Pregnancy, Part 6

April 1, 2021 Roxanne Bogalis

*I want to post a TRIGGER WARNING that this post, and the subsequent parts will detail infertility issues, death, preterm birth, hospital/medical bias, and other subjects that might be triggering for some. There will also be pictures of premature infants which (from personal experience) can be triggering. I will post this at the beginning of each part.*

The next morning I woke up feeling great. I had been at the hospital for almost 5 days, and it seemed like the baby was staying put. The nurse on shift was a blonde, very pregnant woman. She told me that on the weekend shift they schedule c-sections, and because of it she only had me, who was on bed rest, and one other patient who was also on bed rest. She placed me on the contraction monitor. By this point I only was getting monitored once a shift. She said so far I had been stable with no contractions. I asked her if I could have my IV removed since it looked like I would be there for the foreseeable future, and did not need it. She told me she would ask the doctor, and get back to me.

At morning rounds the doctor came in. It was the same doctor who had admitted me. She gave the nurse permission to remove my IV. She quickly left, and I was free to wait for my friends to visit. My partner was still at work, but I knew that he would be coming to see me shortly as well. My sister was still with me so we chatted a little, but basically did our own thing. Time seemed to drag by.

Shortly before lunch time I started feeling uneasy. Something felt off. I went to the restroom, then got back in bed. I drank some water, changed positions, and listened to music to see if I would feel better. I called the nurse on the intercom. I asked her to hook me up to the contraction monitor as I was feeling uneasy. She seemed annoyed that I asked to be monitored. When I tell you this nurse took her sweet time coming to my room I am not exaggerating. It took her about 20 mins to get to my room. Once I was hooked up she waited 30 mins, then expressed that I was not having contractions.

I tried to put my mind at ease, but I still felt off. I tried to sleep, but I still couldn't sleep. I called her again on the call light. She responded over the intercom. I told her, "Something is wrong. I don't feel good. I feel like how I felt when I first came here." She said, "The monitor showed uterine irritability, but no contractions. Maybe you just need to use the bathroom." I explained that I had already been to the restroom, and that I still felt off. She suggested I try again. Annoyed I went to the restroom.

While in the restroom I tried to pee. A small trickle came out, but nothing more. I decided to wipe, and head back to bed. When I wiped the toilet paper was covered in bright red blood. I quickly flushed, washed my hands, and got back to bed. I called the nurse on the intercom again. "I went to the restroom, and I'm bleeding," I said. "What kind of blood," she replied. Exasperated I said, "I don't know it was red blood." She told me she would talk to the doctor and get back to me.

I knew that my partner was on his way in at this point. I called him choking back tears. "Are you almost here?" He responded that he was at the light, and would be there in about 10 minutes. "When you get here can you please find the doctor? This nurse is not taking me seriously. I told her I don't feel well. She told me to use the bathroom. When I did I was bleeding. I can't get up to find the doctor on my own." Calmly he responded that he would find the doctor and "set it off" if need be. That gave me a little chuckle because my partner is usually the calm and collected one.

After I got off the phone with him the doctor entered shortly. This was about 15 mins after I had spoken with the nurse. She walked in, and told me she wanted to check me to see why I was bleeding. I laid down, and got to the edge of the bed. When she pulled her hand back it was covered in blood. "Mom, you're fully dilated now. Your bag of waters is bulging. I'm going to get the ultrasound monitor to see if baby is head down. You're going to have to have her today." She put me back in trendelenburg position and left the room.

At this point the nurse stayed at my bedside and started typing notes. "What is your pain level like right now," she asked. "Around an 8." She casually stated, "Really? You don't look like an 8." In nursing school they tell us that pain is subjective. We were told that whatever number a patient gives us we need to trust because everyone has a different tolerance. In actuality my pain around that time was closer to a 5-6, but I once was told to add 2 points to how I feel because my pain tolerance is high. Once she finished typing her notes, under her breath she stated, "I wasn't expecting to have a baby today." I don't think she meant for me to hear her, but I was so angry I replied, "Neither was I!" My bedside phone rang around that time. It was security letting me know I had visitors, and if it was ok to send them up. I told him that I was in labor, and they would have to come back another day.

