It’s been four and a half months since my son was born at 24 weeks, weighing 1lb 6oz. He’s doing well, is a solid 8lbs 2oz today, and we’re both home now, soaking up our sweet babymoon. He’s on my chest, skin to skin, sleeping peacefully for the moment while my other children and husband are asleep as well.
Now that we’re out of the woods, I think it’s a good time to finally share his birth story.
And since I’m sharing, I guess it’s a good time to tell you his name. Evariste. Evar, pronounced Ever, for short. When I gave birth to Evar back in February and in the weeks following, I was unable to envision us here now. I tried but I couldn’t believe it would happen. I just burst into tears and wept whenever I thought about the future we might not have. I had too much fear. I tried to hope more and more as the days went on and put a brave face on for everyone because I couldn’t be dragged down with sympathies but it was a soul crushing time. Imagine giving birth but not being able to hold your baby for 30 days. You had to look at him through thick, foggy plastic for months. That touching his skin, stroking it, would tear it. And being told you had a decent likelihood of losing him or dealing with moderate to severe health problems if he made it home four or more months later.
Looking back on my experience, spending four days before birth in the hospital, birthing by myself and catching my sweet baby in my hands alone, then spending three and a half months in the NICU with him while my husband and others cared for my three children at home, there are a few things I’d have done differently but it felt so out of my control at the time and I’m really quite thankful for how I was able to navigate it all and make it through to the other side in one piece.
My 4th Pregnancy
I knew at some point last year that our family was missing someone. Evar was conceived in September and my due date was June 11th. Everyone was so excited about a new sibling. My big girls, 4 and almost 6, were over the moon. The first few months of pregnancy were blissfully normal. I was exhausted and cranky and my nipples hurt like hell when my 20 month old toddler nursed but I didn’t have any nausea or anything going on to worry about. I carried on with my three active children as I normally would, going on little outdoor adventures and exploring all that the San Francisco Bay Area has to offer nearly every day. Until one day in December when I was 14 weeks along. I had what seemed to be an all day Braxton Hicks contraction, quite painful if anything bumped my belly, that ended in a gush of blood as I walked up my stairs at the end of the day. Bright red blood out of no where was worrisome. I thought maybe it was the two really long hikes I did in the last week, carrying my 4 year old and toddler for a good mile when my daughter refused to walk a bit of our 4 mile hike. Maybe my body was telling me to slow down, not carry extra weight, rest more. I wasn’t sure what to do except rest in bed until my (first and only planned) ultrasound that was already scheduled in less than two days. So, I that’s what I did. I tried not to nurse my toddler as much as usual, as well. But when the bleeding repeated itself once more the following day, I reached out to my birthy friends and took a tincture a trusted ex-midwife friend of mine suggested, drank lots of tea, and then all was fine.
I went to my ultrasound at 15 weeks worried but the baby was perfect and we were thrilled to find out we were having another boy. We’d have two girls and two boys. Could we get any luckier? The girls play so well together, I was looking forward to that same bond between brothers. Or whatever dynamic they all decided to come up with would of course be just wonderful as well. But two of each seemed really great.
As the weeks went on, I continued my life as normal and slowed down whenever I had bleeding.
I felt my baby kick, watched my belly grow, and I waited for birth dreams like I’d had with my third child. His were so strong and spot on to what would happen, how I would birth. This time, however, I was secretly slightly apprehensive about my upcoming birth, that something was not going to go well. I wasn’t able to envision a sweet home freebirth like my last one. I felt deep down that wasn’t in the cards, but I couldn’t guess what happen. I just knew something might happen. I still hoped for the best, even as I bled occasionally. It wasn’t serious enough to warrant a trip to the hospital until I had a larger gush than usual. At 22 weeks, I went to get an ultrasound at the hospital to attempt to diagnose the source of the bleed to give me some peace of mind. Being in a hospital for the first time this pregnancy, in two actually, felt unnatural. I didn’t like being treated like just another number. I didn’t like being reminded of my first birth experience in a hospital. I didn’t like the florescent lights, strangers that hardly made eye contact, the chilly doctor wasn’t soothing at all, didn’t put her hand on my skin, on my belly once while I was there for a couple hours, just touched me with tools and sent me to get an ultrasound. I also came during dinner time and no one offered an obviously pregnant woman anything to eat or drink. Not even a snack like they had sitting around. I guess I should have thought about it before hand but I almost fainted so I swiped some juice and yogurt from the fridge to settle myself.
