Mamas on Bedrest: Prepare for the Worst but Expect the BestApril 28th, 2010
Dr Jennifer Gunter and “The Preemie Primer”
Last week I had the pleasure to interview Dr. Jennifer Gunter on my podcast show. Dr. Gunter is an OB/GYN and Physiatrist at Kaiser Permanente in the San Francisco Bay Area who surprised me with her revelation that she had been a mama on bed rest with triplet boys. Unfortunately one little boy died when he was born at 22 weeks, but after a cerclage and 4 weeks on bed rest, Dr. Gunter delivered her twins at 26 weeks. Dr. Gunter very candidly shared the challenges that she and her husband faced caring for such fragile premature little boys and how the intense care has resulted in two robust, almost 7 year old boys. Dr. Gunter has compiled all of her professional knowledge and her personal experiences and life lessons into a new book called, The Preemie Primer: A Complete Guide for Parents of Premature Babies–from Birth through the Toddler Years and Beyond.
I keep turning that interview over and over in my mind. Dr Gunter seemed so calm and at peace with her experience. I suppose that after nearly 7 years, you grow accustomed to your life and you learn when to be upset and when not to be. Dr. Gunter admits that she and her husband had to shift their thinking to coincide with their new reality once the boys were born. But I kept sensing an air of faith mixed with subtle wisdom that I found awesome and awe inspiring. It is one that I didn’t have when I had my daughter, a “late preterm” baby.
My experience with a preemie
My daughter was born at 36 weeks and 6 days, just 4 short hours shy of 37 weeks. Due to the timing of her birth and some breathing difficulties, she was labeled a preemie and whisked away to the neonatal intensive care unit (NICU). Of all the things that I had expected to occur with my pregnancy, labor and delivery I had never expected to have a premature infant and nowhere in my mind did I ever anticipate her staying in the NICU. Now granted, she only stayed there for 10 days before she was discharged home, but the first time that I want into the NICU to see her I was completely overwhelmed.
There is no preparation for the NICU. They don’t take you there during the hospital tour; partially because they don’t want to scare and/or overwhelm new parents, but more importantly because those tiny infants are so fragile and so susceptible to infection that the mere presence of a tiny germ on a passerby could prove fatal. At our hospital the NICU was arranged in bays, from the sickest in the farthest corner to those just about to go home nearer to the front of the unit. That is where my daughter was. And even though she was not in an incubator and she did not have oxygen cannulas going into her nose and her IV line was in place but not in use, I was still a bit taken aback to see her on the little warmer bed with various wires taped to her little feet and hands.
No one prepared me for the fact that a baby, my baby, may have difficulty nursing because she hadn’t quite matured enough in utero to know how to breathe while she nursed. When my daughter first started nursing, her oxygen saturations would drop into the low 80′s because she would stop breathing while she sucked. Alarms would sound and I would have to break the latch that we both worked so hard to establish to pat her on the back so she’d resume breathing. There were a couple of other surprises that I had to learn to cope with, which I did, but they were daunting at the time.
Mamas on Bedrest: Prepare for the Worst but Expect the Best
Mamas I highly suggest that you prepare your self for a premature infant. While I am in no way saying that you will have a premature infant, the fact remains that if you have had some preterm labor and are on bed rest, your chances of having a premature infant are higher than those of a woman who has not. I find that when it comes to bed rest and prematurity, no one wants to talk about it. I understand that everyone wants to “stay positive”, but acting like complications could never happen is asking to be shocked. I understand that touring the NICU can’t happen. But that should not preclude a frank discussion between obstetricians and parents about what will be done in the event of complications; what types of complications can be expected if the baby is born at the time of the current OB visit? What protocols do the OB and the hospital or birthing center have in place to support parents of premature infants? What type of assistance is available to assist families once the premature infant is taken home? These can be tough hypothetical questions, but there is no harm in gathering information and even having one or two emergency procedures in place (such as family members ready to help out if needed).
If you have not considered that things could go “not as planned” with your birth, even now that you are on bed rest, I recommend that you at least discuss the possibilities with your obstetrician. Get some information. Prepare for the worst but expect the best. As Dr. Gunter in her wisdom reminded me,
“If we hear that a storm is coming we all go to the store, stock up on food and supplies, board up our windows and wait to see what happens. If it passes us by, so be it. But if the storm hits, we’re ready for it. I’ve yet to ever hear someone say, ‘darn it, I prepared for that storm and look it didn’t happen.”