Mothers of preemies often mention the guilt that accompanies premature birth. Why didn’t I recognize the signs of preterm labor earlier? Did my water break because I was too active? Should I have taken maternity leave earlier? Even when these mothers do everything in their power to ensure a healthy pregnancy – as most mothers of preemies I know did – there is still a sense that their body failed to do what it was biologically designed to do, failed to provide a safe womb for their developing fetus.
I had my moments of guilt early on, especially while I was still getting used to my deflated belly. But for the most part, I did not have to deal with remorse. I blamed my bicornuate uterus for my preterm labor, as that was the only reason anyone could come up with for why I delivered a trimester too early. But my uterus was not myself; I didn’t feel any more responsible for my son’s premature birth than I feel responsible for my own poor eyesight. It’s not really in my nature to blame anyone for misfortune. Most of the time, lightning strikes randomly.
Even though I had a nominal reason for my preterm labor, I did not feel I understood why my labor and Peter’s delivery happened as they did. Many women with Mullerian anomalies carry their babies to term; why did my pregnancy end almost three months too early? Why did the nifedipine I was taking to stop my contractions fail to hold off Peter’s delivery for more than 24 hours? Why was Peter’s delivery so fast, progressing from I need to call my nurse… to My baby’s feet have slipped out my vagina! in a mere half an hour? I hadn’t attended any birth preparation classes, but I was pretty sure that labor was not supposed to happen like this.
Unfortunately, in the case 40 % of premature births, the cause is unknown. Like many other women, my questions remain unanswered. I have, however, been reassured that there was little that my doctors could have done to change the outcome of my pregnancy. My labor progressed relentlessly, ultimately breaking my water. Peter slipped half-way out my vagina at that point, and thoughts of c-section were quickly dispelled.
Peter’s precipitous delivery hit me with the shock and grief of broken hopes and dreams. I had wanted a full-term pregnancy. I had wanted to be a big, round pregnant lady for a few months. I had wanted time to learn about labor and delivery and infant care. I had wanted to get to know my new OB during numerous third-trimester office visits. I had wanted to spend August and September getting my home ready for a newborn. Most of all, I had wanted to give my baby the best chances for a healthy, happy infancy. Peter’s prematurity took a big toll on these chances.
My insurance company sent me a copy of the book, Preemies: The Essential Guide for Parents of Premature Babies, after Peter’s birth. It provided me with the following statistics. As a 27-weeker, Peter’s chance of survival was about 80%. He had a 40% chance of growing up perfectly healthy, a 40% chance of suffering from mild or moderate disabilities, and a 20% chance of ending up with a severe disability. He had a 50% chance of developing bronchopulmonary dysplasia (BPD), and a 40 to 50% chance of having a patent ductus arteriosus (PDA). He had a 30% chance of developing a nosocomial infection, and a 5 to 10% chance of developing necrotizing enterocolitis (NEC), which in turn has a 20 to 30% mortality rate. He had a 75% chance of developing some retinopathy of prematurity (ROP) but only a 4% chance of being blinded by it. He was particularly at risk for an intraventricular hemorrhage (IVH), given both his low birth weight and his vaginal, footling breech delivery.
At this point, I’m happy with the lot that Peter drew. At 4 months old, no disabilities are apparent. Off oxygen after his first month, he did not develop BPD. He did have a PDA, but it was effectively treated with Neoprofen; PDA ligation surgery was not required. He developed a yeast infection and conjunctivitis while in the hospital, but respiratory infections and sepsis were avoided. He developed only a smidgen of ROP which quickly resolved without intervention. He had only a small, self-resolving grade 1 IVH. And most importantly, Peter survived.
So my shock and grief following Peter’s birth gradually turned to hope and pride. Peter had his PICC line taken out at 18 days old. He moved from the ICU to the step-down Continuing Care Nursery at 23 days old. He said goodbye to his nasal cannula at 30 days old. He moved out of the incubator at 37 days old. He started transitioning from gavage feedings to breast and bottle feedings at 44 days old.
And then, I began to grow very impatient. Peter was gaining weight well and in my jaded eyes, was getting quite self-sufficient. He had a bad habit, though, of letting his heart rate dip too low while breastfeeding and sending his blood oxygen saturation plunging in succession. These bradycardia spells were my bane for two long weeks until finally, Peter made it five consecutive days without a recorded “episode.” He was then allowed to go “wireless,” finally shedding the ECG leads and pulse oximeter that had tethered him to vital signs monitors for ten weeks.
My baby was discharged two days later, weighing 5 lbs. 5.6 oz., exactly twice his birth weight. The day of Peter’s birth was not the joyful day it should have been, but the day of his hospital discharge was quite possibly the happiest day of my life. I held back tears of happiness all morning while Son and I completed last-minute preparations for Peter’s homecoming. When we reached the hospital, though, the floodgates burst, and I shed the sweetest tears a mother could produce all over the NICU.
Jesus spent 40 days in the desert. The victims of the 2010 Copiapo mining accident spent 69 days trapped underground. My son spent 73 days in the NICU.
By the end of his stay, I had finally learned that these numbers contain little real meaning. Any amount of time that a newborn has to spend away from his mother in the hospital is an eternity. Just as any amount of time spent fasting in the desert is a trial and any amount of time trapped in a mine is a tragedy. The important thing is that we make it through our hardships alive so that we may rejoice and cherish the gift of life.