March 22nd, 2019 

On, Friday, March 22nd, 2019 I woke up to a golf ball-sized blood clot and immediately called the number listed on my discharge paperwork. I was told on the phone by the nurse that this size blood clot was normal and to come in if I had soaked through a menstrual pad in less than an hour. Following the phone call, I fed my daughter and laid down for a morning nap. When I woke up from the nap, I felt something wet under the blanket, I looked down and saw there was a lot of blood underneath me in the bed. I jumped up and ran to the bathroom where I continued hemorrhaging. I will never forget rocking back and forth with my mother holding me, not having any idea what to do. I could hear my sister on the phone with the paramedics. Then suddenly, I could feel myself beginning to pass out. This is when my mother and my husband laid me down and my husband continued telling me he loved me over and over again. 

When paramedics arrived, they saw me lying there and saw how much blood I had lost, which they noted to be approximately 2 pints (900ML) and I had an initial blood pressure of 70/30. They then called Womack Army Medical Center. The hospital stated that they could not accept critical patients, so I was taken to Cape Fear Valley Hospital (a civilian hospital in Fayetteville, NC). When I arrived at Cape Fear Valley Hospital, they assumed it was a “normal” Postpartum Hemorrhage that some mothers experience after giving birth. 

They did an urgent suction D&C surgery. During the procedure, they found there to be “multiple retained products of conception, likely the placenta. At this time the uterus began to firm up nicely, however, the bleeding had not ceased.” Because the bleeding had not ceased, the decision was made to insert a Bakri 

Balloon (which is used to provide control or reduction of postpartum uterine bleeding when conservative management is warranted.) The estimated blood loss during this procedure was 1500 ML. 

Saturday, March 23rd, 2019 

24 hours later, on Saturday 23rd of March, I was taken back into the OR to remove the Bakri Balloon. During this procedure, I lost an estimated 900 ML of blood. That evening around 1800 I passed a very large blood clot. 

Sunday, March 24th, 2019 

Around 0400 on the morning of Sunday, March 24th, I began to Hemorrhage again. I was taken back into surgery. They completed another D&C and another Bakri Balloon. However, when they were in surgery this time, the Dr. realized the bleeding was not coming from my Uterus itself, but it was coming from my right uterine artery. Dr. Conrad told my parents that they completed the 2nd D&C, however, they could not stop the bleeding. She informed my parents that my right uterine artery had been lacerated during the c-section and the sutures previously placed on the artery had ruptured and failed causing this ongoing bleeding. She informed them that the tissue was damaged from the attempted repair. She then informed them that I needed to go immediately into surgery for a uterine artery embolization to try to repair the injured artery. However, because I had lost so much blood, I needed to receive more blood transfusions before they could complete the embolization procedure. Dr. Conrad then asked if my mom or dad could donate blood. My dad offered right away and asked if he could donate in case I needed more blood transfusions after the embolization procedure. Dr. Conrad said there wouldn't be enough time to test the donated blood for surgery that day, but that if he did donate, they could use it for future blood transfusions. 

At approximately 1700, I was taken into surgery to complete a Uterine Artery Embolization (UAE) which is a procedure where tiny particles (about the size of grains of sand) are injected into the blood vessels that lead to the uterus). During this procedure “approximately 1 cc of Gel foam reconstituted in strength contrast was then hand injected under fluoroscopic guidance into the distal branches of the right uterine artery.” They also noted on my right internal iliac artery angiogram “A large right-sided uterine artery area of active extravasation is noted.” And “right uterine artery area of active extravasation is noted.” Extravasation is the leakage of fluid out of its contained space into the surrounding areas, especially blood from vessels.

Following my procedure, I was informed by the doctor at Cape Fear Valley Hospital that my right uterine artery had been cut during my C-Section and was sutured; however, the suture did not hold causing me to bleed out. This was an Intrapartum Injury that I was never made aware of, it was never listed as a complication in my discharge papers or my medical records. 

