Birth Complications

Mamas on Bedrest: Going Home Without Your Baby

December 8th, 2014
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Me and my daughter the day after her birth. Kangaroo (skin to skin) care is very beneficial to preemies helping them learn to regulate their body temperatures, soothing and comforting them and helping mamas and babies to bond.

Hello Mamas,

We all know bedrest is a beast, but we endure it with the ever pressing hope that at the end of the journey, we’ll end up with a healthy baby. Sometimes the journey ends up not quite how we expected. We deliver and our baby has to be taken into the neonatal intensive care unit (NICU) for special care. Even though all proceeds positively, it’s a tough pill to swallow that after the many weeks on bed rest, you actually have to leave the hospital without your baby. While most mamas on bedrest know that they have a higher than normal risk of delivering a premature infant, few are prepared for the feelings that ensue when they are discharged home from the hospital and their babies must remain. Many mamas describe a feeling of grief, a void and feeling like they didn’t really succeed in having a successful birth outcome. All of these are very valid feelings.

As a mama who had to leave the hospital without her baby, it was really hard to be wheeled down to the pick up circle in front of the hospital, all my personal items and flowers beside me, and no baby in my arms. And I was lucky. My daughter (a late phase preemie born at 36 w, 6d) only remained in the NICU for 5 days beyond my discharge. But it was still hard to walk into my house and to see her room all ready and to see the cradle and changing table in my room and for her not to be there. During those 5 days, I made the most of my time, created a routine with my husband and the order, quite frankly that feeling of control is what got me through.

Structure your days: Every day I got up, dressed and prepared a bag for the day full of snacks and supplies (breast pump tubing, bottles, breast pads, maxi pads and other personal items) and my husband would drive me to the hospital so I could be there by about 9 am. Once I arrived, I assumed most of my daughter’s care. I would weigh her, feed her, change her and weigh her again. Then I’d hold her and rock her, talking to her. My mother had come down to help out, so she would come to the hospital with me and we would take turns holding my daughter. While my mom held my daughter, I’d pump. I pumped every few hours and by the time she came home, we had enough stored breastmilk to take up nearly one quarter of our freezer. Occasionally during the day I’d take a nap in the rocker, but generally I hung out with my baby, holding her and caring for her as much as the nursing staff allowed. My husband would typically pick up my mom and I at about 7pm and he’d bring us home. I’d eat and pump and rest, my mom taking care of me, while my husband would go back to the hospital and hang out with my daughter until about midnight. We repeated this schedule daily until we brought my daughter home.

Now I am sure that many of you are thinking,

“Well that’s just fine for you. Your baby was only in the NICU 5 days beyond your discharge (10 days total). And you didn’t have any other children at home.” 

To this I say, “You are absolutely right!” But the point I want to make is that when your child is in the NICU, it’s stressful. Many mamas feel as if the nurses are bonding more with their babies than they are! Personally, I was kinda pissed at the nurses at first. They held my daughter before I did. Although they had whisked her by me when she was first born, the NICU nurses were the first people my daughter really  “saw”. I knew intellectually that they were doing the best possible for her, but frankly I was jealous. I wanted to be doing everything for her. I WAS HER MAMA!!! And as the days went on, and I was able to do more and more for her myself, those feelings of jealousy gave way to gratitude as I realized those nurses really were doing the best things for her at that time.

Get support: I live in Texas and my family lives in Massachusetts. My mom came down to visit and take care of me. It was a HUGE help. While she really didn’t do much (a few loads of laundry, made sure I ate, helped me move about comfortably), her presence meant more than I can say. She was there when we learned about a lot of my daughter’s lab tests. While most of them were negative and my daugther was progressing nicely, the anxiety that arose each time the neonatologist arrived was stiffling and each day that he said my daughter could not go home, mom was there to comfort me. Also, although I didn’t have other children at home, having my mother present would have enabled me to be with my daughter without having to worry about the care of my older children at home. Do what you can to have folks present to support you. Its invaluable!!!

Take Advantage of Available Services: Many hospitals offer a wide range of services to families with infants in the NICU (Social service consultations, assistance at home, getting medical devices and equipment for home if they are needed, counseling for parents if needed and so much more!). While I didn’t need many of the services offered, I did take advantage of the lactation consultations. My daughter had trouble breathing and that is why she was in the NICU in the first place. But she had difficulty breathing while nursing. The lactation consultant gave me tips on good positions in which to hold her comfortably, how to make sure enough of my breast was in her mouth to stimulate the milk let down reflex, and how to best help my daughter to be able to breathe while nursing.

Be present for all tests and ask questions about the results: There are a million and one tests done to make sure that your preemie is progressing and developing. As much as possible, BE PRESENT WHILE ALL OF THEM ARE ADMINISTERED!! There were a couple that they tried to tell me that I had to leave the room to have done. I refused. You have the right to refuse and be with your baby provided it poses no health risk to her or compromises the test. Speak up! And be sure to get full reports on all the tests and ask questions of the neonatologists when they do their rounds and present the test results to you.