The doctor entered with the bedside ultrasound machine around this time. The baby was transverse (lying sideways). She told me they would have to prep me for a c-section because if my water broke my cord could prolapse putting the baby at risk. She asked me when the last time I ate was. I told her it had been about 4 hours ago. She told me that most likely I would vomit during surgery. and to be prepared for that. She asked if my partner was on the way because they would need him to prep for the OR quickly. I called him, and he was in the process of parking the car. In the meantime an IV team was sent in to place a new IV. Because my veins were horrible for IVs on my left arm and both hands, and the IV had just been removed from my right arm, they placed the IV to the right of my elbow on the inner side of my right arm. Personal opinion that spot was decidedly more painful than an IV in my hand.

When I got to the OR they sent my partner in to prep. Partners are not allowed back when you are getting your spinal/epidural. They sent in the head anesthesia doctor who is supposed to be "the best". I have scoliosis in my lower back, and they knew placement would be difficult. I wasn't allowed to sit up for placement because of the concern with the bag of waters. They had me roll to my side to try and place the spinal. The first attempt at placement was intense. I waited for the "instant pain relief" everyone spoke about. It didn't come. "I didn't get it in the right place. I'm going to have to remove it, and try again," the doctor stated. Ok. I can do this I thought. Just deep breaths. By the fourth attempt I was in tears. This was horrible! By the fifth attempt I begged the doctor to just knock me out. I told her, "I don't care if I don't hear the baby cry." I couldn't handle this anymore. She told me that they had to do a spinal because if they put me under it could effect the baby. Finally after six attempts the pain was gone.

When they wheeled me back to the OR it was complete chaos. I don't remember how many people were there. They prepped me for surgery, and made the first incision. I immediately started vomiting. I turned my head to the side, and it felt like I was choking on it. I couldn't feel my muscles contracting. They felt like they were pushing through wet sand. I started panicking because I felt my chest getting heavy, and as if I was not getting enough oxygen despite being on oxygen via nasal cannula. The anesthesiologist told me once the baby was out she would put me under. A few minutes later I heard a tiny kitten cry, and the doctor stated the baby was out. She told me to take a quick look, but I was vomiting too much to turn my head to see. The baby was whisked away, and everything went black.

Stay tuned for the next part! Catch up on previous parts here: 1 2 3 4 5

Pregnancy, Part 5

April 1, 2021 Roxanne Bogalis

When shift change happened I expected the doctor to come to see me around 10 am as usual. The doctor didn't end up coming to my room until mid-afternoon. The doctor was a tall, heavy set African man soaked in cologne. If you know anything about pregnant people the sense of smell is heightened. While the cologne smelled nice it was sickeningly sweet, and way too overpowering. The doctor was pleasant, introduced himself, and did something I never expected; he sat on the edge of my bed. I think he was trying to seem friendly and put me at ease, but it was very odd. I still don't know how I really felt about it.

As he sat on the bed he asked, "Mom, I hear you want to leave this hospital. and be transferred to TGH. What happened? Why do you want to leave?" Him being that close, with that overpowering cologne, was a little intimidating. I wanted to be a tiger and roar my response, but choking back tears I replied, "I want to have a natural birth. If I have to have a c-section I want to be able to have a VBAC with my next baby. The doctor who was here yesterday told me she would give me a classical incision if I went into labor, and that I would not be able to have a VBAC. I understand this hospital is not VBAC friendly. I know that TGH is VBAC friendly so I'd rather deliver there where I know they would try to honor my wishes."

"Mom," he said, "We're not going to let that happen. We don't immediately go to c-section, and if you have to have one we can make sure you can have a VBAC. I will put it in your chart. You cannot be transferred because you could go into labor in the ambulance, and your baby would be at risk. I'm sorry, but you have to stay. Did you have any food yet?" I shook my head no. I was too close to tears, and knew if I opened my mouth I would start crying. "I'm going to have your nurse get you food. You're going to be able to eat. We will also stop the magnesium, and remove your catheter. You can get up to use the bathroom, but you need to get back in bed immediately after."

