After three and a half years of battling infertility and experiencing one miscarriage in 1998, Mark and I learned I was pregnant on September 30, 1999. We were overjoyed but cautious because of the previous miscarriage, and decided not to tell anyone I was pregnant until the first trimester ended. We knew the odds were in our favor that the baby was fine, but we just felt better not spreading the news until we knew things were going well.
The pregnancy progressed well. I never did have morning sickness, feel tired, or was crabby due to hormone surges. I was gaining as I should and not gaining extra. Every ultrasound, the AFP testing, my blood pressure and urine tests all went well. I felt wonderful throughout the entire pregnancy until our little girl decided to show up early.
As I think back on it now, things really began on the night of Wednesday, February 23. I was in my 24th week of pregnancy. I had come home from work and was cooking dinner, and while standing at the stove I felt a few abdominal tightenings in fairly quick succession. I didn’t really think too much of it, chalking them up to Braxton-Hicks contractions and that I needed to drink water and rest; I grabbed a large glass of water and lay down on the couch. This seemed to help and I finished dinner, ate, and then took a warm bath and relaxed. For the rest of the evening I watched a little TV and looked up Braxton-Hicks contractions in my many books on pregnancy. As far as I could tell that is what they were or at least that is what I imagined them to be after I read the books. They had not been painful and they were not frequent, and lying down helped. I went to bed early and during the night I had a few more of the tightenings but they were very spread apart so I really thought they were just Braxton-Hicks. I also had a loose bowel movement before I went to bed, which was another clue I kind of brushed aside.
I woke up on Thursday and went to work, which was going just fine until around 11:00 am or so when I felt those abdominal tightenings again. I was getting less than four an hour and they weren’t painful, so I chalked them up to Braxton-Hicks once again. I did call my OB and tell them what was going on, and I made an appointment for the following day to make sure all was okay. I planned on taking Friday off just to take it easy. Just before leaving work at 3:30 I went to the restroom and noticed thick, mucous discharge. I thought it wasn't good, so I got in the car and headed home to rest for the weekend. As I was driving home those pesky abdominal tightenings returned and they were radiating to my back. At this point I just drove straight to my OB’s office, unannounced.
The nurse practitioner examined me and told me I was 1 cm dilated and 85% effaced. The doctor examined me and told me he was concerned since my pregnancy had been perfect up to this point.
I called my husband and let him know that I was being checked into the hospital for pre-term labor, where I immediately had to get into standard hospital gear (gown and IV). They hooked up the monitors to track the baby’s heartbeat and the contractions. It was so reassuring to hear the baby’s heartbeat all the time. They started me on magnesium sulfate, took lots of blood and did a urinalysis. After a few hours, the lab results showed I had a urinary tract infection and an elevated white cell count. So at this point the nurse thinks that is what is going on with the contractions, but the contractions continue on through the mag though they had decreased. They were stronger, but nothing like I imagined they would be like. I was starting to get sick to my stomach from the mag and I was sick throughout the night. I finally got a terbutaline shot which made me real shaky but it stopped the contractions.
By about 5:00am I was given another shot of terbutaline. They draw another sample of blood for analysis. My doctor ordered an ultrasound and the tech shows up around 7:00 am or so and didn’t even say a word to me. Just comes in and lifts up my gown and squeezes the gel on my tummy and proceeds to do the ultrasound while completely blocking the monitor with his body. It was a darn good thing I was on magnesium sulfate, which totally zapped any strength I had, or I would have strangled him for being so rude. Another wonderful side effect of the magnesium sulfate was the inability to see straight. I couldn’t even focus on things with both eyes open, one had to remain shut. After the tech finished the ultrasound I asked if the baby was moving around and he said “oh yes” and that was it. He was gone and I was glad! My husband gets there and I explain to him the events of the night and tell him that it looks like I have a UTI that is causing the contractions. So, he visits for a while and feeling reassured he calls his sister to come and stay with me while he goes to work. At around 9:00am the nurse comes in and says your doctor is on the phone for you. I will transfer him. I pick up the phone and Dr. Ebner explains that the ultrasound showed that my membranes were right at the cervix opening. I hadn’t dilated anymore but he wanted to transfer me to Sierra Vista Hospital (in the town where I work) and put me in the care of a perinatologist as a precaution. If everything is fine I can come back down to this hospital but he would feel better if I get checked out up there.
