Premature Birth

By Catherine

Both of my children were premature. My daughter, Jo, was born 8 weeks early. Her younger brother, Simon, arrived 10 weeks early. I'm very much aware that if they'd been born, say, 100 years ago or in a different part of the world, they could easily have died.

With both children, I'd hoped for a home birth. With both, of course, I ended up in hospital. With both, I was given a steroid injection to mature the unborn baby's lungs and a drug (administered by drip) to hold off birth so as to give the steroids time to work. With Jo, that drug gave her a couple more days in the womb. And she breathed well from the start. But with Simon, it only bought him a couple of hours or so - not long enough to be of any benefit.
Jo was in a breech position so I had a caesarean under epidural. To be honest, I wanted a general anaesthetic. I was scared. I didn't want to be awake while I was being cut open. Nor did I like the idea of a needle being stuck into my spinal cord. A nurse pointed out that an epidural would be better for Jo, but the thing that decided me in favour of an epidural was that if I'd had a general anaesthetic, my partner, Rob, wouldn't have been allowed in the theatre. I wanted at least one of Jo's parents to see her birth, to be there to welcome her. So... we both were. I talked non-stop throughout the operation to the South African anaesthetist. Afterwards, as the anaesthetic wore off, I seem to remember an odd sensation of feeling my feet again but not being able to move them. The pain was much less than I'd expected but walking the next day was rather frightening at first - I felt I'd lost some of my stuffing.

With Simon, I gave birth naturally. I was so pleased. There was a moment towards the end of labour when I asked myself why on earth women put themselves through childbirth. Immediately the answer came: "Because of gorgeous little children like Jo." The next day, I felt remarkably well. Of course, Simon was a small baby... but I've felt worse after a miscarriage than I did after his birth.

Unfortunately, natural birth or caesarean, with neither child was there any opportunity for bonding immediately after delivery - no time for looking into the baby's eyes, holding them on my chest, stroking their heads, cradling their bodies. I don't know how a newborn baby feels. Wet, I suppose. Jo's and Simon's first experience of the world was to be taken to one side and checked over by a team from the Special Care Baby Unit. They were then waved under my nose for a quick look from me (I didn't take anything in) before being taken to SCBU to be put in an incubator. Within the hour, a card was brought to Rob and me with a Polaroid of our baby in it. A baby who looked like a famine victim. A baby wearing a stranger's enormous clothes. A baby with tubes from hand, foot and mouth. Not a picture of health.

Finally, several hours later, I was able to visit my child. Jo was breathing well. So I was able to put her to the breast. Of course, she couldn't suckle; the suckling reflex usually doesn't develop until 35 weeks gestation - but it was an important moment. Simon was several days old before I was able to hold him. Until then, I would sit beside his incubator chatting to him and stroking him with a hand stuck through a porthole.

Jo's prematurity and my caesarean were a big shock to me. I'd always been a bit arrogant about my own rude health. I'd always assumed that I would 'breed' easily. A miscarriage before Jo and some bleeding during her gestation had taken the wind out of my sails a bit. But I'd still never imagined myself having a caesarean; and prematurity hadn't even crossed my mind. It was difficult at first seeing the full-term babies on the delivery ward. They looked so round and rosy. But before too long, the babies in SCBU began to look normal (dainty) and the 'normal' babies began to look gross (much too big.)

I was able to stay in hospital with Jo right up until her discharge at 2 ½ weeks. I was given my own room within SCBU and Rob visited daily. We were encouraged to take part in caring for Jo - washing her, changing her, cleaning her mouth, feeding her. That involved putting my milk down her nasogastric tube. That's a tiny tube which runs up the nose and down into the stomach. Jo was soon on 4-hourly feeds and I would spend an hour before each feed, night and day, expressing milk on an enormous electrical breast pump with an idiosyncratic sucking-whooshing sound. I soon had a good supply of excess milk in the SCBU freezer. Then at 2 weeks old, Jo moved off the tube and on to the breast. Such joy!

One evening, when Jo was just over a week old, Rob and I took some time off to go to see the recently released "Shakespeare in Love." I laughed uproariously. We saw some friends who didn't even know Jo had been born. And we ate dinner in an Indian restaurant. It tasted particularly delicious after days of hospital food and in-hospital picnics. But a week later, as breastfeeding was just getting under way. Rob and I went out again. This time to a park. I couldn't relax. I was too worried about leaving Jo to the mercy of a nurse with a bottle.

Simon's early arrival was half-expected. We'd known history might be repeated. I'd just that morning finished washing, ironing and sorting Jo's old clothes ready for Simon, thinking all the while that I'd done it at least two weeks in advance of it being needed. Because he was earlier than Jo and because he hadn't had the time to benefit from the steroids injection before his birth, Simon needed more medical intervention than Jo. With Jo, it was basically just a matter of waiting for her suckling reflex to kick in. But Simon had numerous courses of antibiotics, spent many days under a lamp because of jaundice, and for the first few days needed help breathing. After each breath, his bony little chest would hollow out as if someone had stuck a finger in him.

Nevertheless, second time round on SCBU was easier for me. I knew the ropes... the tiny, tiny babies didn't shock me. I'd seen them before. I knew the noises. I knew the nurses. And the nurses remembered Jo - and gave her a lovely welcome.

But then, after a week, it did get harder. Rob had to go back to work which meant that he was no longer able to look after Jo. Siblings are welcome in Ipswich SCBU during the day. But they are not allowed to stay the night. So I went home. It's not easy to leave your baby in hospital.

Jo and I began 4 weeks of commuting. Visiting every day. Usually by bus. An NNN friend in Woodbridge offered us accommodation so part of each week was spent at her house. That cut travelling time. She offered to look after Jo, too, but unfortunately, at that stage, Jo didn't like that idea.

What with travelling, expressing milk, and meeting Jo's needs for entertainment, fresh air (in the park opposite the hospital) and food, we often didn't have very much time with Simon. Rob visited Simon when he could in the evenings and at weekends. He offered to visit instead of me. But I panicked at the idea of missing even a day of seeing Simon.

All 3 of us - Rob, Jo, and me - ended up very tired. Towards the end, I was sometimes going in at night, too, either just for the evening after Jo had gone to sleep or for the whole night returning home in time for breakfast with Jo. One day, while reading to Jo in the SCBU family room, I found myself repeatedly falling asleep between words.

Jo started throwing tantrums. She caught a stomach bug. Then she took to eating only sweet corn and raisins, which gave her diarrhoea. And in trying to rectify that, I gave her constipation. More for us all to worry about.

And my milk failed. It had already faded and been revived by an anti-nausea drug with the interesting side effect of promoting lactation. Then it failed outright. An hour of pumping produced only 2 or 3 drops. I tried a lactation oil with no success. Then a wonderful SCBU nurse snuck me in the back door of A + E to get an instant repeat prescription for the anti-nausea drug. Wonderful, wonderful drug!

Bringing a premature baby home from hospital can be nerve-wracking. For one thing, they don't fit the carseat. With Jo, I worried so much that she'd get ill and need to go back to SCBU. How could I face the nurses? Hygiene was a big issue. I was even more tense with Simon. Poor Jo had a hard time of it.
But Jo has just turned 5 and Simon is about to turn 2. Both have been dedicated breast feeders. Jo fed until 2 ½ and Simon is still feeding. Both are very healthy with, it seems, no long-term effects from their prematurity. I'd defy anyone to recognise them as premature babies. In fact, a physiotherapist once commented on Simon's nicely rounded skull. Unlike many premature babies, he has no flattened sections from his weeks in an incubator. Well, that's the power of the sling, isn't it? A sling given by that same NNN member.