The Hospital: Day One

On Monday morning, I got out of bed a little after my husband had already left for work. I went to the bathroom and saw that I had had hardly any bleeding during the night. I did not realize it right then, but in the few minutes that it took me to brush my teeth and wash my face, my pad was completely soaked through. I was a little scared but I thought that I should watch the bleeding for a little while before calling the doctor's office. The first thing they ask when you call them about a bleeding episode is how long you have been bleeding and how frequently you are changing pads.

The bleeding seemed to have let up soon afterwards, and I decided I could relax and wait for my appointment, which was scheduled for the next day. But it came back after an hour or so, again filling up a whole pad in a matter of minutes. And then it apparently stopped again. When it came back a third time, I decided to call my husband and then the doctor. Most of the bleeding I had had until that point had been dark red, brown or almost black colored blood. This was bright red, and it was quite heavy. I was hoping and praying that the bright red blood was a sign that the pregnancy was ending naturally. I had thought all along that if it ended of its own accord, I would find it easier to accept the loss and to be at peace with it.

I first called my husband and then my OB's office. They asked a few routine questions and then told me to go to the nearest emergency room. I told them I did not want to go to a place where they did not know my case history and where I did not know the doctors. I wanted to see a specialized doctor whom I knew and trusted. The nurse asked me to hold while she consulted the doctor on call. A few minutes later, she told me to call the office of the doctor who was supposed to do my D&E later that week. So I did. I called his office. They also put me on hold while they talked to a doctor. Then they told me to come to the hospital and go to the labor and delivery floor. The doctor would meet me there and analyze why I was bleeding and if he needed to move my surgery up. I asked if they thought I should pack an overnight bag. They said they really couldn't say whether or not I would need to stay overnight. I just threw some extra pads and extra pairs of underwear into my handbag and called my husband. He said that he was on his way home and he would take me to the hospital. This hospital was a rather long drive from our house and I was thankful to have him with me for the drive and for what was to come after it.

It was close to 2 PM when we arrived at the hospital and neither of us had eaten any lunch by that time. We went to the labor and delivery floor and waited for a nurse to show me where to go. The nurse who met us in the waiting room and led us to the triage area was very friendly and warm. She led me into the triage room where there were three beds separated by curtains. This was where women were brought in when they were in labor. The doctors and nurses would then see how far along their labor had progressed and then decide whether to send them back home or wheel them off to a labor room. I did not want to be among such women at a time like this. But thankfully for me, the other two beds in the room were unoccupied. It was just me, my husband and the nurse in the room. She paged the doctor and told us that he was on his way.

The doctor came in shortly and introduced himself to us. Once again, he said that he was sorry that he had to meet us like that. Then he went on to explain what he was going to do. He said he would do an ultrasound and also examine my cervix to see if it was dilated at all, and to see how much I was actually bleeding. I told him that I did not think I was bleeding much right then, but the bleeding came in bursts. He asked if the bleeding I was experiencing then was different from what I had been experiencing until then, through the course of the pregnancy. I told him that I had had darker blood until that point, but I was seeing more bright red blood that day.

He did an ultrasound and said that there was still a heartbeat. He mentioned that he had thought that I was possibly bleeding because the baby had died, but that did not seem to be the case. Since that had not happened, it was likely that the placenta had ruptured and was causing the bleeding. He said that he saw practically no fluid around the baby. He also said that he thought that termination was the right decision in this scenario, because my health would be at risk if I continued the pregnancy. I could develop a serious infection and suffer large amounts of blood loss. And the baby would not develop functioning lungs.

I wanted to scream and tell him that he was not helping me by telling me that there was still a heartbeat. But there was something about his demeanor that made me feel more relaxed than I had been in the last few days. I was getting the feeling that I was going to stay at the hospital until my surgery happened, and I did not like the idea of staying overnight at a hospital. I had never done that before, and I did not want to do it now. Even so, I was relatively relaxed and calm in the doctor's presence.

He examined my cervix and said that it did not seem like I was bleeding too much right then, but I may be bleeding more in general, since I had said that I was bleeding in bursts. Given that information, he wanted to move up the termination procedure. He said that if I wanted to go in for labor induction, they could probably start that right away. If I wanted the D&E, he would start the dilation almost immediately and put me on what they call an "add on" list for the operating room for the next day. That would mean that they would fit me in whenever they could find a free slot in the operating room, but it would probably happen some time in the late afternoon.

I asked him how long it would take to deliver if they induced labor right away. He said that it could take up to thirty six hours. I asked him if going through labor now would make it easier for me to go through labor again, when I actually had a full term baby. He did not think so, because the fetus at that point was very small, lighter than a pound, and a full term baby would be much larger and would weigh around seven pounds.

