Monday, November 25, 2013

Premature Awareness Month: Life after a Preemie, the Second Pregnancy?

November is premature birth awareness month, and many of the activities were held last week.  I still wanted to help spread some more awareness of what life is like after a premature birth.  One area that I find often on support boards, and in conversations with other people is should you have another child after you have a preemie?  I think beyond the trauma of the event, and the health needs of your preemie this is the issue that strikes a cord with  a lot premature parents.

"Do we risk it all to have another child?"  "Could we do this all over again?"  "What are the chances?"
And the questions and fears go on and on.  I hope to give a little advice on things that I found to be helpful during my second pregnancy.  This is not an all inclusive list, and as with everything in my blog I am not an expert.  I try to spread a few tid-bits that might help you along.  Discussing specifics of your pregnancies and risks are really something to be done with a doctor.

I am a planner, an organizer and I will admit that the word 'anal' has even been used to describe me.  So of course a to-do list for a second pregnancy makes total sense to me.

Step 1:  Gather information.
I recommend that you call and get all your medical records from the hospital and your obgyn office.  This may feel awkward and you may even feel embarrassed.  Don't they are YOUR medical records.  It is the law that these are made available to you, within a reasonable amount of time.  It might take a phone call or few, and some time.  You might have to pick them up or have them mailed.  I still think this is important.  I read mine, and because I have a medical background I understood them.  More importantly I took them to other doctors with me.

I had my first child 300 miles from home, on vacation.  My NICU team, and maternal fetal specialist were not going to be part of my second pregnancy.  So, I met with multiple doctors PRIOR to getting pregnant getting their opinions on my case and the 'what ifs' of my possible next pregnancy.  For the doctors to give you answers about your pregnancy they need to look at your previous medical records.

I interviewed about four different doctors for my second pregnancy.  I ended up using my original obgyn, with phone consultations with a high risk maternal specialist.  I basically set up appointments that involved us talking, I asked questions they gave me answers.  One doctor actually asked me if I considered adoption because she thought that would be a better option for me.  Obviously, the other three doctors I talked to did not share that view and I left her office upset but glad I had talked with other doctors prior.

I wanted to know what my risks were for having another premature child.  They were high.  Factors that impact this were explained to me, in the that the more premature you have a child (i.e. how early where they delivered) the more likely you are to have another premature child.  Also, why did you have a premature birth?  This question is not always easily answered and in some cases not at all.  Unfortunately sometimes it occurs quickly, without warning and no outward symptoms.  Based on my case, there was suspicion that my cervix was dynamic or incompetent.  Making me at high  risk for future complications.

I wanted to know how they would manage my pregnancy.  What would be my treatment plan, and the logistics of that plan.  Could I have these test locally, or would I have to travel to another hospital.  A year prior to getting pregnant with our second child I had a rough outline of what would need to happen in my next pregnancy.  My plan changed a bit during the pregnancy, but even the bed rest, emergency cerclage and  minor hospital stay weren't not completely unexpected because we had discussed them before they happened (years before).

Step 2:  Gather support.
Once, I had talked with doctors about my concerns and our risks.  I then needed to sit down with my husband and decide if this was something we could do.  And I really do mean "WE".  I know that during pregnancy it is often very mother focused, but I think that with a high risk pregnancy you really need to make sure that the whole family is on the same page.

I suggest that you might get some counseling as well, prior to getting pregnant.  Alone and maybe as a couple.  Again talking about your fears and possible outcomes, is important and once you are pregnant and the hormones and stress are occurring well, conversations get all the more difficult.

We kept this a private matter, and I did not tell people outside the family much.  I am the type that would have liked to keep my entire pregnancy to myself if I could have but unfortunately I couldn't.  I still wanted this second child to be our families decision and didn't really want the added pressure from other people.  That being said, you may find a great amount of support and strength from outside you family.

We also had to get our finances organized.  I got disability insurance (STRONGLY encourage), as it was highly likely that I would have bed rest.  Having a preemie, can be very expensive.  The medical bills, and follow up bills and services combined with a cut in your ability to work can really add to the stress.  Saving for a second baby is always a good idea, and if there is a good chance that you will have another preemie I think  it is essential.

