· By Tiny Hearts Education
Meeting Baby Lewis
My pregnancy was normal, a little more nausea than most but fundamentally to a first time mum, my signs and symptoms weren't alarming enough for me to take action. This was namely because I'm an anxious person - I stress before there is stress. So, when aches, pains, swelling and dizziness appeared, I contributed it all to pregnancy.
Maybe if I had of asked a few more questions, my situation could have been different, but I learnt really quickly not to question the what if's or the maybes because you can't change direction once you're headed down a road. All you can do is learn from it and keep pushing forward. We had decided early on that we wanted a more natural water birth - so went through a midwife. The only care and the standard care in Australia is three ultrasounds unless there is evidence that something was wrong. For us, every scan was fine, and every appointment was average and ordinary.
When we went to our 30-week appointment, our midwife seemed concerned about the size of my fundal height to the point of asking for a second opinion from another midwife. I went from calm to hyper-anxious instantly. What could be wrong for him to feel so small? My midwife called an obstetrician, who decided scanning and monitoring for the next two days would be the course of action to discover what or even if anything was wrong. But waiting isn't something I handle well.
To anyone who knows me, my following course of action was, true to form, reading every article on the internet and then self-diagnosing myself. Morning came, and my stress and anxiety were through the roof (despite my partner's gentle, soothing and reassurance that whatever happened we'd all be okay). I called my midwife, and she proceeded to push our scan forward as soon as possible so that we ended up with an ultrasound at 12pm on the 20th of December.
At 12pm, we were ushered into a small room, and our ultrasound technician began the necessary checks. I remember looking up at the screen, and all I could see was our baby - who even by my uneducated eyes, looked scrawny. How on earth could he look so scrawny? My technician contacted an obstetrician who entered quickly and went over the scan in what felt like seconds. He finally addressed us and in no uncertain terms, proceeded to let us know that our baby would be coming soon. He was in distress, and he needed to make the call, but whichever way it went, he could not say whether or not our baby would survive.
He moved us up to our hospital's birthing centre while on the phone dictating to his team that he had a category 1 c-section, that needed to be prepared. I walked into a room crowded by nurses. I was asked to lay down on my end and needles began to be pushed into my skin. My clothes were stripped off, and a catheter was inserted all while the nurses and doctors began to explain why and what was happening.
Words like reverse Doppler flow and intrauterine growth restriction summed up the why - although, I had never heard of it before or knew what was happening. One thing I knew was that our baby was being born today and he would be fighting for his life when he came out. The NICU nurses and doctors came to discuss what they would be doing once our baby was born. They explained what needed to happen as I signed permission form after permission form. My partner messaged his mother, telling her that her grandchild was on the way. I remember looking at him and thinking how lucky I was that he was here, just in case our worst fears became a reality.
Being wheeled into an operating theatre was surreal. I realised how quickly our life had been turned upside down; it was frightening. How could I help but compare this nightmare to what my hopes had been? I'd hoped for a natural birth where after a few hours, I could take my small family home and celebrate our sweet arrival. Instead, I was terrified and holding my breath as I waited to "meet" our baby.
Our son was born a mere hour and a half after our ultrasound. I got a pitiful cry and a brief look at him before he was whisked away. I was told that my son weighed 880grams, was 35cm long, with a head circumference of 27cm. My partner went to watch over our son - he told me later how bizarre the process was. No grinning while they cut the umbilical cord, instead our son was placed into a bag to keep him warm, while I laid on a table being put back together. While I was wheeled into recovery, my partner went to be with our son, Lewis. I laid there and waited to be taken to meet Lewis for the very first time.
Later that day, we were finally allowed to see him. All I wanted was to hold him. The simple fact that I couldn't touch my child was probably the most heartbreaking moment for me. This was the moment, three hours after giving birth, that I allowed myself to cry. I let all the pain out that I had begun building since the night before.
In the following days, we were told about our son's condition. He was an asymmetrical intrauterine growth* restricted baby, as my placenta failed to develop. He was born in a "good condition" and was put on CPAP, and an intravenous line was placed into his umbilical cord. Because he was born early, Lewis wasn't able to handle food well. He suffered through hyper and hypoglycaemia, and his stomach was unable to handle large volumes of milk. He had two pre-NEC episodes - thankfully none by the mouth and medication was able to resolve it. However, we came scarily close to needing surgical intervention.
IUGR premature babies (and premature babies in general) struggle to put on and maintain their body weight. So, while Lewis was breathing amazingly well for a baby his size - he was slow to gain weight. The doctors weren't sure if they should risk fortifying his EBM when he had already shown signs of stomach issues. So, we pushed forward with feeding, and slowly, he gained. He proceeded to be a textbook premature baby.
Lewis had issues developing his own blood cells and platelets - which resulted in two transfusions. He had to learn to breathe and swallow at the same time, and this meant always stopping and readjusting him while I breastfed. We were in the hospital for three months. We saw our son go through numerous tests due to small size and prematurity - including multiple blood tests, eye tests and ultrasounds on his head due to blood from birth.
We finally reached a day that we were able to board in with Lewis, overnight I was in his room changing his nappy when I felt something in his groin wasn't right. I called the nurse in, and she felt where I pointed out to her. It was a hernia. The next morning a doctor came in and reviewed Lewis. He would need surgery to fix the hernia as it had descended into his testicles. My worst fear had been realised. My 3-month-old son would need surgery. Part of me broke in that moment. The constant thought of not being able to protect Lewis while he was inside returned stronger than ever. I struggled going to the hospital each day. Being able to hold him without many wires and being able to walk with him around the hospital was a huge comfort to me.
The day he had surgery was terrifying. I sat in his room and continuously looked at the clock watching time, it went so slowly. Finally, he was brought back to us. He was so pale and sleepy that day - I dreaded how long we would have to stay in the hospital for. I returned the next morning and Lewis was back to full suck feeds. He wasn't in pain and happily allowed his cares to be done on him. Surgeons came around smiling, and they gave us the all clear to take Lewis home if his regular doctors consented - thankfully they did.
We finally went home. 92 days in hospital was at an end. Lewis still has ongoing issues, namely due to an overlarge head that is being monitored closely, and we have numerous appointments with him monthly.
Category 1 C-Section: Immediate threat to the life of a woman or baby.
Intrauterine Growth Restriction (IUGR): A condition in which a baby doesn't grow to a normal weight during pregnancy.
Asymmetrical Intrauterine Growth Restriction: Where the head grows at a regular or near normal rate, compared to the rest of the body - which results in a thin and out-of-portion body. This type of IUGR is developed later on in pregnancy (3rd trimester) due to maternal factor like pre-eclampsia. They will generally have fewer long term issues.
Symmetrical Intrauterine Growth Restriction: Is commonly referred to as global growth restriction. It shows that the baby has had slow growth throughout the pregnancy, meaning everything is in proportion these babies generally have permanent neurological issues.