A Tale of Two Pre-Term Births
By Julie Ann Cook
Every Child is Different
In July of 2006, I was seven months pregnant with my second child. My first pregnancy, labor, and delivery had been a book-perfect experience.
No surprises, save for my short-for-first-pregnancy labor. But even that wasn’t totally unexpected since my mom had been similarly quick with labor and delivery of me and my three siblings.
This second pregnancy seemed to be going just as well. It was a bit more challenging, though, because of the simple fact that I was busy chasing a two-year-old in addition to working part time outside the home. I had become accustomed to the dull, tight, ache of Braxton-Hicks contractions, but had thought little of it besides it being a reminder to drink more water and take a break.
One morning, though, that wasn’t enough. After an hour of drinking water, resting, and trying to “walk it off,” I still just didn’t feel right. So I called my OBGYN. The office said they would squeeze me in for a 9:30 appointment. My husband took me to the doctor, and after vitals, etc., I was seen by the doctor at 9:50.
Not the Plan
At 10:15 a.m., I was being rushed to Labor and Delivery.
I was 34 ½ weeks along, making my delivery “near term,” which is still pre-term, just a less frightening word for it. The doctor had found me to be six-centimeters dilated when he told me, “You’re having this baby today.” My heart fell into my stomach. The wind was knocked out of me.
This was not the plan. I kept thinking. This isn’t supposed to happen. It’s too soon!
I don’t remember much of the labor. I remember crying. I remember being told how I should be breathing. I remember yelling at the nurse who tried to tell me how to breathe as I was busy feeling broken over the fact that my body was making my baby come too soon. My emotional tension made the pain worse than I had expected or remembered—of course, with my first delivery, I had opted for an epidural, but there was no time for such this time. The only thing holding my baby in was my un-ruptured bag of water.
I had no idea what this early delivery meant for my baby. I expected time in the NICU, but what did that mean? Would there be permanent problems? Would my baby be OK? Why was this happening? Did I do something wrong?
At 10:51 a.m., my second child, a son, was delivered. I missed it amid all the chaos inside my own head.
I held him for the briefest of moments, between tears, marveling at his little sounds… until someone—a NICU nurse?—informed me that he was making those sounds because he was having trouble breathing. And my heart broke as they scooped him up and attended to him in his warming bed before rushing him to the Special Care Nursery.
That night was the most emotionally challenging of my life up to that day. Alone at the hospital, I found my way to the nursery for a late night visiting session. I was the only parent there at 2am. With the exception of the beeps and buzz of monitors and incubators and lights, it was quiet as I sat beside my tiny boy’s warming bed and simply touched him, feeling the softness of his skin and peach-fuzz hair. I was emotionally exhausted, but trying to sleep, I discovered, was useless.
That night, one of the nurses suggested I take a baby blanket back to bed with me to sleep with it, to let it take on my scent. I could swaddle him in it the next day.
The next two weeks were full of ups and downs, small victories and apparent setbacks. Our little boy, though generally healthy, suffered from what the nurses affectionately called “Wimpy White Male Syndrome.” Basically, Caucasian males are more likely to have weak lungs than many other preterm babies. So our little guy began his time in the post-womb world on a ventilator. His sucking reflex had not yet fully developed either, so he was on a feeding tube in his early days.
Our source of greatest frustration and emotional exhaustion was that no one would tell us directly what needed to happen in order for us to bring our baby home. Rather than tell us the whole checklist, we were only told one goal at a time, which was painful when we felt we were led to believe that the next hurdle was the final one. The goals our little guy needed to meet were, in no particular order:
- Meet and maintain (or surpass) birth weight of 5 lbs 4 oz.
- Regulate his own body temperature without the help of a warming bed or incubator.
- Be able to breathe independent of any machines, keeping his oxygen levels reasonable.
- Be able to breastfeed and take a bottle (since he was prescribed a supplemental high-calorie formula to help him “bulk up.”)
- Overcome jaundice.
- Pass his “car seat test”—sit in an infant carrier car seat for a full hour without going into distress.
In addition to his goals, my husband and I were required to take and pass an infant CPR test, something beneficial to any adult dealing with infants.
