{"id":25666,"date":"2019-07-31T10:29:24","date_gmt":"2019-07-31T16:29:24","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=25666"},"modified":"2022-07-29T12:55:36","modified_gmt":"2022-07-29T18:55:36","slug":"successful-vbac-but-then-placenta-accreta","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/successful-vbac-but-then-placenta-accreta\/","title":{"rendered":"Why this mother donates blood on her daughter\u2019s birthday"},"content":{"rendered":"
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And they were off. Two-year-old Eva Trostel followed her sisters, Layne, 3, and Teal,5. The three girls \u2014 all in unicorn-patterned swimsuits \u2014 squeal as they run together through a water feature of Loveland Sports Park.<\/p>\n

Tonya, their mother, stands watch. The weekend before, Eva celebrated her second birthday and Tonya marked that day by donating blood at the UCHealth Garth Englund Blood Donation Center<\/a>.<\/p>\n

Tonya is grateful for her three healthy children and thankful for her own life. On the day Eva was born, Tonya nearly died.<\/p>\n

<\/span>Sign up to donate for the Colorado Accreta Survivor blood drive or to donate blood when it works for your schedule.<\/div>
Tonya and other members of the “Hope for Accreta\u201d Facebook group from northern Colorado are hosting another blood drive from 10 a.m. to 1 p.m. Sept. 20, 2019 at the Garth Englund Blood Donation Center at UCHealth Medical Center of the Rockies. Sign up for a donation spot here<\/a>. Can you donate blood? Learn more…<\/a><\/div><\/div> <\/div>\n
\"mom
Tonya Trostel, far right, watch her daughters, from left, Eva, 2, Layne, 3, and Teal, 5, play in the water feature at Loveland Sports Park in July 2019. The oldest was born via C-section, but Tonya was able to have a successful VBAC with both her youngest daughters before tragedy hit. Photo by Joel Blocker, for UCHealth.<\/figcaption><\/figure>\n

Not long after a photographer snapped a family photo with a glowing Tonya holding Eva, dad leaning in and older sisters perched on a hospital bed \u2014 Tonya began to hemorrhage from a rare but dangerous pregnancy complication called placenta accreta<\/a>. She needed an emergency hysterectomy.<\/p>\n

Tonya always wanted a large family, and in her mind three kids was not enough. She was one of six. Only hours after Eva was born, she knew she would never be able to birth another child.<\/p>\n

\"mom
Tonya Trostel holds her newborn and takes a picture with her family prior to doctors realizing she had placenta accreta. Photo courtesy of Tonya Trostel.<\/figcaption><\/figure>\n

\u201cI feel like the first year after Eva\u2019s birth was such a blur that it was hard, but it didn\u2019t affect me as much,\u201d Tonya said.<\/p>\n

Her voice cracked as she continued, \u201cThis year has been harder and more challenging as I tried to figure out why. The months that come and go, and thinking we\u2019d be having another child right now, those months are the hardest.\u201d<\/p>\n

Small-town girl<\/strong><\/h3>\n

Tonya grew up in the small eastern Colorado town of Idalia. Being the second oldest of four brothers and one sister likely sparked her motherly instincts. Participating in sports chased away small-town boredom and earned her a scholarship in track to Colorado State University<\/a> in Fort Collins.<\/p>\n

At CSU, she majored in human development and family studies.<\/p>\n

\u201cI couldn\u2019t decide between being a nurse or a teacher, but I knew I wanted to work with kids,\u201d she said.<\/p>\n

In track, she competed in long jump, high jump, hurdles, javelin and shot put. She also ran the 200- and 800-meter dash. She jogged almost daily \u2014 even up to her first pregnancy.<\/p>\n

\"After
Tonya Trostel, far right, with her daughters, from left, Layne, 3, Teal, 5, and Eva, 2, in July 2019. Photo by Joel Blocker, for UCHealth.<\/figcaption><\/figure>\n

Starting a family<\/strong><\/h3>\n

Tonya and her husband, Evan, met in 2010 at a cousin\u2019s wedding and married in 2012. Evan had two siblings and shared Tonya\u2019s desire for a larger family. They found out they were pregnant shortly after their wedding, but sadly, they miscarried. A few months later, they found out they were pregnant again.<\/p>\n