I just nodded. I had nothing left to say, and no more energy to give. I had tried. I advocated for myself, and was shut down time and time again. After the doctor left I let go, and had a good cry. Everything was just too much. By now I had been at the hospital for about 60 hours, and had not eaten for almost 72 hours. I was having my first meal since being there. It was pleasant to get up, and use the restroom, but I had little else to make me feel better. The nurse came later to give my medicine. She asked if there was anything they could do to make me feel better. I told her I missed my dog. She told me she knew that sometimes dogs could come to the hospital and she would ask the doctor.

A few hours later the nurse returned to my room, and told me the doctor said my dog could visit for a few. I was so shocked I had my partner bring my dog immediately. I did not want to risk that they would change their mind. That night was probably the most pleasant night of my stay. Later I found out they didn't follow all the hospital protocols to allow my dog to visit, but that one hour he was there definitely helped lift my spirits.

The next day (11/13/15) went by somewhat uneventfully. I honestly don't even remember what doctor was on that day, or even if they came to see me. There was another patient who had entered the hospital the day before me, and was on bed rest with threatened preterm labor. I heard her screaming in the next room over. I was not aware until later, but she went into labor that day. I didn't think that boded well for me. I expressed my fears to my friends. They put together a "bed rest" entertainment package for me that they were going to deliver the next day. My in law's church family was also coming to visit me. I excitedly went to sleep that night looking forward to all the people I would get to see the next day. Little did I know all the drama the next day held.

Stay tuned for the next part! Catch up on previous parts here: 1 2 3 4

Pregnancy, Part 4

April 1, 2021 Roxanne Bogalis

Once I calmed down from the initial shock of being admitted I updated my friends, and online support group about my situation with the baby. I lamented that I hadn't had a baby shower yet, and didn't have anything ready for the baby. I had assumed I would have more time. Everything felt like it was coming so fast, and was completely out of my control.

A different nurse came into my room. My bed was put in trendelenburg position (flat on back, feet above head, head toward ground in a 15-30 degree incline). I was given a catheter, and an IV. They started magnesium sulfate, told me I was not allowed to eat, or leave the bed, and was given a surfactant injection to help mature the baby's lungs, procardia to stop my nonexistent contractions, and also because my blood pressure (BP) had skyrocketed. Because of my BP they started a 24 hour urine collection to test for protein in my urine. I have white coat syndrome, so I honestly was not surprised my BP was so high. I was told that in the morning if I had not had the baby yet, someone from the neonatal intensive care unit (NICU) would come talk with me about my expected outcome.

They contacted my midwife for my records. Because my EDD and ultrasounds did not match the hospital's records they called in a specialist to review my records. This changed my due date to 2/10/15 which pushed me back a day on my gestation. This normally would not be a big deal, but the difference of a day can make a difference in the interventions some hospitals allow to save your baby. Many hospitals will not attempt to save your baby if you are less than 24 weeks.

Everything calmed down by around midnight. The doctor returned to cheerfully tell me that my drug test came back negative (duh), that she would be on for the rest of the night, and I would have a new doctor at 7 am. At this hospital the doctors ran in 24 hour shifts. I struggled to get to sleep on the uncomfortable delivery bed, in such an awkward position. I was sad, worried, and confused. I decided to spend my time researching prematurity, what my expected outcome could be, and again the stillbirth day website. I called my mom at some point during all this, and she prayed and tried to calm my fears. She reminded me my cousin was born around this gestational age, and went on to live a healthy life without complications. My triplet mom friend promised to come see me the next day.

Around 6:30 am I finally dosed off for about an hour. The new doctor came to do rounds around 10 am. It was a black female doctor. Now by this point I knew better than to get my hopes up, but in a crisis you will seek any port in the storm. The doctor told me that so far I was stable and my urine test came back negative for protein. I expressed that I wanted to have a natural birth, and that if I had to have a c-section I would want to be able to have a vaginal birth after cesarean (VBAC) with my next baby. The doctor replied, "As of your last ultrasound baby was head down. Because of the gestational age of the baby it's too risky to have a vaginal delivery as the baby could change positions before you pushed them out. I would need to give you a c-section. Also because you're only 27w your uterus is too tough for a bikini cut incision. I would need to give you a classical incision which means you would not be eligible for a VBAC in the future."

