The night it happened, I awoke in sudden pain. I instinctively grasped for the opposite side of the bed, but my husband, Chris, was gone. I remembered in a diminishing fog that he was working nights—not his favorite part of being a resident doctor. I rubbed my belly, which was swollen in pregnancy, and thought, “It’s just a bad stomachache. It’ll get better by morning.”
But I awoke periodically throughout the rest of the night. When my husband finally pushed through our bedroom door, I kissed him good morning and waddled to our bathroom.
Then I saw blood in the toilet.
In that moment I remembered our first loss: a miscarriage at 10 weeks. For days I had curled into a ball and sobbed into the baby clothes our parents had bought us.
But our second son was full term, and I clung to this knowledge like a lifeline. Perhaps I was having another cervical bleed. I’d had one before. It could be nothing.
Just in case
I called to my husband, but when he saw the blood, he did not look reassured. When he asked how I was feeling, I told him I’d been having indigestion.
Chris gave me a long look—one I knew meant he was flipping through his arsenal of medical knowledge. “How long has it lasted?” he asked.
I thought for a moment. “I guess since yesterday evening.”
He paled. He said that I might be in labor. He stalked off to call my doctor, and I laughed at his back, telling him that he was silly, that no one gives birth at 27 weeks. I’d never spoken to anyone who delivered three months early, never read a single article and never seen it on TV! I hadn’t even made it to my glucose screen, not to mention the third trimester. No. He was wrong. It couldn’t be labor.
But I wasn’t surprised when my doctor told me to come in because doctors are always cautious. Much to my husband’s chagrin, I showered, packed an overnight bag and dressed our son Nolan. Chris kept telling me to hurry. But I insisted that even though I was only having a stomachache, they might keep me overnight, so I was coming prepared.
A gut feeling
The drive to the hospital was long and awkward. I kept reassuring Chris that nothing was happening, but he kept shaking his head adamantly. He said that he knew better, that this happens all the time. But I told him surely I could tell the difference between labor and a stomachache. He reminded me that I have a high tolerance for pain—and that I might be in denial.
“Denial?” I laughed. “Hardly! Please. Nothing’s happening. It’s a cervical bleed. We’re going to be fine.” I patted his hand reassuringly, not liking that his skin had gone cold.
While all this was happening, my father—a surgeon—was waiting at a distant airport to catch his flight to Ohio, so he could spend a relaxing weekend with us. I texted him, letting him know that I was bleeding and we were on our way to be checked out. Dad didn’t seem worried. And neither was I. At least not yet.
We arrived at the hospital, and I was examined. I had a brief heart palpitation when they told me that I was contracting and that I was dilated to 1 centimeter. But I swallowed my sudden fear, remembering that my sister had gone into preterm labor, and medicine had stopped it. That was in 1999. Here we were in 2012. I was going to be fine.
I was hooked up to an IV magnesium drip and sent to a high-risk OB/GYN. She determined that, despite my pain and an increased dilation to 2 centimeters, I only had a 5 percent chance of delivering before 36 weeks. We all breathed a collective sigh of relief, and then everyone was sent home. Chris left me with a kiss, looking impossibly tired (but relieved). I waved goodbye to him, my father and my firstborn son.
Afterwards, my friend and Chris’s co-resident, Meghan, came to visit. I remember laughing with her at the absurdity of it all.
“See?” she assured me. “Nothing’s going to happen. They’ll fix you up and you’ll be home before you know it.”
I nodded then winced because—dang it!—the pain was returning, and in full force. When the nurse came to check my cervix, I held Meghan’s hand. We waited, making small talk.
The nurse stood up and her glove was covered in blood. Her face was stricken. And I knew. I knew then with a certainty that comes to me very rarely.
Stop at nothing
I swallowed and was barely able to speak. “How—how dilated am I? Still at a 2?”
She didn’t look at me. “You’re at a 4. In 30 minutes.” She glanced at the door and told me that she needed to get the doctor—and that things were going to happen very fast.
“Are they going to do a C-section?” I asked, feeling disembodied. I needed her to tell me no, that all I needed was more magnesium, or a different medication, or maybe even a hypnotist—something that didn’t require a knife coming at me and my baby being stripped away.
