What it’s like to have a Premmie Baby – Monique’s Story

I am a Plain Clothes Police Officer with the Queensland Police Service and at 25 weeks pregnant in November last year, there wasn’t a lot of operational police work that I could do.  Besides from being diagnosed with Gestational Diabetes at 16 weeks (despite being young, fit and healthy), I had a normal and straight forward pregnancy so far.  Our little girl was due on March 9th, 2017.

I had never heard of anyone having a premature baby and it was never a concept that I knew anything about.  It just wasn’t something that had ever crossed my mind and being my first pregnancy, I didn’t know any different.

At about 3am on Monday 28th November, 2016 at 25 weeks and 4 days pregnant, I began having what I thought must have been Braxton Hicks Contractions.  They were uncomfortable and I was bent over in pain, but they were not regular, so I knew that they couldn’t be true contractions.  They went on for around 2-3 hours.  I woke up for my day and headed to work.  I called the Hospital on the way to work and I was told that because they were irregular and that they had stopped, they would have likely been Braxton Hicks contractions.  Being reassured, I carried on with my day.

The next day, I woke up and showered.  When I got out of the shower, I dried myself as usual, but there was water still running down my legs.  It wasn’t a big gush, just a slow trickle.  I called the hospital and spoke to a midwife and she told me it could just be discharge and to keep an eye on it.  It was now Tuesday and I had a big day assisting with a District Court trial, running around and organising witnesses.  During the lunch break of the trial, I walked to get some lunch and I felt a gush of water.  Had I just wet myself?  I didn’t feel like I had wee’d though and it wasn’t a lot of water.  I called my GP who was managing my pregnancy as I felt like a bit of an idiot each time I called the hospital.  Like I said earlier, it was my first pregnancy and I had never heard of anything happening like this to anyone before, maybe it was just discharge.  I left court straight away and saw my Doctor who did an ultrasound and the baby was surrounded by fluid happy and healthy, with no fluid appearing to be lost.  My Doctor mentioned that it may have been a possible small leak that had already healed itself as I was no longer leaking. She recommended that I go home on bedrest for a few days and go to hospital if it doesn’t feel right.

The next morning was just that.  I didn’t know what was wrong, but something just didn’t feel right.  I wasn’t leaking anymore that I could tell, but my stomach looked completely flat.  I was 25 weeks pregnant, previously with an obvious bump and now, there was nothing.

My husband was away for a family funeral at the time this was all happening, so I drove myself into hospital, thinking I was being stupid and overreacting and that I would have a quick check up and be sent home.  I called my husband and he started making his way to the hospital.  I told the staff at the maternity counter what had been happening and I was taken in straight away, ahead of all the other ladies waiting.  First I was seen by a nurse who did basic triage and laid my down flat with a pad for 30 minutes to see if fluid was still leaking.  Then an obstetrician came in.  He did an internal examination, then all of a sudden, the room was full of people and equipment.  Everyone started rushing around, talking quickly and the look on his face told me that something was very wrong.  He called another obstetrician in and there was now around 6 people in the small room.  He explained to me the job of the cervix in pregnancy and that mine had failed to do its job.  He explained that my cervix was fully effaced and that I had no measurable cervix and I was 2cm dilated, as if I was in labour.  He told me that the pressure of the baby was pushing the membranes through the open cervix, known as ‘bulging membranes’.  He told me that I would have to spend the rest of my pregnancy in hospital and they weren’t sure if that would be a few hours, a few weeks or a few more months.  They told me to prepare to have the baby very soon, possibly within a few days.  They said they would arrange for the Neonatologists from the NICU (Neonatal Intensive Care Unit) to come down and prepare me for having a premature baby.  I burst into tears.

They prepared a room for me and I was admitted to hospital for the remainder of my pregnancy, however long that was going to be.  My husband came straight away with a bag of things.  We were in the middle of renovations at the time, I was still supposed to be at work and my whole life had been turned upside down.  They started the first round of steroid injections, took swabs, started an IV line into my arm for antibiotics every 4 hours.

The Neonatologist came down and gave us a tour of the NICU.  It was really difficult seeing tiny babies hooked up to leads, oxygen and monitors.  I couldn’t take anything they were telling us in, I was beside myself with fear.  I’m glad my husband was there to take it all in.  They told us that if our baby was born in the next few days, there was a 60% chance of survival and an 80% chance of a long term condition, illness or disability.  I couldn’t fathom what was going on, but knew I needed to remain as calm as I could, so as to not induce labour any further.

I had another steroid injection the next day and the antibiotics stopped after 3 days after it was confirmed that there was no infection.  Somehow, I was still pregnant and the leak (which was diagnosed as a hind water leak) had healed itself.  Scans showed that the baby was about 800 grams at that point.

Then the monotony of hospital bed rest crept in.  I was thankful to still be pregnant with each day that passed, but being stuck in a bed, when you are otherwise completely healthy was mentally very difficult.  I was kept busy with visitors and phone calls.  There were days where I couldn’t stop crying because I was so scared of what was going to happen and that I so badly wanted to be out of hospital.  But I knew it was exactly where I needed to be.  By this stage, I had been formally diagnosed with Cervix Incompetence, a condition that will also effect future pregnancies.

