In the United States, 1 in 9 babies is born prematurely, 1 in 10 in Canada. Worldwide, over 15 million babies are born too soon each year. While not all multiples are born prematurely, a multiple birth increases the probability of an early delivery. Babies born prematurely, before 37 weeks gestation, are at a higher risk for health complications in infancy, some of which can have long-term effects. Full-term infants are not all free from their own health complications, of course.
In honor of November’s Prematurity Awareness Month, led by the March of Dimes, How Do You Do It? is focusing this week’s posts on The Moms’ experiences with premature deliveries, NICU stays, health complications, special needs, and how we’ve dealt with these complex issues.
Back when I was in my first trimester, pregnant with our twins, I wrote on here asking other MoMs how I could still work with a midwife and try to have a vaginal birth after being told that I needed to see an OB and deliver in the OR. Some of the feedback I received was to accept what I couldn’t control. I fought this at first, of course. But eventually, I realized that the only thing I could control at the time was my attitude toward the situation. I decided to take this advice and surrender to the experience of being pregnant with twins.
I’m so thankful I did. Accepting what I did not have control over, deciding to trust my doctor and do everything in my power to remain calm was what got this previously terrified patient (and perhaps control freak?) through the crazy end of a twin pregnancy. While I, like every other birth story on here can say it did not go as the way I’d always hoped to give birth prior to getting pregnant, I can also say that, despite having many things go “wrong” at the end of a pregnancy, it’s still possible to have a really amazing experience. I really do attribute this to the rock bottom expectations I had around giving birth and just knowing that I wasn’t calling the shots.
My “birth” story probably really starts at 32 weeks when, after a pretty healthy twin pregnancy, I was sent to labor and delivery at my 32 week appointment. My doctor (now the OB I’d grown to trust) was concerned about my blood pressure, my ginormous feet, and some pre-term dilation. Somehow I knew that the babies were not coming that day, however. We spent two nights on the high risk floor, so that I could receive some steroids for lung development and a drug to stop the contractions. I was then put on bed rest for the next 10 days to get me to 34 weeks, which is when the doctors felt more comfortable with me delivering. Ten days later-no babies. So, I was allowed to return to work.
I was there for one day, and then sent home after I had protein in my urine at my next appointment. Back to bed rest until a preeclampsia diagnosis could be ruled out. 24-hour urine collection at home, loads of fun. And back to the hospital at 34 weeks and 5 days for my ever-increasing blood pressure. Another two nights in the hospital after my platelets were low and the doctors wanted to rule out HELLP syndrome. Another urine collection reveals a preeclampsia diagnosis-what the doctors were waiting for. The night before my 33rd birthday, an IV was started and I was told to fast, in preparation for surgery. (Our son, baby “A”, pretty much sat cross-legged, breech, for my entire pregnancy, and I’d, by this point, accepted a c-section.) I spent my birthday eating ice chips, waiting for the perinatalogist to approve a pre-36 week delivery, and after 18 hours, the doc finally shows up and gives the thumbs down. She wants me to stay in the hospital for another week, to get to 36 weeks.
Oh, hell no. There is no way I am spending another two nights on the high risk floor, then another seven laying here waiting for 36 weeks, then another four nights after a c-section. Only to return home and not sleep for the forseeable future. Not to mention, it took you 18 hours to tell me this?! (Those of you who have spent multiple nights in the hospital know how little they let you sleep while you’re there. During my first stay I was woken up at 3am so they could WEIGH me.) Ready to check myself out AMA, my own doctor fights for me to be on strict bed rest at home, checking my blood pressure multiple times per day, and coming in for monitoring. Deal. I can do that. Multiple close calls over the next week, but I make it to 35 weeks and six days.
(My husband got up and went for a run at 4:30am the day of my surgery. He ran. I definitely appreciate the need he had to burn off nervous energy and somehow commemorate the day with a jog to the beach to watch the sunrise on the day our babies were born. But, I still find the irony hilarious: I hadn’t been able to walk more than the distance to and from the couch/bathroom in a month, and he went for a lovely early morning run. Love you, dear.) Everything was clockwork once we arrived to the hospital-well-oiled machine, despite my anxious tears throughout the entire pre-op process. Many of my fears were knocked down. Fear of going into labor and not getting the doctor I wanted? My doctor came in on her day off to do my surgery (and I could canonize her for this!). Fear of a bunch of old, male doctors who would be insensitive? Of the 17 or so doctors, NICU nurses, etc. who came in and out of the OR that morning, only two were male, and all 17 were great. Fear of throwing up on the table? My iron gut served me that day.
Things that are clear in my memory from the surgery: telling the anesthesiologist resident that I needed her to hang out right next to my head. Telling my doctor to distract me during the spinal with stories about the country concert she’d taken her daughter to a few days before. My husband getting to cut the cords of both babies and telling me our son “has dark hair like you” and our daughter is “light like me” with tears pouring out of his eyes. Asking my husband to take a photo of me on the table so that I had proof that I was there. Telling the OR staff to call our children by name and me Katie (as opposed to Katherine) so that I felt more comfortable throughout the surgery. The tilt of the operating table, supposedly to help bring blood pressure down. Not feeling pain until the very end when the docs pushed on my stomach to get blood clots out. Ouch.
The previous hospital stay where I received steroids proved useful, and our son only needed to be in the NICU for one night and our daughter for two. We knew what an incredible blessing this was! I was put on a magnesium drip shortly after surgery, while we hung out in the post-anesthesia recovery area. Within minutes of starting the IV, I could barely finish a sentence without falling asleep. My husband still likes to tell the story of me, drugged up, while another woman was wheeled in right next to us, and gave birth after about ten minutes, unmedicated, as they were using the area as triage, so close to us, my husband could have caught the other woman’s baby. The first 36 hours or so were rough. Even though I was hell-bent on being the first person to hold our babies, and the NICU staff obliged, I was too drugged up from the magnesium drip to really know what was going on. I absolutely relate to another post on here about feeling out of place, as I watched our family come and go to the NICU with my husband. I kept saying I felt like I’d been in a car crash and was all beat up, but everyone else was celebrating and telling me about what my babies looked like. It was such an out of body experience. The pain was pretty awful during those first two nights, as well. It was absolutely traumatizing to go through such an experience and have my babies away somewhere, while others are able to go off and visit them, while I was groggy, in bed. I remember having dreams that people were sitting on me, pushing and pulling on my body. I had to ask anyone in our room to talk softly. It felt like sensory overload.
By the time the babies were released and were able to stay with us in our room, things had shifted dramatically. The nasty magnesium had finally made its way out of my system, and was able to do some skin-to-skin time with each of them and completely fell in love with my little babies. I still, 16 weeks later, feel like it was an out-of-body experience, and am oddly grateful to have a c-section scar to validate that I was there. I feel profoundly thankful that our babies were healthy, that I was able to conquer a boatload of lifelong fears about giving birth and that despite the drama of the previous month, things never escalated to emergency status. It was amazing to meet our son and daughter on the outside.