The "un-cut" story of my quest to have a second child, from being labeled a "habitual aborter", to having a baby at 24 weeks gestation and our roller coaster ride through the NICU and beyond....

My name is Cori and I’m the mother to two wonderful boys.  My first son, Jake, was born one month early at 36 weeks gestation due to pre-eclampsia.  I was very young and scared.  Jake, however, was born weighing 6 lbs. 7 oz. and was able to come home with me.

Seven years later, I attempted to have another child.  I had remarried and my husband and I had one son each; we wanted them to have another sibling.  I became pregnant almost instantly when we tried.  Things were going well and though we were keeping an eye on my blood pressure, everything looked good.  At about 8 weeks into the pregnancy, I went in for a regular sonogram.  Through a vaginal sonogram it was determined that I was in the process of miscarrying at about the 4th to 5th week.  I was heartbroken, but vowed to keep trying.

Three months later, I became pregnant again.  This time I was scared to death and didn’t tell anyone (friends or co-workers) until I hit the "magic" time at 3 months.  I was very excited and was eagerly anticipating the arrival of my 2nd child.  At some point, all of the signs of pregnancy disappeared.  Panicked, I ran into my OB’s office, husband in tow.  I did not want to face this "loss" alone.  Another vaginal ultrasound that, again, showed my baby had died somewhere in the 8th to 10th week.  My husband and I just both sat in the exam room and cried.  They offered to let me miscarry naturally or do a D&C.  We chose the D&C, because I didn’t want to sit home and cry, just waiting for my traitorous body to expel this so badly wanted child.

After the D&C I was told to wait about 3 months before trying again.  I wanted my doctor to run tests and find out why my body could not carry a baby.  He kept telling me that after 3 miscarriages, then we would have "reason" to justify infertility tests.  I was furious, but decided I would try again.  I was also diagnosed as a "habitual aborter."

Around 3 months later I became pregnant again.  I didn’t even tell my husband for fear of losing this one, too.  It was during Christmas and we were around my cousin who had a beautiful baby girl.  It was so hard to be around her and not just cry my eyes out for what I had lost.  While we were at my aunt’s home, I begin bleeding again.  I was probably only 4-6 weeks along, but it still hurt.

Infertility Tests, Tests and more Tests
I went into my OB’s office armed with all sorts of articles from the internet about different reasons for miscarriages.  He was very open to reading and discussing them and we agreed to go ahead with the testing.

The first test was a Hysterosalpinogram (HSG).  It is essentially an x-ray procedure in which a radio-opaque dye is injected through the cervix into the uterus and fallopian tubes.  This "dye" appears white on the x-ray, and allows the radiologist and doctor to see if there are any abnormalities, such as an unusually shaped uterus, tumors, scar tissue or blockages in the fallopian tubes.  I was told that it would be mildly painful, sort of like cramps.  In my experience, it was VERY painful and uncomfortable.  I was so relieved when it was over.  This test showed no abnormalities, so we moved on to the next test.  On a positive note regarding the HSG, it has been proven that this "dye" somehow makes the uterus more susceptible to allowing an egg to attach to the uterine wall.  I held on to this information with a ray of hope although my problem hadn’t been conceiving, but maintaining a pregnancy.

The next test was an endometrial biopsy.  This procedure involves scraping a small amount of tissue from the endometrium shortly before menstruation is due.  This test is used to determine if a woman has a luteal phase defect, a hormonal imbalance that prevents a woman from sustaining a pregnancy because not enough progesterone is produced.  For me, this test showed that my body was NOT producing enough progesterone.  Finally, we were getting somewhere.

Next we did some blood tests to see if I had an autoimmune disorder.  Autoimmune represents the immunilogic response of the mother to a pregnancy ("self-immune" problems.)  Autoimmune disorders that can cause rejection of a pregnancy mean the woman is rejecting her own proteins - in other words, treating them like they are an invading illness.

I was tested for Antiphospholipid Antibodies (APA) and lupus-like anticoagulant.  Both came up positive.  The APA antibodies themselves do not cause miscarriage, but their presence indicates that an abnormal autoimmune process will likely interrupt the ability of the phospholipids to do their job, putting a woman at risk for miscarriage, second trimester loss, intrauterine growth retardation (IUGR) and pre-eclampsia.  About 4% of women with recurrent miscarriage test positive for lupus-like anticoagulant, which I did. Women with the LAC antibody are at high risk for implantation failure, due to the blood clotting too fast. When this occurs, the pregnancy is interrupted by a spontaneous abortion, usually during the first four months.

