NICU

When it isn't love at first sight

"Oh my gosh, he's got a little pig nose!"This was my first thought when I saw my son, Benjamin, when they lifted him above the curtain that separated my eyes from the surgery that brought him into the world on that autumn day six years ago.My 2nd thought was this: "No! I can't believe that was my first thought about my baby!"

I don't remember what my first thought was about Micah, Benjamin's twin brother. I just remember praying that he would live as they whisked him away to the NICU without even letting me kiss his fragile, white face.

I didn't get to touch my sons until many hours after my c-section. I gingerly held Benji in my arms, painfully conscious of every wire, tube, and IV in his tiny 4 pound body. Cuddling was impossible.

I kissed his head. His stubby hair felt rough against my lips.

Holding him felt strangely foreign. And I didn't want to hurt him so I quickly let the NICU nurse put him back in the isolate.

With Micah, I gently stroked his foot as he received an emergency blood transfusion. I didn't get to hold him until the next day.

My husband and I were prepared for the NICU. We knew the boys would be premature, would have to stay in the hospital for a while.

What I wasn't prepared for was how detached I felt from my twins after they were born.

Who are you, little ones? I wondered, my eyes searching the faces of my babies, who looked more little little old men than chubby newborns.

Who am I? 

This was the thought I couldn't wrap my mind around. I didn't feel like a mother. Mothers gushed over their newborns, exclaiming delight, rapture, love at first sight!

I didn't feel anything.

After two weeks, the boys came home from the NICU in all their 4 pound glory and I plunged my life into caring for them. I was determined to breastfeed; when that didn't work (at first) I pumped around the clock. My children would have "the best." After all, isn't that what "good" mothers do?

My days at home with my preemie twins fell into a predictable, robotic pattern: First cry Warming bottles Feeding Burping Changing diapers Swaddling Back-to-crib Pumping Washing bottles and pump parts

Repeat

I didn't cuddle my babies or gaze in their eyes, stroking smooth cheeks and smelling necks. If I let myself indulge in a snuggle with one, I felt guilty for not cuddling the other. So, in the name of fairness, I didn't waver from my routine: First cry, warming bottles….

Other friends and my sister-in-law gave birth just a few weeks after I did. They posted on Facebook about how they had never felt such a love, how the baby filled every corner of their heart.

I inwardly rolled my eyes. They are lying. They are just trying to make themselves feel better. Motherhood is ROUGH!

But really, I was jealous of them. What was wrong with me as a woman, as a mother, that I didn't feel the way I was supposed to feel about my babies?

I definitely felt maternal. I took care of them to the best of my ability. I did my very best. I loved them, I really did! But the most I felt toward my newborns was "responsible."

Mostly I just felt broken, defunct.

The weeks slipped by. One month. Two months.

Then, a gift.

We were sitting on the couch, doing some eye gazing and one of the boys (I wish I could remember which one!) looked at me and smiled for the first time.

Oh! My heart actually jumped in my chest and tears sprang to my eyes. And in this moment, I felt true warmth toward my baby.

I felt the LOVE I knew was there but had been missing emotionally.

That smile was a seed that began to grow in my heart and I began to realize a shocking, startling truth:

Perhaps not every mother "falls in love at first sight" with her baby. Perhaps, maybe…some love stories start out slowly, growing deeper and truer over an entire lifetime.

Birth is just the beginning.

My twins are now six and a half years old. They are active, wild, funny, affectionate little boys. Every day when I pick them up from Kindergarten, they run like crazy maniacs across the street and fling their arms around my waist, yelling "MOMMY!" at the top of their lungs.

And my heart feels that same warm glow that began six precious years ago.

I still stare at them sometimes ("Mom…why are you looking at me? Stop!") and think:

Who are you, little one?

And instead of being filled with fear and uncertainty, this question fills me with eagerness to get to know my sons more and more as they grow each day, each year to adulthood.

I will never stop wanting to know them more completely, love them more throughly.

Because sometimes you don't fall in love with your baby at first sight . Sometimes love grows slowly with purpose and strength over a lifetime.

Levi's Birth Story, Part Two

Featured Image

July is birth story month at the Motherhood Collective. Reading the good, the bad, the ugly and the BEAUTIFUL experiences of other mothers gives us a real appreciation for the strength we have in childbirth. Hopefully these stories will inspire you. Today's post is written by Kerissa Scott, a regular attendee at the Motherhood Cafe. Knowing her birth story, we asked her to share it and she graciously agreed.  Part One of her story was posted on Monday and ended with the birth of her son.  Part Two of her story deals with the time afterward in the NICU.

