Taking the leap..

A lot of people have asked me how we decided to take the leap into parenthood again after having a micro preemie (born at 23.3 weeks), especially since we did not know the actual cause for Lakai’s preterm birth. There was a lot of speculation and theories: infection, premature rupture of my membranes, preterm labour. All pretty vague, all did however happen again except the infection (I was induced to prevent this). But which was the cause? It turns out it was a few things and one not suspected…an incompetent cervix, with PPROM and preterm labour.

The truth is, Marlow was a wonderful surprise. That being said, we did talk about having another baby before she made herself known. We (mostly me) spent a lot of time weighing the possibilities; I did a lot of “what if” scenarios, and did my research. I knew the stats and risk, and felt like it was something I was personally prepared to deal with. That risk being having another premature baby, except I had convinced myself the next baby would not be nearly as premature. I armed myself with the facts and presented them to my very wary husband (this was long before Marlow was even a little bean in my belly). He was not nearly as convinced as I was; a lot of his concerns were valid. They were not even all regarding having another preemie, some were just concerns any sole provider for their family would worry about.

We shelved it for a long time, and then boom, there was a baby on the way. Panic! Can we do this? Well we had too, there wasn’t any other choice. Not every one shared my conviction that every thing would work out for the best. Some people actually questioned us even having the baby, stating it might be unfair to Lakai should the baby be born early, he would not understand my sudden disappearance. I worried about that as well, but I had faith Kyle would more than make up for my absence, should that happen. I knew Lakai would be ok. And he was, he is.

Bed rest was not easy for either of us, but in a lot of ways bed rest made me a better parent. It forced me to get creative, I scoured websites looking for innovative ways to entertain, teach and engage Lakai. I think I would have reached these ideas and activities at some point in my parenting journey, bed rest just forced me to get there much sooner.

Our pregnancy with Marlow was very tough; I spent most of it on the edge, walking on egg shells. I didn’t enjoy it as much as I enjoyed the little amount of pregnancy I had with Lakai. It was hard to sit back and relax, when every pain or ache felt like it could be the end. Seriously, it was not fun. It was 100% worth every single wrinkle and worry I had over every little hiccup she had (seriously those worried me, as I never got to that stage with Lakai where I could feel them!).

In my 22 weeks on strict bed rest, we are talking only allowed on my feet for 10 minutes at a time, every 2-3 hours, no lifting, no walking up stairs or hills, no baths, no anything, no fun. I thought of what I would pass on to another preemie parent about to go down the road into a second pregnancy…….

Here’s what I came up with………

Before you plan to get pregnant (if you are able to do so) interview potential doctors and specialists, don’t settle on the first one you are referred to. Hit the forums, go online, search and find the doctor who best fits what you are looking for, what ever that is. I cannot tell you what to look for; I think that is something only the parents can know. But here is what I would look for:

1. What gestational age does the doctor consider “viable” (awful word isn’t it?)?
2. When does the doctor give steroids (to the mom if labour is threatened or not)?
3. What sort of preventative care will they give you?
4. Have they dealt with high risk preterm pregnancy and women before?
5. What doctor (neonatal or ped) do they prefer to work with? Or would they ask to work with if your baby was born prematurely? (This does happen, it’s your right to ask and be answered).
6. What are their policies on c-sections and natural births, at what point would they push for a section (I say this because a lot of dr’s want to section all preemies, but this is something you as a parent need to research and find if this is best for you and your baby).
7. What hospital(s) do they work with? (This is important because not all dr’s can go to whatever hospital, so if your baby needs to be transferred to a higher or lower level NICU (hopefully they won’t need the NICU period) would your dr be able to deliver there or would you be in the care of a strange dr. I say this because if it was me, I would prefer to make contact with a dr at the hospital where your doctor does not work. I made contact with the NICU/hospital where Lakai was born, before I was 32 weeks. I wanted to know the dr’s and for them to know us and our situation).
8. Do they have access to programs that allow to have in-home care (nurses usually, that is what we had with Marlow’s pregnancy. They came weekly and daily sometimes to check on us)?
9. How would they prevent or stop preterm labour?
10.  How would they treat PPROM or PROM?
11.  What meds would they use for the above?

Right now that’s all I can think of, there is certainly more questions you need to ask. And please do not be afraid to ask them, this is your pregnancy and your child, it’s your right to know and be properly informed. If the doctor will not answer these questions, the correct reply would be “next”. =)

Before getting pregnant, really sit down and think about what being pregnant would mean and look like for you, your family and your current child or children. This means….

What would happen if you were put on bed rest? Think about each level of bed rest, because each means very different things for you and your family. On light bed rest you could likely manage almost every thing alone, on moderate you would need some help and on strict, you are one with your bed or couch…you need an army of help. You need a game plan, how would this plan look for your family? Do you have a person or people to help you if you are on bed rest?

What would happen if your baby was born prematurely and needed to be in the NICU? Think about who would take care of your kids, who would take care of your house and so on? You need to iron out the details before hand.

You need to think about if you can emotionally handle another NICU journey (unless you are sure it would not happen again of course), could your partner? You need to think about if financially you can handle it, yes I went there…to the ugly topic we hate to talk about..money. But the thing is, it needs to be talked about. Because if you were thrust into a position of loosing your home if you had another long NICU stay, then you need a plan of action to prevent that…BEFORE hand.

You need to decide if your current child or children are in a place where having a sibling would not drastically affect their lives. Now I get having a new sibling is tough on most kids, I am talking more about kids (your preemie) that might have health issues or special care needs that need special attention and time from you and your family. If their lives will be negatively impacted by the birth of a sibling, especially another preemie one, you must first decide what would happen to prevent and make the transition as smooth as possible.

(I am not saying don’t have another baby)

I think you need to think about if you are prepared to have another premature baby, who has more or similar care needs to your current preemie. I personally struggled with ‘what if the baby has more complications than Lakai and what if they drastically alter our current family situation’. I struggled with this because I was unsure if I could pull it off, could I as a mom have two kids with complicated health issues and needs? I knew I could.

I think you need to think about how you will handle the reactions from those around you, your family and friends. Will you be ok if they for some insane reason chose to not support your choice to have another baby? Who will you turn to instead? I say this because I have heard a lot of second time preemie parents confess their families and friends turn their backs on them when they decided to get pregnant again, or worse when the second baby was born prematurely.

I suggest reading all you can on any conditions or any of the possible reasons you might know caused your first premature delivery. Educate yourself, arm yourself with every thing you can. And use it!

Go online and ask other preemie parents who took the leap again what helped them. What made them chose to take that leap again.

Breathe.

Thinking about having another baby period, is scary. Facing the possibility of a second premature baby is utterly terrifying. But it can be done, it might not play out how you hoped, but trust me you will get through it. You have gone through the most impossible situation once already and not to say you can easily do it again, it’s not easy at all. However, you are that much more prepared the second time around. Small things do not bother you as much as they once did; you can navigate the NICU roller coaster a lot easier when you know the up’s and down’s already.