I was told I had a subchronic hematoma but not to worry, that it would likely resolve itself and I didn’t need to restrict myself in any way, just eat some more iron rich foods to replace my lost blood. So I left thankful, while rattled at the whole hospital experience, but I followed my intuition and took it easy anyway. I didn’t feel right getting out and about 100% with my kids. Whenever I was too active, I felt tired and would bleed. It was about like a period though. I kept losing more blood over the week and a half.
By my 23rd week, I was feeling tired, pale, and wanted to rest all the time. I went out once that week with my kids to sit in nature and enjoy some time with our friends but the walk back felt troubling.
It was Wednesday, February 17th, and I was 23 weeks and 3 days along. After a stressful phone conversation with a manager in San Francisco about how it was illegal to discriminate against a breastfeeding mother a child in a public city office, I hung up and I had a huge gush of blood. I knew it was serious so I darted to the bathroom a few feet away and sure enough, I passed a medium sized blood clot and kept bleeding. I got into bed and tried to relax. I called my husband and asked him to come home.
As I was relaxing in bed, I had a huge gush of blood around 4pm that bled through my pants, undies, overnight pad, stained the mattress through the sheets, trailed to the bathroom…It was a big mess. In the bathroom, I passed a smaller clot and lots of little clots. I was hoping the clots were all that needed to pass and my body was healing itself. Too much to hope, I guess. While I was cleaning myself up in the shower I nearly fainted. I quickly sat down and my body lost feeling except for a strong tingling, especially my shoulders, as feeling was coming back. I lost my hearing as well. Then I heard ringing in both ears, dull to other sounds, as my hearing slowly came back but ringing persisted for over 5 minutes, as did the tingling. I stood up after a minute to open window for cold air and eventually got back in bed. At this point, I considered calling an ambulance but I called my husband again and asked where he was. (The commute from his work to home can take an hour or two.)
When he got home, he kept all the kids away from me and fed me in bed. Unfortunately, by that evening I was having regular Braxton like contractions every two to three minutes. I started to write them down. I told my husband but hoped they’d just go away after I relaxed enough.
5:34 Braxton, then gushing feeling, like I’m peeing myself. Blood.
544 felt kicking then hardened
546 more kicking at 546, then hardened again, trickling feeling
553 drinking juice
I stopped tracking to get up to pee and sit downstairs.
649 Sort of painful feeling for the first time, sitting in chair
back in bed
658 painful-ish contraction, laying down on side
724 quick painful ish
727 same. WTH. AM I IN REAL LABOR?
missed tracking one
This continued through the night but I fell asleep. I woke up at 2am to pee and I gushed more blood going to bathroom, then I had a liquid bowel movement. I thought about the diarrhea I had like that in labor with my second child. I hoped it wasn’t a sign of real labor as I showered and cleaned myself up, feeling pale and drained.
While I was in the shower, I assessed myself and considered my situation. In addition to the painful, regular contractions and bleeding, felt my cervix opening up from when I checked a few hours earlier. I decided it was time at least speak to a nurse. I dried off and went in to snuggle with my husband while I thought about it. I was hoping he would wake when I caressed him, I needed to be comforted, but he didn’t wake and I didn’t want to wake him up purposefully. I paused through contractions as I got dressed and snuck out to my car to speak to nurse at the hospital in Labor and Delivery. She wasn’t terribly helpful after I described my situation, just told me to come in “if I felt like it” and they’d monitor baby. I wondered what to do with my sleeping family. I decided that after taking them to the hospital with me for the ultrasound, them spending spending hours outside with my husband stressed out and exhausted when they could have just stayed home, I was going let everyone sleep until the morning. By then, I hoped I would be given labor stop drugs and all would be fine.
I started driving to the hospital with a NICU 25 minutes away and kept tracking contractions.
