Amber’s Story: Hannah’s Premature Birth

On February 19, 2005, at 4:48am, I was woken by a gush. I was exactly 34 weeks pregnant. It didn’t feel like my bladder, but I wanted it to be my bladder. I decided to search online to see if I could find some helpful information. I couldn’t, and I continued leaking. At 5:00am I decided to consult my husband. He suggested that I go back to sleep for a few hours and see if that helped.

There was no way I was sleeping. I tried to watch TV, running back up to the bathroom frequently to deal with my ‘loss of bladder control’. Finally, at 6:20am I had bloody show. I couldn’t ignore that, so I paged my midwife. She told me we had to get to the hospital immediately, because I was in preterm labour.

I woke my husband, and luckily this time it took. We quicklly packed a bag and drove to the hospital. At this point, my contractions were mild, and about 4 minutes apart. I was admitted, and taken up to the assessment room. In the assessment room, the nurse hooked me up to the monitors. I was now high-risk, and that changed things. I would be under the oversight of an obstetrician, and I would have more interventions. The nurse inserted an IV and I received antibiotics. Luckily, the baby’s heartrate was fine, so that was the extent of things.

When my midwives arrived, they took me off the monitors, felt my belly, and said that I would probably have a baby that day. I tried to stay upbeat about giving birth prematurely. I didn’t want to fall apart.

At 9:00am I moved to a delivery room, where my midwives checked me and said that I was 2-3 centimeters dilated. The obstetrician came in, and confirmed that since I was 34 weeks, my labour could progress normally. However, once I was in active labour (defined as contractions 3 minutes or less apart), I would have to stay on the monitors. I was a little worried, since even the early contractions were more uncomfortable when I was lying still, and you have to lie still when you’re on the monitors. Luckily, my contractions stayed at 4 minutes apart throughout most of labour.

My husband and I spent the morning chatting and making phone calls. At 11:00am they hooked me back up the monitor. This time, the baby was quiet. They wanted to see the heartrate respond to activity, so I sat on that monitor for over an hour. By the end, my contractions were fairly uncomfortable. I complained, and breathed, and finally at about 12:20 the baby woke up, the midwives got back from eating lunch, and I was free.

I spent a couple of hours on a birth ball, which helped me to stay on top of the contractions fairly well. Once it stopped working as well, I decided to try the shower. A bath was out for me, since I was high-risk. But the shower felt good, and helped me to cope with the increasing intensity. At one point my midwife came in, and said that once I got out of the shower, they would have to check me. She was giving me the heads-up, because she knew I didn’t want to be on the monitors. So I stayed in the shower from a little before 2:00 until just after 3:00, well beyond the point of reason.

I only got out of the shower because my midwife promised we could talk about pain medication. I was at the point where I didn’t think I could take it anymore, and she knew it. When I did get out, I asked for gas, and they delivered it. I only got a few puffs while three different people checked my dilation. They all agreed that I was completely dilated, took the gas away and hooked up the monitors. My big fear was that they would check me and discover I had made little or no progress, so thankfully that wasn’t the case.

My midwife said I could push if I wanted to. I wasn’t sure I wanted to. I was scared that my baby would be sick, and I didn’t feel any urge to push. I couldn’t even feel individual contractions, I just felt intensely uncomfortable. But I didn’t want to prolong things, so I decided to try. I did what I thought I should do. I lacked confidence, but everyone said I was doing well, so I kept with it.

Some women love pushing. I’m not one of them. But it was my only way out. My midwife told me when I was having a contraction, and with each one I pushed a little more. After 40 minutes I could feel that I was making progress. Everyone started commenting on how they could see hair.

My hospital room got very crowded, as nurses and doctors from the NICU arrived. I got the baby to the point where the head was past my pubic bone, and you could see a couple of inches of hair. Then a contraction hit full force, and my body took over. The baby shot out like a rocket, and landed on the bed. The whole room gasped. The baby cried right away, and I felt immensely relieved. My husband cut the cord. My midwife told me it was a girl. It was Hannah, born at 4:00pm exactly.

I felt great immediately after Hannah was born. I sat in bed and rested, and Jon watched them assess her. She was big and healthy for her age. Her Apgar scores were 8 and 8, and she weighed 5lbs, 4oz. But I only got to hold her for a minute before she was taken to the NICU.

At this point, everyone started looking worried. I hadn’t delivered the placenta. The nurse massaged my stomach. My midwife gave me an injection of oxytocin. That didn’t work, so they tried ergot. The obstetrician came in, and a whole bunch of nurses. They set up an IV with more oxytocin. At some point, I felt some contractions, and gave a push. The placenta came part-way out. After more time, more drugs and some serious discomfort, the rest of the placenta came out in pieces. They couldn’t tell if I’d passed the whole thing. Also, I kept bleeding, although I wasn’t aware of it.

When the bleeding didn’t slow, my midwife said I might need a D&C to clean out my uterus. There was a lot of back and forth. Finally at 7:00pm they decided to do the D&C. Since it was a busy hospital on a Saturday night, I didn’t get in to surgery until after 1:00am. In the meantime, I signed a consent for a blood transfusion. My anesthesiologist said that I had lost close to half of my blood volume. I hadn’t realized the extent of my bleeding, so this scared me.

Once it finally happened, the surgery went smoothly. They found a piece of placenta, which had caused the bleeding. After the surgery, they took my hemoglobin. The anesthesiologist and obstetrician had agreed to transfuse me if it was below 60, and it came back at 60 exactly, so there was more back and forth. In the end, they gave me two units of blood in the recovery room. I could feel the literal lifeblood pouring into me, and I was glad they’d decided to do it.

I spent four days in the hospital, and my daughter spent six days in the hospital. It was hard to have her staying on a different ward, and even harder to leave without her. We struggled with breastfeeding, which I feel was caused in large part by the separation. Eventually, we overcame our difficulties, but it wasn’t easy. And we got off pretty lightly, compared to most NICU families. It could have been much worse. I really wish that we did a better job of keeping preterm babies and their mothers together.

About a month after Hannah’s birth we got test results back on my placenta. I’d had an acute amniotic fluid infection. This was the cause of Hannah’s preterm birth, and my hemorrhage. It was actually good news, because it meant I was not at increased risk for another preterm birth.

Hannah is now a normal, healthy 5 1/2 year old. I don’t see any remnants of our rocky start when I look at her. I will always carry it with me, but she does not appear to.

In spite of the rough bits, my birth was much easier than it could have been, thanks to my midwives. My experience as a high-risk patient would have been very different without them. They kept me informed, listened to my concerns, and advocated for me. Once Hannah was home, they did home visits for a couple of weeks, when I wasn’t yet up to making the trip to see them. Their level of care was outstanding. Every mother deserves that in birth, regardless of when or how it happens.