‘I went into cardiac arrest during labour due to a rare amniotic fluid embolism'
Six months after suffering a chemical pregnancy (which is a miscarriage that generally happens before the five-week mark), I found out I was pregnant with our son Callahan, or Cal, for short. He would be the first grandchild on both sides, so it was exciting for everyone in our family. I had what most would consider a normal, healthy pregnancy. I stayed very active. We actually moved two weeks before my due date, and I was carrying boxes no problem.
At 40 weeks and two days along, I went for a check-in with my obstetrician. (From this point on, I really have zero memory of what happened to me because of retrograde amnesia. I'm an information gatherer, so the specifics been relayed to me, and I got all of my medical records and combed through them after the incident. I've also interviewed, at length, all of the people involved in my care and my family.)
I never could've predicted the turn of events that would happen in the days to come.
At that 40ish-week mark, I was technically past due. I had a high blood pressure reading at the beginning of my appointment, and my doctor wanted to see if it got better by the end. It did not, so she sent me to triage. I started hysterically crying. My doctor said, 'You've been very even-keeled this whole time, what's happening?' My husband said I was uncharacteristically anxious. He specifically remembers me tapping my foot over and over again in the waiting room.
In triage they recommended an induction. I had some fear around the idea of being induced, but after talking at length with my doctors, I felt confident—according to my text messages to friends at the time—that this was an okay process and I could do this. I was zero-percent effaced, zero centimetres dilated.
Two and a half days after the start of the induction—a length of time that is quite normal for first-time mums—I was finally 10 centimetres dilated. My OB went to gown up and prepare for delivery, and as she did, I turned to my nurse and said, 'I'm not feeling well.' She said, 'Well, you're 10 centimetres. That is normal for transition. I'll get you a bag to be sick in.'
I don’t remember what my exact symptoms were, but I'm a people pleaser and I want to be the good patient that doesn’t ruffle feathers, so something had to have been very bad for me to speak up. As the nurse got the sick bag I started screaming that something was wrong with my heart. She hit the rapid response and then immediately hit code blue because I went into cardiopulmonary arrest seconds later.
ICU nurses and critical care teams flooded into my room and made the decision to take me immediately to the operating room.
CPR was started, and my OB got my son delivered within six minutes of the code being called—and it absolutely saved his life and gave me a better chance of survival. Cal had to be resuscitated and was put on a continuous positive airway pressure (CPAP) machine for a few hours, followed by oxygen. He was out of the NICU within 24 hours and has had no lasting complications.
CPR continued on me for about another 10 minutes before they were able to resuscitate me.
At this point, my OB assumed I was having an amniotic fluid embolism (AFE).
An AFE is an anaphylactic-like response to amniotic fluid entering maternal circulation. Most patients who are pregnant get amniotic fluid in their circulation, but a very small percentage of us have a major immune reaction to it, like going into cardiopulmonary arrest like I did. It isn’t treatable—doctors can only use supportive measures to hopefully get the patient through to the other side. Most OBs will not see an AFE in their career. It occurs in only two in 100,000 births per year in the UK.
There are typically two phases to an AFE: cardiorespiratory arrest, or at the very least acute respiratory distress, and then disseminated intravascular coagulation (DIC), which is a bleeding disorder that has a very high mortality rate. Your blood clots everywhere it's not supposed to, which consumes all of your clotting factors, and then you bleed out. Knowing that, my OB prophylactically inserted what's called a Bakri balloon in my uterus, which helped to stem the bleeding there. She also ordered a massive transfusion protocol even though I wasn't bleeding yet. I’m thankful she did that because I ended up needing 143 units of blood product (that's a lot).
Once I started bleeding, they put blood in as fast as it was coming out. I went into cardiopulmonary arrest again, so CPR had to be restarted about an hour later. At this point, the vibe, for lack of a better word, in the OR was very much: We've done everything we can. We don't see her coming back from this. Somehow they were able to resuscitate me within the next few minutes, and they made the call over to another bigger medical centre within their system for extracorporeal membrane oxygenation (otherwise known as the life-supporting measure ECMO). They knew if I couldn't get on ECMO, I wouldn't survive—I would just keep going into cardiac arrest.
They brought ECMO and a team over from that bigger medical centre and were able to stabilise me.
I was still critically ill, and with the DIC, they needed to do a hysterectomy.
