World Prematurity Day. Blogging for Awareness.

My child wasn't premature, but it seemed likely that he would have been born (living or not) as a micro-preemie at 28 weeks gestation when his placenta abrupted Though we eventually discovered that the placenta healed-over, it was assumed that it would happen again or that my son would be born too soon. This experience alone was scary enough to make me want to learn more about prematurity, to help fight for babies who were born too early, and to inform others. I will share my story (which ended up being much longer than I imagined) as well as some facts about prematurity and signs of early labor in hopes of not scaring, but helping others.

The first 26 weeks of my pregnancy were a bit hellish, but probably pretty typical. At 26.5 weeks I noticed a small amount of blood in my underwear and felt cramping. I headed to the ER where they monitored me and decided that all was fine. I scheduled an appointment with my OB who did a test to see if it was likely that I would go into labor within the next two weeks. The test was negative, which was a huge sigh of relief. My belly was really tender, but this was dismissed. I would later find out that I was showing signs of a placental abruption, a condition where the placenta starts to peel away from the uterine wall before delivery, depriving the baby of oxygen and nutrients. Depending on how much the placenta abrupts, it can quickly be life threatening for both mother and child.

A bit later, at 28 weeks, I stopped to use a gas station restroom on my 1.25 hr drive to work. I discovered. by surprise that I was bleeding quite a bit. I immediately called my OB's office and my doctor was paged. When she phoned, my doctor told me to go ahead and go to work as I didn't do anything that strenuous and to call the office to make an appointment. That seemed odd, but I had missed so much work due to the pregnancy and I didn't want to upset my boss (who already seemed annoyed and asked if I should just "go on bed rest"), so I continued driving. The moment I walked in the doors, I checked things out in the bathroom and found a lot more blood. I ignored my OB's directions and immediately headed to a small hospital a few minutes away, scared as hell for my baby boy.

I was quickly put into a labor room and the on-call doctor was paged, though he wasn't due into work for another four hours and he felt no need to see me. One of my supervisors arrived at the hospital kept me company, my husband made the trek out the to hospital thanks to a friend, and we waited. I was monitored and an ultrasound was done to check on our baby. All seemed to be fine. When the doctor arrived, my bleeding had subsided. He did a quick exam and sent me home, telling me to take it easy for the next 24 hours. What he should have known, and I found out later, was that the amount of blood shown is no indicator to how much the placenta has abrupted and even then, with any blood loss at all, this was a serious situation

On the way back home, my rather annoying bladder caused me to stop at the rest room where I found that I was once again bleeding. Phoning my obstetrician's office, I talked this time to the midwife who told me to get to the hospital immediately, phoning ahead to them know to be ready for me. I had no idea what to expect. I hadn't yet heard of placental abruption, a condition that effects 9 in 1,000 pregnancies. I was confused about why two doctors before this were making my symptoms seem like no big deal at all yet the midwife seemed seriously concerned. Though afraid, I was glad that someone was finally taking this seriously. It didn't seem okay.

I was greeted at the labor and delivery floor of our hospital by a team of nurses, a doctor and an ultrasound technician. They rushed me into a gown, checked my bleeding and got to work. The room was full of people, some nurses with nothing to do but stand in the background and look worried. I was given a shot to help mature my baby's lungs. I was checked for dilation and found to be closed. A tear was noticed on the ultrasound while the doctor talked to us about my condition. I don't remember what he was saying, but I knew it was bad, and all I could focus on was staying strong and not crying because I hate to cry in front of strangers. It was mentioned that we could lose the baby, that he could be born now and how dangerous that could be. When he mentioned that I could internally hemorrhage and die with no warning signs my husband had to sit down. The hospital didn't have a NICU and it was heavily suggested that I be transported to another hospital with a Level Two NICU. I agreed. If baby boy were to be born a micro-preemie, they could fully care for him there. 

A specialized team arrived from the other hospital in a huge ambulance, more like a tank really, which was was said to be an emergency room on wheels. They were ready and equipped for anything. I was hooked up to what seemed like endless monitors and we were on our way. The thoughts that were running through my head were horrifying, though I joked around with the ambulance staff to keep myself sane and they worked hard to kept me in good spirits. My laughter wasn't real, but it was all I could do to keep myself from getting a bit hysterical. I don't know how my husband managed to drive our car behind the ambulance the whole way.

Upon arrival I was monitored and ultrasounds were performed, one of so many looks into my womb and at my baby that were to come. I was given a second shot for his lungs. We were urged constantly to have me wheeled down to the NICU to familiarize ourselves. I flat-out refused every time. Regardless, a NICU team of doctors and nurses arrived to talk with us about what would happen if our baby was born that night or soon after. They talked to us about procedures, tubes and ventilators, horrifying complications, surgeries and the possibility of death. No, no, no. I thanked them for their time and told them that I never wanted to see them again. I think they knew what I meant.