334 hospital check-in
I could hardly form sentences to tell the woman while checking in what was going on. I think there wasn’t enough blood going to my brain at that point. I had to tell her to hold on a minute while I gathered myself. I probably looked like a pale, exhausted mess, but perhaps a little too sane to be in real labor. I told her I was 23 and 4, contracting every 2-3 minutes, they were painful, I was dilating, I was bleeding heavily, I had a SCH, I could feel the baby kicking fine, and I was there to get some labor stopping drugs. She had me fill out paperwork, put some plastic name tags on my wrist, and sat me down in a triage room and I gushed more blood, waiting to see someone. I wasn’t treated with urgency or offered any water, juice, or anything.
I kept bleeding, passing small clots, as I sat there but wasn’t feeling that bad besides contractions and feeling hungry and tired. A nurse said they couldn’t feed me anything until they knew what was going on. Bullshit. Why are they starving the anemic pregnant lady who hadn’t eaten in hours? I always have a middle of the night snack at home. I had thought about stopping to eat first but Whole Foods across from the hospital was closed on my way in. I should have stopped at some awful fast food place if I’d thought they were going to withhold nutrients. I drank a juice from their fridge while they weren’t looking because I really needed something.
A nurse put a monitor on the baby, said he was fine and kicking, and confirmed what I’d said, that I was contracting. The nurse said their computers were down, couldn’t see my ultrasound file from last weekend. She asked lots of questions then said she get the doc. She came back a while later to say both doctors were in surgery right then, apologized that they were not available, and commented that “I’m really going at it” referring to my contractions. There’s a photo of my contractions on paper.
Mind you, I had no plans to count contractions for this baby until my premature labor started. I didn’t want or need to the last birth, or my second one either, just listened to my body, not a clock or timing things. I was unhappy with where this pregnancy and labor was going. It was so much more medicalized than I wanted.
At 4:30am, an hour after arriving, the doctor on call finally arrived. She had a gruff beside manner, zero warmth. She shoved a couple of gloved fingers in me and confirmed what I’d been telling them, that I was dilated a couple centimeters. She said I was 80% effaced and she was going to start me on magnesium to stop labor. Oh and my baby was breech.
It was quite agitating to tell everyone exactly what was going on only to have to wait an hour or more while contracting for them to figure it out themselves, to have their machines and gloved hands prove it to them.
At this point, I took off my own clothes and put an awful teal green backless hospital gown on. I knew I wasn’t leaving soon but I didn’t think I’d be staying for four days. I typed up everything to send my husband as soon as he woke.
By 6am, my husband got my message and I was given the first of two steroid shots, betamethasone, to mature my baby’s lungs in case he was born early and was started on magnesium sulfate intravenously with an IV drip to hopefully stop my labor. Thankfully, my labor slowed and then eventually stopped. The mag made me feel slow and hot. I felt guilty about these new random things I was taking, being absorbed by my baby. I had avoided everything I could during pregnancy and now I was taking whatever might keep him in longer because the damage and risk coming out this early was greater than a possible drug reaction. My husband came to join me in the morning after dropping off our kids with a friend. It was so wonderful to see his loving green eyes after a night of strangers.
By noon on Thursday, I was given 3 pints of blood. Apparently, I was only at 20% blood volume when I walked in. I was given 2 more pints in the next day to bring me back into the normal range. I was moved from L&D to antepartum by 6pm. I still wasn’t allowed to eat and this continued for 18 hours after my arrival, in case they wanted to give me a c-section or something. They only allowed ice chips. I had to fight to eat, telling them repeatedly that I was not going to have a CS at 23 weeks (my body, my baby, my choice), and I was pregnant and starving, that I needed to eat. Withholding food was unacceptable.
Antepartum was much more relaxed than L&D. I was left alone and wasn’t hassled for monitoring every hour. I had barely slept at all, maybe an hour or two in the last day, because of how often I was being poked and woken up. Just before midnight on Thursday, my nurse did vitals and a blood draw. My body didn’t like being touched and monitored. Sure enough, soon after, I started contracting regularly again. I was pissed at the nurse and the hospital for their routine policies that didn’t give a shit about patient needs, how I had to beg to be left alone to sleep, for them to couple their checks or put off the unnecessary ones, to not monitor me when I knew I wasn’t contracting and leave my sensitive belly alone when I could tell if my baby was kicking. I finally slept for a couple hours until 3:23am on Friday when I had a really painful contraction that woke me up. I went into steady labor again. I couldn’t sleep and I felt awful. I needed a shower. I wrapped up my IV and line ridden arm with a plastic bag and some tape that I found and rinsed off in the shower. I gently felt that I’d dilated another 2 cm and told my nurse so I could get started on mag again. My hopes of going home now were dashed. I went back on mag for another day and my contractions went away. I was given a second shot of betamethasone.
