Born too soon
How would you cope if your baby was born prematurely and
needed to stay in hospital for a significant period of time?
Elizabeth Gasson shares the story of her son Johnathan's birth at
34 weeks, and gives advice for parents facing this
situation.
My husband David and I have been together since 1996. We have a dog
and a one-eyed cat, but had wanted children for a very long time.
On 7 February 2008, we welcomed our first precious child,
Johnathan, into the world.
We are lucky as both our families live
nearby, and have helped us every day with such dedication and love.
We also have an amazing group of friends and neighbours. However,
even with this support system, having a baby who needed to be in
NICU made me face my deepest fears about parenthood, and it was the
hardest time in my life.
Like most mothers-to-be, I had a
preconceived notion of what it would be like to give birth, stay in
the hospital briefy, and then go home ready to show off my baby to
my excited family and friends. Even at 28 weeks pregnant, when I
started to have contractions while sitting in our first antenatal
class, I didn't realise what was going on - I simply thought that
the excitement of the class and the talk of giving birth had
triggered some visceral response, not that I could actually be in
premature labour.
For the next three weeks, I
continued to have Braxton Hicks contractions. Both my
midwife and doctor said that this was normal, but they kept a close
eye on me nonetheless. At 31 weeks, however, these so-called
Braxton Hicks contractions started coming closer together. The
contractions weren't painful, but I was admitted to hospital
anyway, and given medication to try to stop labour.
The contractions
continued for the next five days. I was exhausted and stressed,
both from the gravity of the situation and the fact that I was
feeling out of my comfort zone. Hospitals don't evoke warm, fuzzy
feelings for me. In my mind, people go to hospital when they are
gravely ill or dying, so being there was making me feel very
uncomfortable. I just wanted to go home, have a shower, shave my
legs, and sleep in my own bed.
Fortunately, my contractions
abated, and on the sixth day I was permitted to go home. But I was
only there for about a week when I felt a funny pain on my right
side, under my ribcage. Back to hospital I went. Again I was given
medication to try to stop labour. I could see my belly rippling
with the force of each contraction, but the only pain I felt was in
my right rib. I was reasonably calm, even making polite
conversation with the nurses. But unfortunately, the medication
didn't work, and soon I was in full-fedged labour. Due to other
health complications, my specialist and I decided that my
best option was to have an emergency Caesarean. David and my
parents had just stepped out for a meal when I called
to tell them I was on my way into surgery. They left their food on
the restaurant table and rushed back to hospital, arriving just in
time to see me wheeled into theatre. David quickly changed into a
surgical gown and mask. I wasn't at all worried - I
was excited because I knew that I'd soon be seeing my
child.
My C-section was textbook, and I was calm
throughout. David, the anaesthesiologist, and the doctor were all
caring and relaxed. They placed a sheet just below my breasts as a
barrier. I could just touch the corner of the blue sheet with the
tips of my fngers. For me it was a connection to what was
happening, since I could not feel or see anything. Within a few
minutes I heard the cries of my baby boy, whom we later named
Johnathan (David liked John, I liked Nathan, so we combined the
two). My midwife took him away immediately; I strained to see what
was happening. I couldn't hear him crying any more, and I was
starting to worry. She called David over and he came back holding a
bundle in a white blanket. He passed him to me; our son was
perfect!
Johnathan was weighed, measured, and
cleaned up while the doctors stitched me back together. He weighed
2440grams, was 46cm in length and had an aPGaR of 9/10. These were
all wonderful signs. One of the nurses told me that Johnathan would
need to be taken to the neonatal intensive care unit
(NICU). I thought that was a good sign, that he was healthy and
strong. I had no comprehension of what being in the NICU would
mean.
David went with Johnathan to
the NICU while I spent time in the recovery room, eating a lemonade
ice block and chatting to the duty nurse. It was very surreal. I
didn't quite comprehend what had happened. My stomach still looked
pregnant, but my baby was nowhere to be seen. The next morning, I
was wheeled into the NICU to see my son. although Johnathan
was born at 34 weeks, which, by the NICU standards,
made him one of the bigger babies on the ward, I was completely
unprepared for what I saw. To me, Johnathan was so tiny. He was in
an incubator, with tubes and wires all over him. He was wearing a
tiny nappy, so small it looked like it belonged on a doll. I was
frightened to touch him in case I hurt him, but after a few
minutes, I put my finger next to his hand and softly stroked
it.
The NICU nurse said that Johnathan was
doing well, but I didn't believe her. They told me that he had been
admitted to the NICU because of "grunting", which was a sign of
respiratory distress, and, of course, the fact that he was
premature. "If he's doing well, why can't we go home?"
I kept thinking. by lunchtime, they had moved Johnathan from an
incubator to a little plastic cot bed. It seemed so strange
seeing this tiny baby in a plastic container. I could now see
him more clearly - he seemed so vulnerable without the incubator
protecting him from the outside world.
I watched the nurses checking his blood
sugar levels by doing a heel prick. I was frightened that he would
scream, but he only cried out for a second. He was brave; I was
not. I saw where the needle had pricked him and it felt like they
had stabbed me with a metre-long needle, right through the heart. I
wondered if this would traumatise him. Then I had to make my brain
switch back into "healthy" thoughts - I knew that it was necessary
for them to take his blood, and that of course it would not scar
him, but the fear and sadness were still real to me, logical or
not.