Be patient: All babies go home. Some, like my daughter only spend a few days in the NICU. Other babies spend weeks to months. Whatever the duration of your baby’s hospital stay, know that they are getting the best possible care. And know that each day that they stay in the NICU is further preparing them to be home with you. One of the worst things that can happen is to get your baby home and for them to have some sort of complication that causes you to rush them back to the hospital. Be patient, allow the NICU staff to do what they do, and with time and grace, your little one will be home to stay!

Mamas on Bedrest: Why I’m so thankful I had my 2 high risk pregnancies

November 24th, 2014

Happy Thanksgiving Mamas!

Thanksgiving is upon us and Christmas, Hanukkah, Kwanzaa are not far behind!

I know that many of you will spend these holidays on bed rest and that is a bummer to say the least. I wasn’t on bed rest during the holidays with either of my pregnancies, but was on restricted activity with my son so I do have a bit of an idea of what you are going through.

For me, the more major complications came when I was delivering, especially with my daughter. For those of you who know my story, you know that I bled heavily after I delivered my daughter. (They didn’t write hemorrhage in my chart as technically I didn’t bleed enough to have hemorrhaged. Go figure!) After my daughter was delivered via emergency c-section at 36 weeks and 6 days, she was whisked away to the nursery because she was having trouble breathing and had fluid on her lungs. Meanwhile my uterus was atonic. It wasn’t contracting and was sluggish and spewing blood like a punctured water balloon. Once my daughter was delivered, all hell broke loose in the delivery suite! Staff members started walking briskly hither and yon and there was a steady clang as new instruments were dumped onto the operating tray from their sterile packages. The former chatter that had been going on as my daughter was being delivered ceased. The room became eerily silent and from over the blue veil, I could see the very intent and focused eyes of my doctor as she contemplated what she needed to do and gave orders.

For a while, things didn’t go very well. Every time she tried to stitch up my uterus, blood shot upward like Old Faithful Geyser. As I laid there, I thought, “I can’t believe that after all I went through to have this baby, I may not make it to raise her.”  I had had surgery to remove uterine fibroids prior to becoming pregnant with my daughter because I had had a miscarriage and they thought that the fibroids were the cause. I had taken progesterone prior to that surgery and had blown up like a ballon. But the surgery went well and I was pregnant 3 weeks later.  However, by 6 weeks of pregnancy, I was sick as a dog and could not hold down a thing so I stopped eating. As time went on, I was able to eat about 10 things; applesauce, ginger ale, hot dogs, oatmeal, apples…but as late as 32 weeks, I had only gained 10 lbs. I felt sick the entire 9 months and didn’t get relief until the day after my daughter was born.

The intense nausea wasn’t the only problem. At about 14 weeks, I began spotting. Panic set in as I feared the worse-I was losing another baby. My OB did a thorough check and we never did find out why I was spotting, but it eventually stopped. At about 20 weeks, I started having cramping. I told my OB who said they were Braxton Hicks. This being my first pregnancy, I trusted what she said and kept going. But she did begin to mention bed rest and I knew that this wasn’t a good sign. I talked this over with my then husband who was traveling internationally for work. I also alerted my mother and mother in law to see if they could fly in to help me out. But at subsequent office visits my daugther was quiet so we held off on bed rest (Despite the fact that she seemed to be always looking for the exit!!) I was forbidden from traveling outside of Austin at 28 weeks and just kind of laid around after that. I went into active labor at 36 week 6 days and my daugther was coming fast so I was admitted and she was delivered.

Things went much better for my daughter and I once she was on the outside. I got pregnant 2 years later and lost that pregnancy at 9 weeks. Devastation. I really wanted another baby, but I was 39 and both my OB and husband were thinking I had better quit while I was ahead! After grieving the loss of this pregnancy for 9 months, I made a pact with my husband that whatever was in progress when I turned 4o we’d go with it. And if I was pregnant and lost that child, We’d stop. Well, my son was born healthy and hefty at 7lbs 2 oz at 39 weeks via c-section. I was 40 years and 4 months old when I gave birth to him! While his pregnancy and delivery were much less complicated, I most certainly did not bounce back after having him. In fact, I still felt pretty crappy 3 years after I had him! After checking blood work, physical exams and saliva tests, I was diagnosed with hypothyroidism-finally. Once my thyroid hormone was replaced, I felt much better. I never really returned to my pre-pregnancy state and have been since diagnosed with perimenopause. I have since settled into this “new normal”.

So why am I telling you all of this? Because these pregnancies changed me. They changed my outlook on life as a clinician and as a woman. I was a physician assistant prior to getting married and having babies and my entire demeanor had been detatched and matter of fact. It’s how I had been trained. “Don’t get too emotionally attached to your patients,” I was told by attending physician after attending physician at Duke University Medical Center where I did my PA training. Oh how this changed as I lay on the table, watching my own blood spew upwards! I had been trained to use words and phrases like, “You’ll experience some discomfort after the c-section.” Discomfort my a–! I was in major pain! And as for “being a bit emotional” from the hormones-I was a raging BITCH! I vaccerated between fear and panic and intense melancholy. Looking back, I probably had antepartum depression with my daughter and I definitely had post partum depression after I miscarried between pregnancies. Neither was diagnosed and quite frankly, no one ever asked me how I was doing emotionally. Looking back I am amazed that I came through those years as “sane” as I am (sic). But after each pregnancy, I vowed that no other woman would have to go through what I was going through-and at the very least, she wouldn’t have to do it alone as I did.