But I knew what she was going to say because the echo of my last OB/GYN’s voice was suddenly ringing in my ears: “You’re one of those women who, when she dilates, nothing can stop it. You’re one of those who could birth in a car on the way to the hospital, before anyone knows what happened … ”
“Yes. I’m sorry,” the nurse said to me. “I’m, I’m really sorry.” And then she was gone.
Meghan looked down at me. We were still holding hands. I looked back at her. And then I started to cry.
“Don’t,” she warned, looking about desperately. “Don’t cry. If you start crying, then I’ll start crying, and then … ”
And then we were both crying.
No time to lose
What happened next happened very quickly. Chris and my father drove back to us white-knuckled. Going against the high-risk OB/GYN’s prognosis, my doctor determined that my placenta had ruptured, which was causing massive internal bleeding and sudden onset labor. We had to act now to save me and my baby.
I was wheeled into the first available OR, which quickly filled with so many medical personal that all I saw was a sea of blue scrubs. Two OB/GYNs scrubbed in swiftly, with my doctor barking orders at everyone, when an anesthesiologist told me that he needed to put in a spinal. I bent over, hugged my knees and focused hard. I hardly felt the pain of the needle because I was so focused on my contractions and reining my fear. Chris and my father appeared, both grim above their surgical masks, and took stations on either side of my shoulders.
But we didn’t have time for the medicine to take full effect. The contractions grew worse, now less than a minute apart, and my doctor said, “Hold onto something, Katherine. This is going to hurt.”
Just a glimpse
What came next was like a giant paper cut across my abdomen. I gripped Chris’ and my father’s hands, telling myself to breathe and be still because—dear God!—if I moved even a inch, they might accidentally kill my baby.
I remember getting sick twice, and then my doctor telling me that our baby was almost there. And then, in a flash, he held our son in the air for the briefest of moments. My heart caught in my throat, and I thought I was going to be sick again. Because what he held in his bloodied hands was a baby far too little to be born, a baby who wasn’t crying, who wasn’t even breathing. And I felt hot tears track down the sides of my face as my first glimpse of Aidan burned behind my eyelids, and they took him away to be intubated.
They let me touch him once before they took him to a nearby children’s hospital. At 990 grams or 2.2 pounds, he was too small to be cared for there. I touched his small body through a cocoon of plastic, whispered that I loved him, told him goodbye and then watched the incubator being jogged down the hallway by three nurses and a police officer to an awaiting ambulance.
That night was my first away from my oldest son, who stayed home with my husband while my father slept on the foldout beside my hospital bed.
Laying in the darkness, with the monitors beeping around me, I felt my tender abdomen, swollen and throbbing, and knew that the life I’d created was gone from inside me.
I lay awake in the darkness and prayed that it had all been a terrible nightmare, and that by morning I would awake at home with my belly perfect and enormous, with Aidan dreaming inside me.
But of course it wasn’t a dream. I woke only two hours later to a nurse wheeling in a hospital-grade breast pump, telling me that they needed my colostrum. As she helped me grapple with getting the various attachments to my chest, I realized that what was happening was very real, and I needed to summon every ounce of courage and determination I had.
Welcome to the NICU
Because they wouldn’t let me visit Aidan until I was discharged, I faked my way out of the hospital after only 40 hours. I found a strength I didn’t know existed, so that I could touch my son again.
I clutched my sutured belly while they wheeled me down a long stretch of corridor that I grew to know very well over the next 70 days. I remember that first time vividly: how I was told to scrub to my elbows as if going into surgery, the stench of the disinfectants, the vacuum-pop in my ears when first stepping into the NICU, signing in as if checking into a prison, the endless stations of sick babies and thinking that every moment felt so surreal.
There were dozens of incubators surrounded by colorful bulletin boards. Some families—mostly long-term ones—had created something close to a nursery with preemie clothes strung onto miniature clothes racks, overflowing pictures and charted milestones. There were plush animals and toys waiting to be played with. I thought to myself, “This will not be us.” Aidan’s bedroom was at home, not in this sterilized hospital.
Back to reality
But after 70 days, that was us. We became those people. We made the space around his isolette as close to a nursery as physically possible, thinking that the photographs of our smiling faces and the stuffed ducks and puppies—even the clothes—might bring our baby some comfort. Or perhaps it brought us comfort.