I was in the hospital for five days. I had to stop bleeding for 48 hours before I would be sent home on bed rest. Every time I got hopeful I would find blood again. They told me that I could be in the hospital until I delivered, which they said would be sooner than later anyhow. It seemed almost certain that I would deliver my baby boy as a preemie if he survived. Even if I did go home, if I bled again I would be on hospital bed rest from there on. While it wasn't enjoyable to be in the hospital, I felt that baby and I were safer there. I had monitors. Doctors, nurses and residents who were at the top of their field were a buzz away if anything happened or to answer questions when I got nervous. Going home was scary. It was up to me to be mindful of kicks, symptoms, and preterm labor signs. Every bathroom visit was stressful at home. I was terrified that I would discover blood. I was (rightfully I suppose) afraid that my baby boy and I could die at any moment.

Since I was high risk, I had many appointments to monitor myself and baby. I fired the OB who didn't think bleeding at 28 weeks was serious, switched hospitals to the one with the Level Two NICU (even though it was an hour or more away, depending on the ferry across the lake) and started seeing the high risk OB's at the hospital offices. Each ultrasound and stress test was nerve wrecking, but the little guy always did great. I ended up back in the ER two or three times with concerns, one where, due to a lack of movement for hours and nothing working to get him moving (that was so not Tyler!) I feared he had passed. I asked to have my baby shower early just in case. I sat on my butt building an Amazon.com addiction, reading, and watching HGTV like a good girl. People wondered how I did over two months of bed rest without complaint. I wanted my baby alive. I was already desperately in love with him. I would do what I could to help him. I hung the outfit I wanted to bring him home in on the wall next to the couch as a reminder to stay where I was.

The last few weeks of the pregnancy were dicey. Though I shockingly made it to full term, Tyler was suddenly measuring small after being right on target every other time. My belly started to get smaller. Stress tests showed that he was well, but it seemed that the earlier placental loss was hurting him. It was unclear how much. Each time in the office, my doctor talked about inducing labor on the next visit (which was once or twice a week), but always chose to keep him in. The longer a baby is in the womb the better so that they can develop fully, but it was still a bit of a gamble. I wasn't supposed to get too worked-up, but how could I not? What if I missed a symptom or a sign that he was in distress? It was all on me to pay close attention and potentially save his life. The last visit at exactly 40 weeks, my OB measured my belly and said it had continued to shrink. She left the room immediately saying that she was calling Labor and Delivery. I was scared to death, again. Was my baby okay? What was going on? She wasn't answering a lot of questions but said that we needed to induce, and though my body wasn't ready and it may take a couple days, our baby boy needed to get out where they could get a look at him and to help him be well and safe. I hated the idea of induction but knew it had to be done. I walked straight up to the L&D floor.

Tyler was born the next night, just after a beautiful sunset over my view of the lake. Doctors and nurses, who were monitoring his heartbeat from outside the room, suddenly rushed in. His heartbeats were becoming slowed and irregular. After many scary drops in his heartbeat during delivery (which caused me to push for only about half an hour to get him the heck out of there), Tyler was born into a dim, quiet room as I had wanted. He had some trouble breathing, which petrified me, but was cleared up, but he couldn't nurse. Though very tall, he was deemed SGA, or small for gestational age because of his low weight. He had loose skin, making us believe that he had actually lost weight in the womb. His skin was also dry and he had healing cuts on his wrists which were a mystery as my water was shown to be fine. His umbilical cord was unusually long, showing how incredibly active he was. His fingernails showed signs of a lack of oxygen. He refused to nurse for over 24 hours which landed us an extra time in the hospital to allow him time to learn to eat, something he struggled with on and off for a while, requiring me to pump and feed him with a syringe and tube several times a day for a couple months.

Day four in the hospital, ready to go home.

The beautiful, lucky  moment we had been hoping and waiting for. Heading home!

Taking a nice skin-to-skin nap on Daddy and showing one of his mysterious wounds.

All in all though, he, who we of course named Tyler, was here. He was long and skinny (and still is at 26 mos), but otherwise healthy. He was later found to have silent reflux and mild sensory issues, though these seem minor to us in light of what he could have faced. Though risk factors for placental abruption aren't always known yet, if it hadn't been for the care of a knowledgeable doctors and all of the previous research on the condition, this story may have had a very different ending. I hope that I've helped inform women on the signs and seriousness of placental abruption and bleeding during pregnancy. As you can see from my story, not all doctors seem to be knowledgeable about the condition. If someone isn't taking you seriously, go see someone else. It could save you and your baby's life.
　

Now onto some important stats, and information from The March of Dimes:　

Preterm birth, characterize by birth before 37 weeks gestation, can happen to any pregnant woman.

In the United States, 1 in 8 babies is born prematurely. Our country’s prematurity rate is higher than that of most developed nations.

Worldwide, 13 million babies are born too soon each year.

A million babies worldwide died this year because they were born too soon, and there are 12 million more who struggle to survive.

Prematurity is the leading killer of America's newborns. Those who survive often have lifelong health problems, including cerebral palsy, mental retardation, chronic lung disease, blindness and hearing loss.

If you have a healthy pregnancy, it is important to wait 39 weeks before giving birth.

About half of the time, preterm birth has known causes. The other half of cases are still a mystery.

For a comprehensive list of preterm risk factors and important signs of preterm labor, visit this link.

The March of Dimes is an amazing resource for parents with or without high risk pregnancies and preterm babies. I highly suggest their website. You can also find your local MOD chapter to help support their efforts. The number of preterm births are dropping a bit, there's been progress, but there's a long way to go. Join a walk, make a donation if you can...these babies depend us.

Thank you for reading!