24 weeks gestation
We had been married for about 2 years when we decided to have a baby, and it did not take us long to fall pregnant. We were thrilled and told absolutely everybody, and in time bought clothes, a cot and started to decorate the nursery. To start with it was a fairly uneventful pregnancy and my due date was 8th January 1996.
At around 16 weeks gestation, I awoke in the middle of the night and found that I was bleeding quite heavily. We rushed to the hospital (our first of many middle of the night trips) and were relieved to find our baby’s heart was still beating. It was at this point we found that my blood pressure was alarmingly high, about 150/100 and I was admitted to hospital for a few days for observation. The next day I had a scan and everything seemed to settle down and I was allowed home.
With my high blood pressure, I was no longer able to attend my antenatal visits from now on at the Birth Centre and was referred back to the general clinic, where I was placed under the care of the senior obstetrician and hypertension specialist. Although my blood pressure was high, it seemed to be relatively stable with the aid of medication.
At 23 weeks and 6 days gestation, I went on a car trip to Bundaberg with my family. I had been feeling unwell for most of the day and by late afternoon I was walking around almost doubled over with pain. My Dad had to stop the car every half an hour between Bundaberg and Brisbane because I insisted I had to go the toilet. We were nearly home, and I was beginning to think I should go to the Medical Centre as I didn’t feel quite right. When I got out of the car, I was shocked to discover that I was sitting in a pool of blood.
We rushed straight to the hospital, where I was found to be 3cms dilated and in premature labour and would deliver my baby that night or the next day. I kept telling the midwives that I couldn’t possible have a baby, as I hadn’t been to my antenatal classes yet. I never did get to go the class! The next morning, my contractions started to intensify and by 11am, were getting quite close. I had my second dose of steroids as they felt that the baby was on the way and a paediatrian was standing by
At 12.32pm on 19th September 1995, Laura Jane Elizabeth (at exactly 24 weeks gestation) made her entry to this world, with a small whimper. She was resuscitated and whisked away to ICN before I could even see her. At that point, I did not even know she was a girl and it was hard to believe that my pregnancy was now over and that I was a mother.
I remember going to see her a few hours later and my first impression was that of a very small, red skinned rabbit. It seemed rather unbelievable that this scrawny transparent creature was our longed for baby.
I went and made a few phone calls to incredulous family and friends who could not believe that I had already had my baby, they seemed to think it was impossible that she could be born and alive. I remember several of the nursing staff telling us were in for the “long haul” and at the time I had no idea what they really meant.
The day after Laura was born, her oxygen went up to 100% and her ventilation rate was up to 100, and they asked us if we would like to have her baptised, “just in case”. I still don’t think the reality of what was happening at this time would sink in until weeks after. After she was baptised, she seemed to stabilise a little. But this world of beeping machines, monitors and medication seemed still too unreal.
I think my first real emotional hurdle to overcome, was when I was discharged when Laura was five days old. It was so hard to walk out of the hospital and just leave her there. I was a mother and other mother’s were able to take their babies home, it was just so unfair that my baby was still there. I just felt sad and empty. When I arrived at the hospital the next morning, I was very surprised and happy that the nurses had printed her footprints onto a card for me.
At this time Laura developed jaundice and spent 139 hours under the phototherapy lights, which we were to find was quite a common occurrence. When Laura was 10 days old, she hadn’t yet had a bowel movement and she turned an almost black colour. They diagnosed a hole in her bowel and believed that she had NEC (necrotizing entercolitis) and she was taken straight to theatre. After awhile, she came back to the nursery with her little colostomy bag and they said that they had found the hole and the operation was quite successful. I think the nurses had to pry me out of the nursery that night, as I didn’t want to leave her side. She had the colostomy bag for the duration of her hospital stay, but the stoma was closed before she came home.
Our next hurdle was Laura’s PDA (patent ductus arterosus) which had closed with two courses of medication, reopened with the stress of the bowel operation. Although the staff assured me that this was a routine operation, I spent the day by her bedside with a box of tissues. She was a tough little thing and recovered remarkably well for such a little girl.
Then came one of the best days, the first day I got to hold my little girl. She was 41 days old and I was yet to hold this precious little one. It was so wonderful and yet so frightening, and from that time on I started to really feel that this was my baby.
