Olivia and her sisters were born on January 1st, 2011.  One of the sisters had died in utero a month earlier.  The three surviving sisters each weighed about a pound at birth.  They had only completed 23 weeks and 5 days of gestation before they were brought into the world via emergency c-section.

Upon the birth of her daughters, Olivia’s mother was given grim statistics rather than flowers and congratulations.  According to the Extremely Preterm Birth Outcome Data collected by the NICHD Neonatal Research Network, the girls each had about a 1/3 chance of surviving.  Their chance of surviving without moderate to severe neurodevelopmental impairment was a slim 1/10.

Olivia’s mother worried about her daughters’ health constantly.  In order to stay strong as the neonatologists revealed one piece of bad news after another, she would imagine a happy day 4 years in the future.

We’re on our way to the ice cream store, and all three girls are riding their tricycles.  I’m holding my husband’s hand and laughing at how worried we were in the weeks after our daughters’ birth.  Savannah’s in front and bolting down the sidewalk, Addisyn’s right by my side because she’s mommy’s girl, and Olivia is lagging behind because she’s the tiniest.

This dream was shattered, however, when little Olivia took her last breath last Thursday at 3:08 a.m.

An OB/GYN named Jennifer Gunter wrote,

Before things went wrong I had mapped out a scene from our future.  I think every parent does. Whether it is your baby’s first smile, how you will look pushing your baby in a stroller, or taking your child to their first day of school.  I suspect the image is different for everyone. For me, it was a picture of being wheeled by my beaming husband to the front doors of the hospital clutching three baby boys. Heads would turn and everyone would say, “Triplets!”

As an OB/GYN I have seen it a lot. The father or partner nervously sprints to the car and as the mother passes by cradling her precious bundle, almost everyone smiles and remarks on the baby. It is hard not to get caught up in the excitement of a newborn. The mothers are like beauty pageant winners, clutching a baby instead of roses, their faces beaming with excitement as they glide through the hallways as if they were taking their first turn on the stage before an adoring crowd. I really wanted that wheelchair ride. But no one looks at the mother without a baby. We are the invisible.

I still come and go from a hospital every day, just as I done for more than 20 years.  To this day I have to turn away when I see those smiling mothers as they glide towards the hospital doors as it reminds me of how I felt getting into our car so many years before. I can never escape it.  It is a visceral reminder of all that was lost. There are some wounds that never heal.  I know it is not their fault that my pregnancy did not go as planned, that after months of intensive care I left the hospital with two critically ill boys instead of three healthy ones, but I cannot help it.  It is a reminder of all those original dreams long discarded but not forgotten.

I must admit that I scoffed the first time I read this essay.  “If this woman is an OB/GYN,” I thought, “she should know that the average birth weight of triplets is 3 lbs. 11 oz. and that very few babies are discharged weighing under 4 pounds.”  When I found out that I was pregnant with twins, I started preparing my heart for the possibility of preterm delivery and a (short) NICU stay.  I never clung to the naive hope that I would one day be the proud parent of a pair of “take-home babies.”

Reading the essay now, for the second time, the universality of Jennifer’s story is more obvious.

I had mapped out a scene from our future.  I think every parent does.

Which scenes had I mapped out before Peter’s birth?  Well, there was that period of about a month during which I had visions of double strollers and strangers asking the inevitable question, “Are they identical?”  Those dreams were quickly extinguished, though.

I had looked forward to hearing my son’s first cry as he emerged from my womb.  That … well, it didn’t happen.  Since Peter’s birth, I’ve heard many birth stories told by new parents of preemies.  Here’s a typical one:

Adelena was born on November 15, 2010 at 27 weeks weighing only 1 pound 12 ounces (797 grams) with Apgar scores of 8 and 9!  I remember that moment like it was yesterday because the doctors warned me that she was most likely not going to cry since she was so early and tiny.  As soon as she was delivered I looked at my husband and started crying because all we heard was our daughter’s LOUD cry!

Sadly, these stories hurt to read.  All I remember from the moments after Peter’s birth is my baby’s silence and my uncontrollable shivers.

In my musings, I have also imagined Peter looking out our window, seeing our neighbors’ son outside romping on his swing set, and asking me whether he could go out to play with Gregory.  I would help him tie his shoes and send him on his way, telling him that he only had half an hour before dinner would be ready.   I would continue preparing dinner, taking short breaks to peek out the window and make sure that Gregory was not being too rough with my younger, smaller son.

Happily, this latter dream is still a possibility.  But after watching so many dreams shatter, I sometimes wonder whether it’s safe to dream.  Do we, as parents, even have the right to hold on to dreams for our children’s futures?

I’m reminded of the essay, “Welcome to Holland,” by Emily Perl Kingsley, a mother of a disabled child.

When you’re going to have a baby, it’s like planning a fabulous vacation trip to Italy. You buy a bunch of guide books and make your wonderful plans. The Coliseum, the Sistine Chapel, Gondolas. You may learn some handy phrases in Italian. It’s all very exciting. After several months of eager anticipation, the day finally arrives. You pack your bags and off you go. Several hours later, the plane lands. The stewardess comes in and says, “Welcome to Holland!” “Holland?” you say. “What do you mean, Holland? I signed up for Italy. I’m supposed to be in Italy. All my life I’ve dreamed of going to Italy.” But there’s been a change in the flight plan. They’ve landed in Holland and there you must stay. The important thing is that they haven’t taken you to a horrible, disgusting, filthy place full of pestilence, famine, and disease. It’s just a different place. So, you must go out and buy new guidebooks. And you must learn a whole new language. And you will meet a whole new group of people you would never have met. It’s just a different place. It’s slower paced than Italy, less flashy than Italy. But after you’ve been there for a while and you catch your breath, you look around. You begin to notice that Holland has windmills. Holland has tulips. And Holland even has Rembrandts. But everyone you know is busy coming and going from Italy, and they’re all bragging about what a wonderful time they had there. And for the rest of your life you will say, “Yes, that’s where I was supposed to go. That’s what I had planned.” And the pain of that experience will never, ever, ever, go away. The loss of that dream is a very significant loss. But if you spend your life mourning the fact that you didn’t get to Italy, you may never be free to enjoy the very special, the very lovely things about Holland.

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