Admitted to Hospital With Stomach Ulcer: She Gives Birth to Baby Boy

Every once in a while we hear a story of a gal who didn't know she was pregnant. Lisa Witchalls, 25 of Essex, England, was told she could not get pregnant. She claims she failed 4 home pregnancy tests. After arriving at the hospital with intense stomach pain....

Doctors checked her blood pressure and carried out two positive pregnancy tests. She was told initially she was 35 weeks pregnant and was transferred to the labour ward. But after a problem with the baby's heartbeat, she was measured again and was told that in fact the baby was overdue. “I could not get my head around what was going on, I went through so many emotions,” said Miss Witchalls, of Romford.

“First I was just happy I was pregnant and thought I would have some time to get used to the idea, then I was told I had to give birth straight away.” Her son, who she has named Reece, was born by Caesarean section and weighed 7lb 4oz.

Ahhh. I love a happy ending. Link.

I Would Die For That

If you can watch this music video with a dry eye, you are stronger than I am. I dedicate this to all parents and infertile couples.

We need to avoid uterine surgery if possible

If we want to retain our fertility, that is. This is one of those subjects I feel SO strongly about, but I don't get the chance to jump onto my soapbox. Why? Because this is a VERY touchy subject. Surgical uterine intervention is often emotional. D&Cs and Cesarean Sections are often criticized, so women feel defensive at the mere mention of it. Although most of the D&Cs that I am aware of occurred after a miscarriage, which is a HORRIBLE time in the life of a woman. A time when a woman is in so much physical and emotional pain. She is very vulnerable. When a woman learns that she is carrying her dead baby the shock and horror defy description. Doctors are human too, and they see our pain, and they want to "save" us from it. They want to make it go away as quickly as possible. There is a problem with that. Asherman's Syndrome. This is where residual scar tissue within/around the uterus prevents subsequent pregnancies. I looked it up in Wikipedia.

The cavity of the uterus is lined by the endometrium. This lining is composed of two layers, the functional layer which is shed during menstruation and an underlying basal layer which is necessary for regenerating the functional layer. Trauma to the basal layer, typically after a dilation and curettage (D&C) performed after a miscarriage, or delivery, or for elective abortion can lead to the development of intrauterine scars resulting in adhesions which can obliterate the cavity to varying degrees. In the extreme, the whole cavity has been scarred and occluded. Even with relatively few scars, the endometrium may fail to respond to estrogens and rests. Often, patients experience secondary menstrual irregularities characterized by changes in flow and duration of bleeding (amenorrhea, hypomenorrhea, or oligomenorrhea) [1] and becomes infertile. Menstrual anomalies are often but not always correlated with severity: adhesions restricted to only the cervix or lower uterus may block menstruation. Pain during menstruation and ovulation are also sometimes experienced, and can be attributed to blockages.
Asherman's syndrome occurs most frequently after a D&C is performed on a recently pregnant uterus, following a missed or incomplete miscarriage, birth, or elective termination (abortion) to remove retained products of conception/placental remains. As the same procedure is used in all three situations, Asherman's can result in all of the above circumstances. It affects women of all races and ages as there is no underlying predisposition or genetic basis to its development. According to a study on 1900 patients with Asherman’s syndrome, over 90% of the cases occurred following pregnancy-related curettage [2]. It is estimated that up to 5% of D&Cs result in Asherman's. More conservative estimates put this rate at 1%. Asherman's results from 25% of D&Cs performed 1-4 weeks post-partum [3][4][5], 30.9% of D&Cs performed for missed miscarriages and 6.4% of D&Cs performed for incomplete miscarriages. [6] In the case of missed miscarriages, the time period between fetal demise and curettage increases the likelihood of adhesion formation to over 30.9% [2][7]The risk of Asherman's also increases with the number of procedures: one study estimated the risk to be 16% after one D&C and 32% after 3 or more D&Cs [8].
Depending on the degree of severity, Asherman's syndrome may result in infertility, repeated miscarriages, pain from trapped blood, and high risk pregnancies [9]. There is evidence that left untreated, the obstruction of menstrual flow resulting from scarring can lead to endometriosis[5].
Asherman's can also result from other pelvic surgeries including Cesarean sections[2], removal of fibroid tumours (myomectomy) and from other causes such as IUDs, pelvic irradiation, schistosomiasis[10] and genital tuberculosis[11]. Chronic endometritis from genital tuberculosis is a significant cause of severe IUA in the developing world, often resulting in total obliteration of the uterine cavity which is difficult to treat [12].
An artificial form of Asherman's syndrome can be surgically induced by endometrial ablation in women with excessive uterine bleeding, in lieu of hysterectomy.