Her pregnancy went well, but Teal wouldn\u2019t turn into the correct position as she neared delivery.<\/p>\n

\u201cWe waited and waited for her to turn, but she never moved from her position,\u201d Tonya recalled. At 39 weeks, doctors scheduled a C-section.<\/p>\n

\u201cI was devastated,\u201d she said. \u201cI was really hoping my body would do it naturally, so it was hard to go that route. But everything went smoothly, and I was just happy that she was healthy.\u201d<\/p>\n

Teal was born on Feb. 20, 2014 at UCHealth Medical Center of the Rockies<\/a> in Loveland.<\/p>\n

Tonya put aside her teaching career to be a stay-at-home mom, and a year later, she was pregnant again. Because she had a healthy first pregnancy and a C-section only because Teal was breech<\/a>, Tonya was a good candidate for vaginal birth after cesarean, or VBAC.<\/p>\n

Lessons about VBAC<\/strong><\/h3>\n
\"After
Tonya Trostel pushes her daughter Layne, 3, while her 5-year-old daughter, Teal, pushes 2-year-old Eva at the Loveland Sports Park in July 2019. Photo by Joel Blocker, for UCHealth.<\/figcaption><\/figure>\n

Women who\u2019ve had only one C-section with a low transverse incision are considered for a VBAC. Doctors use an evidence-based formula that considers women\u2019s age, stature, ethnicity and details from previous and current pregnancy to calculate the chance of a successful VBAC, explained Dr. Natalie Rochester<\/a>, obstetrics and gynecology specialist leading the medical practices at the\u00a0UCHealth Women\u2019s Care Clinics in Greeley<\/a>\u00a0and\u00a0Loveland<\/a>.<\/p>\n

If a mom develops medical conditions, such as preeclampsia<\/a>, during pregnancy; if the baby is very large; or if the mom is not showing signs of laboring at 40 weeks, then a C-section may again be necessary because of the risk to mom and baby if the baby is delivered vaginally. Tonya experienced none of those things.<\/p>\n

At 39.5 weeks\u2019 gestation, Tonya got a call that her ill grandmother didn\u2019t have much time left. At 3 a.m., Tonya and her family drove 60-some miles to Denver. Tonya\u2019s contractions started as she arrived at her grandmother\u2019s side \u2014 but they were far enough apart for her to say goodbye to her grandmother. The Trostels rushed back to UCHealth Medical Center of the Rockies, where Layne, a healthy girl, was born<\/a> vaginally around 9 p.m. on Nov. 3, 2015.<\/p>\n

Tonya bounced back quickly and was out jogging with her girls, taking them to activities and enjoying everything about being a mother. Another year passed, and Tonya was again pregnant.<\/p>\n

\"Teal
Layne Trostel, left, and her older sister, Teal, run through a water feature at Loveland Sports Park in July 2019. Photo by Joel Blocker, for UCHealth.<\/figcaption><\/figure>\n

Again, she was a candidate for VBAC. Tonya didn\u2019t want it any other way, as she felt it gave her a better chance for her dream of a larger family.<\/p>\n

\u201cThe data shows risk of complications increases with each additional cesarean,\u201d Rochester said.<\/p>\n

Tonya\u2019s third pregnancy went well, and she prepared her girls for their new sister: They moved into a room together and practiced being big sisters to their dolls.<\/p>\n

The big day<\/strong><\/h3>\n

At 39.5 weeks\u2019 gestation and in labor, Tonya again arrived at UCHealth Medical Center of the Rockies. She hadn\u2019t liked the epidural she\u2019d had when Layne was born, so this time Tonya chose an all-natural delivery, and after seven hours of labor, little Eva arrived on June 22, 2017.<\/p>\n

\u201cEverything about her labor and delivery was the easiest of my three girls,\u201d Tonya explained. \u201cUntil afterwards.\u201d<\/p>\n

\"After
Tonya Trostel with her daughters, from left, Teal, Layne and Eva. Photo by Joel Blocker, for UCHealth.<\/figcaption><\/figure>\n

Attached placenta<\/strong><\/h3>\n

Eva was placed on Tonya\u2019s chest for some bonding time while her body was left to deliver the placenta.<\/p>\n

But after an hour had passed with doctors working to deliver the placenta \u2014 and more pain than Tonya had ever experienced with childbirth \u2014 she was told that they\u2019d need to perform a dilation and curettage (D&C).<\/p>\n