My Introduction to the NICU

I have always had a passion for preemie babies. It was my absolute favorite clinical in nursing school and I dreamed of becoming a NICU nurse before I found out I was pregnant. So I had been around very, very small babies with many serious issues.  However, no amount of time spent there could have prepared me for my own child being the patient.

My dad had been able to go with the baby to the NICU, and I believe my mom went to see him before I did as well. Thinking back, I may have “sent” them to watch over him. I had to wait until the epidural fully left my body and I could walk. I think this took about 30 minutes.

My son was on a ventilator, which was breathing for him, and there was tape all across his face to hold it in place. He had several wires coming out of his belly button - if they are able to, the hospital uses the umbilical arteries in preemies rather than having to stick them for an IV. There were “leads” on his chest, measuring his respirations, and a pulsometer on his wrist. There are so many machines, making all sorts of different noises, and each baby has several machines, so there was a ton of beeping, whooshing, and all sorts of other noises. He was in an incubator, but luckily for this first visit, it had an open top, so i was able to see him easily, touch him, and love on him. I wasn’t able to stay very long, because I was also still a patient and they wanted to monitor me.NICU 1

The next time I came in, they had put him under contact precautions due to my MRSA. I still had not been able to get my 3 nasal swabs cleared, which automatically put him at risk. It was all so much overkill, but standard procedure. This killed me, because it meant I could not touch him without gloves on. I argued and argued about how I had already touched him and how if he had it, it was from me, so it shouldn’t matter. Every valid argument I could come up with, I threw at them. But alas, I had to wait for the nasal swabs. I remember I would pull off the tip of the glove on one finger, just so I could get that skin to skin touch that newborns and mamas so desperately need.

Under the Bilirubin LightsThe next day he was taken off the ventilator and put on a CPAP machine, one step up! The nurses measured his blood gas levels several times a day, which determined any changes in his respiratory therapy. His bilirubin levels went up (translation: he had jaundice) and he was put under the glorious blue lights with the cutest little shades for his eyes. He was also receiving TPN via IV (total parenteral nutrition), basically food in liquid form, since they had not started feeding him yet.

I would go back and forth from my room to the NICU all day. Pumping every 3 hours, possibly getting in a phone call, and then straight to his side. I’m not sure which day it was but I know one day I stayed so long that I started bleeding down my leg - my pad had totally filled up and was leaking all over, creating a puddle beneath me. It was pretty embarrassing because in Virginia Baptist, there are no curtains or anything separating the babies, so everyone else who was in there visiting their newborns saw me. My nurse was called and had to come get me in a wheelchair.

Everyone always asked me how I picked my son’s name. I was discharged 2 days after he was born, but was able to stay in my room as “hospitality”, so I could be close and not have to drive back and forth (especially because I was pumping and technically couldn’t drive for 14 days). However, they told me they could not officially discharge me without giving him a name, so I was given I think like an hour deadline to have a name. The nurses and everyone asked all the time what his name was, but I really didn’t feel like I was ready to name him. I didn’t know him well enough and hadn’t spent enough time with him. But alas, I sat down with my list next to him and went through my top picks. None of them fit. So I went back to my long list, and for some reason Levi just stood out. I always wanted an Irish name (which Levi is not), but I just knew that he was a “Levi”. So I saved the Irish part for his middle name “Reece” which means “ardent, fiery”. He had already made a name for himself in the NICU as being quite the little firecracker, pulling out all his tubes and IVs several times. He was a fighter from the beginning. Levi Reece. As soon as I said the two together, that was his name.

Settling In to Life in the NICU

At this point all of the days kind of blend together. I have notes written down with his stats for the day but a lot of it doesn’t make sense to me now. The single best description I know of regarding life with a baby in the NICU is a rollercoaster. Things can be going awesome one day, and the next your baby’s life could be in danger. Thankfully, Levi never had any life threatening issues, but there were definitely some low “lows”.

He eventually graduated from the CPAP machine to a nasal cannula, and then would be taken off the nasal cannula, only to be put back on it a few hours later. He was off it for over 5 days at one point, and then they randomly decided he needed it again. I would be told I could hold him, only to find out his levels came back too low, and they didn’t want to risk it. I finally got to hold him June 25, when he was 4 days old. We were still on contact precautions, so I had to wear a gown and gloves, but I was able to hold my baby. He would gain 30-40 grams one day (yes, I said grams, and you better believe I did a huge happy dance if he gained even 10 measly grams), and then the next day lose 50. (For some perspective: he was 1960 grams when he was born - 4 lbs 5 oz; when he was 5 days old he was 1920 grams.) When they started feeding him, his first “meal” was 4 cc of breastmilk. You can barely even measure that. But he could only “eat” if his respirations were below 70. For some reason, Levi has always been a fast breather, so a lot of our “lows” were him breathing too fast and not being able to eat. I knew that in order to come home, he needed to gain weight, which meant he needed to eat, so if he couldn’t eat, he wasn’t coming home.