I asked if he thought that the risk of infection or damage to my reproductive organs was greater with either one of the two procedures. He assured me that he and his team would take good care of me and the risks would be very minimal either way. He would write me a prescription for an antibiotic which I would need to take for about a week after the procedure was done. He emphasized that he wanted to make sure that I was taken care of properly, so that I would refer all my friends to him. I said that I hoped I would never have to refer anyone for something like what I was going through. He agreed, he hoped I would not need to refer anyone for this kind of thing, but for other things.

I asked if he would want to keep me in the hospital for another night after delivery, if I chose the labor induction route. He said, "As much as I like you, I don't think I need to keep you here after you deliver." Basically, with either procedure, they would monitor my vital signs for a few hours and as long as they seemed to be normalizing, they would let me go home a few hours later. I liked the way he was trying to keep the mood light by throwing in some humor.

I also asked him if he thought I was at an enhanced risk of a hematoma and related complications with a future pregnancy. He said he did not think so. He would have said that there was an enhanced risk if I had been a smoker or if I had been taking recreational drugs, but not otherwise.

He left us alone for a few minutes so that we could talk and decide which way we wanted it to end. He said that unfortunately, he could not give us the happy ending that we wanted, but we had to make the decision about how we wanted it to end. That was a matter only of personal preference, because he would make sure that things went smoothly either way. He also added that since I had gone through so much bleeding and pain, he was confident that I could endure either process.

When he came back, I told him that I still wanted the D&E. I did not want to see the baby and experience labor, I was not so sure that I could deal with that emotionally. He said he understood, some people did prefer that. He told the nurse to insert an IV needle into my wrist so that she could draw blood for some preliminary blood tests through it, even though they did not need to give me fluids through IV just then. They planned to start that at midnight, when I would need to stop eating and drinking, but it would be easier to draw the blood through that one needle and minimize the number of times I would be poked at. She asked me if I was right handed or left, because they generally preferred to insert those needles into the hand that was not dominant.

Once the doctor left, the nurse patted my hand in a warm way and said that she would have chosen a D&E too. It was rather reassuring. This was the first female medical professional who had spoken to me about this. The male doctors had been saying all along that an 'advantage' of labor induction would be that my husband and I could see the baby. I did not understand how that would be an advantage. The reason why all of this was so difficult and painful was that we had begun to bond with the baby, we had begun to think of her as a real person, we had started thinking of names for her, I was feeling her move, and we were starting to get to know her. She was real. Actually seeing her and delivering her like a real baby would make her that much more real and deepen our bond with her that much more. It would be so much more difficult for us to get over all of this and move on. My husband and I had talked about it and he agreed that he did not want to see the baby. The doctor asked us later if we wanted to take the remains of the fetus with us or if we wanted the hospital to take care of them. Both my husband and I were very certain that we wanted the hospital to take care of them.

The doctor came in and had me sign some consent forms. I asked him how long he thought I should take off from work and relax at home. He said that I could possibly feel well as soon as the next day, and two weeks would be a very long time for me to just sit alone at home with not much to do. I saw his point and figured that I would take maybe a week's time off.

He started out with the dilation process, explaining everything he was doing as he was doing it. He cleaned me cervix with a disinfecting liquid containing iodine. He injected a local anesthetic into my cervix. I hardly felt that. He did say that I probably would not feel it, since there were hardly any pain nerves in the cervix. Then he opened up my cervix using a speculum, just like he would do for a pap smear. The speculum opening up was the most discomfort I felt. He inserted some thread like things called laminaria into my cervix. Those were actually going to dilate my cervix. He was putting in a number of them and asked me to inform the nurse on call if I saw any of them come out, on toilet paper or on my sanitary pad.

They were going to keep me in the hospital until the next day, when the surgery would actually happen. The doctor expected that I could possibly experience a lot more bleeding or pain and did not want me to need to rush back during the night. He said my cervix was pretty soft and he would not need to dilate it twice, so he could just do the D&E the next day and send me home that evening. He told me that I needed to be aware that I could go into labor because my cervix was dilating, and that I should inform the nurse if I felt any contractions.

Once he was all done, the nurse asked us if we wanted something to eat. That was when I realized that it was about half past four in the afternoon and I had not eaten anything since breakfast. They had prepackaged deli style lunches in their kitchen, which came with a wrap or a sandwich, chips and a few other things. I could only eat a little bit of the wrap, but I ate some chips and maybe a granola bar or something that came with it. In the middle of eating, I felt like I was going to throw up. No big deal, I thought. I had felt like throwing up any number of times during the pregnancy but had never actually had any vomiting. So I just sat there on the bed for a few minutes and tried not to look at the food. But the feeling seemed to be stronger and more persistent than usual, so I went to the bathroom. And it seemed to me that everything that I had just eaten came right back out.

The nurse came back to check on me a few minutes later and asked if I had eaten. I said yes, I had, but I just threw up everything I ate. She said she was really sorry about that. Pregnancy hormones and dilation can cause that kind of thing sometimes.