I honestly had no words. My first thought was "How could you?!? You're supposed to be on MY team!" I was in so much shock I just sat there processing the information. I talked to my partner, and after all that had happened already I told him I didn't want to stay at this hospital anymore. He agreed. Even though the next hospital was 20+ minutes from our house it just wasn't worth all of this.

The neonatalogist came to my room. He was from All Children's Hospital which specializes in premature infants. He did 24 hours rotations at this hospital's NICU. He reassured me that this hospital was equipped to deal with premature infants, and that no transfers would be necessary for the baby. The thought of a possible transfer hadn't crossed my mind so I was happy to hear that. From the things I had researched I learned that breastmilk was the best form of nutrition for premature infants, and that those who received it had better outcomes. I asked the doctor if the hospital provided donor milk if I was unable to produce enough milk for the baby. He replied, "No we do not. Formula is just as good." I was honestly shocked. You're a doctor at another hospital that has strict protocols for prescribing donor milk to preterm infants, but at this hospital "formula is just as good". Erm no. The doctor then proceeded to give me all the worst case scenarios of my baby being born early, then left my room shortly after this.

Around this time I was told that they were going to move me to an extended stay room as I was currently in a delivery room. The room they moved me to had a pull out bed. My younger sister came to the hospital and stayed with me. Two, young, black CNAs came and gave me a bed bath. They were as professional as they could be. They tried to boost my spirits. I was more humiliated by being unable to care for myself than anything. They told me the nurse would come in, and put me back on the contraction monitor.

When the nurse came in, I asked her to have me transferred to Tampa General Hospital. She said she would talk to the doctor, and get back to me. I never heard from the doctor or the nurse for the rest of the shift. At shift change a different nurse came to give me my medication. I asked if I would be allowed to eat. She stated that was not possible at this time. By now I had not eaten for over 48 hours.

After the nurse left my triplet mom friend came to visit. She brought me a gender reveal cake, and a sign her kids had made with their hand prints., and footprints. She talked me through some things I could expect. She explained that doctors have to give all worst case scenarios so that if they happened we were not surprised. I wasn't allowed to eat the cake she sent, but I did taste the frosting at least.

By night time I still had not heard from the doctor. I knew by now she was ignoring me. I decided that I would talk with the doctor that came on shift the next morning. Someone was going to listen to me.

Stay tuned for the next part! Catch up on previous parts here: 1 2 3

Pregnancy, Part 3

April 1, 2021 Roxanne Bogalis

My visit to my midwife was on a Friday. Two days later, on Sunday, before disaster struck I was in so much discomfort. I don't want to call it pain because I've had much worse pain in my life. I called my mom, and expressed frustration with my situation, and how the midwife was handling it. My mom told me to put myself on bed rest. I did that for about 24 hours, but we needed to go grocery shopping. Our shopping trips take around 2 hours because we price check, coupon, and tally as we shop. I knew this was going to be a long trip, especially considering we hadn't bought groceries in a month.

When we got to the store I decided I was going to use the electric wheelchairs to take as much pressure off my pelvis as I could. Of course when we got there I could only find one wheelchair, and it was not charged. I decided to bite the bullet, and just get it done. By the time we got back in the car, my hips and back were screaming. I was in so much pain. Actual pain now no longer discomfort. I immediately went to bed, and had my partner unload and put the groceries away.

The next day (11/10/15) I woke up feeling a modicum of relief. I knew I needed to babysit, but it was around the time the child usually napped, so I could continue my bed rest on the couch. Everything was fine at that time. I had a counseling session to head to so I went immediately there. While I was waiting I started to just feel bad. There is not really any one symptom I can pinpoint. Something just felt wrong. I let my counselor know I was going to have to miss this session as I was going to the hospital. She chastised me for even coming in instead of going straight to the hospital.

I got in the car, and headed home. I called my midwife first, then my partner on the way, and let him know we needed to immediately head to the hospital. I explained to him that most likely we would not be having the home birth we prepared for. He asked me why I felt that way. I explained it was a feeling I had. Something wasn't right, and I was sure we were going to have an extended hospital stay. I text my triplet mom friend, and she gave me positive words of encouragement, and asked for an update when I had a chance.

