By Pam Stone, co-leader of API of Merrimack Valley, New Hampshire
On a Wednesday afternoon, several weeks before my twins were due when I was on bedrest in the Maternity part of the hospital, I started having contractions about five minutes apart. My doctor was out of town, so his midwife came to check on me. I had dilated some, but she wasn’t certain whether I was going into active labor or if it could be stopped, so I was transferred to Labor and Delivery. Thankfully, my doula, Joan, happened to be visiting at the time and she was able to go with me. I don’t know what we would have done without her.
The fabulous nurses in Maternity allowed my husband and daughter, Greg and Sophia, to keep the room here so that we didn’t have to move our things and they could continue to spend the nights. The covering doctor did not suggest doing anything more to stop the labor since I was beyond 34 weeks. He wanted to wait to see if I was going to go into active labor. So, we were waiting patiently when all of a sudden, I developed unbearable headache and stomach pain like I had never experienced. I was vomiting frequently. Greg was tending to Sophia until his mom could arrive to help, and Joan and the labor nurses were there to give me strength. It didn’t seem long before I was begging for an epidural not for the contractions, but rather to stop the pain in my head and stomach.
I don’t remember much from around this time, but I know that my lab results came back indicating severe preeclampsia, and the situation suddenly became very crazy. They started me on several medicines, including magnesium sulfate to avoid seizures. I remember the doctor saying that if I were to progress quickly, we could still do a vaginal birth, but that we couldn’t let things go for too long. He said that the best way to stop the preeclampsia was to deliver the babies, Nico and Kian. He broke Nico’s water, and I was given an epidural.
For a short time, things seemed to be back on track. Then, just as quickly, Kian started showing distress at every contraction. The doctor recommended an emergency Caesarean section, and in what seemed like an instant, we were in the operating room and the boys were here! Nico Dennis was born at 10:28 p.m., weighing four pounds, six ounces and measuring 16 inches long. Kian Albert was born two minutes later, weighing four pounds, four ounces and measuring 17 inches long.
Nico did well from the start, scoring 9 out of 10 on his Apgar. Kian struggled a bit. He wasn’t breathing and only scored a 1 or 2 on his first Apgar. I remember someone commenting that it was good that they got him out when they did. Within a couple of minutes he was OK, and he scored a 9 out of 10 on his five-minute Apgar. I was allowed a quick kiss before they were whisked away to the Neonatal Intensive Care Unit (NICU). Greg went with them.
Back in my labor and delivery room, I wasn’t feeling well. I wanted to go see the babies, but I was too unstable. The side effects of the magnesium sulfate, along with the after-effects of the anesthesia, left me in rough shape. I stayed in my room during the night.
I was able to see the boys twice, for about 10 minutes each, on Thursday. I began pumping milk for them. I was achy and tired and had blurry vision, but I was OK. Then, my stomach became distended and my suture line looked swollen. I began running a fever. I was started on two I.V. antibiotics. That was the beginning of the next downturn, which started Friday morning. The nurses suspected I had a case of hospital-acquired C. difficile, a bacteria that causes intestinal illness, and put me on contact precautions, meaning that everyone who came into the room had to wear gloves and gowns and I couldn’t go to the NICU to see Nico and Kian. It was a very hard day, but Greg kept me updated on Nico and Kian, who were doing marvelously.
The initial C. difficile test came back negative, and I was told that if my fever stayed away for 24 hours, I could go to the NICU again. But before we had time to celebrate, the final C. difficile results came back positive. Nobody was really sure what to do, and there wasn’t an Infection Control doctor in the hospital because it was the weekend. They wouldn’t let me see go to the NICU on Saturday and wouldn’t let me send up any milk for the boys, either. I also wasn’t able to hug, kiss, or even touch Greg and Sophia.
We were told I’d need more antibiotics for ten days. I was still suffering from the side effects of the magnesium sulfate, and adding the C. difficile on top of it was miserable. I cried a lot.
By Sunday morning, I was already feeling a little better. My body was starting to win the battle against the C. difficile, and the effects of the magnesium sulfate were wearing off. I called to talk to the NICU, and they had been able to reach Infection Control during the night. I was going to be able to see my babies! I could breastfeed directly and could send up milk. I was so relieved.
The Labor and Delivery department needed my room, so I moved back to Maternity early on Sunday morning. Finally, my doctor visited on Sunday and removed the contact precautions. Good hand-washing hygiene would do. My platelet count was recovering, so they could at long last remove the epidural catheter, and my doctor began treating the massive rash that had broken out due to an allergic drug reaction. I was allowed to hug my family, and spent several hours in the NICU visiting Nico and Kian. They were fabulous. I met with a lactation consultant and was able to breastfeed them both. Things were beginning to turn around.
Nico and Kian still battled the many challenges that many premature infants face, but today, they are home and are doing well.