Today, 17th November, is World Prematurity Day and I felt that I should write something to mark the occasion as this year I had the (mis)fortune of becoming mum to a preemie. I say ‘(mis)fortune’ because everything about giving birth to a premature baby is a guaranteed-to-mess-with-your-mind-not-so-happy bundle of mixed emotions. It’s also something which to me still feels very raw, hence this feeling that I should write something while not particularly relishing the idea of reliving the experience.
When I tell people that T was born 10 weeks early they inevitably say something along the lines of ‘Aw, bless, he was in such a hurry to meet you’. There are many reasons why babies get born early but the unborn foetus’s desire to meet its parents is not one of them.
Some babies get wrenched into the world too soon because either they or their mother, or both, will die if they stay in utero any longer, sometimes preterm labour is triggered by a diagnosed (or undiagnosed) medical condition such as an incompetent cervix or untreated urinary tract infection and sometimes medics can’t find any good reason why. Whatever the medical reason given, every mother of a preemie will almost inevitably blame herself.
Today, 9 months, 2 weeks (quick look at clock) and almost exactly 3 hours after T was born, I’m still haunted by the question of what I did wrong or wonder if somehow I could have kept him inside just a few weeks more. Things that I sometimes wonder if they made a difference include:
1) I was a superfit (though borderline anoxeric) vegan when I conceived T, so part of me wonders if my body somehow ran out of resources to sustain the pregnancy (though I do also wonder whether my (over)consumption of decidedly non-vegan chocolate biscuits, fried foods and as much cheese as I could ram into my mouth as soon as the pregnancy hormones hit also played a role).
2)My whole pregnancy was quite frankly rubbish. I bled on and off from 6 weeks and after 4 previous miscarriages, 14 years of trying to conceive, 4 goes at IUI and 7 attempts at IVF I spent the whole pregnancy convinced that I was going to lose this baby too. Perhaps all that worrying turned into a self-fulfilling prophecy. Basically I think I jinxed it.
3) The weekend I went into labour, I’d just started to relax about going into premature labour (my reasoning was that the survival rate for babies born at 30 weeks is pretty damn good). The very fact that I was the type of pregnant woman who read up on survival rates for premature babies also leads me to conclude that I jinxed it.
4) I’d just started to read a book about hypnobirthing (basically relaxation techniques to help you achieve a wonderfully calm and natural birth). Jinxed it.
4) That week I had finally got over my fear of jinxing things and started buying things for the baby. Thereby jinxing it.
There are, however, two things that I just can’t forgive myself
T was born on a Monday morning. I’d spent most of Saturday at the hospital because I was having contractions, after having an IV drip of Buscopan the contractions had calmed down sufficiently to no longer be picked up on the monitor. But I could still feel them. Why didn’t I make more of a fuss about being sent home?
The contractions gradually got stronger throughout the day on Sunday but I put off going to the hospital because I didn’t want to cause a fuss and because the inlaws were due to pop over for a visit. I decided that yes I did need to go back to the hospital but that I could wait until after they’d gone home.
My waters broke 5 minutes after my inlaws arrived.
And so I will no doubt torture myself to the end of my days with the idea that perhaps I could have stopped T coming so soon if I’d just gone back to the hospital on the Sunday morning.
By the time we got the maternity ward it was basically too late to do anything but hope that they could slow down labour long enough for me to be given a series of steroid shots in the hope of boosting T’s lung function. I was told that he’d be arriving by C-section as he was breech but that I needed to do everything within my power to keep him in as long as possible. Cue the longest night of my (and my husband’s) life.
Labour hurts but when you go into labour at full term you have the consolation that each wave of searing pain will bring you closer to meeting your baby. So much of the literature about giving birth talks about welcoming each contraction and trying to relax into it. When you go into premature labour it’s the opposite- you just want the contractions to stop, not because of the pain but because if the contractions continue it means that your baby is coming and you would do anything in the world to keep that baby inside you for longer. You can’t welcome the contractions because everything in your head is screaming ‘Nooooooo’ and you can’t relax into the contractions because you’ve been told that you have to do everything in your power to keep that baby where it is for as long as possible.
From7pm to 10.30am I had contractions every couple of minutes, I couldn’t move from the bed to pee or change position because I was hooked up to drips (pumping me full of antibiotics, drugs to try to slow things down and fluids -I was nil by mouth as they knew I would have to rushed into theatre at any moment) and a foetal heart rate monitor (nothing like staring at one of those go up and down for 15hours, except then spending 7 weeks in NICU watching a monitor showing your baby’s heart rate, breathing and oxygen saturation levels).