All the while, I expressed my breast milk, the one small thing I could consistently do in my role as “mommy.” Overall, though, I felt helpless and in the dark because I did not know what questions to ask.
We were fortunate that we lived close enough to the hospital that we could visit for multiple feedings each day, but with a toddler at home (who was not allowed to visit his baby brother), that was a challenge still. We rarely visited together. Every free minute seemed to be spent at the hospital or in the car to or from.
Finally, the day arrived, as a surprise actually, when we brought our little “Bean” home. We hadn’t realized until that morning that he would be discharged that day. How good it was to have our whole family together under one roof!
Two and a half years later, I was pregnant yet again. This time, with “high risk” on my chart due to my previous early delivery.* I took the recommendation to get weekly progesterone injections starting at 16 weeks. (Studies suggest that progesterone injections can help reduce the risk of preterm labor in some women who have previously had a spontaneous preterm delivery.) So every week, I would offer my upper thigh as sacrifice to a stinging shot in hopes that my third child, another boy (we had found out ahead of time with this one) would be safely delivered in mid-August.
With five-year old and almost three-year-old active little boys, it was not a stress-free pregnancy. But we were determined to do what we could to keep our little guy gestating. I was terrified when, in mid-May, at 26 weeks, I had a bout of false labor that wouldn’t go away. I spent the better part of that day in the hospital as they worked to stop contractions. Fortunately, they were successful, and my littlest boy was still safe inside me.
Déjà Vu All Over Again
Another July rolled around, with all its heat and humidity. Aside from my May scare, the pregnancy had been relatively uneventful, though full of Braxton-Hicks contractions. My doctor had been keeping an eye on my cervix, and did not seem too concerned.
But our third son was just as eager as the second, and again at 34 ½ weeks I found myself in active labor.
…But Completely Different
This time, though, was my best birth experience to date.
Though our little one was early, I had a good idea what to expect. We had done this before. And as an added bonus, I had arrived at the hospital early enough to get my requested epidural. (I don’t have anything to prove—besides, I’d already proven that I could labor naturally and established that I preferred not to. I’m a wuss.)
Comfortably numbed and emotionally calm, I was able to focus my energy and attention in the moment. I was even able to control my breathing for the most part. Of my three live births, this was the one for which I felt most present.
After about 5 hours of labor in the hospital, our third son was born. He too had underdeveloped lungs and needed some extra care in the hospital, but this time, I knew the main obstacles he would need to overcome before he could come home. And I knew what questions to ask. I was familiar with the nursery’s hours and workings, and I was more comfortable with dealing with a tiny baby than I was the first time around. I relished every moment of kangaroo care. And I spent more time making memories with my little boy than worrying about making plans.
|3 Healthy Boys!|
If there is one thing I’ve learned from these experiences, it is simply to do what you can and give the rest to God. It feels like a lifetime ago, and a blink of an eye, but these memories are just that. In the end, these preemies are just as much the active little boys that my full-term firstborn is; sometimes even more so. I find little use in hovering over my children: I did everything “right” and yet I still couldn’t protect them from coming early… which to me simply says there are some things beyond our control.
- "A mom of one preemie has about a 15% chance of having another; a mom who has had two preemies has about a 40% chance of having another; and a mom who has had three preemies has almost a 70% chance of having another premature birth."
- Preterm labor and birth http://www.babycenter.com/0_preterm-labor-and-birth_1055.bc
- Project Sweet Peas offers support and resources for NICU families http://www.projectsweetpeas.com/
Julie Ann Cook is a happily married, joyfully outnumbered mother of four boys, one who was stillborn at 20 weeks. Between assisting in living room railroad construction and addressing concerns of who would win in a fight between Megatron and Iron Man, Julie is an author, artist, and webmaster. Julie's writing has appeared in various publications including Kakalak Anthology of Carolina Poets, moonShine review, MaMaZina.com and The Wolf. She is the author of Love Like Weeds, a book-length poetry collection to be released by Main Street Rag later this year. Julie blogs at Digging Cheese out of Carpet in her *ahem* spare time. Check out Julie's Facebook page for more!