Wednesday, July 4, 2012
Birth Story One - Norah
My first daughter, Norah, was born at 34w2d due to severe
pre-eclampsia. I had a fairly uneventful pregnancy. Around 30 weeks I
began to have a lot of swelling in my hands and legs, but figured it
was part of being pregnant in the summer. At my 34-week appointment, I
was surprised to discover that my blood pressure was elevated and I
had protein in my urine. My OB sent me to the hospital for monitoring.
I was diagnosed with severe pre-eclampsia and was induced the next
day.
The induction was far from the birth scenario I'd envisioned. Instead
of walking around and keeping myself distracted, I was stuck in bed
(mostly on my left side) and told to minimize stimulation to keep my
blood pressure low. I had wanted a natural birth, but the only part of
that plan that happened was no epidural. After 11 hours of Pitocin, my
OB said Norah wasn't handling contractions well and we'd need to do a
c-section. She left the room to arrange it, but Norah had other plans!
I felt a quick change from painful contractions to a strong need to
push. She was born after only 10 minutes (approx 3 contractions) of
pushing. She was 4lbs 11oz and 17.5 inches. I got to hold her for a
minute before she was taken to the NICU. Unfortunately I had issues
with retained placenta and had to have an emergency D&C under general
anesthesia, so I wasn't able to see her again until the following
afternoon. My husband, who was amazing through labor, was able to be
with her. It was very hard emotionally to be separated from my sweet
baby. My blood pressure remained high while I was in the hospital, so
I had to take it easy. I nearly laughed when (months later) I noticed
that my discharge instructions said "home to bedrest with bathroom
privileges." Not exactly feasible when you have a NICU baby!
Our 23-day NICU stay was uneventful - no breathing issues, jaundice,
or serious health concerns. Norah just took her time figuring out how
to eat so she was fed through a tube that went through her nose into
her stomach. I had no idea that the suck-swallow-breathe instinct
isn't developed until around 37 weeks. Sure enough, that's right about
when she caught on. We gave her bottles to get her home faster and she
never looked back, so I pumped for 8 months.
Now Norah is a vibrant, curious girl of nearly 3. She loves to read,
dance, and pretend to be a princess. She has always been small for her
age, but otherwise you'd never know about her rocky start to life!
Birth Story Two - Emily
As a stark contrast to the first time around where I conceived immediately, it took 14 months to conceive our second child, Emily. I was watched more closely from the beginning, but felt confident in my odds of having a full-term pregnancy since my OB estimated I had a 20% chance of pre-eclampsia again. We found out during my first pregnancy that I have a bicornuate uterus (heart-shaped), so I knew I had some risk of pre-term labor and a breech baby, but I wasn't terribly concerned.
Once again, I had a rather easy pregnancy during my first two trimesters. We were excited to find out that Norah would have a baby sister! At 30 weeks, I had a scheduled ultrasound to check baby's growth. This is when things started to fall apart. We were shocked to learn that baby was measuring about 3 weeks behind, particularly since her measurements were right on track at 20 weeks. In addition, she was breech and my amniotic fluid level was at 7 (8 and above is normal). I was put on strict bedrest and was referred to a maternal fetal medicine specialist. Over the next 5 weeks, I continued on modified bedrest and had weekly biophysical profile ultrasounds. My fluid levels improved and stayed in the 8-9 range. Emily passed every BPP with flying colors, but didn't grow very much and changed from SGA (small for gestational age) to IUGR (intrauterine growth restriction). Bedrest was a huge challenge, particularly with a toddler! I would get sore from laying on my side and felt quite lonely since I was used to being on the go and seeing friends often.
On a Friday around 34 1/2 weeks, my blood pressure began to creep up so I was sent to labor and delivery for monitoring. It improved when I was resting on my left side, so I was sent home on strict bedrest for the weekend. When I saw my OB on Monday, my blood pressure was better but my fluid levels had dropped to 6.7. I was sent home but told to come back the next day with packed bags. On Tuesday, my blood pressure was up again, I had protein in my urine, and my fluid level had dropped to 5, so I was sent to the hospital to be induced that afternoon. My OB thought conditions were favorable for induction/vaginal delivery since I was already dilated to 2cm and Emily had flipped to head-down the previous week. However, after a few hours of Pitocin, Emily wasn't doing well with contractions - experiencing elevated heart rate between contractions and decelerations during contractions. My OB recommended a c-section and we agreed that was the best option. A short time later, Emily was born, all 3lbs 8oz / 16.75 inches of her!
Despite some anxiety about the c-section experience, Emily's birth was much less traumatic than Norah's birth. Part of this I attribute to lots of prayer and lots of confidence in my OB's judgement. I also think my previous preemie/NICU experience helped me to be a better advocate for myself. And even though she was tiny, Emily acted every bit of her 35 weeks gestational age! She began looking for food right away and my OB asked the NICU staff to allow me to breastfeed in recovery. This was an amazing experience and she did so well!
Emily's NICU stay lasted 14 days and was uncomplicated. Like her big sister, she was a feeder/grower the whole time. We worked on breastfeeding, but decided early on to focus on bottle feeding to get home sooner. Again, the NICU was a very hard place to be. With a child at home, I always felt guilty for being away from one of my children. My husband and I have amazing parents and siblings who pitched in to help with our toddler while I spent time with Emily in the NICU. I definitely had at least one NICU meltdown after a failed attempt at breastfeeding. I'll never forget the kind nurse who noticed and brought me a box of kleenex.
Once Emily came home, we began to work more on breastfeeding. Our lactation consultant used to be a NICU nurse and she was an invaluable resource as Emily and I learned to be patient with one another and finally (around 8 weeks old!) succeeded in breastfeeding! I'll always be proud of both of us for sticking with it!
Now Emily is 3 months old and is a very happy, laid-back baby. She melts my heart when she finishes nursing and looks up at me with a smile on her face! And even though she started at a mere 3.5 pounds, she has some cute little rolls on her thighs!
After having 2 preemies, I'm almost entirely certain that our family is complete. This definitely brings feelings of sadness since I never got to have a normal 3rd trimester and childbirth experience. I'll never know what it's like to think "this is it - I'm in labor!" I'll never get the excitement of being discharged from the hospital on the same day as my baby. Instead I have a special set of skills. I can change a tiny diaper of a baby through the holes in an isolette while keeping the attached wires out of the poop. I can speak in terms of cc's and mLs. I have weighed diapers, taken countless temperature readings, and charted food intake for months on end. I love my girls fiercely and know they are a gift from God. Being a preemie mom is hard, but I hope it's given me more empathy for other moms and patience for my children.
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