By this stage, it was leading up to Christmas and I was beginning to think that I would be spending Christmas in Hospital.  My family was amazing and had planned to having Christmas day in my room, we were organising what food we could bring in, if I could have half a day of leave away from the Hospital even!  But at 27 weeks I began contracting again and I had dilated to 4cm.  Our daughter was still small enough to ’swim around’ in the womb, so she was continually swapping between head down and feet down.  Then at around 28 weeks, she stayed one foot down, or footling breech.

My medical team explained the likelihood that I would have a cesarean birth and due to my uterus not being well formed yet, it may have to be a ‘classical cesarean’, where they open the uterus up vertically, not horizontally.  They wouldn’t know how well my uterus was formed until they started the surgery.  I signed the consent forms.

The contracting continued on and off for days and days.  It wasn’t painful, just tight, but my cervix stayed at 4cm. I discussed going home on Christmas Day and they told me that they honestly didn’t think I would be pregnant by Christmas.

Then, all of sudden, on 22nd December at 29 weeks and 0 days pregnant, I woke up bleeding.  The bleeding continued most of the day and got heavier, but I wasn’t dilating any further.  By the afternoon, I was taken down to the birth suite ‘just in case’.  I was given a ‘rescue dose’ of steroids, another painful injection in my leg.  I was also hooked up to an IV of two magnesium sulphate transfusions to protect the baby’s brain during birth.  It made me feel terrible.  I felt like I was in a sauna, everything was hot and I became extremely disorientated.  The first transfusion was 20 minutes of hell, the second transfusion was less intense and after 40 minutes I felt normal again.  My obstetrician did an internal examination and confirmed that I was 7cm dilated and he could feel the baby’s foot pushing the membranes into my vagina canal.  He was able to feel her foot in my vagina canal.  The risk of a full membrane rupture and cord prolapse was now greater than the need to stay pregnant and I was rushed into the next room for my spinal tap.  My husband had been at work and had just arrived in time.

I had an amazing cesarean experience, even in the most rushed of circumstances.  I felt calm and in control.  I had an amazing team for myself and my baby.  There was around 20 people in the room, the usual surgeons, nurses, midwives and anaesthetist as well as Neonatologists and a rescus team for our baby when she was born.  We were warned that our baby may be silent when she comes out and may require resuscitation, but the rescus team would stay out of sight unless they were needed, to keep us at ease.  Within 10 minutes, I heard a huge cry.  I burst into tears and said, “she’s crying! She’s crying!”  She was here, but after a couple of moments, she did need a little help breathing.  She was placed on a CPAP ventilator, but was doing surprisingly well for being born exactly 11 weeks early.  My husband helped cut the cord and took some photos of her to show me as I was getting stitched up.  She was wrapped in insulating plastic to keep her warm and was a tiny 1335 grams.  I saw our daughter in an incubator for about 10 minutes and my husband stayed with her while I went down to recovery.  Aside from the bleeding, I had a ‘silent labour’ with no pain and no contractions.  They suspected I had developed an undetected infection called Chorioamnionitis (infection of the membranes) due to my cervix being open for so long.  They wouldn’t be able to confirm that until the results of my placenta histology came back 4-6 weeks later.

 

Shortly after birth, they advised us that the NICU at the hospital I was in was full and they would need to transport our daughter to a hospital over an hour away in an Ambulance, which they did.  They bought her up to my room in her travel incubator before she left.

 

I didn’t realise it at that time, but I felt no connection to my baby and I honestly didn’t even really believe that I had given birth or ever been pregnant.  It was all a bit surreal.  And now my baby was over an hour away, I felt more disconnected than ever.

I chose to stay at my original hospital and be discharged two days later, on the morning Christmas eve.  We travelled straight up to the hospital where our daughter was and it was then that I truely saw her hooked up to the leads and monitors.  She had wires all over her, tubes coming out of her stomach, an IV in her hand and a tiny CPAP mask over her face. I was able to have my first cuddle of my daughter late Christmas and into the early hours of Christmas Day. We named her April.

 

April initially spent 5 days in the NICU and was taking off all oxygen support at 5 days old.  At 7 days old, April was transferred back to our home hospital and into the Special Care Nursery.  Everything seemed to be going well and she was gaining weight well.  At around 3 weeks old (32 weeks gestation) April’s oxygen saturation continually dropped and she began having high temperatures.  They thought that she may have developed late onset sepsis, passed on from the infection in my membranes.  She was put on antibiotics and high flow oxygen and taken back into the NICU.

 

We had to wear masks and gowns to go into her room.  However, her bloods all came back clear, but she had dangerously low red blood cell levels, a condition known as Anaemia of Prematurity.  She was given an urgent blood transfusion and from there she improved drastically.  From there, it was just a waiting game for her to learn to feed without a tube and gain enough weight to come home.  April was never able to breastfeed and I pumped breastmilk for her for 5 months, which was extremely exhausting in itself.

April spent 67 nights in hospital and came home at 38.5 weeks gestation.

Next month, we will be celebrating April’s first birthday, even though she’s only meant to be 9 months old.  We have had 4 hospital admissions in her first year, the worst being when she developed RSV bronciolitis 8 weeks after her due date and she spent a week in hospital on oxygen.  The difficulty of having a premature baby doesn’t end when they leave hospital.  There is the constant fear of them getting sick, wondering when they will catch up to other babies their age and always questioning if you are doing the right thing as a first time parent.

I feel like I missed out on so much being a Mother to a premmie baby, things like holding your baby at birth and breastfeeding, but I gained so much more. Monique x