The doctor on call scolded me for checking myself and told me to keep my hands out of my vagina. I’m pretty sure I gave them the “eff off” eyes because it was my body, I had made sure my hands were clean, and I knew I was more gentle with myself than they were.
That night I had a birth dream while sleeping on that lumpy hospital bed. I dreamed of waking up to go to the bathroom with my husband sleeping near, birthing by myself in the hospital bathroom, bare and free, and welcoming my baby, and a team of nurses running in to help my baby after I held him.
It felt comforting and peaceful for what it was. It was my first birth dream of this pregnancy.
During the day while my contractions were gone, I wondered if I was going to go home and have a normal birth or if I was going to have to stay for weeks in the hospital on bed rest or what was going to happen. I just lived hour to hour. Something was always going on, a new nurse, a new doctor. I continued being checked and prodded all day, all night. I had bruises on my arms for too many bad blood draw and IV attempts. I had to convince each new doctor and nurse that I didn’t want continuous fetal monitoring and I wasn’t going to have a c-section, that I could continue to eat. It was a constant fight to be listened to and left alone. It felt like it was all about control and slowly breaking me. I couldn’t believe this was standard care, that women were treated this way. Where was the respect?
I put on a brave face for my kids when they came to visit me. They asked when I was coming home. I didn’t know.
Besides family or those watching our kids, I kept mum about what was going with me. I couldn’t handle any outside stress. I had to focus on myself and my baby and I had nothing else to give. I felt guilty not telling a few people but I hoped they’d understand later.
A doctor came in to try to confirm my dates and to tell me the dismal statics for preemies born at 23, 24, and 25 weeks, giving me handouts to read about how awful my baby’s life was likely to be, if he even survived. It was depressing. Another doctor popped in to report that my blood results came back from the blood mixing screening and there haven’t been any fetal blood cells and my blood, so they didn’t need to give me Rhogam.
My husband spent his time with me or taking the kids back and forth between friends and relatives or staying home with them. I really wanted him with me 24 hours a day but he couldn’t. He did bring me some things from home to help me feel better, like a couple dresses and flip flops. I was able to take a hot bath and relax.
The next night, Saturday night, I had the same birth dream again.
Sunday, February 21st
I woke up in my antepartum room feeling hopeful. I didn’t have contractions or bleeding and I had a sweet, soothing nurse that told me I should have hope that I’d go home and carry this baby to term. It was a possibility. She confided that she was a midwife decades before but didn’t tell staff there her background because they didn’t believe in natural birth. She’d delivered hundreds of babies, had her own at home, was the kindest, most soothing person I could have met there. She was just what I needed to feel a little better about feeling like an animal trapped in a cage. She said she couldn’t work in L&D anymore because the control, monitors, the lack of staff trust in our bodies…It was too depressing for her. I agreed. It was depressing. But I was thankful she was there with me. I had met other nurses there during my stay that told me their birth stories or the best, most natural ones from their work, like delivering a breech baby in the ER waiting room. That nurse told me her mother was bullied into a CS for her breech baby 30 years before, that she and her mother felt scared by it, that her mother had always felt regret about how she was coerced into it. When the nurse, the daughter, told her mother about her breech delivery, it seemed like they both healed a little bit.
The docs decided to switched me to an oral muscle relaxer, Nifedipine, on Sunday because they said magnesium isn’t safe for the baby past a few days. I was hopeful the new drug would stop my uterus from kicking back into gear and I could go home the next day.
At this point, I asked the doctor of the day if I could eat outside because I was craving the outside world. He denied my request. I ignored the doctor’s orders on Sunday evening and went outside into the garden and ate my dinner outside before sunset with my husband.