One of the only things I could do for her, was express breast milk. I had started expressing the colostrum a few days after she was born. I was having difficulty maintaining any sort of milk supply and Laura did not have any for the first four weeks, but I was hoping that I could continue to provide a good start for her. Her first feed of breast milk at 45 days old, was 1 whole mil. I was so excited that she was having her first feed, but when they tube fed the milk, she had a bradycardia and had to be resuscitated. I asked the staff not to give her any more milk, look what she did, but they assured me that it was alright. I kept on expressing, usually by hand, and bringing my precious but small amounts of milk to the hospital every day. After about 9 weeks, Laura was having more formula feeds than those of my breast milk. I struggled for days about whether or not I should keep expressing. I consulted my GP and sort out a few different opinions. I know that lots of Mums successfully breastfeed their premature babies, but I was having such trouble and blaming myself for not being able to adequately provide enough breast milk for her. By this time, she was having feeds of 20ml every two hours, and I was only able to provide 20-40mls per day, after spending hours expressing. I decided that I had given her the best start I could, and stopped expressing. Laura herself showed me that I was not a failure as a mother, at her next weigh in two days later, she had put on 120grams. I felt that this was the right decision for me and my baby and felt an enormous weight lifted off my shoulders.
During this time, Laura was still fully ventilated and on a small amount of oxygen. We had tried CPAP four times but to no avail and we were still in Intensive Care, while lots of other families that we had made friends with were now around in Special Care. With the constant saturations of oxygen, it had affected Laura’s eyes and she was diagnosed with Grade 3 Retinopathy, and would require Laser Surgery. (Yet another box of tissues I blubbered my way through). She had total of 760 burns to her left eye and 702 to her right, which would help to restore some of her vision. This operation turned out to be blessing in disguise, because after the surgery, they tried her without any ventilation or oxygen to see how she coped. After a total of 1070 hours of being intubated, she was finally breathing on her own, and after 12 weeks, we were finally headed for Special Care.
In SCN, we became more involved in her feeds, bathing her, changing her, and just enjoying cuddling her, as she was now in an open cot. There were lots less monitors and we were encouraged to be more hands on.
We celebrated her 100 days milestone, and looked forward to her first Christmas. We were not disappointed that she was still in hospital, as we had not expected to have her home yet, her due date a few weeks away. She had visits at Christmas from her Grandparents and Aunty and we bought her a little singlet that said “My First Christmas”, although it came past her feet.
At this time, the doctors decided to repair Laura’s stoma as she was now over 2000 grams. After a false trip to the theatre, Laura had her bowel closed on New Years Day 1996, and when she returned from theatre she had to back to ICN and into a humicrib.
I was upset to see her go back to ICN, although the nursing staff assured me that this was not a backwards step for her. At this point, all those long days and nights at the hospital, lack of sleep and irregular eating habits were starting to take their toll, and I was cracking under the pressure. I could not bear to see her back in ICN and spent two days at home on the couch, under a blanket with the phone next to me, so I could call and see how she was every few hours. This was the beginning of PND, and I started medication to help me get through.
When we went back to SCN, Laura decided she wanted to come home and was taking nearly all her bottles, and was gradually being weaned off her medication. We were on the home straight now.
Only 9 days after her due date, and after 120 days (17 weeks – 13 in ICN and 4 in SCN) we were able to bring our beautiful little girl home, she now weighed 2800 grams. We were so grateful that she had the will so survive all she had been through and was now coming home, and we no longer had to leave her behind at the hospital.
She achieved most of her milestones around her corrected ages, and only suffers a few long term problems. Laura is now nearly 8 years old, and a happy and mostly healthy little girl. She is in Grade 3 at school and loves science and plays hockey. She is still in the lower percentile weight range for her age, she has just hit the 20 kgs mark but is quite tall. Although she had a few problems associated with her bowel in the first two years, she appears to have outgrown this although she still carries prominent scarring on her stomach. With her eyesight, she has virtually no peripheral vision, but we believe that she only has lost 30% of her vision and at this point in time, she does not yet need glasses. We are also lucky that she has shown no sign of cerebral palsy.
By Kim Rivers