Now that I knew what I was facing, my doctor and I devised a plan.  I was to start immediately on baby aspirin to thin my blood.  Once I conceived, then I was to begin taking prednisone, a steroid that acts as an immunosuppressive.  Aspirin therapy, sometimes in concert with prednisone in severe cases, can increase blood flow to the placenta by inhibiting the tendency for clotting in women with abnormal levels of autoantibodies.  He also prescribed progesterone suppositories to increase my hormone levels needed to sustain a pregnancy.

Pregnant AGAIN!!
In February of 1997, I conceived Bo, my miracle baby.  By this time, I knew what I needed to do to hopefully achieve a successful pregnancy and began the drug therapy.  I took the medications religiously and prayed that these would get me through this last chance of a normal pregnancy.

The pregnancy progressed smoothly.  I gained an outrageous amount of weight due to the steroids, but I was okay with this because I would hopefully get a baby from it.   Because of all the previous miscarriages, I was monitored very closely and had sonograms done on a regular basis.  During one of the many ultrasounds, we found out that I was carrying a boy and we decided to name him Bo Robert Smith.

At 15 weeks, while at work, I began to bleed.  I rushed home in a panic, thinking all along that I was miscarrying.  My doctor’s office told me to come into the office immediately.  My husband and I arrived and were escorted back to the sonogram room.  We were both terrified of what we would see.  I was crying and praying and hoping against hope that everything would be okay.  The doctor did a vaginal sonogram and then promptly removed it, stating that it looked like I had "placenta previa".  An external ultrasound was done and it confirmed the placenta previa and, more importantly, that the baby was fine.

In cases of placenta previa, the ovum implants on the weaker lower portion of the womb, causing the placenta to grow over all or part of the cervical canal.    As the placenta grows and becomes heavier, the weaker portion of the uterus is not able to offer sufficient support.  The placenta may stretch and thin out, and as a result, could tear and begin to bleed.  Painless bleeding, in either the second or third trimester, is the only symptom of this potentially life-threatening situation for both mother and baby.

At this point, I was admitted into the hospital until the bleeding stopped or slowed down.  I spent 1 week and 1 day in the hospital in bed, only getting up to use the restroom.  During this time, I missed my first son, Jake’s, 7th birthday party, which was severely depressing.  I cried the whole day and even when they came to see me after his party and brought pictures.  I was so depressed and scared.  My husband insisted on staying with me every night, because he was afraid I would die and he wouldn’t be there.  This was such a stressful time for all of us.  My son stayed with my mother and my husband's son, Cy, went to stay with his mother in Oklahoma.

While I was in the hospital, I was taken off the prednisone, progesterone and baby aspirin.  I remember hating to go to the restroom, because I was always so afraid of what I might find each time.  Slowly, the bleeding began to taper off and I was allowed to go home.

My instructions for home bedrest were to stay off of my feet.  The bleeding was still present, but it had turned to "old" blood and it looked like it would stop at any time.  For nine long weeks, I stayed home and worried.  I was still going to see my doctor on a regular basis and at one appointment after an ultrasound, I was told that the placenta had moved up.  I was very excited with this news, but still a little surprised, since I still had some spotting.  Another look at the ultrasound and it was determined that I had a blood clot "sitting" over the top of my cervix.

Since this wasn’t as serious as the "previa", we were all able to relax a little.  My bedrest was modified and I was allowed to take my sons to football practice and sit and watch.  I felt like I had won the lottery.  I wasn’t used to this much freedom!  I was finally starting to "show" and went out and bought all kinds of cute maternity clothes.

On August 12th, my 29th birthday, I went and had lunch with some dear friends from work to celebrate.  I ate like a horse and they enjoyed me looking pregnant.  When I had left work to begin the bedrest, I hadn’t been "showing" at all, so they got a big kick out of it.  Of course, I was very proud and happy and really enjoyed our lunch.  That afternoon, while I sat and watched television, I felt like I had started my period and went to the restroom.  Once again, I had started to bleed.  It wasn’t bad, but it was very fresh blood, which scared me too death!  I immediately called my OB and we once again rushed to the hospital.  Another ultrasound showed that the baby was okay.  My doctor said it was probably just left-over blood from the previa, but just in case, they’re going to admit me for monitoring.