It was the first time since Thursday early morning, driving to the hospital and checking in, that I’d felt the sun and air on my body. I felt so trapped there, hands with needles stuck in them covered in plastic, wearing an uncomfortable gown and mesh undies for days, confined to my room, unable to walk outside, put my toes in the grass, see the stars, breath the outside air, take a shower without an IV.
On Sunday night, I was told I hadn’t pooped enough for them, maybe it’d been a day or two, and they needed me to produce a bowel movement. Makes sense that I hadn’t gone since I was given strange hospital food, iron supplements, other drugs, and couldn’t walk around to get things moving. So a nurse gave me a couple cups of prune juice and something else, a pill to help me go I can’t remember the name of. I joked about pooping out a baby with the amount of prune juice they had me drink.
By 8:30, I had enough. I took out my IV lines (nothing was being pumped into them at that point anyway) and my hospital bracelet. I wanted to take a shower with both arms free of junk. I figured they could put that crap back on me if it was an emergency but I needed to feel like myself again. (Did I mention they tracked and measured everything that came out of my body?) By 10pm, my body started going in to labor again. My husband was going to sleep and asked me if was okay. I said I just felt pushy, like I needed to poop. I blamed the start of a new round of contractions on the prune juice, them feeling like they needed to get me to poop and mess with my body. I went to the bathroom while he fell asleep on the fold out chair in the room. He was exhausted.
After a shower and sitting on the toilet a couple trying to poop, I realized I was in labor. I thought about my options as I sat in the bathroom. I’d been told my body only needed to open to 5 or 6 centimeters until my baby would come out because he was so small. I knew I was almost there already and tonight was the night. I definitely felt guilty, felt terrible knowing my body was kicking my baby out to protect itself, to stop the bleeding, and I couldn’t stop it. But I was in a state of calm acceptance and had to figure out what was best for my baby.
Option 1. Call the nurses and either be prodded while birthing right there or be wheeled in for an emergency CS.
Option 2. Wake my husband and labor with him secretly but then I knew he’d lose his cool and call for help.
Option 3. Labor by myself with my baby, just us, and I’d birth him and catch him and then call for help.
Obviously, I went for option 3. It seemed like the safest thing for my baby and myself at the time. The studies I’d read didn’t report benefits for a c-section for babies of his age, that vaginal would have been safer, and I knew getting drugged up and controlled by strangers was going to make things dangerous for us. After a couple of painful contractions by the toilet, I laid out a couple of chux pads to catch the blood and crap I was sure was coming.
I was alone, naked in the bathroom, losing myself to the contractions. I was so thankful no one was there telling me what to do, no pressure from anyone to get in the “convenient” birth position for them (when I asked a day earlier about positions while birthing my preemie, they made it clear I’d have to be on the bed, likely lithotomy), when to push, no monitors or lines trapping me. No pressure for a CS. I did not push, I just let my body move him down like I’d done with my last birth. I felt the ring of fire. My body slid Evar out, everything else, too, placenta and all in one contraction as I knelt down on the chux pads. I caught my baby boy and his bag of water broke as it hit my hands. I admired him and felt the relief of everything coming out. He looked perfect, though tiny, healthy, eyes closed but breathing, and I heard him cry. It was so fast.
It was 11:05 pm.
I felt exhausted but good, not like I was going to faint. I saw the huge clots with my placenta, knew my body needed to get them out, so finally there was mental peace instead of fear. I knew I was going to be okay now. And as soon as he was born, I held him to my body, said hello, watched him for a sweet moment.
Then I yelled for my husband. “The baby’s here!” He jolted awake, ran out of the door to the nurses station at the corner to call for help. He said they were shocked and took a moment to move. An ALS nurse came in a minute later and assessed Evar. He asked if we wanted to save him. We asked how he thought he was doing based on his professional opinion. He said he looked good and we said yes. (Babies born before 25 weeks are not saved unless the parents request it.) He milked the cord to give him more blood and then cut it. I was thankful it wasn’t too rushed but I wished he had carried the placenta up with the baby instead of cutting it. A team of nurses arrived as he was squatting with me in the bathroom. He took Evar from my hands and lifted him to the incubator table surrounded by nurses.
It couldn’t have gone any better under the circumstances.
I had an unassisted freebirth, en caul just like my last baby, except in the hospital where I felt safe to have the baby receive immediate help for him.
