By Rita Brhel, editor of The Attached Family publications
This birth story goes along with the article of how I came to Attachment Parenting through my premature daughter’s birth. Find the article, “AP from a Preemie Mom’s Perspective,” in the “Your AP Stories” section of TheAttachedFamily.com or by clicking here.
As my second trimester came to a close at the end of May, with the summer promising to be very hot, I began to wonder how big I would get and how exactly I’d be able to do my busy, active journalism job as my pregnancy progressed. While I was starting to get a little nervous about my due date, August 13, and was sad that I’d miss my usual summer activities of water-skiing and canoeing, I still felt good. Besides some swelling in my ankles, the pregnancy seemed to be going along just fine.
The morning of Tuesday, June 6, everything changed. Pregnancy was no longer nearly as fun or as full of promise for a healthy baby. I woke up at 5:30 a.m. in a pool of blood. My first thought was that I had lost the baby, but as soon as I stood up, I felt a kick. I couldn’t grasp that she was still alive when it was clear from the blood that things were not at all OK.
Fifteen minutes later, my husband Mike had driven me to the clinic in Hartington, Nebraska — only 10 miles away, but the ride seemed like an eternity. The doctor hooked me up to the ultrasound and contraction reader, found the baby’s heartbeat and said everything was going to be OK. However, I would need to go to the hospital to stop the labor that had begun. I was also given the first of two painful steroid shots to quicken my baby’s lung maturity.
Because I was only 30 weeks along in my pregnancy, it was decided that I would need to go to the Avera McKennan Hospital in Sioux Falls, South Dakota, a hospital that specializes in high-risk pregnancies and has a Level III Neonatal Intensive Care Unit, or NICU, a nursery that is able to handle the youngest and sickest babies, basically any baby born before 32 weeks gestation. It was a long ambulance ride up there, one and a half hours away from Hartington. Mike followed the ambulance in the car; I distracted myself from the contractions that were coming every 10 minutes by chatting with the paramedics.
Once I got to the hospital, the perinatalogist determined that I had a placental abruption, a dangerous complication in which the placenta prematurely separates from the uterus, causing the mother to hemorrhage and the baby’s oxygen and nutrient supply to diminish. I also had effaced nearly 100 percent, signaling that labor had been going on silently for longer than just that morning, most likely caused by an incompetent, or weak, cervix. Luckily, dilation had not begun, I was stable, the baby showed no signs of distress and my water had not broken. There was hope.
I was placed on strict bed rest — not even able to go to the bathroom, shut the curtains, or turn on the TV — and put on a powerful dose of magnesium sulfate, a drug that effectively stopped labor but left my body wrecked. The first dose of medicine, put through my I.V., felt like fire running through my veins. I was extremely weak and dizzy, and had to be on oxygen. My heart rate, blood pressure, blood-oxygen levels, urine output and temperature were checked every hour by the nurse; my medicine level checked every four hours by a blood draw; and I could only eat a liquid diet. I still cannot eat Jello to this day. But it worked; I had stopped bleeding and I felt less than four contractions an hour, not enough to cause labor to progress.
The ultimate goal was to delay labor long enough so that my baby wouldn’t be born until the steroids had time to work, at least 24 hours past the second injection. The hope would be that I could stay on bed rest at the hospital until at least 32 weeks, when the survival rate of premature babies jumps up to about 98 percent and complications were less likely and less severe. The survival rate for a 30-weeker was 90 percent but complications were more common and their severity higher.
At one point during my hospital stay, a neonatalogist visited my bedside to give me an overview of the NICU. I had no idea was he was trying to tell me — I thought the drugs would work, the pregnancy would last until my baby was term, my baby wouldn’t need any sort of NICU care. I had never even heard of the NICU before then, and when he asked me if I had any questions, I just stared at him blankly … even though my mind was racing with them.
Thursday, June 8, was the day of truth … in my mind. That was the day I was to be taken off the magnesium sulfate and put on the pill form of procardia, a drug created for heart patients, with the hope that it would keep labor-progressing contractions at bay. Unfortunately, Mike had to return to work on Friday, so I begged for my dad to come and stay with me, instead.
Thursday was a good day. Friday was not. My contractions came back early Friday morning, June 9, with all the intensity they had on Tuesday. At 11 a.m. Friday, I was put back on a magnesium sulfate I.V. with a double dose of the procardia pill and an injection of terbutaline, another anti-labor drug that gave me the shakes. I braved each contraction, with the help of my dad and a nurse as my coaches since I had never been through childbirth classes, with the expectation that the drugs would work. But when the perinatalogist checked my cervix at about 3 p.m., he found that I was 7 centimeters dilated and far beyond the point of halting labor. I had also started hemorrhaging again, and birth was the only sure way that neither me nor my baby would die. It was devastating to hear the doctors say there was nothing more they could do to stop labor and that my baby’s well-being was left to fate.
I was immediately wheeled down to the next floor to prepare for delivery. I was given an epidural, not only for my pain relief and to help keep me and my baby calm, but also to ensure that an emergency C-section would be possible. If the baby showed any signs of distress, it was expected that I would undergo a C-section immediately.
Mike got to the hospital just as soon as the anesthesia started working, but although he had missed most of the labor, he was right in on the action during birth. My time to push came so quickly that he didn’t even have time to scrub in. Wearing a pair of shorts and a sweaty shirt, he helped hold my leg and my hand, telling me how great of a job I was doing.
I had been pushing for 40 minutes when we ran into a snag. The baby was starting to show signs of distress, a slowing heart rate. I was put back on oxygen to help my baby out, but the doctor advised me he’d have to help her out in his own way. He decided to try an episiotomy, but said that if the baby didn’t come out with one pushing cycle, we’d have to do a C-section. After all that work, and especially an episiotomy already done, I did not want that C-section. And, luckily, I didn’t have to have one.
At 10:17 p.m., a little girl with blond hair was born measuring 16 inches long and weighing three pounds, seven ounces, about a pound more than the neonatalogists were hoping.