My Two High-risk Pregnancies

Before Gang and I planned to have a baby in 2013, I had never expected myself having anything to do with “high-risk” pregnancy. I was young and healthy, no genetic disease, and women in my family never had any problems with conceiving or delivering.  Even today my mom is still proud of her intense physical exercises when she was carrying me.

Things went smooth at the beginning too: I got pregnant and saw a little heart beating in the uterus during my first OB visit. We shared the news with our family and friends immediately, hearing their stories of how to raising kids and imagining how our baby would look like in the future. Every office visit went well; every test result came back fine. The only thing that bothered me was morning sickness, which also started to disappear after the first trimester.

Then something weird happened in my 25^th week. It was an afternoon in October; I was working in my office as usual, packing my things up and getting ready to run for the BART. Then I found I was bleeding. I didn’t know why it was happening or how serious it could be, so I called an ambulance immediately, which took me to the nearest hospital. I was told that I might have a preterm labor due to frequent contractions and therefore transferred to Alta Bates Hospital in Berkeley which can handle situations like this.

I received magnesium for two days, a medication to slow down contractions for women with preterm risks. Then I was told that they couldn’t find out why I was bleeding and they couldn’t identify the bleeding spot. But I was told that they ruled out the bleeding caused by placenta detachment, which was their biggest concern. I was discharged three days later and told to rest as much as possible.

I followed the doctors’ instructions and went home. I still couldn’t believe that I was suddenly considered as a high-risk pregnant woman, but I was confident that I should be fine. However later that night, I started to feel more frequent and stronger contractions. I started to realize that something may be wrong, but in spite of all the discomfort I didn’t see any bleeding or spotting, which made me hesitate to go back to the hospital. Finally I couldn’t stand the pain and we ran back to ER, where they found out my placenta was completely detached from uterus and my baby already died. And because the placenta blocked cervix, all the blood stayed in my uterus and I failed to observe them.

That was the most dangerous moment in my life. I didn’t even have time to cry for my baby girl: I fell into coma soon and woke up two days later after an emergent surgery. I lost 2-liter blood and was very sick for a long time. Later I learned that my case was further complicated by pulmonary edema, which happened 1 in every 5,000 blood transfusion with a fatality rate of 9%. But luckily, my lungs finally recovered and surgeons were able to avoid a C-section and left no scar in my uterus. I was told that I could get pregnant again in three months.

Placental abruption happened to less than 1% pregnancy, and it was even rarer for healthy women (no high blood pressure, or diabetes, etc). And even it happened, it usually detached slowly from the uterus over a long period, giving mama and doctors enough time to respond. While in my case, it was completely detached and it happened very quickly – more quickly than any of us could respond. Doctors were not able to find out the reason, but they believed that pressure and tiredness can be a potential cause. When I think about the few days before the accident, I was working late to meet a deadline, and I did feel tired every morning when I got up to catch the 6:50am BART. Maybe my body was already sending me warnings, but I was too busy to notice them.

(And for those who are interested in testing your math, here is a good question. The probability of having placental abruption during a pregnancy is 1%, and 5% of these placental abruptions are considered as severe. Let’s say 89% of women with abruption receive blood transfusion, and 0.02% of blood transfusion causes pulmonary edema. What’s the probability of having a severe placental abruption and pulmonary edema at the same time? And if the probability of having placental abruption is randomly distributed among pregnant women, think about the total number of your female friends, what’s the probability of you knowing anyone with this experience?)

Therefore I became more careful when I was pregnant again in October 2014, one year after my first miscarriage. The previous experience changed my opinion on pregnancy: it’s no longer a natural, easy process, but something that needs intense care and extra attention.  This pregnancy had a less optimistic start. During my first visit, I was told nothing was observed and we should come back one week later to try our luck. A week later, we finally saw a little heart, tiny but beating strongly in the uterus. What a relief! MY OB also explained to me that because of my history, I may want to be extra careful with this one, and follow up with her more closely. After the first few prenatal visits, I talked to my manager that I wanted to change my job to a part-time one. Luckily he was very understanding and was flexible with my schedule. But then things got worse, I had to work from home to spend more time resting in bed. And a month later, even wfh became impossible, and I was completely off work until delivery.

Bed-rest is not as comfy as it sounds. Spending the entire day, entire week or even the entire month on bed is horrible. But things started to get better in May and I started to walk around a little bit. I even tried to wfh again in early June, which seemed to be a bad idea – a week after I started working, I was sent to emergency room again due to frequent contractions and high risk of pre-term labor. Doctors were not able to find out the reason for my frequent contractions, and they were concerned about my blood work result: one result showed that I might be experiencing some internal bleeding, and they were worried that my placenta might be detaching again. Therefore they decided to keep me in the hospital for observation. Luckily my placenta stayed well for another month until Alby was induced. Alby was born a little premature, but we are very grateful that he arrived safely and healthy.

I do not write this article to scare anyone about pregnancy. I only want to say, pay attention to your body and do not over trust yourself. Sometimes we are more vulnerable than we thought we are. And always get enough rest when you are pregnant.  Also I wish there are more supports for pregnant women in the US: I was lucky that I have a supportive OB who wrote notes to put me off work for half a year, and a considerate manager who approved my disability leave, and also the fact that I live in California allowed me to collect some disability benefits to pay my rent; but I know a friend who also experienced a high risk pregnancy but wasn’t able to get any rest at home because she was in a state without any disability leave. I can’t even imagine what would happen if I continued working during this pregnancy, and I’m glad that both my OB and I were more alert this time and were able to address any changes timely.