-second history of this pregnancy: G1P0, 21w1d, tubes blocked from endometriosis, subsequent IVF, DVT at 5 weeks, SCH at 9 weeks, complete placenta previa, red blood and a clot, blood seems to be slowing down, should I go to the Emergency Room? No, she said. You should go to Labor and Delivery.

I'll pause for a second to let you take that in. Labor and Delivery. At 21 weeks. As I drove to the hospital, hating every song the radio station played because I knew I'd forever associate it with this moment, I got ready to hear: There's nothing we can do for you. We've made a certificate with the baby's footprints for you to take home. Would you like to speak with the Chaplain?

Harry met me at Labor & Delivery and, mercifully, led me right back to the triage unit where they were expecting me. They led me to a little room with a whole bunch of monitoring equipment that I could just tell was meant for a much larger bump than the one I sported. A nurse came in with a Doppler and tried to find the baby's heartbeat - over and over, putting it on different spots on my belly, and distinctly not hearing the familiar thumpthumpthump that my OB has always been able to find on the first try. Harry and I were quiet, me thinking silently "But I can feel the baby moving, he can't be dead! Oh G-d, maybe this is what early labor feels like! Or maybe I've been wrong the whole time and that's not fetal movement at all!" Finally I said out loud, "Is there any way we can check with the ultrasound? The suspense is killing me." She agreed and brought in the ultrasound, which was turned off so we all sat there as the machine booted up. Seriously, I guess it runs off Windows because it was going through all the screens and hourglasses and everything, and I have never hated a computer more than I did at that moment.

The ultrasound showed within seconds that the baby was fine. His heartbeat sounded strong and regular, he was just curled up against the top of my uterus. Oh, now he's moving around and his heartbeat can be heard over here. Wait, now he's over here, try this spot. By this time two separate doctors had seen him on the ultrasound and they both remarked that he was a very active baby! Sigh of relief #1. They also saw, wonder of wonders and miracle of miracles, that there was no placental abruption and my cervix was long and closed. I wasn't contracting (I hadn't felt any pain the entire time, which obviously was a good thing) and the bleeding appeared to have stopped. Sigh of relief #2.

The final doctor who examined me was the OB I had called earlier that night from my practice. She did a speculum exam (don't want to irritate that cervix further by rooting around in there!) and said that everything looked okay although there was still a small amount of blood visible. It could have been any number of things that caused the bleed, ranging from a random event aggravated by the Lovenox to a final clot coming down from the original sub-chorionic hemorrhage to the classic problem of placenta previa: painless bleeding caused by the cervix dilating slightly. Basically, there's no good answer. I didn't bring it on by doing anything (for heaven's sake, I was lying around reading blogs and watching YouTube videos, about as sedentary as it gets) and the only thing they could recommend was that I take it very, very easy over the weekend. I'm off the Lovenox for now so nobody was willing to actually say the words "bedrest," and they emphasized moving around my legs as much as possible without using my abdominal muscles or exerting myself in any way. And, just like that, I got to go home. Total time door-to-door: 2 hours.

I left Labor & Delivery with my baby still alive inside me and an appointment with my OB on Monday. Not a bad outcome given what I was steeling myself to face earlier that night, but who are we kidding, this was not a good thing. Do I need to tell you that bleeding in two different trimesters significantly raises my risk of any number of other complications, including preterm delivery? Do I need to mention the statistics surrounding complete previa when the first bleed appears at 21 weeks? Should I cite the research about infant survival at a gestational age of 24 weeks (my new so-close-yet-so-far-away, crossed-fingers-and-toes goal)? Probably not.

This entire experience has been such a rollercoaster. I didn't know that my infertility blog would turn into a complicated-pregnancy blog, and I'm trying to prepare for the possibility that it'll turn into a pregnancy loss blog in the next few days or weeks. We had about five weeks recently where things were stable and we started seriously thinking about having a baby come fall - planning a shower, signing up for a birth/parenting class, actually buying a onesie. I was beginning to visualize myself with a giant belly, fantasizing about holding our son for the first time, wondering if the previa might clear so I'd have a shot at a vaginal delivery. Now my best-case scenario involves CPAP, an NG tube, surgery for ROP, cerebral palsy. And my worst-case scenario, well, I can't even bring myself to type it. I really, really don't know which way this will go. But I'll let you know as things unfold.