Anyway, after having two steroid shots 12 hours apart and rejoicing at having managed to make it through the night, at 10.30 I felt a sudden need to go to the bathroom (and we’re not talking a pee). Having barely been dilated through the night, the doctor who examined me was not impressed to find that not only was I now fully dilated, but that T was heading out buttocks first.
Never have I seen so many people flood into a room so fast. I don’t imagine emergency c-sections are ever much fun. And mine was no different. I particularly wasn’t keen on the fact that the epidural was only partially successful, and had to ask for more pain relief as the surgeons started whatever they were doing behind the sheet.
I’d like to say I can laugh about it now. But I can’t. It makes me cry just thinking about it and it makes me feel physically sick. The worst thing about the whole experience was that nobody talked to me. Nobody looked at me. Nobody told me what was going on. Nobody told me if they had got T out. Nobody told me if T was alive or dead. At one point I begged the person nearest to me to tell me what was happening. She said she couldn’t tell me anything. That someone would tell me something soon. I know at some point I caught sight of someone rushing from the room. And I also heard a baby cry -though given that we were in a room on the delivery suite (as there was no time to wait for an OR to become available), there was no way of knowing if that was the first time I heard T cry or if I heard someone else’s baby. It was the loneliest, most terrifying wait of my life. Eventually, a doctor came in and held an aluminium foil wrapped thing close to my face. All I saw was a red face and a blue hat. My baby. And then he was taken away.
I didn’t get to hold T until he was 9 days old.
That’s something you don’t know about having a preemie until it happens to you. All any woman who has just given birth wants to do is hold their baby close to them,. You can’t hold your preemie until they’re stable. It’s torture sitting by their incubator and only being allowed to touch their head or cup their feet-though of course they’re so tiny that you’re terrified of touching them, of breaking them and their fragile looking skin.
And here is where preemie mums start to feel guilty again. We feel guilty because of not being able to keep our babies safe inside us and we feel guilty because in any NICU there are other babies who are so much sicker, so much tinier than ours. 9 days to hold my baby was nothing compared to those mothers whose babies had been born at 24 weeks.
I was one of the lucky ones. T was born weighing 1.4kg (just over 3lbs) and though he dropped down to 1.2kg (2lbs10oz) he didn’t have any serious medical problems- no brain bleeds, no hole in the heart, no real breathing difficulties. And though two weeks in, when he’d been doing brilliantly, he developed septicemia and I thought I was going to lose him, our seven week stay was medically just a matter of T learning to feed and put on weight.
I’ve only recently begun to think about those weeks again, and to be honest I’m not sure that I’ll ever really get over the experience. When you give birth to a preemie you find yourself in some bizarre limbo- everyone congratulates you on becoming a mother but you don’t feel like a mother because you aren’t doing any of the things which mothers do for their newborn child. You can’t hold them when they cry, you can’t change their nappies (at least until they’re catheter free and stable), you can’t be with them 24 hours a day (though I wanted to be), you can’t feed them (though after a few days you might be allowed to slowly depress the syringe to send a couple of ml of milk into their feeding tube). You have to stand back and let the neonatologists and nurses do everything in their power to keep your baby alive. T’s birth was probably both the best and worst experience of my life. The second worse was being discharged from the maternity ward three days after his birth and not being able to take him home with me. I don’t think I’ve ever sobbed so much as I did that day, watching all the other dischargees and new dads set off with their lovely plump babies tucked into car seats while we trudged slowly back to the NICU to spend more hours sitting next to T’s incubator.
I felt robbed. The birth of a baby should be joyous and a cause for celebration but with a preemie it’s hard to feel the joy. Even on a day when your NICU baby is doing well and the medical team are ‘cautiously optimistic’ you can’t celebrate because all around you are other babies who aren’t doing so well. You learn to live one day at a time, measuring out your days in mls of breastmilk pumped and grams of weight gained.
Today, I do feel the joy.
It’s a day to give thanks to the dedicated medical teams who keep our ‘little fighters’ alive, a day to be grateful that modern medicine has made it possible for so many preemies to make it home, T included, but it’s also a day to remember the ones who didn’t make it.
In memory of Alexander C and Judith N.