At this point I was kind of scared about seeing a new doctor because I love my OB so much, but I didn’t argue with his plans of course. My sister in law calls my husband and tells him what is going on so he gets off work to go to the other hospital with us. I was given a shot of the steroid to help develop the baby’s lungs. The transport team arrived and I was jostled into the back of an ambulance. The nurse wanted to get me to the hospital quickly so we did the sirens and everything. It was a very bumpy ride which made me sick all over again. Yuck! I do remember being wheeled outside and how wonderful the sun felt on my body.
We arrive at the hospital and for the life of me I could’t tell you how I got up to the third floor where L & D is located. I was so zombied out on the magnesium sulfate I could hardly move. I felt like gravity was pulling on me at 10x the normal force. Those of you who have been on it know exactly what I am talking about. The perinatologist, Dr. Cedars, came in and introduced himself and all my fears about meeting a new doctor quickly fade. He was so nice, gentle, and genuinely caring. By this time my husband and sister-in-law make it there and ask if I have seen the doctor. I say yes and I describe him perfectly. The nurse was astounded since I was on the mag and had met him for maybe 1 minute max. Dr. Cedars returns a short while later wheeling in his ultrasound machine. I was surprised the doc was wheeling it himself though…he is just that kind of guy. He does the ultrasound and is very in depth and explained everything and what everything is to us. The baby looked great and measured perfect for this stage in pregnancy which was 24 weeks 2 days. He continued me on the magnesium sulfate and says he is going to have a C-reactive protein test done on my blood and that he will also have the previous hospital run that test on the blood they took this morning. If the CRP was high and increasing he will strongly suspect that I have an infection of the amniotic membranes and fluid (chorioamnionitis). The lab came and drew the blood they needed and my IV was relocated because it was starting to swell at the other site. A few hours later, Dr. Cedars comes back in telling us the my CRP was elevated and increasing. The next step was to do an amniocentesis. At this point I just looked squarly at him and told him, “I scared to death of this test.” He quickly assured me the test is over rated and that it doesn’t really hurt. I lay there thinking, “Oh sure, you have never been on the receiving end of that needle”.
He returns a few minutes later wheeling in his ultrasound machine again along with various other sundries to perform the amnio. I was still pretty nervous about the pain of this test but I knew I had to have it done. He applied the gel to my tummy and does the ultrasound to find the right area to put the needle in. After he found the correct spot he prepped my tummy and then gave me a local anesthetic which didn’t hurt at all. He then pulls out a LONG needle and said, ‘Here we go”. I didn’t even feel the needle go into the skin. As I lay there and watched the U/S monitor I could see him have to stab into the uterus a few times before the needle pierced it. He was in and out very fast and I never did feel a thing. As he was drawing out the fluid he noted the fluid looked cloudy and that further confirmed his suspicions of an infection.
Several hours went by and I am just visiting with my husband and sister-in-law. Finally, my sister-in-law had to leave because her daughter was leaving the next day for a 10 day trip to Washington DC and area with the rest of her 8th grade class. She had to make sure she was all ready to go. Well, shortly after she leaves Dr. Cedars comes in with another doctor, Dr. Van Scoy, the neonatologist. Dr. Cedars tells us the amnio was positive for bacteria and that we had an option at this point. We could go the conservative route and deliver the baby now. We knew at this point that she was healthy and doing well. Or we could do the aggressive approach and continue on with the antibiotics and repeat the amnio in 24 hours and see how things are going at that point. There was a risk for the baby to get infected from my infection but she may already be infected. He told us there was no right or wrong answer and it was for us to decide on what to do. The neonatologist explained how things progress with delivering a baby this early and the problems they face. He did assure us that they have an excellent track record with babies this small.