His respirations caused the most controversy between the nurses and me. From nursing school, I knew that you were supposed to count for a full minute for any newborn (especially a preemie) because their breathing is so erratic. Yet many of the nurses would only could for 30, then double the number, and his respirations would be “too high” to eat or be held, etc. I began demanding they count for 60 seconds, AND let me count with them. I also knew that high respirations was not a good reason to not let me hold him. Science has proven that skin to skin contact is extremely beneficial for babies, and can calm a restless baby in seconds. So I pushed as much as I could, every time, with every nurse, to hold him; some would give in, some were cutthroat you-know-whats.Tiny Baby

So many things have to happen in order for a baby to be ready to come home from the NICU. Most have to be able to breathe on their own, be able to drink from a bottle, and be “weaned” off the incubator to room temperature air. One day they could be doing all of these things like a champ, and the next they could not be doing any. I know I talked about this earlier, but it REALLY is a rollercoaster. And some days I felt like he would never come home. It was so hard not to compare Levi to the other babies in there. I know all babies are different, but no matter how much textbook knowledge I had or sought out, I still measured him up to his fellow NICU babies. Since I only heard little tidbits of each baby's story, I couldn’t TRULY compare them. Everyone progresses at a different rate, but if I noticed the boy next to him was being taken out of the isolette, or sent home, I was immediately discouraged.

Problems Arise

When Levi was about 11 days old, I started paying attention to EVERYTHING much more closely. I started seeing discrepancies and things the nurses ignored. He was still on the cannula, but it was rarely in his nose because he pulled it out all the time. They would tape it on his face even more to try and keep it in, but that was making his eye swollen because it was too tight. Every nurse was different - there didn’t seem to be any consistency or “protocol” they followed. Some would offer to let me bottle feed him, some would tell me he was only allowed to be gavaged (fed through his Nasogastric tube). Some nurses let me hold him for hours.  Some claimed there was a 30 minute limit. I came in one day and noticed his IV had infiltrated - meaning the fluid that was supposed to be going into his vein/artery was now just going into his tissue, and his entire arm was swollen. I am the one that noticed this and pointed it out - not the nurses. Several times I found him with a poopy diaper that he had been sitting in for a while, because it was stuck to his butt. One nurse put the wrong setting on his nasal cannula air, which wasn’t remedied until the respiratory therapist came down to give him the correct cannula for the percent of oxygen (sorry if you don’t understand the medical references). I was getting incredibly discouraged and felt more and more that I needed to be next to him 24/7, which was impossible for me to do.

When he was 13 days old, I left the hospital to return home. This was the hardest thing for me to do - and looking back potentially one of the worst decisions. I still came to see him multiple times a day, but we lived 30 minutes from the hospital. I called all the time, but the nurses were only willing to share so much, or talk to me for so long. It’s hard to describe the feeling of being away from your newborn, but imagine only “visiting” your child twice a day, rather than them basically being attached to you. It was so unnatural, unnerving. Point blank: I hated it.

Levi breastfed for the first time July 9th, which I had been pushing for from the beginning; but even then they would only allow him to nurse for 10 min prior to a scheduled feeding, and then they would feed him as if he hadn’t nursed. This means if he had residual, they would base it on how much they fed him, not accounting for the extra milk he got while nursing. And if he didn’t finish his scheduled feeding, they counted it against him. They said they did this because most of the babies don’t really get anything while nursing, but when I “let down”, milk shot everywhere, so I can guarantee you he got quite a bit if his mouth was anywhere near my nipple. This almost made me want to NOT nurse him, because I felt like on the charts, it would look like he was doing worse (not finishing feedings, having residuals) if I did. Quite frustrating.

More problems started to arise. Even though he was gaining weight and doing great with feedings, they decided to mix my breastmilk with fortified formula to help him gain more, faster. As soon as they started doing this, he started having what they call “residuals”. Each time before they feed him, they pull back with a syringe on his NG tube to see if there is anything left undigested in his belly. If there is any, they measure it, and usually feed him that much less for the given feeding time. Instead of stopping the fortification, they decreased his feeding amount, which made no sense to me. He started losing weight and spitting up more. I didn’t know at the time that I could DEMAND they only feed him breastmilk. If I had known that, I definitely would have done so. It got so bad that he stopped taking feedings from a bottle altogether, and was back on an NG tube at 4 weeks old.

Here is a little excerpt from one of my updates, written in the moment. I feel like it shares my feelings at the time so much better than I could summarize now:

He had a rough few days there. Not sure if he is out of that yet or not. But he wasn't taking a bottle, or if he did, he would only take like 10 ccs (out of his 51 cc feeding). So he was basically being gavaged 24/7. His respirations are back up again. They did an xray to make sure he hadn't developed pneumonia or anything, but that looked clear.

