Progesterone and Bed Rest

That is what saved my second child's life. Some would argue it was prayer, or God's will, but to be honest I don't put much stock in either of those things these days. No, I put my faith in modern medicine, and my faith was rewarded.

Perhaps I should start at the beginning.

On the 16th of November I found out I was pregnant again.

It was a mere six weeks after my second miscarriage, and I was patiently awaiting my first period post-D&C. While I had dealt with the emotional fallout from yet another loss, I would be lying if I said it hadn't left me feeling a little nervous about falling pregnant again. Rod and I had agreed to wait until the new year before even thinking about trying for another child, and we hadn't been intimate since I had last fallen pregnant. I just wasn't ready. After my last post - my cleansing - with my confidence renewed and my burdens lifted, we indulged in a little morning delight. I thought nothing of it; after all, it had been a month since my D&C, and any day my cycle would resume its monthly dance across the calendar.

But when Fate intervenes, she always has her way.

When the first twinge of a symptom visited itself upon me, I refused to believe it. It couldn't have been that easy? Four pregnancy tests later I was willing to accept the truth - I was in fact with child again. I laughed, I cried, I shook with fear. And I went straight to my doctor's rooms. When I told her why I was there, I thought the smile would explode off of her face. She had been there with us through all of it, and was overjoyed for us. She wrote up a prescription for progesterone, handed me lab forms, and sent me off to get my betas done. When I saw her two weeks later for my six week scan, the screen revealed a beautiful, strong heartbeat. It was one of the most beautiful sounds I'd ever heard. We wept.

A week later, though, things started to change. At first I noticed just a little odd-coloured discharge, but when odd-coloured became vaguely bloody, I panicked. Doc upped my progesterone from 100mg to 200mg per day, and told me to take it easy. It seemed to help, and I went about my life. Christmas was around the corner, and we had decided to announce to our parents then. I had a scan scheduled for three days before Christmas, and I would be nine weeks along - it seemed a safe time. Morning sickness had started to flatten me, and most days I wouldn't even get out of bed other than to nibble some toast or go to the bathroom. I had never been that ill with Ricky, and was knocking back all the Asic I was allowed, but it barely seemed to make a dent. At last, at around 11 weeks, I began to notice a little relief. I was able to leave the house for brief outings to the store, but my favourite pastime was still lying in bed watching Downton Abbey on repeat. I just felt weak and powerless, my two least favourite sensations. We had decided to share our happy news with the wider world at 12 weeks, after our scan, but again Fate intervened.

Just two days short of 12 weeks I started bleeding.

We had ducked out to the grocer to pick up some veggies to make a stew I'd been dreaming of for days. On the way back I complained to hubby that I felt a bit bloated, thinking I just needed the bathroom. Progesterone does that. But as I stepped out of the car, it felt as though someone had opened a faucet between my legs. I froze. My first instinct was to thrust my hand into my pants. It came out red. Within seconds my jeans were soaked through with blood to the knee. I grabbed the house keys and ran inside. By the time I got to the bathroom, the blood was pooling in my shoes. I stripped everything off and sat down on the toilet. The blood continued to pour out of me in a steady flow. But there was no pain. Rod immediately got on the phone to my new doc. For personal medical reasons I won't explain, my doc had been forced to hand over her pregnant patients, and I hadn't yet met my new doctor. It was to be a baptism of fire. We arrived at his rooms twenty minutes later, by which time labour had started. Blood is a life-giving substance, but what they never tell you is that outside of its closed system, it is a mighty irritant. And my uterus was irritated. Contractions were coming about four minutes apart, and I was in agony. It seemed an eternity before I was ushered into his rooms. In reality it was maybe ten at most. I expected the worst, I was cursing the Universe and Fate and all her sisters. I hadn't asked for this pregnancy, it was given to me, so why was it taken away in such a brutish fashion? I was pale and shaky from blood loss as I lay down on the bed, prepared for everything except what we saw. Doc placed the wand on my belly, and there it was - a heartbeat of 171. I was in shock. How could a little baby, no longer than the width of a palm from crown to rump, survive such a deluge? But there it was, kicking away like nothing was happening. But it wasn't alone. A dark shadow spooned my baby on the ultrasound. That was the problem.