I am thankful for my pregnancy experiences. I don’t know if I would have been as thankful a mom if I had breezed through pregnancy. I was on a mission to “get it done”, and pregnancy and childbearing are so much more that checking something off a “to do” list. Arrogantly, I had seen women labor and struggle through pregnancy and often thought, “Geez, she’s making such a big deal out of something so natural!” Oh Yeah, the arrogance of ignorance!!! It’s so easy to be caviler when you’re not the one on the table doing the work! And it’s because I did lay on the table and truly believed that I would die without holding my daughter that I feel so deeply for you all. They tell us not to feel in our medical training, but I just can’t imagine how clinicians are expected to care otherwise? You have to feel to care.

This Thanksgiving, you may not feel so thankful for being on bed rest and that’s okay. But one day down the road, you’ll be able to look back and see the blessing in this time. For me, it’s Mamas on Bedrest & Beyond. I never would have started this service had I not so wanted it for myself when I was “going through”. I am so thankful for all of you mamas who stop by and allow me the great honor of being a little bitty part of your lives in one of the most important times in your lives. I stand with you and I stand for you and I am here because I was once where you are now. Happy Thanksgiving and may you all be richly blessed!

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Mamas on Bedrest: Do You Know The Signs and Symptoms of Preterm Labor?

November 10th, 2014

March of Dimes Promo ImageMarch of Dimes Promo ImageHello Mamas!

November is Prematurity Awareness Month. Spearheaded by the March of Dimes, perinatal organizations nationally and globally are sponsoring educational events and presentations to raise awareness of the issue of preterm labor and premature birth. As an industrialized nation, the United States fares poorly on the global scene when it comes to preterm births, earning a C grade on the global stage. This is one of  the worst grades amongst industrialized nations. According to the March of Dimes, there are 450,000 babies born too soon annually in the United States. That is 1 out of every 9 babies!

There is much being done to reduce the number of babies being born too soon. American obstetricians and hospitals have revised their protocols so that there are fewer preterm labor inductions and fewer unnecessary cesarean sections. However, the large number of infants born prior to 39 weeks persists.

African American women have the highest rates of preterm labor and premature births in the US, ranging anywhere from 2-4 times the rate of preterm labor and preamature birth in white women. Researchers and public health officials are implementing some very targeted perinatal health care programs to address the disparities in access to care, affordability of care and the quality of care provided, especially as it pertains to lower income women who are on government subsidized health care plans . Two non-government organizations with whom  Mamas on Bedrest & Beyond is partnered with are The Birthing Project USA and The National Perinatal Task Force. The Birthing Project pairs African American support volunteers “Sister Friends” with pregnant mamas to help them navigate the health care system, gain access to resources and to be a support and birth attendant if necessary. The success of this program comes from the fact that the less experienced mama has a direct resource to ask questions,  seek assistance and who is often (but not required to be) present when mama delivers her baby. The National Perinatal Task Force is a group of perinatal health care workers who are dedicated to improving birth outcomes in African American Women and babies by being a very visible presence in the African American Community and providing information, resource referrals and support to mamas in need. Both programs provide African American women culturally sensitive care and support that has translated to improved birth outcomes.

The important key to reducing the rates of preterm labor and premature births is education. If you ask a cross section of pregnant women what are the signs and symptoms of preterm labor, many don’t know. This alone may account for many premature births. A woman experiencing intermittent contractions that are not particularly strong, or if she has an above average pain threshold, she may not recognize that she is in preterm labor. Other non specific symptoms such as diarrhea or back pain may be misconstrued as gastrointestinal upset or simply a normal ache from pregnancy respectively. Since it is imperative to be able to recognize the signs and symptoms of preterm labor and to seek medical attention immediately (as preterm labor immediately addressed can often be stopped!), here are the most common signs and symptoms of preterm labor. Please make a note of these symptoms and contact your health care provider IMMEDIATELY if you are or have recently experienced any of these symptoms.

  • Contractions (your belly tightens like a fist) every 10 minutes or more often
  • Change in vaginal discharge (leaking fluid or bleeding from your vagina)
  • Pelvic pressure—the feeling that your baby is pushing down
  • Low, dull backache
  • Cramps that feel like your period
  • Belly cramps with or without diarrhea

Again, the March of Dimes has educational events taking place all this month throughout the United States. Check the March of Dimes Website for state chapter information as well as the calendar of events in your area.

Have other questions? Schedule a Complimentary 30 Minute Bedrest Breakthrough Session to find the solution! Schedule yours today!