An Intimate Conversation About Premature Birth
I recently had the opportunity to sit down with Lauren, a fabulous mama of two, whose youngest was born about 10 weeks prematurely. Lauren was so generous in sharing her story of giving birth to her son Oliver, and giving perspective on what this experience was like, and advice for others facing similar experiences in delivery and postpartum.
You have two children, and Oliver, your second born and third pregnancy, came prematurely. How were your pregnancies different?
“My first pregnancy and delivery of my daughter Ruby went as normal as could be expected. After Ruby, I had a miscarriage, so I was more focused on how I felt when I got pregnant with Oliver. Pregnancy with Oliver was more uncomfortable than usual. I had trouble sitting for any longer than 15 minutes at a time, and my stomach was tight. After discussing these symptoms with my midwives, there was no indication anything was really wrong though, or that the delivery was going to be different. I was just more uncomfortable, which I figured wasn’t unusual for a second pregnancy. They always say that each pregnancy is different, so I attributed much of my discomfort to this line of thinking.”
At what point did you know that Oliver was coming early?
“It wasn’t until I was being wheeled down the hospital hallway, screaming in pain and already in full labor that I really knew I was actually going to give birth at 30 weeks. At 22 weeks, I began feeling mild discomfort, and then much more noticeable discomfort at 28 weeks. I never had this issue with Ruby, so the midwives dismissed it on several occasions as harmless Braxton Hicks contractions.
After the third major incident where I was told to wait and see if the contractions just went away, I took a shower to relax a bit, and I felt a pop. I knew what that meant, but hoped I was wrong. After I got out of the shower, I confirmed that my water broke. Luckily, my husband was home, so we rushed to the hospital to see what could be done.Once your water breaks, you can sometimes stop delivery and safely stay pregnant as long as the medical staff take precautions to prevent infection and are able to stop your contractions.
I was still optimistic labor could be stalled for a little while longer. At the hospital they tried to stop contractions by giving me magnesium sulfate. I remember having completely normal conversation followed by a sudden excruciating contraction, but the contractions were getting further apart, so I was hopeful and still not thinking about the possibility that my baby could really be coming this early. The nurse came back in to check on me, and I mentioned casually that while they were further apart, the few contractions I was having were starting to feel like pitocin contractions, so she sent the doctor to check. He found me already seven centimeters dilated and was quite irked at the nurse for not noticing how far along I was into labor. This was when it was determined I had to give birth - by Cesarean section, and fast.”
This must have been pretty overwhelming for you. How did the delivery go?
“I was sent to the operating room immediately. I remember when I was taken off the magnesium sulfate, my body started going into transition as the baby descended the birth canal. This was happening while I was being wheeled to the operating room. It was really quite intense, I was shaking the rails of the bed and screaming, almost like something out of a movie. I couldn’t give birth vaginally though, because the attending OB confirmed he was breach. So I had to get set up in the operating room while resisting my body’s natural reaction to birth him. I later found out that they had to stitch me up because Oliver had almost completely descended the birth canal and actually had begun to emerge, feet first, vaginally, so far that he actually tore my perineum while they were setting me up for a C-Section.
I was terrified of surgery. I laid there for what felt like forever, dealing with the thought of being awake through surgery, not wanting my husband to see my organs laid out on the table in front of him, and waiting to see if the baby was okay. In reality, they cut right into the uterus and got the baby out. It was such a relief when my husband leaned in and happily told me it was a boy and then I heard the sound of my son’s cries.
What was your experience like postpartum, in the hospital and taking care of Oliver in the NICU?
“There are certain milestones every Preemie baby must meet before they come home. Oliver was in the NICU for 30 days. He had to stop having cardiac events (bradycardia is common), and he had to be able to take all feeds by mouth with a bottle as opposed to through a nasal tube for two days straight. He also had to get to the point where he could keep his body temperature regulated without intervention. He didn’t have enough fat to regulate his own temperature, so it took some time to thicken him up. Now he's super chunky! I did try to nurse him as much as possible. Breastfeeding is more convenient for me, so a goal in the NICU was getting him to latch. We did kangaroo care (skin to skin holding), which stimulates the baby and acts as an incubator. It also helps overall outcomes and helps with bonding. When I did the kangaroo care with him, he would leap into a feeding position, which was exciting. He was weaned off of bottles by 37 weeks. He latched the first time successfully at 31 weeks, and started actually drinking breast milk a couple weeks before coming home.”
How was your experience with your clinicians?
“We went to a hospital, which was very close to our house and super convenient when it came time for daily visits to the NICU. They have an amazing NICU ward. The staff there was wonderful, they were very reassuring, had great bedside manner, and took incredibly good care of us. We are still so grateful for their excellent care. We’ve remained friends with many of them -- we even go see one of Oliver’s neonatologists play in her band sometimes!”
Since coming home, are there any continued concerns for Oliver's health or yours?
“I am completely back to regular health. Oliver is doing very well too! So far there are no major issues, but he does have a birthmark on his eyelid, called a hemangioma. This is more common in preemies, and we are working on shrinking it with medication and strengthening his eye by using an eye patch on his good eye for a couple hours every day. If the medication and eye patching doesn’t work, we’ll have to do a minor surgery so that his vision won’t be affected long term.
Oliver also has begun receiving physical therapy services through early Intervention for a minor gross motor delay, although it is unknown if this delay was caused by his prematurity or if something he would have dealt with regardless. We do realize there are things that may pop up later with development -- so we are not completely out of the woods with him. We will continue to monitor him with a checklist, based on his chronological age, which measures his age from his actual birth date, although they do give him leeway towards his adjusted age, which takes into account his due date and the 10 extra weeks he spent not in utero. His doctors say that most preemies catch up to their peers by age two.”
Is there any advice you'd give to other families in similar situations?
“First, Hand To Hold is a great resource for information and support. I wish I had found their website earlier into my journey as a preemie mom. Second, I would just advise putting one foot in front of the other. All you can do is have hope and take it one day at a time. Remember that it is a marathon not a sprint.
For friends and families of preemie parents, please remember to not be offended if you are asked to not visit or asked to wash your hands, etc. Just be open to what is needed by the parents, because the last thing they need to be worrying about during this stressful time is if they are offending you in some way. Take extra care when the baby comes home, and remember that the baby is very vulnerable and health issues will still be a big concern for quite a while.”