21 + 1

10/6/24

Sunday started like any other day; Anthony and I went out for a nice breakfast, got our grocery shopping done, then I settled into the couch for the Bills game. Anthony was heading out of town early in the week so he was running some errands and getting ready for his trip. Throughout the week I had noticed a bit of extra fluid other than the normal pregnancy discharge I had been having. It had gotten bad enough that it became a bit of a joke in our house when I would cough or sneeze and just pee myself; I always thought that happened after the baby came out, but what do I know, this was our first baby. So when I got up during a commercial break and had more of a gush of fluid, I decided to do a quick Google search. With the new diagnosis that week of the amnion chorion separation I wasn’t sure if this was related or concerning or what was going on. I was not prepared at all for what I would find out.

As a first time mom I had really no idea what to expect or what was normal for pregnancy. I felt great so I just assumed everything was good. As I started Googling what a clear liquid fluid could be, I very quickly realized this was largely considered to be amniotic fluid, and this was not good. I thought maybe it could happen more broadly so I texted my sister who had three little girls and asked if she ever leaked amniotic fluid, and she informed me this is not normal. After the larger gush of water and the scary Google reports I was seeing, I decided to call the experts and get their opinion.

I called my regular OB and got the answering service because it was the weekend. A doctor called me back within three minutes and told me I needed to go to labor and delivery triage at the hospital. This all happened in about an hour's span so it seemed a bit dramatic to me, but I thought I would rather be safe than sorry. My husband had just gotten home and I told him I was going to go to emergency to get this checked out. It was 5pm on a Sunday, the Bills had already lost, so I might as well get this over with so I can sleep tonight. Anthony and I tend to be the type of people who go to the doctors if we’re dying and for no other reason; but when we received the multiple diagnoses at our appointment earlier that week we made the decision to follow step-by-step what our doctors said was best for our baby and myself. So off to the emergency I went.

I was seen quickly, received an ultrasound and everything looked good at first. They did a few tests, including testing the fluid, and nobody seemed overly concerned so I texted Anthony that I should be home soon. I thought this whole trip would be a waste of time and I was just going for peace of mind; so I did not have him come with me because I wanted him to be able to get ready for his trip. Shortly after my “be home soon” text, one doctor came in and said they found some concerning results on the tests. They called in additional doctors for a second opinion and confirmed the results as amniotic fluid.

At this point I was still not quite processing what this meant, because again, I felt great and had an amazing pregnancy so far. I grew more anxious when one doctor came in and said they were going to admit me for the night because the presence of amniotic fluid means that my water is broken and I have a rupture somewhere. She said that often when this happens you go into labor within 24-48 hours… A second nurse came in and said I should have my husband come up because the doctors were going to come in and talk to us about our options and that is a hard conversation that “he will want to be a part of.” So my “be home soon” text turned to a, “can you come here” text, and my mind started racing.

I know you aren’t supposed to Google medical things, but I’m sitting in a room by myself, 21 weeks pregnant with broken waters, waiting for my husband and the doctors to come in, what was I supposed to do? I discovered this is called PPROM, a preterm premature rupture of membranes, also known as breaking your water. When my husband arrived the doctors explained that there is still fluid around baby which indicates a tear somewhere, but that I had not lost all fluid yet, so that was good. Other than actually going into labor in the next 24-48 hours, the next biggest concern was an infection. If fluid is able to get out, that means bacteria is able to get in. The membranes protect the baby and when they are compromised the baby can be compromised as well and an infection is immediate need for a c-section. I also learned that along with my rupture, I was already 1 cm dilated; this added in additional concerns of a prolapsed cord, which is another immediately life threatening issue and reason for c-section. Finally, I learned that there is also a risk of, and I wish I were joking, a hand or a foot or a baby part trying to come out… due to the lack of fluid, the dilation, and the size of the baby, it was actually possible that a part could come out and this would also be an immediate threat and reason for emergency c-section.

I know this one is long, but this was a long night and we got a lot of information from a lot of doctors. After learned about lack of fluid, dilation, all the causes for emergency c-sections, prolapse, pre-term labor, and all the risks of having baby so early; they told us about the rule of viability. When I went into the hospital I was 21 weeks and 1 day. At our hospital here in NY the age of viability for a baby is 22 weeks. They told us that this means if we were to have baby, regardless of how it happened, sometime in the next six days there is nothing they can do to help the baby survive. They can not and will not take any life saving measures (which would need to be extreme on such a young baby) for the baby until after the 22 week mark. The doctors said they can do “comfort measures” and we would get to say goodbye to baby and that is all they can do. After everything we had learned that night we horrified and terrified that there was a possibility our baby would come in the next few days, and there was nothing we could do to stop that or help baby survive. So we did all we could do; we waited…