I was super frustrated with the nurses. I felt like they are not aware of everything going on, they didn't really look through his chart to try and catch patterns, but just assessed based on the “here and now”. One Saturday morning I was there and they were severely under staffed. There were only 2 people in the NICU pretty much the whole time I was there. Babies were just left crying. They weren't getting fed, or were getting fed way late. Monitors were going off and there was no one free to check on the baby. I did NOT want to leave him there with it like that, but I had to go to my baby shower!

Also, for his feeding that visit, the nurse wanted to gavage him because his breathing was too high. I questioned it, thinking they should at least let him try, but she was pretty firm. So I kangarooed with him while he got his tube feeding, and had to fight him the whole time. He kept wanting to nurse, and trying to pull his tube out, crying, etc. It was awful.

So when I went back that night and they wanted to do the same thing, I got pushy. It was a new nurse (new to me not to the unit) and I knew she didn't know him at all. She said it’s a policy that they don't feed them if they are breathing over 70. His respirations were at 72.... so after some bickering, she recounted him, and he was 62. I pulled out all that stops that time, wanting to make this visit worth the while because he has been having so much trouble. I got her to let me take him into the parenting room. I got to breastfeed for 10 min and then she said he could "try" the bottle. He sucked the whole thing down like a champ, after having already breastfed.Mama and Baby

I felt like if he did THAT much better for me, they must really not be trying. I knew he will probably have done better with me no matter what, because I'm his mommy. To have that big of a difference was questionable.

Let’s take a break from the stress for a funny story: After I fed him one night, he had a really stinky diaper. I decided to just change him on my lap since he was already out of his isolette and it was a pain to put him back in. Well, clearly I should not have made that decision, or at least decided to point his butt a different way, because I got shot! I guess he was not done pooping, because he so nicely squirted the remainder onto me (an impressive distance I must say). It went all over and down my bra, yummy chunky bright yellow. I could barely stop laughing long enough to clean it up. One of the nurses there got quite the kick out of it - sharing that she had been pooped on multiple times, once even in the mouth (YUCK!).

Major drama

Okay now that you’ve had some comic relief, prepare yourself for the worst part of my story. On Monday night, July 19th, 2010, Levi was given someone else’s breast milk. How this happened doesn’t even need to be told, because it was so careless and unacceptable. This opened up all sorts of infection control issues: What is the mom whose milk he had received had HIV or some other transmittable disease? Or (more likely), what if she was smoker, or had drugs in her system? What was even more frustrating, is I brought in a bag a milk the previous day, and every single bag has to be labeled with time, date, and his personal sticker label that they give you. I accidentally forgot to label some of my bags; so, following protocol, to ENSURE no one got the wrong milk, they threw 5 bags of my milk away. Anyone who has had to pump round the clock will understand how upsetting that was. But then, to find that because they didn’t even look at the labels or double check them, Levi ended up getting someone else’s milk anyway. By the way, I found out about this via a phone call at 1 A.M. Sleep deprived, pumping round the clock, NICU mama, and they called at 1 A.M.

When I visited him the next day, the nurse told me his respirations were 72, so he couldn’t bottle feed. Except she only counted for 15 seconds. She didn’t even do 30, I mean 15 seconds? Are you kidding me? I proceeded to give her a lecture on standard procedure for measuring an infant’s respirations and demanded she count again, for the full minute. 66. Of course. He was totally ok to bottle feed, she was just being lazy. How many times did this happen while I wasn’t there? How many other nurses only counted for 15 seconds, leading to him not being bottle fed?

The previous day I was told he had a heart murmur. I questioned it, as it was the first I had heard anything about it. After looking at the records, they had been hearing it for almost a week, yet no one told me. My mom and I sat in on rounds the day after he was given someone else’s milk, and I found out IN ROUNDS that not only did he have a murmur, he had a hole in his heart. He was scheduled for an ultrasound of his heart that day, and had one several weeks ago, but I was always told that it looked good, everything came back normal. In reality, that was when they first saw the hole, but that entire time I had not been told. Not ok.

I had been thinking about transferring him to a different hospital almost from day one. I was thinking more and more about it once we started having issues. Eventually, I was thinking VERY seriously about it. I didn’t want to move him far away from me (Roanoke or Charlottesville), which is why I hadn’t done so before. But at that point I felt like I should have done it a week earlier and I should have seen the problems coming. I honestly thought that I was endangering my baby by leaving him in that NICU alone. I no longer trusted anyone there. I did not believe he was safe, or that they cared about him and his progress at all. The only thing holding me back was the cost. I would have to pay out of pocket to transfer him, and it would cost several thousand dollars.