My purpose in mentioning this is to educate. I pray that you are never faced with this. But if you find yourself in the situation of a miscarriage, PLEASE consider waiting to miscarry naturally. Of course there are times for surgical intervention. But remember. You never know *which* D&C will be your last.

Here is part of an article from TimesOnline.

Rebecca McAra went through £1,000 of tests over a 12-month period before discovering that she had Asherman’s, caused by a D&C carried out after a miscarriage. “I was so traumatized when I lost my baby that when I was offered a D&C I jumped at the chance, thinking it was the quickest and easiest option. I wish I had been told that a snap decision made in a hospital scanning room might irreparably compromise my fertility.

“I could have waited to see if the full miscarriage occurred naturally but was told this could take up to a month. I wasn’t informed about medication as an alternative to uterine surgery, nor about the risk of developing Asherman’s if I had a D&C.” Having undergone hystero-scopic surgery to remove uterine scar tissue, McAra is now trying to conceive again. Professor Ledger believes that hospitals should routinely warn women that there is a risk of developing Asherman’s if they opt for surgery. “The NHS is very hot on producing leaflets about anything and everything but few women are informed about Asherman’s.”

And Cesarean Sections can be a problem for future conception. Here is a quote from Web MD:

The study involved 283 women who completed questionnaires roughly three years after delivering their first child by cesarean section or vaginal delivery using forceps or vacuum pump. Three quarters of the women who said they wanted a second child achieved a pregnancy during that time. But the women who had vaginal deliveries were twice as likely to have conceived as those who had cesarean sections,

This is from Childbirth Connections:

# Future reproductive problems for mothers: A cesarean section in this pregnancy puts a woman at risk for future reproductive problems in comparison with a woman who has a vaginal birth. These problems may involve serious complications and medical emergencies. The likelihood of experiencing some of these conditions goes up sharply as the number of previous cesareans increases. These problems include:

* ectopic pregnancy: pregnancies that develop outside her uterus or within the scar
* reduced fertility, due to either less ability to become pregnant again or less desire to do so
* placenta previa: the placenta attaches near or over the opening to her cervix
* placenta accreta: the placenta grows through the lining of the uterus and into or through the muscle of the uterus
* placental abruption: the placenta detaches from the uterus before the baby is born
* rupture of the uterus: the uterine scar gives way during pregnancy or labor.

A couple of stories

Yesterday was a bad day for food. I was SO hungry. Then everytime I went into the kitchen, there was a horrible smell. I couldn't eat, it was SO nauseating. I had made fish the night before, and so I took out the trash, but the smell lingered. I kept sniffing around and had it narrowed down to one corner of the kitchen, but I couldn't figure it out. It was like something had died. So later my husband came home, walked into the kitchen, and made a face. What smells bad? We looked around some more and couldn't figure it out. Then a few minutes later, I thought about the bag of potatoes that was sitting in the basket on the counter with the onions and bananas. Sure enough, there were a couple of BAD potatoes! EEEEEK!!!! Unfortunately, this was not until after dinnertime, so I really spent all day with this nausea problem. I weighed myself this morning and it turns out that I am 1/2 pound up from where I was at 4 weeks pg. I had been 1 pound up, so I lost back the other 1/2 pound. Whatever. The little bub is growing fine. And I should end the first trimester at what I wanted which was gaining between 1 and 4 pounds. That way I can gain lots of weight in the second and third trimesters. Wahoo!

I finally decided to tackle the problem of my filled sharps container. I have 2 very large sharps containers for my used syringes. I asked my husband about taking them to work, since that is where he got them for me, and he asked won't I be embarrassed??? I said NO! We are trying to have a baby and that is NOTHING to be embarrassed about. No, I'm not embarrassed in the least! The coworkers know we are trying anyway, so it will be no shock to them if I turn in a huge container full of used syringes. Then he asked if I was going to walk through the parking lot with it? No. I had planned on putting it into a large paper bag, which is what I did today. I then asked the office manager to meet me in my room and told her that I needed a new one. She totally understood. She is the sweetest person in the world. I felt a little bad, though, because she has infertility. No kids. Then she asked how things were going and I went ahead and told her that I was 9 weeks along, but that I wasn't going to get excited until after the amnio at my age. She said that she thought that I might be pg a couple of weeks ago, but she didn't want to ask, knowing it has been a hard year for us. I felt so bad for her telling her today, but she has gone through this with us before, and we have to face it sometime. Gosh, I hope she and her DH can have a baby someday. She is younger than me. I will never ask, though. I know that she broke up with her first husband after their failed IVF. It really destroyed their marriage. So I keep to myself and hope that there is happy news someday. The whole crew and I went out to lunch today for mexican food. It was fun. I got to drive everybody in my new minivan. That was myself and 4 coworkers.