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By Alyce Collins and Amber Latsch
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As a certified nurse midwife, I have helped countless women through their pregnancies, held their hand through the difficult moments, and watched them glow with pride while cradling their new baby.
There is something so fulfilling about being present during such a lifechanging moment. As a mother myself, I know how special that time is for any family.
In 2019, I was delighted to discover that my husband, Garrett, and I would get to go through the whole experience again. I found out I was expecting very early, and at just six weeks, I asked a colleague to do a quick ultrasound on my lunch break.
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I thought it may be too early to detect anything, but it was worth a shot.
“I can see a heartbeat,” my friend announced.
How wonderful! I thought that would be it and I could go enjoy my lunch, but that wasn’t all.
“I think I see two heartbeats.”
That’s right. Twins.
‘I Was in Kidney and Liver Failure’
For the most part, my pregnancy was pretty smooth, and my eldest son was so excited about getting two younger brothers.
Unfortunately, everything took a turn when I reached 32 weeks gestation.
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I became very ill, had abdominal pain, couldn’t stomach food and became extremely lethargic. My husband could see that something wasn’t right, as he even noted that I was acting strangely. It was almost like I was drunk, but obviously I hadn’t touched a drop.
Feeling concerned, he took me to the hospital to get checked out. Doctors did some lab work, and as soon as the results came back, they recommended an urgent caesarean section.
Just 30 minutes later, the twins were delivered.
Thankfully, they were both healthy, but still, as they were born so early, they had to spend just over a month in the NICU.
As for me, my health continued to deteriorate.
Following the birth, I experienced a postpartum hemorrhage which led to hypovolemic shock, a life-threatening emergency after losing more than 20 percent of my body’s fluid.
Initially, doctors believed I had HELLP syndrome—a complication that is considered a severe variant of preeclampsia—but that wasn’t the case. They later realized it was acute fatty liver of pregnancy (AFLP).
It’s a rare but very serious condition that occurs when too much fat builds up in the liver during pregnancy. When fat clogs up, it can lead to liver failure, and if untreated, it can be fatal.
AFLP falls under the umbrella term of hypertensive disorders of pregnancy, but this one is the rarest and most life-threatening. It affects about one in 10,000 to 20,000 pregnancies annually, and unfortunately, many babies of women with AFLP are stillborn.
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Everything happened so quickly.
I was in kidney and liver failure, so I was given numerous medications, received over 50 units of blood products, had an exploratory laparotomy where they removed three liters of blood from my belly, and then they kept me open with a wound vac. Not to mention, I also had a uterine artery embolization.
While I was in the ICU, I had to be sedated and intubated on a ventilator.
That was how I spent the first seven days of my twins’ lives.
Many people assume sedation is like sleeping, but as I lay in my ICU bed, unable to move, talk or even breathe independently, I was lucid.
‘Like I Was Talking and No One Was Listening’
I have what feels like an entire week’s worth of memories, but they’re all quite patchy as there’s no real sense of time.
I knew when people were in my room, although I did not always know exactly who it was. I could hear my family talking around me.
I remember my twins being brought to see me when they were 4 days old.
I could tell when people were touching me. Whether they were brushing my hair, repositioning my body, holding my hands or giving me injections, I felt all of it.
I remember the people who came to see me—my OB doctor, my nurse friend, my boss, my husband, dad, mom, sisters. I can recall times when certain people were in the room and who was on which side. But I didn't know what was happening or where I was.
It felt as though I was just floating between these different scenes within my mind, but they were very consistent—almost like a recurring dream. It was like a scene playing out in my head, then I would leave that scene after a while and return to it later.
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My memories are patchy though because I only heard bits and pieces of what was going on around me. Unfortunately, my brain filled in the rest—and not in a nice way.
My brain took every word, sound and movement around me and took it to the scariest place imaginable. I was in this constant state of fight or flight, and I feared what was happening around me. I didn’t think I could let my guard down because if I did, even just for a moment, I could die.
The reason I know it wasn't just a dream is that there were certain phrases and voices I heard, people I saw, touches that I felt, but I interpreted them all in such a scary way. One example I will never forget was the moment nurses brought my babies to me and were telling me they were going to take care of them. But I thought they were saying that they were taking them away and giving them to another couple.
Some of the main recurring visions I had were that my organs were being harvested, that I was lost at sea and couldn't get home to my 4-year-old son, that my babies had been taken from me and they were pumping me to give my milk to a factory.
Another recurring "scene" that played out in my head was of a woman using an ordinary vacuum hose to suck my air out if I didn't talk. It felt like she was suffocating me, and then she would give up until later.
The hardest part of that whole experience was that no one could understand me. I thought they could, and I genuinely believed I was talking normally the entire time. I had no idea I was intubated, it just seemed like I was talking and no one was listening.
That made the fear escalate because it was so scary to believe that the people I trusted most in this world were betraying me and letting me suffer right in front of them.
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‘My Husband Almost Had to Plan a Funeral’
Seven days after surgery, I was closed up and finally extubated.
The first and only words I could muster were, “where’s Garrett?”
I was so confused about where I was, why people weren’t hearing or seeing the same things that I was, and why they had been so mean. I was desperate for food and water, but they wouldn’t let me have anything until I passed my swallow study.
Of course, I didn’t know any of that. I’m pretty sure I was losing my mind from the hunger. I started swearing at people because I was so mad at all of them, even though they were just happy I was alive.
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In the days after I came off the ventilator, I started making progress by standing with assistance, shuffling over to the chair in my room, walking to the bathroom, and then walking down the hall with a walker to visit my coworkers at the nurse’s station. It took around four months to recover physically, and because I was young and healthy prior to all this, I was able to make big strides every day.
As for the mental recovery, that was much harder.
What I went through took its toll on my marriage because I had this sense of betrayal. I believed that my husband had subjected me to all of the imaginary scenes that I thought I lived through, even though I knew Garrett was the best support and did not leave my side.
It was unfair to him, but I went to therapy and that truly helped me process everything.
Now, seven years have passed since this experience. I am so grateful to have made a full recovery and have a beautiful family with three healthy children.
Not all women are afforded the same outcome.
Survivor's guilt is real, and I have a newfound respect for the fact that not everyone survives childbirth. My husband almost had to plan a funeral instead of a homecoming.
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I know I survived because I was privileged to have a husband who knew how to get me help when I couldn't help myself, a medical team that acted quickly, a hospital full of coworkers who went above and beyond to make sure I got the appropriate care.
I truly believe that if I was a patient who did not have the same hospital connections and the knowhow that I had, I would not have survived. That, will forever be, a sobering thought.
Amber Latsch, 36, resides in Wisconsin with her husband Garrett, their 11-year-old son and 7-year-old twins. She has been a certified nurse midwife since 2017 and has turned to social media to document her traumatic birth story to raise awareness for AFLP.
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