Continuing with C-section stories, (see Jill Arnold’s story from Wednesday), today we share Kristen Terlizzi’s journey with you, as she endured and overcame hardship during her second birth due to a largely unknown condition that resulted from a C-section during her first.
In 2012, I was 30 and thrilled to be pregnant with my first child. I was healthy, active and fit. The pregnancy went great, but at 36 weeks my husband Jeff and I learned that our son was head-up breech. My obstetrician advised a cesarean and alerted me of the increased risks of things like blood clots or infections and a longer recovery time than a vaginal birth. I was disappointed, I had never wanted a cesarean. But I understood the benefits too and I wanted a healthy baby. A month later, Everett was born via planned cesarean. The C-section went fine, it was faster than I had expected and without complication. I recovered well.
When Everett was a year old we were thrilled to find out that I was pregnant again. Everything went well until my 18 week ultrasound when I learned that I had Placenta Previa – placenta covering the cervix. Weeks later my imaging revealed that my placenta had invaded my prior cesarean scar and developed into Placenta Accreta, a rarely discussed complication where the placenta imbeds too deeply into the uterus. I had never known that a prior cesarean puts the mother at risk of developing this life threatening complication in a future pregnancy. Placenta Accreta carries a maternal death rate of 7% and puts the mother at high risk of hemorrhage when the placenta is removed. My imaging would go onto show that I had developed the most severe form, Placenta Percreta, and that my placenta had invaded my bladder.
In July 2014, at 32 weeks pregnant, I was admitted to the hospital where a team of 20 specialists began planning my complicated birth. I delivered in the main OR at a tertiary trauma center at 33 weeks and 6 days gestation. Although premature, my second son Leo did great and was born healthy. My case ended up being more risky than expected and I would spend two months postpartum in the hospital. I ended up requiring an emergency hysterectomy and bladder resection where I hemorrhaged, but my team was prepared and they were able to transfuse me with 26 units of blood products and remove my placenta successfully.
It was a tough road, but I’ve made a full recovery and am doing great now. My son Leo is a healthy 3 year old and you’d never even know that he was ever a preemie. Since my experience I’ve learned that cesarean rates have increased drastically over the past 30 years and now account for 1 in 3 births. Placenta Accreta used to be very rare, but as a result of increased cesarean rates, Accreta now affects 1 in 333 births. Studies have shown that many of these cesareans may not be necessary, and it seemed like no one was talking about Placenta Accreta. My story illustrates the potential future cost of every cesarean, and after my experience I wanted to bring attention to Placenta Accreta, cesarean reduction and patient safety in maternal health. So I started telling my story at hospitals, blood banks, medical schools and conferences.
Now, I’ve presented my story to over 60 California birthing hospitals as part of quality improvement initiatives to reduce primary cesarean rates. I am proud that I have brought attention to Placenta Accreta and have helped care providers to connect why cesarean reduction is so important. It’s not just about reducing cost and recovery times – it’s about patient safety. My story resonates and by sharing it I hope to make women aware of this potential downstream complication and to help providers consider a woman’s reproductive future when making delivery decisions.
While what happened to me was unfortunate, I recognized that it gave me an opportunity to improve maternal health and ensure that there are fewer stories like mine in the future. I am proud that my story has played a critical role in igniting a large scale conversation about increasing patient safety in maternal health.
Kristen’s story highlights the importance of the PVI Principles of Safety, Information, and Accountability. We hope, as she does, that her experience helps prevent future mothers from enduring the same hardships during their own pregnancies. Thank you for sharing you story, Kristen.