I was put into a L&D room and they hooked me up to a fetal monitor and blood pressure monitor.  Bo was still so small that they had trouble keeping track of him in the womb.  The nurses would get a good reading of his heartbeat and then he’d go swimming off.  It was really quite comical and I was relaxed because I wasn’t sensing any imminent danger. During this time, my husband had brought the other two boys and we all sat in the room together.  He went to get us something to eat and my son, who was 7 at the time, absolutely refused to leave my side.  He kept watching the fetal monitor print out and listening to Bo’s heart beat. Finally the bleeding stopped and everything looked fine, so I was able to go back home.

That night was uneventful, but the next day was another story.  That evening I began to feel the same way that I had the night before.  Another trip to the bathroom with worse results.  I was bleeding again, so I called the doctor-on-call since it was after hours.  He told me to come on in, but I talked him out of it because I was sure it was just going to be a replay of the previous night.  I promised to come in if the bleeding got any worse.  So, I propped myself on the couch, feet up and started to try and relax.  Next thing I know, I felt a gushing feeling and ran to the restroom.  Sure enough, I was bleeding so badly that I was passing large clots of blood.  This all began at about 10:30 at night, so both boys were in bed asleep.

My husband rushed me to the hospital again after waking Cy, who is 14, and telling him we were leaving.  They had school the next day, so we didn’t want to drag them out again.  We got to the ER and they had trouble locating my doctor, but finally found him and we were sent to a room up on the L&D floor again.  The admitting person asked if I wanted a wheelchair, but I said that I could walk.  I was still thinking it’s just a replay of last night and so my husband and I are joking and laughing on the way up.  By the time we got to my room, my pants were soaked through with blood and then I started to panic.

The nurse hooked me up to all of the monitors again and had me lay on my left side.  My blood pressure was through the roof at this time and they were getting concerned.  I’m was just in for "monitoring" so the doctor didn’t even stop by.  As I lay there in the hospital bed, I kept feeling gushes of blood.  No matter what I did, it wouldn’t stop.  The nurse kept coming in and trying to clean me up to no avail.  My husband, meanwhile, was sleeping over on the couch.  We had nothing to worry about, right?

Finally, I told the nurse that I insist she page the doctor and get him up to my room immediately.  He showed up about 30 minutes later and started explaining what was going to happen.  He brought in a sonogram machine and he verified that Bo was still doing okay.  He said that the bleeding was not slowing down, so he wanted to transfer me to a hospital with a Level III NICU, just in case.  In my denial I kept telling him that I would stop bleeding and everything would be okay, but if it made HIM feel better to transfer me, then okay.  On a side note, I had never met this doctor before, even though he was in the same practice with my doctor, so I was a little concerned.  The doctor asked me what I wanted done if we had to deliver Bo.  I wasn’t sure what he meant, but that if he was asking if I wanted him to save my baby, then yes, do whatever is necessary.  I was shocked that he had to ask and he explained that some parents choose not to resuscitate and let nature take its course.  However, I was still positive that this would not end with me delivering my baby at 24 weeks, so I wasn’t too concerned.

He told me that he had called my doctor and that he was planning on meeting us at the other hospital.  I finally told him to explain to my husband what was going on, because I just couldn’t think clearly or speak at this time.  So we woke my husband up and explained what was happening.  Of course, our car needed gas, so he waited until the ambulance came to get me and then he rushed off to get gas.  This was my first ride in an ambulance and I was kind of excited about it.  I asked the driver why they weren’t using the siren and they explained that the siren will usually cause distress, which was NOT what I needed as my blood pressure was still sky high even with me lying on my side.

By the time that I arrived at the other hospital it was about 3 or 4 in the morning.  I was rushed to an OB/GYN Critical Care Room.  When I saw that sign, I finally realized that I was probably in real trouble.  They began hooking me up to all of the monitors again and were having trouble finding little Bo.  The doctor came in and was able to find him right away and we went ahead and did another ultrasound.  Everything looked okay, except for the heavy bleeding.  At this point, my husband and I decided to call my mother and she and my stepfather rushed over to the hospital immediately.

My mother and stepfather had just come into my room when Bo’s heart-rate slowed dramatically.  I looked over to the nurse with a panicked look and she assured me that it was probably just due to him flipping around and tangling in the umbilical cord.  I relaxed a little and started explaining to my mom and stepfather what had been happening.  At this point, the nurse turned the monitor down, so that I couldn’t hear it anymore and calmly tore of the sheet with the heart-rate read-out and then left the room.  I was still oblivious and still certain that the bleeding would stop at anytime.  The way I figured it was that I’d most likely have to stay in the hospital again until the bleeding stopped.