On Wednesday, March 21, 2012, ultrasound imaging showed us that we were expecting a little boy.
On Wednesday, March 21, 2012, ultrasound imaging also hinted that this would be our only biological child.
Note: There is a happy ending to this story.
Our anatomy scan, performed a day before our 18-week mark, showed that our offspring was indeed male. We gloried over the four chambers of his heart and watched them beat in perfect symphony. We marveled over tiny bones, a round little belly, a huge noggin, a small upturned nose.
A boy! As the oldest of five girls, the novelty of a boy in the family rang through me. Mike squeezed my hand excitedly as the ultrasound tech explained all we were viewing.
I felt awash in the glow of motherhood. I had felt a few small movements before, but now I was finally looking at my child.
The ultrasound tech continued her exam, explaining she would next check out the placenta. Mike asked her what the big holes were on the screen. Everything looked like Swiss cheese. The tech muttered something, though in my euphoria I didn't recognize what she said. Honestly, I wasn't listening; why should I care about a placenta when there are small pictures of my baby's profile to obsess about?
Mike persisted a little, but the tech, in a totally professional manner, declined to say much more. About half our exam focused on the placenta. The tech saved many images of it, at least as many as of our baby. Eventually the scan ended. I wiped the gel off my belly and we headed back to the midwives' office to go over the results.
One of our midwives met with us in a small room. The walls were covered with pictures of babies, fruits of the delivery efforts of the office team. I beamed at Mike. We were having a boy! It was like finding out we were pregnant all over again. After months of morning sickness, I felt rejuvenated by the news.
The midwife held up several images of the baby, confirming everything we already knew: he was healthy and strong, a good size for his age.
"We're thrilled!" I told her.
She then held up a sheet or two of images of the placenta. "A normal placenta will look smooth and uniform. Do you see these dark holes?"
We nodded our heads. "I wondered about that," Mike said. "Why does the placenta look like that?"
The midwife asked if I'd ever had uteran surgery of any type before. When I said I hadn't, she shook her head and explained the symptoms of an uncommon condition called placenta accreta. It occurs when there is a lack of endometrium in part of the uterus, so the placenta bonds to the uteran wall instead. Endometrium fails to form over scar lines, hence the question about surgery. Older women who have had multiple C-sections are at greatest risk, since they often carry thick scar tissue. Combined with a low-lying placenta, these women sometimes develop placenta accreta. The consequence of placenta accreta is surgery of some form. The best case scenario is that the placenta is only barely attached to the uterus, requiring a minimum of cutting to release it. The worst case scenario is that the placenta is firmly attached to the uterus, necessitating a complete hysterectomy. An untreated placenta accreta that won't detach from the uterus can hemorrhage until the mother dies. Hysterectomies, though extreme, are often recommended since they are the best way to guarantee the mother's survival.
Apparently, the dark spots in my placenta indicated connections between the placenta and the uteran wall. Even though this was my first pregnancy. Even though I had no known scarring. Even though my placenta was high up on the right side of my uterus.
"You both need to prepare for the possibility that this will be your last pregnancy."
Mike remained silent. I tapped the counter with my finger. "But the baby is fine, right?" I asked. "Is he at risk because of this?"
"The baby is totally fine," the midwife said. "There's no reason why he won't be completely healthy. This condition isn't hurting him."
"Well, that's good, we just want a healthy baby," I said.
We sat in silence for a moment. Then the midwife addressed Mike. "Are you alright? You seem more shaken up about this than your wife."
"It's just a lot to take in." I could see that Mike was upset, but I was still so excited that we were having a boy and that he was going to be healthy.
The midwife referred us to a perinatologist, to see if I did in fact have placenta accreta and how to proceed. The rest of our conversation as a blur. We left the office, three precious ultrasound images in hand, and walked out to our car.
I don't know if the magnitude of what happened hit me in the elevator or somewhere on the blacktop outside, but I had to hand off our little pictures to Mike because I suddenly felt so ill. So completely gripped with the reality of being a hysterectomy patient at 25 years old.