Step 3:  Jump into the deep end, and don't be surprised when you panic!
We were discussing a second child during my hospitalization with our first daughter.  When deciding different medical options for my treatment, I would always ask what impact it would have on future pregnancies.  Then I spent the next two years of my preemies life talking with people and planning for the next pregnancy.  My poor husband had more conversations with me, then he probably ever wanted to determine when we would have another child, and listening to all my 'what if' fears.

At some point it was time to jump. Stop talking and start living.  It was time to move forward and do what we had planned. Luckily for us, getting pregnant is not a problem at all and so I couldn't over analyze or plan that portion out too much.

I do think you need to realize though that you will panic during your pregnancy.  You will have some real scares, even if your pregnancy goes great.  I just don't think there is anyway around it.  And the closer you get to when you had complications or your had your first child, well that is when the really blank will hit the fan.  I mean I know there are a few people out there that are able to just cruise through and put all their fears aside, but I really don't think that is how most people feel.

Being pregnant is such a unique period of time.  The feelings of how your body changes, how the baby feels kicking, and unfortunately for those of us with preterm labor issues the way that everything feels like a contraction.  During a second pregnancy, it is like being on hyper alert  all the time.  It is exhausting for everyone.  My doctor retired after my pregnancy (seriously, my second daughter was one of the last babies he delivered), and I am sure he was thrilled when I wasn't either in his office or on the phone anymore.

I actually gave up sleeping from about 23 weeks until 34 weeks during my pregnancy.  Which is really interesting when you are on bedrest, and not something I recommend.  I had contractions constantly at times, but became a master at taking my medications, laying down, talking to the nurses, and talking myself off the cliff of full panic. I had a countdown sheet that I crossed off every day that I was pregnant.

Step 4:  ENJOY!
All the issues aside, you do want to enjoy your life and your decisions.  And maybe you don't find any of the second pregnancy enjoyable. Maybe even you decide that you can not go through having another child, or despite all your planning that pregnancy won't come.  At some point you have to let a breath out and gather your family close and smile.  Having a premature child, and a high risk pregnancy(ies), has taught me more about myself than really any other life event.  I learned that I was able to survive and do more than I ever though tpossible.  I earned each of my children through a lot of work and tears, and I do not take them for granted.   And at the end of day, I am happy that I did dare to take the plunge
  My most pregnant picture with my first daughter, taken at 22 +weeks, I was hospitalized later that week.
.My most pregnant picture with my second daughter, taken a day before my due date.  17 weeks of bedrest.
                                   One born at 1 lb 14 oz, the other at 7 lbs 7 oz.   Worth it all.

Previous Premature Awareness Posts

I am a few days late, but all of Novemember is Prematurity Awareness month.  I just wanted to highlight the post from the past few years that I have done to help promote awareness.

Remembering those we left behind.

What to do for a parent of a preemie

Symptoms of Premature Labor

 I also wanted to share this beautiful video I watched recently during this month of awareness.  I found it so beautiful and such a good example of the having a preemie.  I could barely watch the first parts, and which reminds me that even though I have come so far certain images can take you back in a second.

And then the next post will be my addition for this year...

Having another baby after a Preemie!

Monday, November 11, 2013

Whose to blame for a premature birth?

Almost every week I run a six to seven mile loop around a lake in the woods.  It is one of my most favorite places in the world.  I rarely meet up with anyone else, and it close enough that I can get there all year round.  I have run it in snow, rain and sun.  I have been doing this weekly run for about seven years.  I ran it every week of my first pregnancy, until week 23 when I went into preterm labor.

And that is where the pause is.  I ran it every week of my first pregnancy.  I ran it in the snow, I ran it in the rain, and I ran it completely pregnant.  I remember running down a fairly steep hill, with a hand on my small belly and my other hand with my dogs leashes.  My little growing baby would kick, and I would say to myself we are having a fun little run Kate (I had her name picked out from the moment I knew she was girl). I was hoping to run around that lake every week until at least the third trimester.

I didn't blame many people for the having a premature baby.  Really I didn't blame anyone except one person.  I had some slightly angry feelings at the nurse I talked to about the strange feeling I had earlier in the week, and again when I talked to somebody about changes in discharge.   I was generous with everybody though, and realized that they didn't have all the information and they did the best they could.  No, I let everyone else off the hook.  I was the only person I blamed.