Well, July 21st, two days after the wrong breast milk incident, I had just finished breastfeeding Levi and it was time for him to take his bottle feeding. What do you know, the bottle the nurse handed me had someone else’s name on it. (It is still so hard for me now to contain my anger as I write this. I don’t understand how a hospital could ever let this happen. Not only once, but twice. And KNOWING about the previous incident, you would think they would pay extra close attention.) My mom took a picture of the bottle and then we confronted the nurse. She insisted that it was my milk, she had just put the wrong label on it. She was totally expecting me to still give him the bottle, with someone else’s name. Maybe it WAS my milk, but if it wasn’t labeled correctly, how could she know that? And I’m pretty sure it would be against protocol to give a baby mislabeled milk, even if you KNEW it was the right milk. Even more upsetting, I have no doubt that if I had not been there, Levi would have been fed that milk.

Mama and Baby 2Mama Knows Best

That was the last straw. Mama was mad. I went straight the unit manager and demanded Levi be transported. The manager said because it was not “medically necessary” the insurance wouldn’t cover it. I kindly reminded her of all the medical malpractice that had been going on in that unit, and that, to me, this was indeed medically necessary, because her staff was clearly inept. She claimed that she would “look into” the hospital absorbing the cost for transport. That was Thursday, July 22. Friday she came back and told me once again, it was not medically necessary. I felt helpless. I felt like the one thing my baby needed, I couldn’t seem to make happen.

From then on I called hourly. I questioned every single decision. I called not only the nurses, but the doctors as well. I argued with the doctor who wanted to put Levi on diuretics. Apparently I pissed her off, because an hour later she called me back and asked if I still wanted Levi to be transported. She apparently had gone to the unit manager and told her about our conversation, most likely how she was fed up with being questioned by a 22 year old, and the unit manager agreed to personally cover the cost!

And OH the difference! Levi THRIVED once we got to Roanoke, and I did as well. I finally felt able to step down as medical inspector and just be mom. I cried, this time not from stress and helplessness, but with relief and from happiness. Each incubator had a big comfy chair and curtains surrounding it - privacy! It was like a castle and VA Baptist had felt like a dungeon. I got to hold him as much as I wanted. He bottle fed every feeding - respirations were never an issue to them. They wanted to start breastfeeding as soon as possible, and get him out of the incubator as soon as possible. They could not believe he was still in one - he barely fit at this point.

The BEST difference was the doctors and nurses. Once the doctor heard (through the grapevine) that I didn’t No Tubes!totally understand something, HE called ME immediately to make sure I understood everything. I have never experienced a doctor CALLING someone just to explain what may have been misunderstood. I really wasn’t even at the point of needing further explanation, but he wanted to make sure I was totally comfortable. Night and day. The difference was incredible.

Also, in Lynchburg, I had to buy my own bags to store breast milk. At Roanoke, they had an endless supply of bottles. I swear I had previously spent over $100 on the bags, so this was super exciting to me. They also label and SCAN their milk, just as if it’s a medication. And they don’t just scan it once, they scan it TWICE. When they are mixing breast milk with the fortifier, they scan the milk as they put it in the mix. Then the mixture gets a new label, and they have to scan THAT before giving it to the babies.

I got to stay at the Ronald McDonald house, in walking (or biking) distance to the hospital (yes, I did bike there... often). It was so not what I was expecting - I thought it would be kinda dirty, I mean it’s free. But it was like a 5 star hotel - GORGEOUS! They served free dinner every night and had a stocked kitchen I could help myself to all day. There’s a library, formal living room, dining room, kids play room, TV room, laundry room (they even supplied detergent!).

The night my water broke, the lady from my church that met us at the hospital told me about another woman, Robin, from our church who was going into an emergency c-section at only 29 weeks. Her baby, Rhiley, was born at only 1lb 8 oz and was in the NICU at Roanoke, as well. We had never met before, but we were able to connect in Roanoke. It was so nice to have someone who understood exactly what I was going through without saying anything.

The second day in Roanoke a speech pathologist came to see us and help feed Levi, She analyzed how he sucked on his pacifier, then how he ate, aHeading Homend tried several different nipples on the bottle. She determined he should use a slow nipple and needed to be paced. He sucked way too fast and held his breath. So after he sucked a few times, I learned to pull the bottle away and make him breathe before he could have more. She also showed me what position he should eat in - the “elevated side lying” position. I didn’t even know speech pathologists did that kind of stuff. I also got to meet with a lactation consultant and Levi caught on right away.

