How is you Monday going? I hope your weekend was restful as well. It was a weekend in which the thermometer was at 0 degrees all weekend – so we did a lot of snuggling indoors in between the regularly scheduled grocery run.
We get to hear part 2 of Chelsea’s birth story today! If you missed part 1 of her birth story, catch up here. Her postpartum story is amazing, awe-inspiring and was anything but a normal postpartum recovery. I remember seeing Chelsea during postpartum rounds and checking in on her during her maternity leave…but before I get ahead of myself – I’ll let Chelsea tell it. Here’s her postpartum story:
My biggest wish postpartum was to get showered as soon as they would let me up. I told my nurse as soon as my epidural wears off, I need to be in that shower! We waited and waited and waited longer than normal. Two hours after my epidural was removed, I still was not confident enough to get up. I still had not regained feeling or movement in my left leg. I asked for the nurse to page anesthesia who refused to come see me yet. He wanted to give me another hour for the epidural to wear off. An hour later, I asked my nurse to call back. She was uneasy about calling but did (it was not the nicest anesthesia provider on that night). He still refused to come see me. I stood up for myself at that point, requested my nurse or the charge nurse page him to come see me immediately or I would call him myself from my personal cell phone- perks of having access to the call list. I knew it was not normal to be 4 hours post-epidural with no feeling in one leg! At this point, I’m thinking worst case scenario and was so concerned about the epidural placement because it appeared so easy and rapid earlier in the day.
The anesthesia provider came to see me. He was new to this shift and did not place my epidural. He did a lengthy neuro assessment and admitted to me that he was unsure of what happened, but it wasn’t good. He said we’d have to wait until morning for a more experienced anesthesia provider to come see me and assist with figuring out exactly what’s going on. “It’s not good.” Excuse me? It’s not good. YOU refused to see me, when I knew something was wrong in the first hour after birth and now you tell me, “it’s not good.” I’m a very calm person but I was not happy at this point. My left leg was numb from my hip to my ankle. I could not move it and I had absolutely no feeling or sensation in it whatsoever. He advised me that I needed to stay in bed and not attempt to sit up/get up until morning. We didn’t know any better to do anything otherwise at this point, so we did just that. By morning, I had a God send of a nurse in my corner (shout out Brandy Aiken!!). As soon as she took over my care, she had the team of anesthesia providers and OBs in there to see me first thing where they started to diagnose me with nerve damage from childbirth. With the providers go ahead, she cleaned me up, changed my sheets–you know, the ones I birthed my child in because I couldn’t move at all the night prior– and she and my husband carried me to and from the shower. I could cry. I just wanted to shower. It was so amazing.
The next day and a half were a bit of a blur. My blood pressure was elevated still, I had anesthesia, OB/GYNs, midwives, nurses, neurologists, lactation consultants, pediatricians, and physical therapists visiting at all hours. In addition, my hospital commanders and coworkers were visiting me constantly (which was so welcomed for me as an extrovert to keep my spirits up). Every single one of these people had my best interests in mind. I vividly remember an intense discussion at the nurse’s station outside of my room that included the raised voices from my care team specialists arguing about what was best for my care and my child’s ability to continue to breastfeed based on some medications we would be trialing for the nerve injury. I cannot shout it loud enough that LANGLEY AFB DID ME GOOD. They cared for me and treated me immediately after recognizing my nerve injury. When I first saw the neurologist and physical therapists, they warned me that I may never be able to run again. They told me I may never walk without a cane or walker. We all knew that only time would tell how permanent the nerve damage would be.
I quickly found an online support group for women who suffered from femoral nerve injury from childbirth. Many women went undiagnosed for months and suffered permanently because of the delay. They weren’t able to get into physical therapy for months after their birth injuries. Many women never even saw a neurologist. Their nerves and muscles weakened during those extended periods without interventions. Many have long-term and permanent damage. Within 24 hours of my birth, I had a diagnosis, specialty care, and already had two PT sessions in-hospital. After my delivery, I could not walk on my own. I could not move around with my baby. I could not hold my baby and transition to various positions on my own. I could not safely move my own child to care for him. I could not get up to change my own pad or my son’s diapers without assistance. Childbirth and motherhood are difficult as they stand. For a moment, imagine not being able to get up to change your child’s diaper or pick him up to bring him over to nurse. It would’ve been so easy to feel upset or completely shut down with this injury, but I just knew I couldn’t not walk ever again; I couldn’t not run ever again.