They took me back into the OR to do the surgery and removed my right ovary because it was just a massive hematoma. Then they packed my abdomen and left it open because they knew they were going to have to continue to go back in subsequently. Then they transferred me, still on ECMO, to the medical centre.
Though ECMO was keeping me stabilised, my heart wasn't recovering. My cardiologist went to my family and said, 'We've tried everything to get her heart to pump effectively. The ECMO is keeping her alive, but if we don't get her heart to start pumping and clearing out blood, it's going to clot and she's going to die.'
She recommended inserting a tiny heart pump called the Impella. She described it to my family as this little windmill device that would go into my left ventricle and offload all of that work that my heart wasn't doing, with the goal of giving my heart a rest to recover. She was honest with my family, telling them she’d seen it work before, but that this was such an intricate case, she didn’t know if it would work or not.
Thankfully, it worked. Doctors expected me to be on ECMO for at least two weeks and then spend another few months recovering and rehabbing in the hospital. But after 24 hours on the Impella, they took me to the OR to not only remove the device but take me off of ECMO too. I was still intubated and having abdominal surgeries every morning to tie off any bleeders and clean out the sternum-to-pelvis incision.
I was extubated three days after the AFE and met my son the following day. I have no recollection of that moment, but my family did a fantastic job documenting everything, so we have a really beautiful video of it.
I expected to sail off into the sunset as a happy family of three. But, when we got home, it was the absolute opposite of that.
The first memory I have of my ordeal is from about five days after my heart stopped. It’s of my OB and anaesthesiologist sitting down with me to explain what happened. The next day I was transferred down to the regular ICU, and 14 days after my AFE, I was transferred straight from the ICU to home.
Everyone was traumatised. My parents were living with us. I adore them, but no one wants their parents living with them and their brand new baby for six weeks. I could not take care of my own child at all, and I really wanted nothing to do with taking care of him.
I was so out of it. I was so sick still, and I would just sit on the couch and watch everyone else take care of him. We definitely experienced some delayed bonding, which is pretty typical after birth trauma. It took probably about a month for me to be able to start integrating into his care and feeling physically okay enough to begin to do that.
The hysterectomy will always be one of the most difficult parts of my story. Even though I would choose to have that hysterectomy every time, because it meant surviving and getting to be Callahan's mom, I still didn't get the choice. We planned to have more than one child, and I know Callahan would make the most incredible big brother, but, that's not how our story goes. I am eternally grateful to my team who not only made all of the right calls, including the hysterectomy, to save my life but who also delivered this news with such empathy and compassion, truly understanding the impact it would have on my life and our family.
The physical recovery happened much more quickly than the emotional recovery, which is ongoing.
As a licensed therapist myself, I thought, Everyone will be going to therapy. You're all traumatised. But I didn't realise how bad it would be for me. I got into therapy the first week after I was discharged. My perinatal therapist was with me for three years, and she absolutely pulled me out of the awfulness that was this experience. There was a lot of guilt and a lot of shame related to birth trauma and being told that my body should be doing this in a certain way and was made to do this but didn’t.
I felt like my son suffered because of that. There was a lot I was holding onto, and I didn't feel like I had any right to because I was here and he was here. That's really when I decided to talk about it openly—the emotional side of birth trauma from both my professional experience as a therapist and my personal experience going through it—via platforms like TikTok and Instagram.
I've received a really good response overall. I got a message on TikTok once from a bunch of nurses who said, 'We were slow in labour and delivery the other night, and we were watching your TikTok. We were like, We should brush up on amniotic fluid embolism just in case.' A week later, they had an AFE and saved the woman. It gives me chills, and I get a little teary when I think about it.
When I reflect on what happened to me, I think along two avenues.
On the medical side, I want patients to speak up. I want patients to know that if things are wrong, you can say that things feel wrong. I want them to be able to advocate for themselves. On the birth trauma side, I want people to know that if you experienced trauma during the birth of your child, you're not crazy and don't have to hold it by yourself. Sometimes these things happen, and it's unfair, and I wish that people knew that they weren't alone and that it does get better.
When there's trauma that interrupts the transition into parenthood, especially when it's your first kid, we end up on the other side thinking, Oh, this is just how it feels to be a mum. That's terrifying, when really it's the trauma that's playing a role in that. It will get better with treatment and with time.
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