Levi progressed SO fast once we were in Roanoke. I say this a lot, and I don’t think this was really happening, but it was almost like he was being drugged at Lynchburg, and once we got to Roanoke he was alive again. He just kept surpassing every expectation and meeting every requirement needed to go home. And low and behold, July 31, less than a week after arriving in Roanoke, weighing in at 6 lbs 5 oz, I finally got to take my baby home!

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Today Levi is a healthy 2 year old little boy, and no one would be able to guess what he went through as an infant. I sincerely hope that this story does not cause anyone anxiety, but rather encourages you to educate yourself and not be afraid to question the doctors. Doctors and nurses are overworked, have too many patients, and are subject to human error. You are the only person who is solely concerned with yourself or your baby, so don’t be afraid to stick up for yourself. If a doctor ever seems to have an issue with you asking questions, that’s when there’s a problem. Seek out a new doctor, find someone who will listen, and take the time to explain.

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Levi's Birth Story, Part One

BW Levi

July is birth story month at the Motherhood Collective. Reading the good, the bad, the ugly and the BEAUTIFUL experiences of other mothers gives us a real appreciation for the strength we have in childbirth. Hopefully these stories will inspire you. Today's post is written by Kerissa Scott, a regular attendee at the Motherhood Cafe.  Knowing her birth story, we asked her to share it and she graciously agreed.

Kerrisa's Story

Before I start I want to give a huge disclaimer/warning: For those of you who worry about every possible thing that may go wrong, this may not be a post you want to read. Also, I will try to remain as neutral and factual in relaying everything that happened, but just know that we did not have the best experience, and so I may go on some rants. Given all of that, I still think Levi’s story is amazing and beautiful, and has the power to touch lots of mamas, especially those who have been through similar situations. I believe so strongly that we as mothers have the power to affect our own and our babies’ healthcare. We have a mother’s intuition and a right to know everything and be active in every decision, and as you will read, that is exactly what I learned through this entire process.

The Beginning of It All:Maternity Pic

I was sitting on the toilet the night of June 10th, going to the bathroom (perhaps trying a little too hard)... and out of nowhere, I heard a pop. The gush didn’t happen until I stood up, and then, of course, came the massive panic. I was only 30 weeks. My baby was not ready to come, and yet my water had broken. At the time I was in college, single, and living in an apartment with two other girls. Thankfully one of them was home, so I screamed for her help (like she could really do anything... I just made her freak out more than I was). I was a nursing student and had been through OB class/clinicals, and I have always had a passion for newborns and birth - so I was pretty educated in the area. After a few minutes of panicking, I was able to calm myself and go into nurse mode of what I needed to do. My roommate got me a glass of water which I just kept chugging (your body is constantly making more amniotic fluid, so I knew if I drank, it would make more, hopefully replacing as much lost as possible). I lay down on the floor with a towel between my legs and started making phone calls. My roommate didn’t have a car at the time, so she couldn’t take me to the hospital. I couldn’t get in touch with my parents. (I swear I called them both 10+ times.) Finally I got in touch with my sister. I called the hospital to let them know what was going on and that we were on our way. Of course, because it’s the hospital, they doubted my water broke.  I was obviously ignorant and had just peed... enough to soak three bath towels...totally possible right? Ha.

When we got to the hospital, a lady from our church was already there waiting for us (my entire family has always been close with her). By now I had gotten in touch with my parents and they arrived very shortly after we did. I am still amazed at the response I got when we arrived at the Birth Center. I called telling them what happened, they knew I was only 30 weeks, I was leaking water by the gallon, and yet I stood at the little desk for 10 minutes before they took me back. I remember I just kept saying (I don’t know if it was out loud or to myself), “Why aren’t they doing anything”. They still did not believe that my water has broken.

When I finally got into a room, they had to run the litmus test to check for amniotic fluid. By now I had started having mild contractions, so as soon as they had scientific proof that my water did indeed break, they hooked me up to the monitors and started going to town with IVs. They gave me a steroid shot which is supposed to help the baby’s lungs develop faster - the lungs are one of the last things to fully develop, and yet very essential to life outside of the womb. They gave me meds to stop my contractions, and told me that their goal was to keep him in for at least 48 hours, but the best case scenario would be for him to stay in for 3 to 4 weeks.

Now, as I said before, I had been through nursing school and read all sorts of books, but I had NEVER heard of a baby staying in a mama whose water had broken for 3 to 4 weeks. I had always heard (as I’m sure most of you have) that you have to have the baby within 48 hours of your water breaking (due to risk of infection)... and they were talking 3-4 weeks?

