This is what a 30 weeker looks like

A few days after my admission to hospital, it began to sink in that my baby might be born any day. Or in a few weeks. Maybe a month. The prognosis was uncertain, consultants were vague but there was only one purpose of the two painful steroid injections I had received. My baby was being given the best possible chance to survive outside of my womb.

In my typical fashion of wanting to prepare as much as possible for every scenario, I googled ’30 week baby’ hoping to see a glimpse of what my baby could look like. I was scared. Would my baby be covered in hair? Would he be translucent? Focusing on his appearance was a distraction from dwelling on his precarious situation.

The Google results were fairly mixed. Lots of Bounty-type websites came up, telling me what exciting stage of my pregnancy I should be experiencing. There were photos of big bumps and smiling ladies next to 30-week milestone cards. And dotted throughout were photos of real-life preemies. The results were so variable. Some babies were in plastic bags, most had wires and some were wrapped up in little blankets. When I clicked through the results, it seemed that most babies were a few weeks earlier or later than my baby. I just wanted one page were I could see a real life story and outcomes.

So here is what my 30 week baby looked like. L was born at 30+6, weighing 2lbs 10oz. He was born via emergency c-section due to absent end diastolic flow and IUGR (I was in hospital for 5 days before hand).

He was placed in a plastic bag (which I never saw) and taken straight to NICU. He was on CPAP (a type of breathing support machine) from birth until he was a few days old. Apart from being tiny, he was fine. Perfectly formed. I still can’t quite believe it.

L’s eyes were not fused shut. He did not have hair on his tiny body and he was not translucent. He was nothing like I had imagined even after my Google search. He was jaundiced, which made him look very very red rather than yellow.

He could cry, urinate and poo like a normal baby. I have no idea if he followed the same ‘first poo’ cycle as a term baby as I didn’t see him for around 6 hours after his birth. Mainly because I was bedbound after my surgery. He did not feed for a few days and received total parental nutrition via a long-line in his foot.

On his first day of life, I couldn’t hold him but I helped changed his nappy. I stroked him through the incubator and he held my finger. When I eventually held him on day 3, his head easily fitted in the palm of my hand. I held him down my top (kangaroo care) – with his head on my chest, his body stopped before my belly button.

My 30 weeker was in hospital for over 40 days. At 8 months old, he has no known ongoing health issues. He is still small but he is perfectly healthy.

I hope someone afraid of their 30 weeker finds this post. And mums of fellow 30 weekers, please do add your experiences in the comments.

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Debrief me 

Like most parents of premature babies, I’ve been desperate for answers to my situation. I couldn’t comprehend how I had gone from heading into hospital for my third reduced movements scan (which I rationalised as my usual tendency to panic about everything) to suddenly being kept in hospital, learning that I couldn’t go home until my baby was born. At 7 months pregnant.

For the 5 days that I remained in hospital before L’s delivery, I constantly received different interpretations of my situation. In a matter of hours, doctors would fluctuate from deciding I would have a c-section within half an hour to discharging me as the baby had stabilised. It was, and remains, a difficult situation to get my head around. From what I could grasp, my baby was too small and was not getting nutrients from my placenta (a condition called absent end diastolic flow). There was nothing that I could have done. Google was my friend, the scant amount of references to absent edf that I could find reassured me that it wasn’t my fault. But my baby had been fine two weeks early at my 28 week scan. Surely I had done something to harm him.

So I sought answers. I have had three debriefs since L’s arrival five months ago, two of which happened while I was still on the postnatal ward. I suffered from extreme anxiety following my c-section (unsurprisingly) and the midwives arranged a debrief for me. Someone who seemed to be a senior midwife arrived in my room. I talked through my worries and mentioned how traumatised I was from the treatment I received the night before L’s delivery. But I wasn’t seeking to complain, I simply wanted answers. The midwife was extremely abrupt with me, spending our session defending the actions of the midwife in question and trivialising my behaviour on that night (where I could not tolerate an IV drip as I had an extreme reaction). She spent around 20 minutes with me and left me a sobbing mess, making me feel even more guilty.

I conveyed my disappointment to the midwives; it was pretty clear to see, as I spent all my time on the ward in tears (when I wasn’t hobbling down to NICU of course). They scheduled a session with someone they called ‘MoM’ which I understand is the manager of midwives. She was absolutely incredible. The MoM spent over 90 minutes with me, reading every single page of my maternity notes and checking if there was anything I wanted to discuss from each appointment or incident. She apologised for the treatment I had received the night in question, which meant a lot. But most importantly, she explained as much as she could about absent edf. She had never encountered it during her time as a community midwife. I was unusual and extremely unlucky. Or lucky, in her view, that I had trusted my instincts and reported to hospital. I felt as though a weight had been lifted, finally.

But as time went on and I witnessed L go through numerous medical procedures, guilt crept back into my conscience. I needed an explanation from the consultant who made the final decision to deliver my baby early. The last time I had seen my consultant, I was hooked up to the CTG monitors after a night of no sleep and starved for a possible c-section. The last thing she told me was that my baby had a 10% chance of dying during the surgery. I was pleasantly surprised by how easy it was to arrange a debrief; I called her secretary and a few weeks later I received an outpatient appointment for Antenatal Clinic. For some reason, I still needed my blood pressure taken on the day (120/74, go me).

The consultant explained my situation with excellent clarity. I had suffered placental insuffiency, which had led to the absent end diastolic flow. As a result, L had become severely growth restricted (IUGR). The results from my placental analysis confirmed that it was infarcted. The placenta hadn’t been able to cope with L growing any further. He probably stopped growing sometime after my 28 week growth scan. I had reported the reduced movements at just the right time to save L’s life.

The consultant couldn’t explain why this had happened to me. I didn’t smoke, I wasn’t too young or old and I wasn’t overweight. My only risk factor was a first time pregnancy. But not all mums end up with their first born in NICU! My risk of subsequent placental insuffiency is increased compared to the general population, but the consultant thought it was unlikely a future baby would be so severely growth restricted. Interestingly, she said my chances would be increased if I had a baby with a different father (which is obviously the case). Apparently the body tolerates subsequent pregnancies with the same biological father in a better way.

I left the debrief with the knowledge that my stress and worry during the pregnancy didn’t cause L’s prematurity. If I fall pregnant again, I’ll be put on a course of aspirin. But I can’t help thinking my second baby will also be a NICU baby too.

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