accreta experience: joree novotny
Finding Grace in Grief
I became pregnant easily when my husband and I first started trying, at 30 years old. With no serious health conditions or medical history, no previous pregnancies, and no risk factors, you can imagine my surprise (and the shock of my doctors and medical team) when my placenta wouldn’t detach after giving birth to my son. I had labored for 36 long hours after being induced due to high blood pressure. The thrill of that moment, when I finally felt the release of his exit from my womb and entrance into the world, was indescribable, but short-lived. I’d worked so hard and stayed so focused on my goal to deliver vaginally so that I could enjoy skin-to-skin and take all the right early steps toward nursing. I’d not considered the possibility that I would be the “winner” of such long odds… One of the rare placenta accreta pregnancies that affect first-time mothers.
When my obstetrician realized my placenta would not detach, I was taken to the OR for a D&C. After further unsuccessful attempts to remove the placenta, my blood pressure plummeted to 60/40 and I required a transfusion of two units of blood before a bakri balloon was inserted to stem my bleeding temporarily. I was extremely fortunate that an interventional radiology team was onsite the day I delivered to embolize my uterine artery and prevent further bleeding. There’s a long list of fast-acting decisions and instances of sheer luck that coalesced for me to be alive today, learning to be the mom of a 10-month-old only child.
After spending five days in the hospital after delivery recovering in the ICU and later on the maternity floor, I got to spend a week at home with my newborn before going back to the hospital for a scheduled hysterectomy. An MRI had confirmed I had increta. Not only would future pregnancies be extremely dangerous, since they would be unable to remove a significant amount of the embedded placenta, but I would have to live with the real possibility of infection or bleeding at any moment. It was an easy decision for my husband and I to make, since we were freshly overcome with the trauma of my birth experience. But it was and still is a difficult decision to live with.
If you’ve reached the survivor side, congratulations. You have already made it through an enormous physical and mental challenge and likely have literal and figurative scars to show for it. There are more battles ahead that you will have to wage physically and mentally to recover, but I know you can do it. You are already a survivor, so remind yourself of your strength every day.
In the short-term, as you are recovering from your hysterectomy, be kind to yourself but firm. Set small, achievable goals and push yourself to reach them. Remember that your physical and mental health are intertwined. It helped me to get moving after my surgery as soon as I could to put both my physical and psychological recovery on the right trajectory. As you are grappling with the loss of your uterus, and grieving the children you will never have, I first want you to know that you’re not alone. I spent the early weeks of my son’s life marking every “first” half with joy and half with unbearable sadness, knowing he’d be the only baby I’d have. Every time he would drift to sleep in my arms, I would stare in wonder, tears welling in my eyes, desperately broken that it might be the last time I would hold my own child as they slept. People would tell me that favorite refrain, “they grow up so fast,” and I would feel the endless depth of my grief once again. When I felt like I was making some new parent mistake, I would become overwhelmed with regret that I would never have another chance to “get it right.” It’s okay to feel your loss deeply, but stay in open communication with your partner and loved ones.
Seek out professional support if you need it. The world of postpartum healing and parenting a newborn is challenging enough without the unique grief you’re experiencing. For me, it was therapeutic to talk and write about what I was going through, including with my pastor. Find what works for you and take each day as it comes. In some ways, it’s much like experiencing a death. You may not ever “get over” the loss of your womb, but you can grow into accepting and embracing your new reality.
I know my experience has regrettably had some chilling effects on friends of mine who are pregnant or hoping to have more children. Even my closest friends have hesitated to talk with me about their hopes for new pregnancies or their debates about baby names. It’s very important for me that they know their joys are my joys, and that I want to walk with them on their journeys. Keep in mind that your loved ones don’t know what you’re feeling or thinking and that it’s helpful to everyone involved if you are open about any triggers or trauma you may have, so they can foster conversations and environments that are safe and welcoming for you. For example, many women mourn their inability to nurse after being separated from their baby at birth, and may find discussion about nursing uncomfortable or unwelcome. Most people have not experienced what you’ve gone through, so trust that by making them aware of your state of mind, you are empowering them with the information and tools they need for the comfort and support they want to show you.
Finally, remember that with any accreta pregnancy, your spouse or partner is likely struggling emotionally, too. While it may not be possible for you to provide them the support they need on your own, encourage them to care for themselves. My husband watched me wheeled into the operating room and my son wheeled to the NICU, not knowing whether we’d survive. He sacrificed much of his own mental health to care for me and our baby as I recovered. It wasn’t until weeks later that he confessed, in tears, the mental anguish he’d been failing to cope with on his own. If you have the fortune of a diagnosis before delivery, use it to prepare your support network for what’s ahead. If, like me, your accreta was undiagnosed, the best thing I can tell you is that I’m so sorry for what you’re experiencing, and that you will find joy in your sorrow and strength in your pain. I believe in you and there’s a network of accreta moms who believe in you, too.
I’ve always enjoyed writing and I’ve finally found a story worth telling. I’m working on completing a memoir reflecting on my pregnancy and birth experience, caring for a newborn in the midst of recovering from a hysterectomy, and learning to embrace parenting an only child. As I’ve told friends, it doesn’t matter to me if anyone else reads it. It matters to me that I’m putting the words on paper and processing everything, with humor and lightheartedness as much as possible. Ten months postpartum, I’m now able to laugh at the pizza delivery order I requested when flushed with pain medication in the OR. What’s happened to you is very serious and will have ramifications on the rest of your life. But I’ve found that healing happens when you let the sun shine on your scars. I’m wishing you grace and peace.
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Joree Novotny lives in Columbus, Ohio with her husband Ryan, their son Finley, and their rescue pup JoeJoe. She works full-time for an anti-poverty nonprofit organization and spends her free time on adventures with her boys and rooting for the Blue Jackets, Browns, and Indians.