Aidan was three days old before I could hold him. I remember him being so fragile, like a baby bird. I had fantasies of sneaking him out in my purse or stuffing him between my breasts and flying out of there. Freedom!
Then reality would set in, and after my time was up, I’d kiss him goodbye, lay him down onto his starched bed sheets, close the door to his isolette, peek in a final time and then finally turn away. I’d take those long first steps until I made it to the station to sign myself out, then pushed out the door, down the hall and—depending on the day—into the freezing/too-bright/rain-soaked parking lot, where I tried to dislodge the rock that was wedged into my heart.
Those 70 days were some of the hardest of our life. Chris and I made it through by leaning on each other, by loving each other, loving our children, and by the support of our parents, family, and friends. Because we could only manage one visit per day to the NICU, we needed as many images as possible of our second son, who slept in an isolette 30 miles from our embrace. I took thousands of pictures. I made video montages. And they did help.
Pumping with purpose
Due to his traumatic delivery, Aidan was born with a broken clavicle and had to be intubated for several days. Over the next few months he endured multiple blood transfusions, eye infections, staph infections, retinopathy in both eyes, a burned leg caused by an IV infiltrate and—most worrisome—stage-2 and 4 brain bleeds, heart valve surgery and sepsis.
Because I couldn’t control Aidan’s catastrophic medical issues, I focused on pumping breast milk for him. I knew that breast milk, especially for extremely premature babies, is fundamental in development. But because I’d birthed him so early, I feared I would dry up either during his NICU stay or after he was discharged. Although I’d successfully nursed his brother until 17 months, I read (and in some cases, re-read) every book I could find on the subject. I spoke to every available lactation consultant. I pumped. I pumped. And I pumped.
In the end I would overtake two of the NICU center’s three refrigerators, both of ours at home, as well as the deep freezer that we were forced to purchase. Over the next 15 months, I pumped 51 gallons of milk (or 6,577 ounces) for a staggering total of 1,461 pump sessions. Because of my oversupply (enough to feed triplets at over 60 ounces a day), I went through the rigors of becoming a breast milk donor. I eventually donated over 15 pasteurized gallons of milk to the national NICU milk bank—all in addition to nursing Aidan for almost 15 months.
To have and to hold
Throughout everything, Chris and I (usually) managed to suppress our grief. Our marriage grew stronger because of how much we had to hold it together, for ourselves and for our children. When I held Aidan to my chest and nursed him from my breasts, I hoped only good things would come to him. That he would have a good life.
Aidan reached his original due date at home. I was able to cuddle him, kiss him, nurse him and hold him. No scrubbing to my elbows in a stainless steel basin, no signing into a log, no opening a porthole in a plastic incubator to touch him hesitantly with the tips of my fingers. The difference was staggering.
But our future wasn’t all roses and sunsets. After Aidan’s hospital stay, our family faced all sorts of challenges: There was an overwhelming amount of doctors appointments to coordinate, intensive at-home therapies, a labyrinthine-like insurance policy, an onslaught of bills, as well as the added stress of breastfeeding/pumping/bottle-feeding a preemie.
But we made it through.
My son is now two years old. He recently graduated from all seven of his therapies, the hardest being physical. There were weeks when I dragged my sons to four different medical appointments and spent hours working on developmental milestones that come so effortlessly to other children.
Now we see Aidan’s doctors every three to six months. Our weekly therapy sessions are over. Instead of a Therapy Mommy, I can now simply be a Mommy—and there is a world of difference between the two.
When I look at my second son, I know that every bit of it—from every struggle to every triumph—was worth it.
Our Amazing Aidan, who was born at two pounds and now swaggers around the house at more than 30, who tests off the charts in his verbal skills, who looks up at me and says, “¡Hola, Mommy! I see my mommy!”—my son who brings joy to my heart, taught me in those darkest moments the true meaning of resilience, and strength, and depthless bravery.
Katherine Tirado-Ryen (katherinetiradoryen.com) is the author of three novels, including Forgetting Me. She lives in Ohio with her husband and three children, and is currently working on her next book.
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