Since I was not used to seeing a baby this
small, let alone my own, in an environment like this, all the
machines and tubes were overwhelming. The nurses explained that he
had a nasal gastric tube in his nose that went to his stomach for
feeding, a heart rate monitor around his foot, which measured his
blood pressure and the amount of oxygen his blood was getting, and
an IV line for fluid in his arm. He also had a heat lamp keeping
him warm and another machine to monitor his breathing. They
all made strange noises - beeping and pulsing.
If Johnathan moved his arm in a direction that restricted the fow
of fluid, an alarm would sound. I watched his heartbeat and oxygen
levels, praying they would not stop or slow down. However,
sometimes they did. Alarms would sound and my heart would stop,
until I realised that the little band had just slipped off his tiny
foot. It took a while for my panic to abate. In the end, I decided
that the band was quite cute because it was so tiny. I took one
home to put in his baby box.
I stayed in the maternity ward for the
next few days, where I was taught how to breastfeed. It was bizarre
having a stranger showing me what to do with my breasts. I thought
I would be uncomfortable, but I was just focused on learning so
that I could give the vital colostrum to Johnathan. We had to
manually squeeze the colostrum from my nipple into a syringe, which
would then be squeezed into Johnathan's feeding tube. It took a
long time, but I remember how excited David and I were when we
reached 5ml.
Due to my health complications, I could
not stay all day in the NICU. I needed to rest and Johnathan was
asleep a lot, so we would come and go every few hours. This may
have contributed to my feeling of surrealness. On the third day, I
was discharged from hospital, and we were invited to stay overnight
in the rooms at the NICU. We went home briefy and gathered what we
needed. I packed a few family pictures. Unfortunately,
on my second night in the NICU, I had further medical complications
and was admitted back to the maternity ward. When I was discharged
two days later, we couldn't stay long in the NICU as
the rooms are in constant demand. We had no choice but to go
home. Leaving Johnathan behind was agony. I felt that I had failed
my child, that I was a "bad mother", and I blamed myself for going
into premature labour, which had put him in danger. I was so
frightened for him and angry at myself. I cried a lot in those
early days, but I also coped with the shock of Johnathan's
premature birth by putting on a euphoric face, to mask my true
feelings of anxiety, so I would not be judged by others.
The staff in the NICU deal with anxious
parents and premature or sick babies every day. It's a difficult
and delicate task, balancing the needs of their tiny patients with
the reassurance needed by the parents. How parents cope with their
child's stay in the NICU varies from person to person. David coped
by affirming his belief that our son was staying in "Baby Hilton".
In my husband's eyes, Johnathan was being cared for at
a six-star hotel, with all of his needs met 24/7. My way of dealing
with it was to ask lots of questions. I'd write each question down,
then ask the nurse to write the answers when she had a moment.
Writing those questions down helped, as I could go
back over my list and start taking all the information in.
At two weeks of age, Johnathan was finally
released from the NICU. I had hoped I would feel better when we
arrived home, simply because we were out of the hospital
environment. But I still felt scared. What if I couldn't keep
Johnathan safe? What if he got sick and I couldn't make him better?
I felt panicked all the time and was irrationally afraid of
everything he came into contact with. 
It took me a long time
to realise that my fears originated from the unjustified guilt I
felt over Johnathan's premature birth. He was so small and
precious, and I was so afraid I'd lose him. Eventually, I learned
that this way of thinking was self-defeating. Instead of berating
myself for things that were not my fault, I should have
sought help earlier. The "stiff upper lip" concept is rubbish. What
I really needed - what all parents going through something like
this need - is support, time, rest, and especially understanding,
and to avoid judgemental people.
It has taken me a long time to come
to terms with having a baby born early. By being open and honest,
by asking for things that I needed to help me feel more secure and
less afraid, and by being informed about my choices, I feel that we
had the best possible care I could have hoped for. I now have a
very happy and healthy baby boy who is a constant joy and bright
spark in our lives.
Strategies for
coping if your baby is in the
NICU
1. If you are
feeling unhappy or anxious, respect those feelings, and talk to
people you feel close to rather than ignoring how you feel. Try
writing them in a journal.
2. Leave a message on your phone asking people to
call before they come by, in case you don't feel like
visitors.
3. Once your baby is home, talk with your
partner about the common rules in your household that will help to
keep you comfortable and lower your anxiety, for example, asking
people to wash their hands before holding your baby.
4. If you are worried about taking your new
baby out, for example, to the doctor's office, and exposing them to
germs, ask if there is a separate room where you can wait before
appointments, away from other sick people. Or place a cover over
the pram or capsule so people won't be tempted to touch your baby
without your permission.
5. Make sure you have people who can come
and help you with housework and cooking.
6. Keep in touch with your healthcare
professional, and let them know how you are feeling. Be
honest!
7. See a counsellor. They can help you
maintain a healthy perspective.
8. If you are still struggling and feel like
you can't cope, there are medications that can help, and that are
safe to take while breastfeeding. Talk to your GP about your
options.
9. Look for support networks in your area or
online, where you can talk about your concerns.
10. Make sure you get plenty of both rest and
exercise. Ask a friend or family member to babysit while you sleep
- I don't know what I would have done if my mother had not helped
me get some sleep!
11. It takes time to feel yourself again, so
be kind to yourself while you are going through this process.
12. Invite your partner to talk about his worries
or concerns too, so you can take his feelings into
account.
Elizabeth Gasson is Mum to one-year-old Johnathan.
As seen in OHbaby!
magazine Issue 5: 2009
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