Mark and I decided to keep the baby growing in utero as long as possible. She seemed so healthy on the ultrasound and her heart rate was excellent, so we thought she would be spared from the infection since I have been on antibiotics for over a day at this point. The docs were happy with our decision and we all got some sleep. Poor hubby slept in a horrible chair that made into a bed…well, they called it a bed. I am pretty sure it was some medieval torture device.
After a night of seemingly endless pokes and prods for blood, BP, temp, etc. morning finally rolled around. We were up pretty early as life in the hospital goes. Breakfast was served but I gave that to Mark because I had zero appetite. Mark decided he would go to work so he once again called his sister to come up and stay with me. Well, about the time Mark was going to leave I have him help me roll over in bed and gush, I felt a gush of fluid run between my legs. I was pretty sure it was my water breaking and I had Mark get the nurse. She didn’t come rushing in by any means however. I think they were still giving report as the shifts were right in the middle of changing. Mark’s sister walks in at that point and I told her, “I think we’re having this baby today”. I tell her what happened and she walks out and gets the nurse and drags her into the room to test. The fluid was too evaporated at this time to come up with a conclusive test. So, a little bit later I get another gush of fluid and the nurse comes in and tries to test but doesn’t see a for sure change in the pH paper so she gets a slide to look for ferning under the scope. The sample wasn’t wet enough anymore for her to get a good swab though. FINALLY, I have another leakage and she comes in with the slide and gets her sample and comes back 5 minutes later saying that is was definitely amniotic fluid. This was about 8:15 or so.
The nurse called the doctor and he tells her to stop the mag sulfate and he comes down to the hospital an hour later or so and checks me and I am at 1 cm dilated with zero effacement. As he does the exam he feels something strange and says, “that feels strange, in order for you to have a vaginal delivery she needs to be head down and right now I am not sure where she is.” Once again, he leaves and returns with the ultrasound machine and does an ultrasound and the baby is in perfect position. What he was feeling was my very full bladder. He asks if I feel like I have to go to the restroom and I tell him no, but I will give it a try. I do as asked and I did go some and felt like it emptied to me, but upon repeat u/s I still had plenty left in the bladder. The mag sulfate had relaxed those muscles as well. The nurse comes in and was going to shampoo my hair for me since I hadn’t had a shower since Thursday morning. The doctor looks at her and then at me and says, “how about a shower?”. I was so happy! I took a nice long warm shower still feeling a little groggy from the mag. It felt so wonderful. I was so happy to get all nice and clean. After the shower the doctor had the nurse put in a catheter that will be taken out at delivery time. I ask the doctor when he thinks delivery will be and he estimates between 6 and 8pm.
The contractions start up a little bit, but nothing too major because of the residual mag sulfate. I was feeling so much better being off that medication. Mark said he didn’t realize how much it was affecting me until I was off of it. So at 11:30 they started me on pitocin to speed things along some. Right after that we got a tour of the NICU unit. The nurse was so nice, she stopped whenever I had a contraction and consoled me. I cried some as we toured the NICU. It was hard to see those babies in there on all the monitors and whatnot. They showed us the bed where Lydia was to be after delivery. It was all set up and getting nice and warm for her.
We got back to the room and I got all settled in. I was trying not to watch the clock too much since I didn’t want to get discouraged. The contractions started getting closer and increasing in intensity but nothing too unbearable. With each contraction though there was a gush of amniotic fluid which felt terrible. Lucky me, I was wearing those “fish net” stretchy gauze underwear with a pad that felt like I was stradeling a surf board. I went throught the contractions pretty well since I had no clue what to expect since we hadn’t been to any birth classes and this was our first baby. I asked the nurses if labor hurt less because it was premature and the baby was so small. She smiled and says, “nope! It is all or nothing regardless how far along you are in the pregnancy.” I was pretty shocked because they still weren’t hurting too much. Don’t get me wrong, they did hurt, but nothing like I had envisioned them after watching the women on a ‘Baby Story’.