March 26th, 2019 

I was discharged from Cape Fear Valley Medical Center. 

After being released from the hospital, we noticed that my newborn daughter could not move her right arm. We went through previous photos that had been taken and noticed that this was something that had been present since birth. We then remembered that my daughter had not cried at all when they placed the IV in her right hand on the day of the delivery. So we immediately got concerned. We scheduled doctor’s appointment to try to determine what this could be. 

March 27th, 2019 Everly was originally diagnosed with a right wrist drop, then diagnosed with Klumpke Pasly, then on April 11th, 2019 she was diagnosed with a brachial plexus injury. 

April 18th, 2019 

Approximately 3 weeks later, on the 18th of April, 2019 I suffered another postpartum hemorrhage at home. I was taken to Cape Fear Valley Hospital by ambulance, again. Over the next 24 hours, I was given medications like Tranexamic acid (TXA) to try to stop my bleeding. I was also given 5 blood transfusions. This helped me make it through the night. 

April 19th, 2019 

After I came off the medications that were given to me the night of April 18thI immediately began to hemorrhage again, passing large-sized blood clots. On the 19th of April 2019, I was taken back into surgery for another Uterine Artery Embolization procedure. In the surgical report, it stated “Review 4/20 – UAE – Dr. Shakespear “a pelvic angiogram was performed and showed abnormal opacification” in the right pelvic region with early opacification of the right gonadal vein. Right internal iliac artery was then selected, and a right internal iliac arteriogram was then performed which showed abnormal opacification in the right hemipelvis with early fillings of the right gonadal vein. These findings suggest an AV Fistula formation from the previous intrapartum injury. The right Uterine Artery was then selected with a high-flow microcatheter. Right uterine arteriogram was then performed which confirmed the findings of AV fistula formation.” 

This time, with a bead and coil which the doctors were fully convinced would stop the bleeding for good. Within 45 minutes after that procedure, I hemorrhaged again, however, I could not move due to the required rest time of the Embolization. That evening was very traumatic for everyone. Due to the amount of bleeding, the doctor had to put his entire forearm inside of me to apply pressure to where the bleeding was coming from. I was in and out of consciousness and my heart rate was increasing. Once they were able to control my bleeding, I was transferred to the ICU.

April 20th, 2019 

Over the next 24 hours, I was given multiple blood transfusions, Premarin Injections (which are typically used in the treatment of abnormal uterine bleeding due to hormonal imbalance in the absence of organic pathology.), Methergine injections (which are used to prevent and control bleeding from the uterus that can happen after childbirth.) and was closely monitored to try to stop my bleeding. 

April 21st, 2019 

On the 21st of April 2019, after I was taken off these medications, I hemorrhaged again almost immediately. This time, it was far worse than any other hemorrhage I had ever had. I had soaked the hospital bed through the bottom and through the top of my blanket. The Dr. had gone back and forth on what the next steps were because every single viable option had been pursued and failed. The only thing left to do was to have a hysterectomy. I was immediately rushed down to pre-op. I had been hemorrhaging so bad, that the doctors didn’t even wait for the transport team to arrive. The nurse herself wheeled me down into the OR. On the way to surgery, I could feel myself hemorrhaging. I could feel the blood clots, the size of golf balls spitting out of me. The last thing I remember is looking at my husband and telling him “I was so sorry I wouldn’t be there to see her grow up and begging him to tell her that I loved her every day”, before passing out. I will never forget that feeling of not knowing if I was going to make it out of surgery. Coming out of surgery my hemoglobin was 5 g/DL, which is considered critically low and close to death. “Hemoglobin levels have to be extremely low (below 6.5 g/dL) to cause death.” After the procedure was completed, the Dr. who performed the hysterectomy concluded that no matter what was done, I would have eventually had to have a hysterectomy due to the intrapartum injury I suffered during my C-Section at Womack Army Medical Center.