The hospital I went to has a protocol where when you go to L&D the security guard has to tag you, and push a button to allow elevator access. When I got to the front desk I was almost doubled over with the earlier discomfort that had now become pain. I leaned against the desk, and explained I needed to be seen. "Who told you to come here," he asked. I explained my midwife sent me. "Who is your midwife?" Disgruntled I explained that my midwife was not a part of the hospital staff. He looked from the top of my face to my (nonexistent) belly and said, "I'm going to have to call them to see if it's ok to let you go back." By this point I didn't care. I was in too much pain to argue. Because I had been seen at 20w I was in the system, and they let me up. I'm sure the security guard did not think I was pregnant. Can't really blame him too much since it is his job to vet everyone who comes in. At 27w exactly I barely was showing a bump. I'm sure I looked suspicious.

As I walked with my partner down the long corridor to the elevator I lamented that at least he could have offered me a wheelchair when it was obvious how much pain I was in. I know my partner was trying to put on a brave face, but he was clearly upset too. When we got inside the elevator he pushed the button for L&D, and nothing happened. Puzzled he pressed the button several more times. By now we are both upset. He leaves the elevator. Not wanting to leave me alone he yells down the corridor that the elevator isn't working. There is a camera pointed at the elevator. I'm not sure what distracted the guard, but that pretty much set the tone for how the rest of my stay would go.

Finally we reached the floor. My partner went back down with the elevator to properly park the car as we were double parked. I was shown to a room by a nurse. She asked me to leave a urine sample in the bathroom, then get undressed, and get in bed. Now remember I said I had joined a birth group to talk to other birthing people? Because of this I was well aware of all the gross things that your body goes through while pregnant. When I wiped after leaving my sample I lost my mucus plug. Disgusted I flushed it, got undressed, and climbed in bed. This was quite possibly the most uncomfortable bed in the history of beds. I later found out it was a birthing bed that could drop away to allow the doctor access during delivery.

A different nurse comes in, and she was an older Asian woman. My spirits lifted a little. I was happy to see another person of color. Back then I was naïve to social justice, and lateral biases. The nurse was so nice to me. She explained the different monitors she was putting on me. I told her I had lost my mucus plug. She asked me if I had saved it. Puzzled I said that I flushed it, but there was no mistaking what it was. She continued on friendly as before. Everything changed when my partner walked in the room. Part of me wanted to believe I was imagining things, but my partner later expressed similar impressions. All the niceties went out the door. Her voice was no longer cheerful, but seemed annoyed. I brushed it off as maybe me projecting my anxiety on to her. I'll never truly know as I never saw her again.

When the doctor came in the room she washed her hands, and introduced herself. She was a Latina doctor, and I was again excited to be seen by another person of color. She listened to the report the nurse gave her on my status. The doctor looks at me when the nurse was complete and says, "You are not having contractions. It sounds to me like you're experiencing round ligament pain. It would be best for you to get a belly binder when you go home." Cue internal screaming "IT'S NOT ROUND LIGAMENT PAIN I DON'T HAVE A HUGE BELLY TO PUT ANY PRESSURE ON MY LIGAMENTS!" Outwardly I just grimaced, and waited for the doctor to continue, "I am concerned that you lost your mucus plug already. I'm going to go ahead and give you a check if you don't mind." I gave the doctor permission to check.

I have never had a pelvic exam while pregnant. Sure I've had pap smears, and the such, but when you're pregnant every thing is heightened. That was quite possibly worse than the pain that brought me there. When she was finished checking me she removed her gloves and said, "Well you are 100% effaced, and three centimeters dilated. Seems you're not going home after all." She began washing her hands while I looked at my partner because I was right this whole time, and should have gone with my gut. While drying her hands, and exiting the room, as the door was closing she said, "By the way we are going to drug test your urine because that's usually the cause of preterm labor." My mouth fell open. "Ok....?" I replied.

Stay tuned for the next part! Catch up on previous parts here: 1 2

Pregnancy, Part 2

April 1, 2021 Roxanne Bogalis

Before I ever tried to conceive I had done research on different birthing techniques, and providers. I had toured (online) birth centers, and had an idea of what center I wanted to go to. I discussed with my partner that I would most likely not go the "usual" route of doctors and hospitals because pregnancy is not an illness. My partner had already discussed a mistrust of Western medicine, and decided to defer to me (within reason) when it came to any and all medical decisions.