I blamed myself for every aspect of it.  My body had failed me.  My mind and decisions had been poor.  I had not said the right description on the phone.  I had worked too hard during my pregnancy.  I didn't ask the right questions or read the right books prior to my pregnancy.  These and countless other thoughts are what I have and had thought for the last four years.

Funny the stories we tell ourselves.  And how we believe them.  I have quieted the blame voice in my mind a lot in the last year.  Honestly I thought that I had made peace with myself over a lot of it.  Then I realized that once a week, I let the story replay over and over.  On my run.

There I was on my run, like I do every week.  I realized that every time I get to that steep hill, I don't smile and think of a nice little memory of my baby kicking as I run down it with my dogs.  I think, SHOULD I HAVE BEEN RUNNING?  DID I CAUSE PRETERM LABOR BECAUSE OF THIS DAMN WEEKLY RUN I LOVE?  I DID.  I DID. I DID.

Every week I have been turning part of a great pleasure into a way to blame myself.  I bend what could be a happy memory from my first pregnancy (which lets be honest there aren't a lot of happy memories there) into a way to villainize myself.

I have decided this story needs to stop.  I have to forgive myself.  I have to run my run  and say that it was okay maybe even great that I ran that run every week.  I have to remember that my daughter was born at 25 weeks, 1 lb 14 oz and was able to breath without a ventilator or surfactant.  She came out screaming.  She developed those strong lungs during my runs.  My daughter learned to fight on trail runs that her mother loves.

The stories we tell ourselves sometimes are all we have.  Often there isn't the answer to why something happens.  We get to fill in the answers. Like the choose your own adventure books, does she continue to beat herself up for the next forty years or does she decide to forgive herself for being human and move one.  Does she jump into the underwater cave or does she finish the laundry?  Everyday we are choosing how we live and replay the stories of  our lives.

The blame story isn't working well for me.  Takes me directly to the end of the book, and the books is depressingly over.  I want to decide to go in another way,  I think that most people would agree that even if you are to blame for a situation at some point in time you have to forgive yourself.  You have to accept that this is the journey you are one, and it is good place to be no matter how you got there.


Monday, November 4, 2013

Witches Tea Party

I think a secret to life is to adjust your dreams.  Not exactly a Hallmark card statement.   All the same you can sometimes adjust your dreams and be as happy if not happier than you ever imagined.  For example, I always wanted to have a child with a birthday near Halloween.  I thought having a Halloween Birthday themed party (every year) would be great, since I love Halloween and it could be a win win for everyone.

Of course my children were born in June and February, no where near Halloween.  I really tried with Kate, as she was due in late September.  But between a crazy ability to get pregnant quickly and have my babies even quicker there was no chance for my Halloween Birthday dream to happen.

It is a slightly silly dream in the world of aspirations.  All the same I wanted it to happen.
 Time to adjust the dream.  No Birthday Needed.  And we arrive at the 'Witches Tea Party'.  I invited a group of both big and little witches for fun games, finger foods and a tea party though at this age group it was more like a juice party.  Mimosa with witches fingers were available for the big witches.
 Kate and I had a lot of fun getting ready for the party.  Since it wasn't for one of the girls Birthdays it felt a little bit more relaxed for me, and I didn't have the whole 'fair' or will we do this for the other daughter stress hanging over my head.  I have lots of decorations from pre-kids life when my husband and I used to host an adult Halloween party.
 No party is complete, especially when little girls are coming without cupcakes.  In our house it is chocolate that is greatly appreciated, so no need to go Martha Stewart, we just whipped up some from a box with pre-made frosting.  Good friends don't notice or care when you cut corners to have fun.
It would have been easy to sit around and feel sorry for myself, that I would never have my Halloween Birthday bashes.  It really was even easier though  to adjust my dream, and come up with a fun way to have it all. Throwing a fun kid and adult party without a Birthday involved was really a great way to spend time with the girls and also enjoy a holiday I love.

Saturday, November 2, 2013


The cold, the dark, with wind and rain has officially showed up.  My favorite quote I heard today was from Kate, "Papa lets get cozy and cuddle on the couch together."  I couldn't help but smile on my way off to work, seeing my big husband coffee in hand with two itty bitty girls in pj's cuddled up on the love-seat together.

I am going to try and embrace the dark winter season this year.  I can't change it, so I am going to really try and embrace it.  Cozy, cuddle and all.  Don't remind me of this post in January