For the next four months, I attended physical therapy 3 times a week and fought to push my muscles to complete fatigue each session. I was in the gym 5-6 days a week re-strengthening muscles to further stabilize my leg and prevent any further atrophy. I had ANGELS caring for me while my husband worked out of town. My physical therapy clinic not only allowed me to bring my son in for my appointments, but they would safely carry him to and from my car for me. I had strangers push my son’s stroller into the gym for me and park it next to an elliptical while I crutched in next to them. Little by little, I gained feeling back in my leg and the numbness began to fade until it only surrounded my knee. I had several months of knee buckling and a few falls, including one with my son in my arms. It could be so easy to feel defeated through this, but I really was just determined. I learned to walk again which transitioned to running on the Alter G treadmill, and eventually running on a normal treadmill again. Next, I ran outside with an empty jogging stroller for stability and finally, I ran with no assistance at all. At 11 months postpartum, I not only ran, but crushed a half marathon in hilly Nashville. Finally letting my emotions get to me, I started crying throughout the last mile of the race. I did it– I ran again.
Looking back, there are a few things I can say that I think contributed to my nerve injury, but nothing directly caused it. Prolonged pushing, lithomy positioning, epidurals, stirrups, nurses/partners force pushing legs back, and improper baby positioning have been shown to lead to nerve injuries. My nerve damage was identified in the femoral region versus being caused by epidural placement or nerves in my spine. However, because I had an epidural, I believe I was unable to feel the pain of when the injury actually occurred during pushing. I think prolonged pushing and pulling my legs back contributed to my injury. While I mainly held my own legs back, occasionally a nurse or my husband held a leg with me. I have some pretty intense photos of me pulling my own legs back… all the way to my shoulders, which could have also contributed to the injury.
Many women I meet with this injury have a direct cause– a nurse forced their legs back the entire 3-4 hours of prolonged pushing; they remained in stirrups for multiple hours pushing, they had an epidural mistake with spinal involvement, etc. Generally, prolonged pushing seems to be a component. I don’t feel like there was any possibility for malpractice or direct cause in my injury. It was probably just the perfect storm of risk factors coming together. Moving forward, I dream of my next birth constantly. I have had to have some follow-up physical therapy due to compensation injuries. My most recent physical therapist was amazing, but advised me to consider a c-section with future children to avoid this injury again. Many mamas I have met will not consider attempting a vaginal delivery after their initial injury or have providers who will only recommend a scheduled c-section after this type of injury. I have met with a few providers while trying to conceive again who are supportive of a natural vaginal birth in my future. I also should mention that this injury is not unique to vaginal deliveries; it can occur with c-section deliveries as well. For me, willingly going into a major abdominal surgery that carries the risk of another femoral nerve injury in addition to surgical risks, is riskier than considering a natural vaginal delivery understanding the complications could always occur again.
I do not regret my birth story and I would not change a thing. My husband refers to my nerve injury as a “blessing in disguise” because it forced me to slow down for this period in my life. He jokes that I can never just rest; I always have to be doing something, and he is right. This injury let me soak in all the sweet cuddles, naps, and moments with my little guy during my maternity leave without worrying about chores or my to-do list.
WOW. You guys?! Do you have all the feels? Chills? Shock? Heart warming smiles? I have them all reading her story and I was there for parts of it! It brings tears to my eyes to see her after she finished her race too. So inspirational. Thank you for sharing Chelsea!
I asked Chelsea about the sites and support groups she utilized and she recommended:
- This website: Nerve Damage from Childbirth
- This facebook group: Moms with Femoral/Peroneal/Sciatic Nerve Damage from Labor/Delivery
I specifically asked Chelsea to share her story because of an article in JOGNN published in November 2020. We’ll chat Wednesday on what YOU can do as a nurse, a mama, or a provider to prevent lower extremity nerve injury in birth. See you then!
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