I had an idea of the local midwife I wanted to go with. I called her office to schedule the new patient walk through to see if my partner was also comfortable with her. She had a great reputation, and offered home birth. We were on the fence about home birth because we lived in an apartment complex at the time, but she set our fears to rest. I really liked that the office wasn't set up like a traditional doctor's office. Every thing was explained ahead of time, and any questions we had were answered. Because of my irregular cycles my midwife opted for a dating ultrasound.

When I went in for the ultrasound I was 10 weeks based off my last menstrual period (LMP). The ultrasound put the baby at 7w3d. I was a little concerned that the ultrasound was not accurate, but I had no knowledge of ultrasounds or how to read them so I had to believe what I was told. Because of this my midwife visit was pushed back as she did not see clients before 10 weeks.

So as I waited another 2+ weeks for my first official check up I tried to find all the information I could on what to expect. My only experience with pregnancy had been my mother who had horrible hyperemesis gravidarium (HG) where she couldn't keep down anything other than cactus water, had premature rupture of membranes (PROM), and a stillbirth at 28-29 weeks, and a best friend who had triplets at 25w3d. Suffice to say pregnancy after the second trimester was a mystery to me. Because I have a scientific mind I wanted to know what the developing baby looked like. I came across a website called "stillbirth day" that showed pictures of babies that did not survive based on gestational age. Probably not the wisest thing to do, but it oddly gave me a sense of peace knowing that if worst came to worst my baby would still be celebrated.

Around 17w I had a migraine for about three days. I am prone to them, but they had never lasted that long. I decided to forgo seeing my midwife, and just go to the ER. At the ER they told me that based on my LMP I was 20 weeks, and that I needed to go to labor and delivery (L&D) as they were not allowed to help me. At L&D I was given an ultrasound where they said I was indeed 20w pregnant, and that other than fluids there was nothing they could do about my migraine. Looking back I'm glad I established my pregnancy there as it would come in handy later.

Fast track to 25 weeks. I had met with the midwife. My partner liked her. We did parenting classes with her. We learned about home birth, and decided we would give it a try as her birth center was not completely finished yet, although it might possibly be by my estimated due date (EDD) of 2/9/2015. In the birthing classes they discussed hypnobirthing, which I had already researched and decided I would do, and breastfeeding. As much research as I had done on pregnancy I was completely ignorant about breastfeeding. You would assume with my scientific brain I would do more research on that as well. I chose not to. I knew my midwife had staff that would help if I needed it, and left it at that. I did research into hypnobirthing, and decided to go with the Mongan method because it fit better within our budget. After having done the Hypnobabies vs hypnobirthing method I would highly recommend paying the extra for Hypnobabies.

I had a perfect pregnancy up to the second trimester, outside of that one migraine incident. I had no morning sickness. No evidence of preeclampsia, and my gestational diabetes test was perfect. I gained no weight, but my uterus was in position, and baby was growing accordingly. We had no desire to know the gender of the baby, but our friends wanted to know. I had an ultrasound at a 3D place, because I wanted to throw a reverse gender surprise party for my friends. Two of my friends were there to get the gender and photos with the plan to throw a party later. Everyone who was invited would know the gender beforehand so they could plan accordingly. Right around this time I started having issues with morning sickness. My midwife tried to assure me it wasn't "a thing", but my inability to keep anything down, and 5 lb total weight gain thus far said otherwise. I was disgruntled with her response, and felt my concerns were no longer being addressed. I complained to my partner, but tried to stay chill because I wanted a "peaceful pregnancy".

Right around 26 weeks I started having some pain in my abdomen. It was hard to describe. It was like a sharp pulling, that was a continuous ache. It coincided with pain in my vagina. It felt like the baby was trying to kick their way out. I expressed this concern with my midwife. I asked her to check me for a UTI because I had them chronically in the past. My urine test came back negative. My midwife told me it sounded like round ligament pain, get a belly binder, and call her back if I experienced cramping or any bleeding.

Looking back I'm sure she believed I had first pregnancy jitters. In medicine there is a symptom called "feeling of impeding doom". That is the only description that fits how I was feeling at that time.

Did you miss part 1? Check it out here. Stay tuned for more.