Once they hooked me up to all the IVs and taken all the precautions, things quieted down a bit. My contractions had stopped (thankfully) and it was time to rest. They kept trying to get me to take a sleeping pill, which I refused (daily), if I was going to go into labor I certainly did not want a sleeping pill in my bloodstream. I talked with the Neonatal doctor whose purpose was to “prepare” me for whenever the baby did come. I was also knowledgeable about preemies though. I had done an internship in the NICU in high school and had clinicals for nursing school in there as well. My main concerns were that I still be able to have him vaginally (as long as no further complications arose), and I wanted to know if I would be able to hold him after he was born. The doctor assured me that the goal was to have him vaginally, but he could not promise me I would be able to hold him. That was when I finally broke down. This whole time in the hospital I was in nurse mode:  wanting to know everything they were giving me, all the details, possible side effects, everything. But once I was told I may not be able to hold my baby, it all became so much more real.

The Waiting Game

At this point, we just had to wait. Wait for the medicine to help his lungs.  Wait and hope I don’t have any more contractions. Just be calm and wait.

They did an ultrasound to estimate how big he was and measure how much fluid was left. They estimated 4 pounds - which is pretty big for a 30 week old. I was happy to hear that, but knew that the estimations aren’t very accurate, and being big didn’t necessarily mean he would be healthy.

I was still on magnesium sulfate, the medicine they give you to stop contractions, which at that point I thought was the worst medication ever created. It made me feel like total crap (understatement). You are only supposed to be on it for 48 hours total, and they almost tried to give me it for 72 hours.  This was the first mistake I caught and was adamant they double (and triple) check, as it can cause complications and damage if you take it longer. I ended up being right (doesn’t that feel so good?) and they started weaning me off it. There is always a risk going off it that your body will go back into labor, so they were watching me carefully. If I went into labor at any point, they would not stop it again, as it had been 48 hours. But alas, Levi behaved, and agreed to stay inside a little longer."Thumbs Up" from Kerrisa

As I’m writing this I am looking back on my daily updates for friends and family, and after one day on bed rest, I was complaining about how much my butt hurt.

“I am able to get up and use the bathroom (Thank God! Hate bed pans and catheters!), but other than that, I'm pretty much stuck in bed. My butt is already starting to hurt! Hard to imagine the possibility of being in here for weeks, but easier when I think of baby rather than myself. Mom has been a very good patient advocate - trying to see if I can get a shower at the moment. They have to ask the doctor.”

I have to say, my mom was AMAZING through this whole thing. She stayed with me in the hospital camping out on the pathetic pull out beds. She helped me learn what questions to ask, what to be pushy about and what wasn’t a big deal. More than anything, she was there for me, at a very lonely and scary time.

And she apparently was a very convincing advocate - because after three days in the hospital, I was able to shower! Hallelujah! It was definitely one of the best showers of my life. Afterwards, my mom, sister, and I all worked for over an hour to get all the tangles out of my matted hair. We made the floor slippery from using so much leave-in conditioner. I learned that it was best to braid my hair after that endeavor. That way, if it was a few days before I could shower again, at least it wouldn’t be a huge nest.

After taking me off the IVs, ensuring I was not going to go into labor, and finally letting me shower, they moved me to the mother-baby unit to wait. It was so nice to not be hooked to monitors 24/7 and be able to go to the bathroom by myself.  I had to have assistance over in the Birthing Center...it’s hard to go when you have someone over your shoulder. I finally felt I could relax. Before I was just constantly being checked on and really didn’t have any privacy at all.

While in waiting, I would be monitored once a day for half an hour and have an ultrasound once a week. The monitoring was called a non-stress test. They just watched the baby’s heart rate and any contractions. The ultrasound was different than the others. It was called a biophysical profile. It was essentially a test for the baby. He had to do a list of things in 30 minutes, wiggle his fingers, practice breathing, etc. It is so much harder to tell what you are looking at when there is little amniotic fluid - in a regular ultrasound, the fluid creates the nice dark contrasting background. Another downside to low amniotic fluid - there was no cushion for his kicking. I felt every little movement, and there were times I thought he was going to break my ribs!

Because I was leaking amniotic fluid constantly, I had to wear pads, which the nurse had to check every time I changed them for signs of infection. This was awkward for me - leaving a used pad lying out so someone could “check it out”. Sometimes the nurse would call in another nurse to look at it with her, just to be sure - so weird. If the discharge became greenish that was a sign of infection and they would need to induce me.

After a few days I started getting horrible nose bleeds because the air in the hospital is SO dry. I rejoiced when they brought me a humidifier. I was in online classes at the time so most of my day was spent reading and doing school work. One day my sister came and helped me make invitations for my baby shower (which now would happen after I had him).

I was on contact precautions because I had MRSA about 2 years earlier. Apparently after you have a positive MRSA test, you have to go back to the doctor and get 3 nasal swabs that come back negative. No one ever told me this and they couldn’t do the nasal swabs until I was off antibiotics. So this caused extra headache. I got in trouble for leaving my room. A lot of the nurses wouldn’t take my water jug out to refill it.  They would just bring in little styrofoam cups. I was drinking crazy amounts of water at this point so the little cups were not enough!