A D&C is a surgical procedure in which doctors use a special instrument to scrape the uterine lining while the cervix is dilated. It\u2019s used in cases of early miscarriage as well as post-delivery when the placenta doesn\u2019t want to detach from the uterine wall, which is what seemed to be happening to Tonya.<\/p>\n

What had gone wrong?<\/strong><\/h3>\n

In pregnancy, the placenta develops inside the uterus and provides oxygen and nutrition to the baby; it also removes waste. The placenta connects to the baby through the umbilical cord, and after delivery, the uterus contracts to deliver the placenta. A retained placenta can cause serious bleeding and infection.<\/p>\n

In Tonya\u2019s case, her placenta had invaded \u2014 not just attached \u2014 to her uterine wall, preventing it from being delivered.<\/p>\n

Typically, when the placenta implants itself and causes accreta, it attaches to pre-existing damage within the uterus, such as scar tissue from a C-section or an earlier D&C. Past uterine manipulation can increase a woman\u2019s risk for accreta, but there are cases where accreta has occurred in women without previous uterine manipulation, Rochester said.<\/p>\n

Waking to a new reality<\/strong><\/h3>\n

Tonya doesn\u2019t remember much of what transpired once she was taken for the 7 p.m. D&C surgery, though she remembers waking up afterwards.<\/p>\n

\u201cWhen I woke I was in a panic because I wanted to rip out the ventilator,\u201d she said. Then she saw the clock and her eyes got big: 4 a.m.!<\/p>\n

\"Tonya
Tonya Trostel donates blood on her daughter’s birthday, which is also the anniversary of learning she had placenta accreta, losing 11 pints of blood and needing emergency surgery. Here, Tonya donates blood at Garth Englund Blood Donation Center at UCHealth Medical Center of the Rockies on Eva’s first birthday. Photo by Kati Blocker, UCHealth.<\/figcaption><\/figure>\n

\u201cIt was supposed to be a 30-minute surgery,\u201d she said.<\/p>\n

That\u2019s when she wrote down her question on paper for her husband: Did I have a hysterectomy?<\/p>\n

\u201cHe said, \u2018yes,\u2019 and I just started bawling,\u201d Tonya said.<\/p>\n

During the D&C, Tonya began hemorrhaging.<\/p>\n

\u201cThey tried several ways to stop the bleeding and nothing was working,\u201d she said. \u201cIn order to save my life, they had to get the uterus out.\u201d<\/p>\n

Tonya required 11 units of blood. The average human body contains about 11 units of blood.<\/p>\n

Returning home<\/strong><\/h3>\n

Physically, Tonya was recovering from a vaginal birth and a major surgery. She had three children to care for along with herself. She leaned on her husband, family, church friends and faith to get her through those days. She appreciated that her days were full of activity, as it distracted her from the reality that she would never deliver another child.<\/p>\n

Busy was good, she thought \u2014 until it wasn\u2019t.<\/p>\n

At two weeks old, the family held a baptismal party for Eva. Tonya was busy getting everything together on that hot summer day, when just as the ceremony concluded, she fainted.<\/p>\n

\u201cI tried to bounce back after Eva\u2019s birth, but I didn\u2019t,\u201d she said. \u201cI was trying to do too much. I was bad about relaxing. I was bad about asking for help.\u201d<\/p>\n

\"After
Tonya Trostel helps her daughter, Layne, 3, put on her dress after playing in the water park, while her daughters, from left, Teal, 5, and Eva, 2, look on. Photos by Joel Blocker, for UCHealth.<\/figcaption><\/figure>\n

She has difficulty recalling the details of that first year, but knows it is when she began to struggle with anxiety.<\/p>\n

\u201cI\u2019d never had it before,\u201d she explained. \u201cI used to be a very social and outgoing person.\u201d<\/p>\n

She has found strength in prayer and in her husband. Her drive to be the best she can be has steadied her and helped her triumph.<\/p>\n

\u201cSitting in prayer has been a huge help. And I express myself to my husband, being open to how I\u2019m feeling. And I\u2019ve learned to push myself out of my comfort zone.\u201d<\/p>\n

She\u2019s pushed herself in other ways as well.<\/p>\n