The hours roll by and the contractions are increasing in intensity and frequency…the amnio fluid gushing is increasing too. By about 2:00pm they were pretty close at about 3 minutes apart and lasting for about 45 seconds.I wasn’t getting much of a rest between the contractions. They were hurting more but nothing I couldn’t tolerate. One nurse kept saying over and over that I wasn’t going to deliver until 10:00pm that night since this was my first baby. Dr. Cedars called in at 3:00pm and had the nurse come and check me. To her surprise I was 6 cm dilated with contrax coming on very quickly and lasting 45 to 60 seconds. She calls the doc back and tells him the status. He has them start getting things ready in the room for our early arrival. The room is just a beehive of activity at this point. People wheeling all kinds of things into every corner of the room. At about 3:30 I had a pretty big contraction with lots of fluid and I feel the baby’s head move right into the birth canal. I tell them the baby’s head is engaged and is ready to come out! I was fully dilated at this point. They quickly tell me not to push and put an oxygen mask on me to give the baby more O2 since she could get a little stressed waiting in there until the doctor comes.
It was so hard not to push. That was all I wanted to do and I wasn’t sure if I could stop myself from pushing. I finally just put my mind in another zone and try to forget all that was going on around me. It worked thank goodness. Dr. Cedars and Dr. Van Scoy the neonatolgist came rushing in at around 3:40pm or so. Dr Cedars dropped the foot of the bed and got me all positioned and deluges me with a very cold bowl full of Betadine solution. He then checks me and rummages around in there for what seems like forever and anounces everything looks good now lets wait for the next contraction to push. Well, he kept his hand up there and I never did get another contraction! Finally after a minute or so he says “lets push between contractions”. He tells me to push so I happily oblige him. He tells me to stop but I was mid push then and, whoosh, Lydia Joyce was born at 3:48pm on the 26th of February. She weighed 1 pound 9 ounces and was 11.5 inches long. Her one minute APGAR was 7 and her five minute APGAR was 9.
She was so tiny but she was a little fighter from the start. She was pink and crying with sound and all. Dr. Cedars gave her over to Dr. Van Scoy and they intubate her and show her to us briefly before they put her in the isolette and took her to the NICU. I deliver the placenta which looked pretty bad because of the infection. Dr. Cedars tells me how great I did with all this and congratulated me that I did it without meds. He says they are cautiously optimistic for the baby. By 4:00 pm the room is cleared out and it is just Mark, Patty (his sister) and myself with frequent visitors from the nurse to come and push on my tummy.
It was strange it was over so quickly. Kind of felt surreal really. I felt good. I wasn’t sore and I was able to get up and walk around which felt good. Finally at about 6:00 pm we were able to go and see our baby. The nurse brings in a wheel chair but I passed on that. I really felt like walking. She was so tiny laying on the open bed hooked up to all the monitors and with IV’s in her and what not. She was doing very well, but it was a long road ahead of us. I cried as I looked at her. I think I cried every time I saw her for the next week or so I think. All in all I know wer are so blessed to have our little girl with us and doing so well. I did feel kind of jipped that I didn’t get to experience any of the third trimester but the end result is here and that is all that matters.
Lydia did extremely well in the NICU. She did have to have a surgery to close a duct off the aorta that normally closes when a baby is born. Patent Ductus Arteriosus. She had that surgery done during the second week of life. We were told of the many things that could go wrong with a baby being born so early but Lydia didn’t encounter many problems at all. She never did have any bleeding in the brain. She was on a ventilator of 5 weeks but did well coming off the vent, and never did need medication to help stimulate her to breathe once off the vent. The nurses had not heard of a 24-week baby not needing that medication. She had very few episodes of bradycardia and apnea. Her eyes are developing well. She did have a little tiny bit of stage 1 retinopathy of prematurity (ROP) but it resolved it self the next week. She gained weight very well. She finally got to come home after 82 days in the NICU. She weighed 5 lbs when she came home. She did not have to have any monitors or medication coming home. She has been home 9 days now and weighs 5 lbs 11.5 oz. Her due date was June 12th. We know the Lord has been with us every step of the way throughout this whole thing. Many prayers have been answered and we are now a family with Lydia at home.