Facing Hemorrhagic Shock as a Postpartum Surrogate Carrier

 

Tara Erkinger is the Director of Electronic Data Interchange (EDI) Management at a local health system near Reamstown, Pennsylvania. She and her husband have been married for 17 years and have four children. She loves to help others and in addition to volunteering as the Vice President of the East Cocalico Parks and Recreation Board, she is also a board member for Cocalico Alternative Sports Association (C.A.S.A.) which helps youth involved in alternative sports. In May, she gave birth to Leo, her healthy surrogate baby

This is the story of her traumatic birth and postpartum recovery.
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After a long night of labor and a herculean push, I became a mother. The joy I felt after they placed my child on my chest is something not adequately defined by the human language. Experiencing that four times in my life is simply miraculous and, being able to help another woman experience that is priceless. Surrogacy allowed me the opportunity to carry someone else’s child to help them complete their family.

The moment I saw the profile and photos I knew they were the ones, so in the middle of a global pandemic, I was matched. The Hoffmans are a beautiful family from Brooklyn who were suffering from secondary infertility. They were able to conceive their first child naturally, but they were struggling to conceive a sibling. Despite being in the middle of COVID, things moved rather quickly. We matched in early April, had contracts done in May, and the transfer was scheduled for June.

On Mother’s Day morning, my water broke at 36 weeks and 3 days: technically still in the “preemie” zone. I called the Hoffmans, who were not scheduled to come to town until our scheduled induction, and let them that know my water broke, and they’d need to head to Pennsylvania. Then I headed into the hospital, not feeling any contractions, and sporting an adult diaper to catch the water that was still trickling and at moments, gushing out of me.

The Hoffmans arrived at the hospital and there were hugs all around. I felt such a huge relief once they were there; I didn’t want them to miss the birth of their child. The labor was long. I was put on Pitocin because I wasn’t in active labor and things didn’t start to progress until after midnight.

A little after 2am the doctor came in to check me and I was almost 10cm. I had a very small piece of cervix left that they felt would move if I tried pushing. They started breaking down the bed and everyone took their positions. I pulled my legs in tight and pushed. I heard the mother say, “Look at all his hair,” and I thought how is he already down that far? After three more pushes, he was thrown onto my belly screaming. He was crying so much; it was such a relief because it meant that his lungs weren't too premature. I grabbed Amanda’s arm and looked at her, tears filled our eyes, and that feeling I couldn’t find the words for hit me a thousand times over as the baby she’d been praying about for years was finally placed onto her chest. 

I will never forget looking at her at that moment and seeing tears rolling down her face. It was one of the most incredible moments I’d ever been a part of next to delivering my own children. I delivered the placenta and then the bleeding began. The doctors spent the next 2 hours compressing my fundus and pulling huge clots out of my uterus. Every time the doctor told me she was going to pull more clots out I cringed, I had never felt a pain like that before. Then I started to get very cold, like Leonardo DiCaprio in the movie Titanic cold. I was shivering so much that my teeth were chattering. I remember saying I’m so cold over and over but nothing they did was helping me warm up. 
My whole body was shivering and at that point, I went into hemorrhagic shock from the blood loss. My heart rate was up to 153, my blood pressure dropped, and my oxygen levels were 67% (normal is >92%). I had lost 2 liters of blood. I don’t remember a lot because I was in and out of consciousness during this time, but I will never forget how cold I felt. I kept hearing everyone calling my name and at one point I remember opening my eyes and seeing my sister Jenn leaning over me crying and it was at that moment I thought I may not make it home. I may never see my husband or kids again. I tried to tell them to make sure my family knows I love them, but I didn’t have the strength to speak, so I asked God to let me see my family again.

I was pumped full of fluids, hooked up to oxygen, and given a blood transfusion, a fresh frozen plasma transfusion, antibiotics for my fever, and tranexamic acid for clotting. A Bakri balloon with tubing and 250cc of fluid was inserted into my uterus to assist in clotting and monitor blood loss. Around 4:30am, I started to regain color and become more coherent. During this time, the Hoffmans never left my side. In a moment when they were trying to bond with their baby, they watched the woman who brought him here fight for her life. I can never imagine how hard that was for them, but their support and love through that meant so much to me, and the fact that they stayed in that delivery room until after 5am to ensure I was safe speaks volumes to the amazing people they are.

Postpartum was the hardest thing for me in this journey and I believe it's because of the traumatic birth experience. A preterm baby and a hemorrhage were not the delivery story I had envisioned when I decided to become a surrogate. When I arrived home from the hospital, I cried all the time because I kept thinking about the hemorrhage and how I could have died. My husband was amazing; he gave me lots of hugs, listened, and talked with me whenever I needed him.

Around three weeks postpartum, I was having episodes of crying that lasted for hours at a time and I was hardly sleeping. I knew I had to reach out for help. I was reluctant to talk to others about what I was feeling because I knew right away, they would think I was crying because I wanted the baby, which was the farthest thing from the truth. Unfortunately, there is a stigma around surrogacy where people think and say things like “How can you give up a baby,” “I could never give a baby away,” or “I’d be too bonded.” When you go into surrogacy you know from the beginning it’s not your baby. I know I will forever be bonded to baby Hoffman and his family, but I know he isn’t mine and I never thought or wished he was. I went to see my OBGYN and they confirmed the tears and emotions I experienced were a mixture of hormones, loss of sleep, and postpartum depression.

They wanted to start me on medication right away, but I was hesitant and asked if I could start exercising again. I thought if I could get back into my normal routines it might help. I felt like I was showing weakness if I had to rely on medication. I agreed to speak to the counselor from the surrogacy agency to let her know what I was experiencing. I also reached out to other surrogates to see what they'd experienced during postpartum. Speaking with the counselor and other surrogates helped me see I wasn’t alone in this and there were other surrogates who experienced a hemorrhage and very similar postpartum experiences to mine. 
While these things helped, I ultimately went on the medication because I was still experiencing a lot of the postpartum depression symptoms, the worst of which was not being able to sleep. I’ve been on medication for two weeks now and I am feeling better and getting more sleep. I don’t think I’ll have to stay on these medications long-term, but I know I needed them to get through this part of the journey and you know, what that is okay!

Being able to recognize I needed help and then accepting the help isn’t weakness; it's the definition of strength. I am so thankful I was given this amazing opportunity to help the Hoffmans complete their family.