# Kidney Failure caused my c-section?



## azzeps (Sep 7, 2007)

Can someone please help me understand this? 7 months later, I'm still trying to understand why I had a c-section, after planning a natural waterbirth in a birth center. I did all the right things, and yet, I still ended up in the hospital because my labor stalled out at 9 cm and I had no urge to push. We went into the hospital after I had spent 3 days in the birth center. We tried everything to get labor going, and I guess it was enough to get to 9 cm but not enough to get the baby out.

I had routine blood work done in the hospital and they put me on some pitocin, which did nothing. Finally the midwife said that they had to do a c-section because my labs came back and basically I was in kidney failure (she didn't use those words at the time). So that's what happened. I'm still trying to make sense of it. What if I had said no, I don't want the section, let my kidneys fail?

This is a very abbreviated birth story. Please ask questions if anything needs clarification, and thanks for your insight.


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## whalemilk (Jul 11, 2008)

I guess I don't understand what you're asking. Do you realize that kidney failure could end up being fatal if they don't treat it? Do you understand what dialysis means and involves? That acute kidney failure can quickly spiral into heart failure as the body overloads with fluids? It sounds like you had a medical emergency and a necessary c-section from what you have said. Are you wondering if it would have been OK to just let your body fail and keep working for that vaginal birth?

??


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## azzeps (Sep 7, 2007)

I guess I didn't realize it was that serious. Yes, I really did want a vaginal delivery. Sometimes I still feel like I gave up, like I failed. Like my body failed me. Like I should have asked for more time.


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## paintedbison (Dec 10, 2007)

I think after three days in a birth center and a failed induction with scary looking lab work... it may have been a medical necessity. Most of the time our bodies work and do what we need them to do... but not always. I'm sorry you didn't get the experience you wanted. I know it will be a hard emotional recovery for you... but I think you did the right thing in getting the section.


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## azzeps (Sep 7, 2007)

Thanks, paintedbison. I guess after spending an entire pregnancy reading and researching and studying and hearing over and over about how so many c-sections are not medically necessary, it is hard to believe that mine was truly medically necessary. I mean, the doctors always make it seem like it's necessary, even if it's not, right? I guess I was so against being in a medicalized environment for this birth that when I ended up there, I just didn't trust anyone.


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## syd'smom (Sep 23, 2008)

I'm sorry your birth experience wasn't what you expected, but yes, kidney failure is fatal. Kidney disease runs in my mom's family (genetic, which is part of the reason I'm adopted), but failure is failure. Dialysis only buys a bit of time; the toxins still build up until you either get a new kidney or..... I hope you are both healthy and happy now!


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## whalemilk (Jul 11, 2008)

I'm sorry your care providers didn't explain the situation to you more clearly. It's possible they didn't want to scare you or make you panic, or that they felt they didn't have enough time to explain because it was an emergency. Although, I still would have hoped they would have debriefed you later at least.

Quote:

I guess I was so against being in a medicalized environment for this birth that when I ended up there, I just didn't trust anyone.
This makes sense, and FWIW I think it's a risky side effect of some of the very adamant focus we sometimes put on staying "natural" at all costs.


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## mwherbs (Oct 24, 2004)

so just your kidneys? how was your blood pressure, platelets, liver labs, white count(did you have an infection)?
how are your kidneys now are you on dialysis?
I am wondering if you had pre eclampsia or HELLP instead of kidney failure - urine protein 300 or above coupled with a bp of 140/90 or above


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## MsBlack (Apr 10, 2007)

I'm thinking exactly what mwherbs said. "kidney failure" may not be what happened at all--however, with pre-eclampsia or HELLP syndrome, "kidney stress" could be indicated by labs and/or B/P. I think you need more information about this, to clarify your understanding. If it really was kidney failure, ok--but if not, if what they meant was 'suspected/potential kidney problems due to signs of pre-eclampsia/hellp syndrome--well that is a horse of another color indeed. It could well be that the csec was indicated either way--but if you plan on having any more kids then 'kidney failure' is a hell of a burden to carry into the next pregnancy!

I would get a record from your birth--especially from the time you entered the hospital, including lab reports and all. Then, find out what labs were done and what the results were; get help interpreting all of this if need be. I think you need a much clearer understanding of all this--both to reconcile the past and to be able to move forward more peacefully and wisely.

In the meantime....I know from my own experience that it can be so hard to integrate the reality of a csec when planning a natural birth. I hope that you will duly credit yourself for your strength and committment in hanging in there for so long, and for your love of your child that prompted you to do all that research and all you did to try to grow a healthy baby and have a normal birth. In other words....as you recover emotionally and also seek some answers, do look for, and accept, all of the good that can be reaped from this experience.


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## nashvillemidwife (Dec 2, 2007)

I had a friend who had atypical undiagnosed pre-eclampsia. Her only presenting symptom at her last prenatal visit was fluid retention and her BP was normal so they didn't think twice about it. Four days later she presented to the hospital not only with full-blown symptoms but already in kidney and liver failure. Telling her that her blood pressure was elevated was the least of their concerns.


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## LilacMama (Aug 18, 2008)

I agree with those who said that kidney failure is extremely serious, but that it sounds like you don't have all the facts you need to understand exactly what happened. Can you get copies of your record and sit down and talk with the midwife or doctor involved in the case? This is important for you when considering future pregnancies. C/S have saved many mothers and babies lives and it doesn't mean that those who needed them are inferior people.


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## felix23 (Nov 7, 2006)

Kidney failure is extremely serious and a good reason to have a c-section. Did they mention anything about pre-eclampsia or HELP? How are your kidneys doing now?


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## azzeps (Sep 7, 2007)

Thanks so much to all of you who have responded. I really appreciate all of your insight and questions. This has been such a long process. I never imagined it would be such a long and emotional recovery. Thankfully, I haven't suffered any long-term problems with my kidneys since the labor.

Quote:


Originally Posted by *whalemilk* 
It's possible they didn't want to scare you or make you panic, or that they felt they didn't have enough time to explain because it was an emergency. Although, I still would have hoped they would have debriefed you later at least.

You are right, they didn't want to scare me. The CNM only used the words "kidney failure" at my 6 weeks postpartum visit. What's odd is that when she told me I would need a section, she also said something to the effect that it was a case of CPD. I know I heard her say that, in addition to the concern about the lab work. I remember saying, "well, this better be one heck of a big baby, then!!!"

Quote:


Originally Posted by *MsBlack* 
I hope that you will duly credit yourself for your strength and committment in hanging in there for so long, and for your love of your child that prompted you to do all that research and all you did to try to grow a healthy baby and have a normal birth.

I guess it's been difficult to do this since I didn't achieve the outcome I wanted. I've felt so foolish for believing that we are made to give birth, and our bodies will know what to do if they're not messed around with. I really don't trust my body anymore. I feel bad because my DD had to be resuscitated after being taken out. She had meconium staining and low cord gas pH. (does anyone know what that means?) Her Apgars were 5, 7 and 9. She had to spend 4 hours in the NICU for observation purposes. Otherwise, she was normal and healthy.

Quote:


Originally Posted by *mwherbs* 
so just your kidneys? how was your blood pressure, platelets, liver labs, white count(did you have an infection)?
how are your kidneys now are you on dialysis?
I am wondering if you had pre eclampsia or HELLP instead of kidney failure - urine protein 300 or above coupled with a bp of 140/90 or above

I do have all the records... Here are some numbers and some of the dictation, if someone can help interpret... I believe the one they freaked out about was the uric acid. I think the midwife said it was the highest number she had ever seen. My birth center midwife gave me a chart from one of her books that said it should be between 2.6 to 6.0 mg/dl

Uric Acid 12.4 mg/dL
creatinine 1.5 mg/dL
WBC 16.7
Hematocrit 41.0
Hemoglobin 14.5
Platelets 205

BP upon arrival at hospital: 131/86
Pulse upon arrival: 112

Notes from the doctors state:
"afebrile with stable vital signs and normal blood pressure. The fetal heart tracing was reassuring"
At this point they offered a c-section but I opted for Pitocin, which did not help me dilate any further.

They diagnosed Stage I Arrest, BP was 150s/90s, markedly abnormal Pre-eclampsia labs, 1+ proteinuria

They started me on Magnesium Sulfate before the section.

They also diagnosed me with Post dates (42 weeks 3 days)

After the section, they diagnosed Anhydraminos (no amniotic fluid) and Meconium staining.

During the course of labor, I stopped being able to urinate and had to be catheterized numerous times by the midwives at the birth center. Could this have been part of the kidney failure problem? Any insight into what might have caused this issue? (so I can avoid it during future labors?)

Gee, if you are still reading, I really appreciate it! Thanks for any and all insight.


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## MsBlack (Apr 10, 2007)

I'd like to hear from the other mws on this, but it does look to me like a diagnosis of pre-eclampsia. In that case, then 'kidney failure' would have been a worst case scenario--it looked to them like you were heading there.

It is not that uncommon, by the way, for women to have difficulty passing urine late in labor. But no, urine retention in the bladder does not connect to kidney failure--your kidneys WERE working, making urine and sending it to the bladder; it's just that you could not let the urine pass. However, later in the hospital, the uric acid finding indicated that the kidneys were no longer functioning as well as they needed to be.

You labored a long long time and probably during that time did not get as much rest, food and fluid as a person needs who is essentially running a marathon--which is not to blame anyone, just to state a probable fact. You had a fairly 'late' baby (tho that is a relative term and possibly not as 'late' for your baby as 42 +3 might be for some others)--point being that this is worrisome for most HCPs because of slightly elevated risk for babies after 42wks. The amniotic fluid was gone, and your own signs were troubling in various ways....it was time for baby to come out. Agreeing to a caesarian was the right thing at that moment, most likely the healthiest thing for you and baby both.

But this does not mean you are broken or that you will experience all or any of this again. I'm sure there is a lot more to this story, and various ways in future you can work toward a normal birth. For one thing, did you ever find out if baby was posterior, or otherwise stuck in a poor position? Did anyone provide insight concerning the size/shape of your pelvis--any of the mws or docs, or have you seen a chiropractor? (if you haven't seen a chiro, I'd recommend it for evaluation and work to improve pelvic alignment/mobility). You say that labor 'stalled' and you worked to 'get it going'--yet there are different ways to approach the matter of a labor like yours....something else that bears another look.

Also, while it seems that the research shows that pre-eclampsia is essentially inevitable for a small number of those who experience it, due to predisposing genetic factors--the majority of women ARE able to avoid it later through various measures (and there are some good threads here on the topic). And maybe I'm all wrong here, but from your story I can't help but wonder how much the course of labor itself contibuted to the development of problems eventually found via labs: labor's length, the likelihood that you didn't get enough calories, AND eventually, under a tremendous amount of stress, given the notion of a 'stalled' labor and time ticking away on a 'late' baby (speaking here of the mental/emo stressors you were likely dealing with at the time).

In any event, there is much to possibly 'unpack' as you heal and move forward....and in my mind at least, very real possibilities for a normal birth next time. Meantime, DO credit yourself; few women would have found the grit and strength to hang in there so long. And you DID grow a healthy baby who survived way more than the normal amount of labor stressors very very well! You DID make the right decision at the time to allow surgery--little that you wanted to do so, your love for your baby did guide you rightly. Yes, you are grieving and questioning--and that is right too, this has been so hard on you in various ways.

So, I do NOT say "well, you made the best choice and have a healthy baby, so don't grieve"; instead I say--while you grieve, while you work through and honor your emotions that only naturally and rightfully spring from such a difficut and disappointing experience, ALSO honor your courage at the time, ALSO remember the good good work you did then.


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## mwherbs (Oct 24, 2004)

so you had Pre eclampsia that seems to have started in labor the PE labs and then your blood pressure elevated to fit the picture-- this alone stresses the kidneys labor obstructing urine flow as well --- Did they give you IV fluids when you got there? no amniotic fluid seems like you must have been dehydrated -
that you were dilated to 9cm for so long and even with pit (and I am guessing adequate contractions) did anything change? - sometimes babies need time to find their way, sometimes babies move in labor to what they think is a path of least resistence (posterior) and then get so far and cannot move that there was little fluid would contribute to the baby not being able to easily move out of the position it decided to take on the way out-
I think that the term CPD could be used for this baby, this birth this time-- it is unusual to be so far dilated and not continue to contract-
but I also want to say something about how your body did work and did work well- you got to 9 cm dilated-- that alone is no small feat and that you labored for 3 days also speaks to your overall ability and endurance--
you were also getting sick (PE) and perhaps your body did the most conservative thing it could do to protect you at that point and that was to stop/slow labor- it seems you didn't have enough fluid (and probably electrolytes in general) and that can contribute to the muscles not contracting properly also no fluids going out- or not easily going out.
I would say that this is not necessarly a repeating situation - unless you have a chronic illness like diabetes that has not been recognized before this will probably not happen again if you were to have another baby-
I would also recommend that you go get a physical- labs and a urine test to see what your kidney function is, and a glucose tolerance test just to rule out any ongoing health problems, most likely you are healthy
there is probably no simple way to just be normal , but there are ways to come to peace with this
take care

take care


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