The nurse informed us that I was going to be moved to the surgical floor, where I would probably be more comfortable because I would not have to be around women who were having their babies or had just had them. I certainly appreciated the thought. I had not seen any such women the whole time, except for one woman who was signing in when I had just signed in and was waiting for the nurse. And she had arrived at the hospital by herself and did not appear to be in active labor. But she was evidently close to her due date. I had, however, heard babies crying a few times, but that was all.

I began to develop severe cramps in my lower abdomen. Now I had had almost equally bad cramps during the course of the pregnancy, with most of my bleeding episodes, but I had not taken any medication to help with those. I had always tried not to take any medication when I was pregnant. Even ones that were supposedly safe for the baby. I always worried that there could potentially be some side effects for the baby. But now I wanted medication. I wanted something to help with the pain. I was still very nauseated, but I went to the bathroom a few more times and nothing came out. I did not think there was anything more in my stomach that could come out.

I got up from the bed and walked around the room and that seemed to help with the pain a little bit. The nurse told me that a room was being cleaned up for me on the surgery floor and she would take me up there as soon as it was ready. She said her shift ended at half past seven, so she would be the one to take me up there. The nurse taking care of me over there would give me medication for the nausea and pain once I was in the room.

It was a little past seven when she actually took me up to the room. The nurse who greeted me over there was also close to the end of her shift, but she said she would get me settled in before she left. She was probably about fifty years old, and she reminded me of the nurse at the RE's office who had done the IUI for me that cycle. The one who had taken care of me when this life inside me had begun. And now this nurse was going to take care of me as this life was ending.

The nurse told me that they often got patients on that floor who had problems with their pregnancies. They always preferred to keep such patients on that floor rather than the labor and delivery floor, so I was not an unusual patient for them at all.

We were on the twelfth floor and the room had a huge window from where I could see the city lights. It was a great view, but I was in no state to enjoy it. There was a patient bed and maybe three comfortable chairs, but there was no place where my husband could have slept comfortably if he wanted to spend the night. I told him that he should go home and get some sleep because it had been a long day and he would need his energy the next day as well.

There was also no place to shower. There was an attached toilet with a bathroom sink, but no place to shower. I had been asked to shower with a special surgical cleaning soap the night before and the morning of the surgery but there was no place to do it. We had bought that soap but we did not bring it with us to the hospital, so they would have to come up with both the soap and a place to use it in, for me.

The nurse informed me that the doctors were putting in the orders for pain and nausea medication for me and I would get those soon. They would also start the IV fluids when they brought in the medication because I had been throwing up and was probably beginning to get dehydrated. I was still allowed to eat and drink for another four hours or so but it did not seem like I could, so I would have to be on IV fluids soon.

Shortly after I got into that room, I threw up again. I did not know where any of that stuff came from. I had not eaten anything since the last vomiting episode and it had seemed like I had thrown up more than I had eaten at that time.

Shortly after that second vomiting episode, the nurse who would be taking care of me that night came in. She had heard me throwing up. She asked how I was feeling. I told her that I was in a lot of pain and very nauseated. She went away and came back shortly with the medications. Now I had had the IV needle in my wrist for a few hours, but it had not really been used, except to draw a couple of vials of blood right when it had been inserted. It hurt badly at the site where the needle had been inserted when the nurse first used it to give me some nausea medication. It hurt again when she switched it over to the pain medication. She said she would be back after a few minutes to switch it over to the fluids, once I had received the appropriate dose of pain medication. The dosage was controlled electronically, and the electronic gadgetry was plugged into an electrical socket. She showed me where she had plugged it in and told me that I would need to unplug it each time I wanted to move about, and then plug it back in when I came back.

She told me that I was allowed to get the pain and nausea medication again four hours after the initial dose, so I should let her know if I wanted it then. She also wanted to keep track of how much I was bleeding and how much urine I was making. I thought that was rather gross, and not something I would want to keep track of for another person, but presumably, she would have known what she was in for when she signed up for a career in nursing. She put something called a 'hat' on the toilet to measure the amount of urine and I was to call her each time I changed a pad and to let her look at it before throwing it away.

She brought in a solution of the surgical soap and a few towels and washcloths and helped me clean up using those. It did not make me feel clean and fresh like a real shower would have, but it was something.

The pain killer began to take effect pretty quickly, and I was just beginning to feel comfortable when the device made a beeping sound to signal that it was done with the recommended dose. The nurse came back in to change the IV over to the fluids I would need to keep me from getting dehydrated. And the wrist hurt again at the point where the needle was.

My husband stayed with me until quite late that night, but eventually agreed that he needed to go home and get some sleep. I did not get much sleep that night. I could not get too comfortable in the hospital bed and I also needed to get up every so often to change my pad. Just getting up to go to the bathroom that was ten steps away was an ordeal, I needed to unplug the IV, wheel it along, go to the bathroom, wheel the IV back, plug it back in, and call the nurse and tell her that I just changed a pad. That was quite enough to make me feel completely awake each time I woke up. I hoped my husband got some sleep that night, because at least one of us would need to be well rested to face the day that came next.