Several times I started having consistent contractions and they would move me over to the Birth Center, only for the contractions to stop. They would keep me there overnight to carefully monitor me, but come morning I would always end up back in my room. Whenever I was in the Birth Center I got very little sleep. They monitor you more frequently, and the beds are not as comfortable. I hated all the chaos of moving back and forth.

So Sunday night, June 20th, 10 days into my hospital stay, I decided not to tell anyone I was having contractions. I knew that even if this was the real thing, it would be a while before active labor, and I wanted some sleep! After a few hours, I was pretty sure I was in labor for real this time. The contractions would wake me up every now and then, but I just tried to rest as much as I could before being taken to the Birth Center. Around 6 a.m. I finally told the nurse that I had been having contractions all night. She hooked me up to the monitors and agreed that I was in labor, but doubted that it had been all night. My discharge had also started having a greenish tint, so they took me straight to the Birth Center.

The Big Event

It just so happened that the day I was in labor, a neonatal birthing specialist (I can’t remember her real title) was visiting from North Carolina. Because they didn’t believe I had been having contractions all night and they didn’t want them to stop again, the specialist recommended they put me on Pitocin, as I was showing signs of infection. I wish I had known enough to refuse this, or at least request they monitor me for another hour before making that decision, but at the time I was convinced that was what was best for my baby. I was having moderate contractions, but at noon, when they hooked up the Pitocin, everything changed.

Being induced (usually by Pitocin) always causes stronger, longer contractions. Add that onto me already being in labor. I wanted a natural labor, without pain interventions. I knew I could do it, everyone in Africa does it. (That’s what I kept telling myself!) My birth classes were supposed to be the next week so I hadn’t officially been through them. I had sat in on several through nursing classes, but was not able to take them as planned with my mom, so we didn’t really know how to work together. I remember being in total disbelief at how long it took to get a nurse, and how little they were willing to help. They let me get in the shower for a little bit which was absolutely amazing, but other than that I had to pretty much stay in the bed because they were worried about umbilical cord prolapse. I got to the point where I needed to do breathing exercises to get through the contractions, but in the moment I couldn’t. I needed my mom to tell me when to breathe, and she ended up making me hyperventilate because she was so caught up in the moment. We couldn’t even get a nurse to come help me breathe.

I don’t really remember how dilated I was in the morning - I’m thinking a 3 or 4. By 2:30, I was having a really hard time dealing with the pain and getting control. They checked me and I was a 7. I knew if it wasn’t going to get a ton worse, and would be over soon, I could do it. But the nurses told me it was going to get a lot worse and be several more hours (liars). So I gave in and they put in the order for the epidural. The anesthesiologist did not show up until 3, and no one thought to check my dilation THEN, because they had just checked it 30 minutes ago. Well, little did I know, I was in transition. As the anesthesiologist was putting a needle in my back, and I was being ordered to stay still, I was screaming, “The baby is coming. He is coming NOW!”. Once again, they didn’t believe me. But low and behold, as soon as the epidural was secure and I flopped on my back, they could see his head. I was told not to push, the neonatal team had to be called and prepare everything for my premature baby. After what seemed like forever, it was time to push. I don’t remember much as I was in that “zone”, but (per my orders) my mom secretly videotaped the delivery. I do remember the doctor telling me to reach down and feel the top of his head and I freakMama and Babyed out thinking he was TINY and that I was feeling the full circumference of his head (not just the crowning, overlapping skull bones). At one point, he was having bad decels so they gave me an episiotomy (which I specifically told them not to beforehand). They did so without even telling me they were doing it, or why. I wouldn’t have known this without the video, but the cord was wrapped around his neck. Everything happened so fast. The epidural was officially in at 3:15 and Levi was born at 3:33.

I didn’t really get to see him. My sister had walked in as they cut the cord and I kept asking her what he looked like, how he was doing, was he alive, etc. Everyone had left me and was paying attention to the baby. Finally, my mom was my amazing advocate again, and convinced the doctors to let me hold him. It was only for about 10 seconds, and then he started turning blue, but I got to hold him and kiss him and tell him everything was going to be ok.

Precious BoyI don’t remember delivering the placenta, but I do remember being sown back up. Even with the epidural (which had been turned off basically as soon as it was put in), I could feel all the tugging and thought to myself, I’m glad I got the epidural if it was only for this. Before I knew it, they were wheeling my baby out to the NICU, away from me.

 

Kerrisa's story continues here as she tells us about Levi's time in the NICU.

 

 

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