After the birth
I stood at the table with my baby, naked and covered in shit and blood, as they cared for him. I don’t recall exactly what was going on. I guess they were doing APGAR and giving him oxygen. They told me later APGAR scores were 5, 3, 7. A couple of nurses tried to get me to sit down and put an IV in. She looked surprised when she turned my hand over and saw that I didn’t have a line in. I declined. I think someone covered me in a blanket. I was focused on my baby and watching him. I wasn’t sure if he’d die then or make it but I wasn’t going to miss those minutes being separated.
They said they were ready to take him upstairs and asked if I wanted my husband to go up or stay. I was confused on why they didn’t just assume we were both going up. Why couldn’t I go up? I told my husband to go upstairs with the baby and CAT team. The baby was doing well so far, and I had to fight a new strange doctor to let me go, sign paperwork that I refused his immediate vaginal exam, IV. I was pretty pissed that I had to spend that time with him, a rude doctor, was being pressured to follow their policies, when all that mattered to me was being with my baby. They were taking that time away from me with BS. I wanted to tell him and everyone to leave me the fuck alone, to eff off. But I was as polite as I could be, kept repeating, “No, thank you” to whatever request they threw at me that seemed unnecessary. A few minutes later, I was on my way up to the NICU being wheeled up by a nurse the former midwife nurse had said she’d know I’d love, a doula that supported home birth and women and babies naturally. She was so kind, smiled, looked into my eyes. We shared a couple of laughs about how I just pooped by baby out and was perfectly fine.
When I arrived in the NICU, it was blur. It was my first time there and it was an odd place.
My baby was in a strange bright room with people around him. I was thankful my husband was there. I asked the charge nurse when I could hold him again because I was worried he would die. Later, she said, but I don’t recall what else. It was hard to leave him a couple hours later but I needed to sleep and I couldn’t sleep next to him. There wasn’t room. It felt cruel to leave him, to not have me near after months of us being together.
We spent the next day watching him, “compassionate care” touching him, having the kids meet him.
He was so tiny and red. He stretched, twitched, wiggled. He couldn’t cry with a tube down his throat.
I attempted to rest during the short periods I was away from him, pumping in postpartum, which was thankfully on the same floor. I waited to hold him again. It seemed to be my life goal at the moment. I rushed down the hall to his bed every couple hours and asked to hold him. The nurse kept pushing me off, telling me to ask again in a little bit. I didn’t understand why I couldn’t hold him. What if he died and I never got to hold him alive again. That day without holding him felt like my heart was being ripped out. They gave me a scent doll to hold and sleep with. I wished it was him and I bawled.
I wished I was still pregnant, really, that I hadn’t failed to keep him inside and safe until he was strong and plump like all of my other babies. So many emotions, guilt, anger, happiness, love, fear. Finally, I was able to hold him again on Tuesday at 7:30am. I wept with joy when they put him on my chest.
Holding Evar was wonderful. He was impossibly small and wiggly, just over a pound. I cried as I heard his breathing, felt his hand wrap around my finger. His hand was the size of my fingernail up to my first knuckle. They said he was big for his age but definitely a 24 weeker. He peed on me while I held him.
It was still awkward and a bit uncomfortable though because he was covered in wires, tape, and tubes and I had to have thing taped to me and they were itchy against my skin. When he was first born, he was naked and free, smooth and perfect. If I hadn’t held him that first minute, I would have felt so lost, devastated, without that memory to help me through. I will keep it my whole life, I’m sure, his weight in my hands, against my body, the sound of his cry.
As the days went on, I was so thankful he made it, was able to be saved, but so worried he wouldn’t make it, that something awful would happen. I battled emotions that it was all my fault for not being able to keep him inside. (I feel much better about this now, by the way. Preemie births like this are not the mom’s fault. We do the best we can in the face of a frightening situation.)
But our NICU journey over the next three and a half months is a whole different story. I’ll save that for another day.
I am enjoying where we are now, living a life full of sunshine and love without fear.
Did your baby have to stay in the NICU? Did you have a micropreemie? Share your story!
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If you’re in the NICU now, have hope. You will bring your baby home.
My posts on my 4th pregnancy, my son’s birth, our time in the NICU, and breastfeeding: