Let me start by saying that this is a very personal post. I have been toying with writing about this for a long time, but always get stuck somewhere between sharing too much of something so personal and helping someone. I was finally convinced a couple weeks ago that it’s time to tell the story, the story of Giovanna Phoenix Ramirez. My intent is to tell people what happened, so that maybe people that have been through something similar would know that they aren’t alone, and God forbid, anybody that goes through something similar in the future may have an idea of what to do in the middle of the chaos.
So let me tell you what finally pushed me to write this. I was at the Maternal Fetal Medicine Clinic at Loma Linda, for my 33-week check up, and when I was scheduling my next appointment, the nurses were writing a referral to another patient to see a doctor in my town. I live two and a half hours away and there is only one OBGYN in my town, I’ll call him Dr. M, so when the nurses mentioned the doctor’s name I knew that she was from Ridgecrest. I turned to her and asked her if she was from Ridgecrest even though I already knew the answer. She replied that she was, and asked me if I was. I said yes, and she next asked me why I wasn’t seeing Dr. M. I couldn’t reply for many reasons, which I hope you’ll understand by the time you’re done reading this, so she asked me if I was pregnant with my first or second to which I replied “It’s my second only because the doctor you’re seeing lost my second”. The nurses immediately jumped all over me saying, “Don’t say that!” and then began telling her it would be fine. As I looked at the girl who asked me and watched her face drop I thought to myself that maybe I shouldn’t have said anything, but after thinking about it for a while and talking to those close to me, I realize that if I help one person by telling my story, then it’s completely worth it. So here’s the story of Giovanna Phoenix Ramirez.
The month of July 2009 was full of big plans and big events for our family. We were moving into our first home that we had been building the previous four months. We got the keys on the first of July and started moving in immediately. It was the standard self-move full of boxes, clothes, and furniture. On the second of July, I was busy steam cleaning our couch because I had noticed that there were black spots on it from some boxes that had been set on top of it. Now, at this point I was 20 weeks 6 days pregnant. We already had one son who was a little over a year old and decided to keep the sex of the second a surprise. The pregnancy had been going great. Completely different from my first. I felt healthy, energetic, and happy! I was sick with my first a lot, and felt drained throughout the pregnancy, but this pregnancy was different. Because we hadn’t finished moving our furniture in, we were staying at my parents for the night. During the middle of the night our son, who was sleeping with us, woke up from a nightmare. After consoling him, I got up to use the restroom and noticed that I was bleeding.
Before I continue, I want to talk about the town I live in and the hospital for those that aren’t familiar with Ridgecrest. I live in a town of 26,000 people, and the nearest metropolitan area is about an hour and a half away. We have a hospital that has no ICU or capability to handle major emergencies. Patients are usually transported to Loma Linda or Bakersfield, C A if they need care that Ridgecrest Regional Hospital cant give.
When I noticed the blood, I wasn’t sure what to do. My whole family was sleeping, and the pregnancy had been going so smoothly I didn’t want to freak out needlessly. So I called my insure providers nursing line. The nurse said that I should seek treatment, but that it wasn’t necessarily a bad thing. I woke up my husband and told him what was going on, and by this time, my mom was already up. My husband encouraged me to go to the hospital. We headed off to the E.R. at about midnight and left our son with my mom.
We waited about an hour in the E.R. and when we finally saw a Dr. he said that I probably had a urinary tract infection, prescribed me some anti-biotic and made an appointment for me to see an ultrasound technician the next morning. Apparently, the hospital didn’t have any ultrasound technicians on call. So I went home and barely slept.
My husband and I woke up first thing in the morning to go see the ultrasound tech. At this point, we still hadn’t found out what we were having. We already had a boy and we were fine with whatever we were having next. When the ultrasound began, the tech. asked us if we wanted to know the sex and we said no. As the appointment continued, the techs face began to look more and more concerned. When she left the room in the middle of the appointment, my husband and I knew that something was wrong. She returned and said that Dr. M said he wasn’t our doctor, and she asked us if we had been seen somewhere else. I explained that he was in fact our doctor and had an appointment with him next week, and had seen him throughout this pregnancy as well as my first. She called him again, and he said that he would see me at my next appointment. She couldn’t hide her concern anymore, and told us that we needed to go get treatment somewhere, anywhere. She told us that she suspected that I had an “incompetent cervix” and I had started to dilate. I was at 3 centimeters already. We were in shock and weren’t sure what to do next. We asked what we were having as we were leaving, and got amazing news that we were having a little girl!
As we were leaving the hospital, I called Dr. M and his nurse told me that his instructions were that I should just lie down and try to stay in bed until he saw me next week. Dr. M didn’t seem that concerned, and I wanted to trust him. I felt that if he wasn’t worried, I shouldn’t be. I didn’t want to overreact. I know someone that overreacts about every health concern, and after awhile you stop listening to them. I didn’t want to be that person so we went home. I wanted to trust my doctor. Trust that they wanted to do the right thing and would never put me or my baby in harm’s way.
I stayed still Friday day but by that night, my bleeding had picked up. My husband and I went to the ER again, and this time I insisted on being checked into the “B” Wing. The “B” Wing is the Birthing Wing within the hospital. They called Dr. M who then said he wasn’t treating me for anything and I was discharged faster than I had been checked in. I went back to my parent’s house where we were staying picked up our son and went to our new and empty house. Luckily, my husband and my dad had put together our bed and enough things that we could stay there. I was worried and confused. I cried myself to sleep.
The next day I stayed mostly still. I was up and down, but refrained from doing anything strenuous. That afternoon I was using the restroom and I noticed that a bag of bulging water was protruding. I told my husband and we dropped our son off at my parent’s house again, and we headed to the hospital. I checked myself into the “B” Wing again. The nurses called Dr. M again, and he said that if I wanted to, I could stay, but that he still wasn’t treating me for anything so I could only stay one night. Every time I tried to show the nurses the sac, it would recede. I’m not sure if they believed me or cared. We laid in the birthing wing listening to the nurses discuss who was going to Dr. M’s house for his 4th of July party, and who was going to wear what. I was astonished, mad, sad, confused….you name it that I still hadn’t been seen by Dr. M and that part of it was because he was having a party. I cried myself to sleep again, but this time in the hospital.
The next morning I woke up to use the bathroom, and the sac was showing. I called the nurse in to see it, and she finally called Dr. M confirming that she had seen it. At this point, he still hadn’t seen me or my ultrasounds to make any type of diagnosis himself. She told me that he would be in later that day. An important point to make is that not only was he my OBGYN and had been treating me throughout both my pregnancies, he was and had been the Dr on call.
Dr. M finally showed up towards the end of the day. He asked me what was going on, and after I told him everything, I asked him why he hadn’t seen me. His reply was that it wouldn’t have helped if he did. I believed him at the time. I was exhausted physically and emotionally, and had never been given an actual diagnosis by a Dr to research. He again told me that he could not admit me to the birthing wing because he wasn’t treating me for anything. He told me to go home and wait, that the birth of my little girl was only a matter of time. He told me that because it was so early in my pregnancy, that if she was born so early and kept alive that she would have Cerebral Palsy at the very least. I started crying…harder. I kept saying that I was scared I was going to have her at home and I didn’t know what to do. Dr. M pulled my husband aside, gave him a specimen bucket along with surgical scissors, and told him where to tie and cut the umbilical cord. He left with our number and said he would call to check in on me.
The next day, Monday, my husband and I drove an hour and a half to Lancaster for a second opinion. In the first two hours I had more care and attention then I did in Ridgecrest. I had a heart rate monitor hooked up, blood work, ultrasounds etc before I could even blink. Within two hours I had been checked into the Birthing Wing and assigned two Dr’s, a regular OBGYN and a high risk OB. The put me in the trendlenburg position and prepped me for surgery just in case the high risk OB prescribed it.
Later that day, the specialist came in to see me, and we told him what we had been going through. He didn’t want to hear about what the other Dr hadn’t done which almost made me feel ashamed for feeling as if he hadn’t done anything to help us. He did however want to do an emergency cerclage and diagnosed it as an incompetent cervix. As we finished telling him about how the bag had been exposed, he no longer wanted to do the surgery. He said that the bag had been exposed to bacteria and it was only a matter of time until the bacteria ate through it, and if he were to sew my cervix, it would only speed up the process. He also said that I had dilated too much by that time to safely put in a stitch. The Dr. gave me the option to stay at the hospital for as long as we wanted or until she was born. I talked to my husband about it, and decided that the outlook for our little girl was not good and that being away from my son and family was not something I could stand to do in such a hard time. We checked out and went home.
Over the next few days I stayed in bed, cried a lot, denied the situation to myself, talked to this little marvelous girl in my belly A LOT. I let her know that I thought she was an incredibly strong little being and that whatever she decided to do, I would support her either way. I apologized over and over to her for not having a healthy and sound enough body to keep her safe and sound until she was supposed to be here on earth with us.
I started becoming ill… My husband and I slept with the bathroom light on every night. The surgical scissors, specimen bucket, and tons of towels had been laid out in case I delivered her. The thought of having her in the bathroom made me sick to my stomach every day. I was scared to go to the bathroom. What happened if the bag came out and I delivered her? I had already dilated and I knew she couldn’t be that big. My husband and I barely slept, barely talked, and cried a lot.
By Friday, July 10th I was running a fever, had been bleeding heavily for over a week, and had become increasingly weak. Dr. M still hadn’t called to check on me so I called him. He said that he would be right over (this was in the A.M.); he didn’t show up until about five in the afternoon. He did a quick exam and said that I was becoming septic and that I needed to be induced. He told me to show up to the hospital the next morning at seven.
We showed up the next morning July 11th, and began the induction. I don’t remember much except for the immense pain that the contractions were bringing. It wasn’t long until my little girl was born. No one was there to catch her, and I just remember asking if she was alive. The nurse told me she was and asked me if I wanted to hold her. I was crying so hard I couldn’t bear to look at or hold her. I felt ashamed that my body had failed her and that I hadn’t done more. I held on to my husband and cried.
The next thing I knew I woke up as I was being wheeled out of the delivery room and was told that I was going to need emergency surgery. I woke up again later after a couple of transfusions. The Dr examined me and cleared me for release.
After I woke up and came to, I wanted to hold my baby girl. The nurses brought her to me along with some photo’s that had taken. She apparently didn’t live more than a minute or two. She weighed over a pound and was almost a foot long. I looked at her little face when I was holding her, now 22 weeks old, and she looked just like me. My son looks just like my husband and my little girl looked just like me! She had my nose, my eyebrows, and my lips… my everything. She was perfect. There was absolutely nothing wrong with her, just the house that held her.
I had to fill out the birth and death certificate before I left. We were given the option to leave her as a Jane Doe but I couldn’t do it. I felt that I couldn’t do anything else for her, the least I could do was give her a name and an identity. She hadn’t done anything wrong, and I wanted to remember how perfect she was. My husband and I had always like Giovanna for a first name, but had never discussed the middle name. I had brought up Phoenix a couple of times but it wasn’t met with much enthusiasm. This time when I brought it up, it fit perfectly. We named her Giovanna Phoenix Ramirez and went home.
The next time I left the house was for a checkup with Dr. M. I told him that I was still bleeding heavily and he said he wanted to check to make sure everything was okay. He did an exam and had found that he left large pieces of placenta intact. He removed them right then and there. I felt even more humiliated and sick. He told us that God must have chosen us for a reason and that this experience had encouraged him to go back to church again. He told us that if we weren’t strong enough to handle this God wouldn’t have given it to us and that we needed to find faith. We went home.
My husband and I went to work shortly after, but neither of us dealt with the public that well. Friends made comments like “If it makes you feel better…” or “why didn’t you” some people disappeared all together and others acted as if nothing had happened. While some disappeared, others showed up as expected and expected angels. My supervisor at the time referred me to grief counseling and let me work from home. He is one of my favorite people to this day for the guidance he gave me. My dad checked on me and listened, a lot. My best friend and cousin held my heart from afar. Most importantly, my husband and I learned to work through it together.
Over the next couple of months, I talked to Dr’s about what happened and researched what could have been done. I could have received an emergency cerclage if caught early enough and given medication to stop the labor. I should have trusted my instincts and not relied so heavily on the Dr. I should have been assertive and demand that I receive the proper care, but now I know. I know that I can refuse treatment, and if I don’t get the treatment I want or deserve I can go get it somewhere else.
I would be lying if I said my husband and I have completely pulled it together since this. I still think about her daily, as does he. We sometimes find moments that bring all of the thoughts and feelings rushing back, but don’t know how to properly cope, or try to handle it on our own. Anniversaries of the day she was born and the day she was due have come and gone and it affects me every year. I’ve pulled out of the depression I was in, and have re-evaluated my relationship with just about everyone, but most importantly my four-year-old son and my son due in just a couple weeks. We don’t get a do over in this life. It’s here, it’s now. Do the best you can with the one’s you have.
Miss Morgan's 365 Photo Project 