ITP Pregnancy, The Birth

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 Feature image from ITP&ME

In the first few days after my son was born, I couldn’t shake this feeling that I had let him down in some way.  I kept thinking there must have been something I could have done better, some sign I could have noticed earlier, another hour bouncing on the fit ball, or another 20 minutes inverted off the couch, that might have made his entry into the world a little calmer, happier and healthier.  

In the first weeks, I slept terribly.  I was happy, don’t get me wrong.  I was having the most wonderful time during the day and into the night with him.  But just in those moments right before I drifted off to sleep, I would replay the birth in my mind, looking at all the little moments I should have done something differently.

Don’t worry.  My feelings about of the birth have changed a lot since then.  

The more information I have and the more I come to understand the events, the prouder I am about how everything happened.  As I learn about footling breech births, remember more and more, and as I speak to other women about their birth stories, I’m starting to consider the whole thing an incredible fucking success.  

I am glad I waited a little while before writing this.  Had I written this article earlier, it may have sounded like a completely different story.  So here it is… The story of our ITP Baby.  

(In saying that, I don’t believe it is possible to ever really tell your birthing story.  There is no way to sum it all up or convey everything that happened.  When I talk about the birth of our son with others, I find my words falling so short of the mark; such a blunt instrument to play such a complex sound.)

The birth of my son was a triumph over the medical profession’s interpretation of a high-risk pregnancy.  It is considered legendary among midwives and doctors.  It was beautiful.  But it was nothing like the sacred feminine worship, I was lead to believe birth was (could be).  

The Birth

Our son was a footling breech baby, born early via spontaneous vaginal delivery. 

Very little of our labor had anything to do with ITP.

In fact, now that I look back on the birth, my platelets were the least of my worries. 

After feeling the tiniest change in my body, I decided to call the labour ward – just to check.  I had been classified as a high-risk birth right from the very start and knew to call the hospital regarding any little thing that was concerning me, especially before 37 weeks. 

My husband and I presented to the labor ward expecting to be examined and sent home to spend the next few weeks experiencing Braxton hicks and getting ready for the baby.

When I was examined in the consulting room, it was clear that my membranes had ruptured and that the baby was breech.  I had not really felt my ‘water break’ as such.  I thought I would notice my water breaking but I didn’t.  I expected to feel it, and see the ‘water’ but I had nothing like that.  The best they could guess was that I lost it the night before. 

So my water had been broken for 10 hours. 

An ultrasound revealed that it was a footling breech.  And there was no more water.  And the blood flow to my placenta had changed.  And I was presenting with sudden onset preeclampsia.  And we were now having a caesarian (I had just eaten the most delicious chicken salad sandwich so I had to fast for a few hours before it could happen).  

As we waited and prepared for a caesarian section (recommended for breech births due to the risk of oxygen deprivation, soft neurological complications, cord prolapse, head entrapment, trauma and the list goes on..) our labour begun progressing beyond our control.  I was dilating fast.    

We were rushed to theatre for the caesarian. 

My platelet count was high enough for an anaesthetist to be happy with giving me an epidural (Anaesthetists differ in what platelet count they are comfortable with before an epidural can be given – during the pregnancy we were told a few different numbers from 120 /100 / 80 depending on the anaesthetist we spoke to.  They each said it was a personal and professional decision).  

At the door to the theatre, I was fully dilated and he was coming out. 

It was too late for pain relief and too late for surgery (Thank God, I think now!!)

It seemed our baby was determined to be born vaginally.

10 minutes later he was born thanks to the calm skill of the obstetric team at RPA.

Platelets – During the pregnancy, my platelets were monitored every two weeks or less.  During the FIRST TRIMESTER my platelets fell quite low, but since then, they were staying around 100. 

My platelet count had been taken 4 days before I gave birth during a routine check.  I was not due to give birth, so there was no urgency to the test.  I remember my platelet count was at about 100 but at the time the number was insignificant.  It wasn’t too low.  100 was considered a wonderful number for me to give birth with. 

Once it was clear that we were going to have a caesarian, I gave a little blood to have my platelets re-checked.  A few hours before my planned c section, it was noted that my platelets were falling.

Medication – During the pregnancy, I was taking 10gm a day, quite consistently. I also had Clexane injection daily and Aspirin.  My aspirin was ceased at 35 weeks and I did not take Clexane for 12 hours before the birth (I was very lucky about when I took my needle and when we happened to head to the hospital).

During the birth, I was only on prednisone.

Bleeding – My labor report said I only lost about 300 ml of blood during the birth.

Bruising – I experienced no bruising before, during or after the birth.

Nausea – I was a little nauseous during transition, but it’s all.

Headaches – Yes.  In preparation for the caesar, I was not allowed to drink water.  That is when I started to feel a few stress headaches behind my eyes.  Everything was moving quickly and I was starting to get a little worried.  I needed cold towels all over my face for a while.  Also probably a symptom of blood pressure, pre-eclampsia issues.  

Our Baby – His platelets were tested at birth – all fine. 

I didn’t realise at the time the magnitude of what happened during our birth.  I’m told footling breech is the hardest to push out naturally.  It hurt so much that I screamed till my throat was hurt and my voice was hoarse for a week after – but I thought everyone did that.  In fact, my throat hurt more than anywhere else on my body.

There are few people who have experienced or been present during a breech birth, and now I understand why.  I understand why doctors would encourage people away from it.  The risks are high and the trauma to both mother and baby (emotional and physical) is also high. 

But I am so glad I was able to give birth naturally.  If I had another breech baby I would try again to have a natural breech birth.  I am going to encourage everyone I meet to push for a natural breech birth. 

I’m so grateful that there was no other option – and while I am in no place to give any medical advice, I must share the fact that it is certainly possible.  When it goes well it is totally scary but fucking amazing!!

ITP Issues During the Birth

ITP Pregnancy, gestational thrombocytopenia, immune thrombocytopenia during pregnancy, breastfeeding with ITP, birth with ITP, ITP birth plan, low platelet pregnancyITP was the least of my worries during the delivery.  There was so much other craziness happening that my platelets were the least of our worries.  

It is never what you worry about that comes to be the problem.  My ITP turned out to be such a micro part of the birth that I’m almost embarrassed at how worried I was about it.

Afterwards, I felt fine, ready to run a marathon.  I knew that the hormones of pregnancy would change me, but I didn’t expect the change to be so profound.  After the birth, I was not tired at all.  (I looked like I was on speed)

I survived the first week with 1 to 1.5 hours of sleep.  Now that I am getting 5 or six hours a night, I consider that a miracle.  

I recovered quickly.  Already my body has healed and returned to its pre-baby form.  I have noticed, during my small amount of research that people who have a breech baby, have very little damage down below.  Though I can’t figure out why…

Byron is now 7 weeks old.  At the moment, Byron and I are enjoying our strange time together.  We are a funny little team that eat and sleep together.  We have jokes that others don’t understand, and both of our blood results are doing just fine.

If you are wondering whether or not it is possible to have a baby with ITP, the answer is yes!

Read about the 1st TRIMESTER2nd TRIMESTER & 3rd TRIMESTER here.

For stories about people who had LOVELY BREECH births and people who were MORE PREPARED FOR A BREECH than us, check out these blogs.

by Meg

Meghan Brewster is a writer and blogger. She is an ITP patient and launched ITP&Me in 2011. She is a coffee lover and a try hard dancer. @meghan_brewster

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