When Melbourne mum Bethany Girardi gave birth to her second child, it was one of the happiest moments of her life.
But what came next was more than a year of debilitating pain and sickness that left doctors baffled.
Shortly after the arrival of baby Ezra in August 2021, her mental and physical health began to decline in a way that would change her life forever.
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Part of Girardi’s placenta did not completely detach from her uterus while giving birth.
A year-and-a-half later, Girardi “passed” an “eight-inch piece” of placenta.
Girardi, now 28, described her second pregnancy as “horrendous”.
She suffered severe nausea and was bedridden for several weeks.
“It was … a very difficult pregnancy,” she told 7NEWS.com.au.
After giving birth to her son, now aged two, Girardi experienced trouble during what is known as the third stage of labour — when the placenta naturally separates from the wall of the uterus, and when the baby’s umbilical cord is clamped and cut.
The placenta acts as a temporary organ for the baby immediately after birth, providing them with oxygen and nutrients. For most women, the placenta will naturally pass, but this is not always the case.
But Girardi’s placenta would not release from her uterus, even with the help of a medical injection. The next step was a manual removal, performed by her obstetrician at a private hospital in Melbourne.
Everything seemingly went according to plan, and Girardi was sent home to begin navigating life with a newborn and a toddler with the help of her husband, James.
But six weeks later, everything changed.
“I (was) just feeling really sick still. The nausea had never really gone away, but it started to ramp up again,” Girardi said.
“I had pelvic pain and pelvic instability the same way I did when I was pregnant.
Girardi’s mental health also started to deteriorate.
“I went downhill very rapidly,” she said.
Girardi went to her doctor for help. Her doctor theorised Girardi had diabetes, or multiple sclerosis, but both were subsequently ruled out.
Given her nausea and pelvic pain symptoms, Girardi thought she might be pregnant again.
“I was taking pregnancy tests,” she said.
“I’m like, ‘I really can’t be pregnant, but I’m getting all these pregnancy symptoms’.”
While at home in December 2022, Girardi began to experience “terrible”, “labour style” cramping. The cramps lasted for two hours before she “passed” part of her placenta.
“I passed a two-inch by eight-inch piece of material,” Girardi said.
“First thing I (thought) was … ‘what the heck is this?’
“Second thing I thought was ‘that’s a placenta, it can’t be anything else’.”
‘Rare complication’
Following birth, it is possible for some placenta to remain attached to the uterus.
Cases of retained placenta are not common, but the problem is usually recognised quickly, Australian Medical Association (AMA) president Steve Robson said.
“We probably see (it in) … about five cent of births (where it) subsequently comes to light that there’s a little bit of placental tissue left behind, and often it will present because a woman will continue to have bleeding or something like that goes on for weeks,” he said.
Cases of retained placenta are serious, and can be fatal due to infection or blood loss.
After “passing” part of her placenta, it became apparent to Girardi that some of her placenta had been left behind, or torn, following the manual extraction she had to remove it shortly after giving birth.
When the placenta is still attached to the uterus it produces pregnancy hormones, which explains Girardi’s nausea and pelvic pain, and also what happened after she delivered the placenta.
“The other thing that happens when the placenta comes off the uterus wall is that the milk (for natural feeding) comes in,” she said.
“And my milk came in again.”
Girardi recalled discussing what had happened with a friend, who is a midwife, right after she passed the placenta.
“We went ‘oh hang on a second, all of your symptoms are pregnancy symptoms’ and at that point we all kind of went … ‘your body thought you’d been pregnant the last year and three quarters’.”
Girardi’s body had been producing pregnancy hormones since becoming pregnant with her son in late 2020. Essentially, her body had been in a state of pregnancy for about two years.
Robson said it was extremely uncommon to have a large piece of placenta left behind.
“It probably happens maybe one per cent of the time,” he said.
Robson said Girardi had suffered from an “extraordinarily rare complication”.
“It sounds like a dreadful experience … and it has the potential for serious long-term effects,” he said.
Long-term complications can include scarring of the inside of the uterus, which can make it difficult to have children in the future.
An ultrasound in February 2023 showed that there was still some “debris” remaining. In March 2023, Girardi had surgery to remove what was left.
Only the beginning
She thought this would be the end of an exhausting and debilitating experience, but it would just be the beginning. Girardi has fibromyalgia — a chronic condition that causes body pain and muscle stiffness.
Those who suffer from the condition can be more sensitive to pain and can experience extreme fatigue.
Girardi said that she normally does not wake from anaesthetic very well, and that it was usually difficult to get her pain levels under control after surgery.
“Generally after an operation I need high-level medication through a drip for 24 to 48 hours to get the pain levels down,” she said.
“And then they send me home with basic opioids, and then I take those for a couple of weeks, and then I’m good.”
She said she was discharged the day of the operation and given pain medication to last two days.
But her health worsened following the operation to remove what was left of her placenta.
She said her fibromyalgia symptoms ramped up in part due to the surgery, but also because of the placenta she had retained in her body for so long.
“I was in so much pain (that) it transitioned and progressed my fibromyalgia,” she said.
Robson said it was possible the retained placenta could have worsened her chronic condition.
“I think one of the possibilities is that with this retained tissue, you would have a lot of inflammatory chemicals running through your body, and it’s certainly possible, in the same way that you get a vaccination … and you can feel really sore for a little while,” he said.
“It’s a similar principle with all of the inflammatory factors.”
Girardi struggled to get through a full day without pain, which she likened to a “stabbing” feeling. Looking after a toddler and a baby was almost impossible.
The family are now in significant debt due to ongoing medical bills.
Hospital responds
In a statement to 7NEWS.com.au, the private Melbourne hospital said it has reviewed the care it provided to Girardi and that it was “satisfied that it was appropriate”.
“(We) cannot comment publicly on our patient’s personal or medical information due to confidentiality,” the hospital said.
“We are happy to discuss with her any concerns that she may have and wish her well in her recovery.”
While her condition has improved, Girardi said the experience has changed her family’s life forever.
“The whole experience means that I can’t look after my kids myself. I have lost so much strength that I have very little ability to run after them,” she said.
Girardi has applied for NDIS support.
To help with ongoing medical bills, which she said cost almost $1000 a week, a friend has set up a GoFundMe for Girardi and her family.
Despite her struggles, Girardi said she feels grateful to still be alive, and with her family.
She hopes her story can serve as a warning to other expectant mothers.
“If there’s even one other woman in this circumstance, and it makes them go, ‘hang on a second, that sounds like me. Yeah, I’ll go …. and get it checked out’, then I think it’s worth putting myself out there,” she said.
“I hope that people have the guts to question the doctors. Because if I thought to have questioned … if I thought to ask at my check-up, then we probably wouldn’t be here.”