The SCH on the day of the Big Bleed - the shadow reaching from
the lower left corner of the image, and reaching up towards baby's rump.

I had read the term subchorionic hematoma before. I have spent many hours educating myself about anything obstetric, trying to understand my history. I now am convinced that is what caused my second loss. The symptoms are all too similar for it to not be. This mommy, it would seem, is just a bleeder. I was admitted to Ward 7 - my usual haunt these days - with a diagnosis of "threatening miscarriage". Not the most comforting term I've ever heard, but the "threatening" gave me hope - it was not a miscarriage. I was in a dream world. Call it shock or blood loss or elation, but I remember little more than my son pushing me back and forth in a wheelchair at admissions while I awaited my bed designation. His attentions were such a comfort.

The SCH 9 days after the Big Bleed - the black shadow cradling
the underside of baby. Darker shadow = old blood = good!

Doc threw the book at me. Atarax for the pain, a magnesium shot to calm my uterus, more progesterone to do the same, and a sedative. The aim was to stop labour. It worked. I spent the night, chanting an incantation of "stay with mommy" to the little bub growing in my belly. When I saw my doc for a follow-up scan the next day, he was delighted to see that baby was still well and happily kicking away. I was sent home and placed on strict bed and pelvic rest. And for six weeks that's how it remained. I was allowed a weekly jaunt to his rooms for a complimentary scan to check on baby, and the progress of the clot. The hope was that by 20 weeks it would have reabsorbed completely, removing all danger to my baby. But at almost 15 weeks I found myself back in the ER.

I woke at 3am, I couldn't tell you why. I shifted in bed and felt a familiar gush from between my legs. Again I reached down, but this time my hand came up black. I ran to the bathroom, waking Rod as I did, and sat down on the toilet. I was covered in a black sludge that I can only describe as looking like molasses. It was thick and syrupy and had the metallic tang of dead things. Again, there was no pain. I cleaned myself while Rod got Ricky up and dressed. He was a dream. They both were. I was tended to by a young male doctor, fresh out of medical school. He was very professional while he checked my cervix - not dilated - and reassured me that my baby would be fine, but his discomfort made me doubt he'll find his calling in gynecology and obstetrics. Again I was admitted to Ward 7, spending all of 8 hours in their charge before being sent home with another successful ultrasound tucked into my handbag. An SCH, I was told, will either reabsorb or, if it is big enough, bleed out before finally reabsorbing. That is what was happening with me. As long as the blood remained old, and labour was kept at bay, we remained safe.

The SCH the day after the secondary bleed.

At 18 weeks I had my last bout of brown spotting, and my energy had started to return. By 19 weeks I was finally weaned off of the progesterone that had saved my baby's life. At 20 weeks my scan revealed that the clot had completely reabsorbed, and we happily announced to the world that we were expecting. It's a boy.

Between episodes of Downton Abbey and mugs of soup I searched, to no avail, for any stories to give me hope that my baby would be okay. I read stories on forums, I downloaded white papers to read on my phone, but it all provided little comfort. People are all too willing to share their stories of woe, but not much else. That is why I have chosen to write this story down. I wish that I could have stumbled across a story like this one 14 weeks ago. Majority of SCHs are mild, causing little to no spotting, and are only diagnosed when they show up on an ultrasound. That was not my experience, and this story could have had a very different ending. I found no solace in my searching. I simply chose to have hope.

The day after my Big Bleed, doc admitted to us that he had been worried the entire night, expecting a call from the ward that I had lost my baby. At our last visit he again echoed these sentiments, and his delight that our little boy was still with us. Our little Zakk truly is a miracle baby; a miracle growing two weeks ahead of schedule and expanding mommy's waistline weekly. As I type this, I am nearly 26 weeks along, and sporting the belly I have so long hoped for. The 1st of April - the anniversary of my first miscarriage, and the start of this journey - came and went without incident. And, superstitious as it may sound, I feel I can finally exhale. The nursery is almost ready to receive our new addition, our booking appointment with the hospital is tomorrow morning, and I have allowed myself to truly accept that everything is going to be okay.

A wonderful man, my sweet little Ricky, the support of my family and a few good friends, a pair of stellar doctors, progesterone, and bed rest. That is the recipe for the tonic that saw us through. And for all of that, without any trace of irony, I say thank you.