On Jumping Off A Cliff With The Hopes That A Tiny Branch Might Save You [Pregnancy After Preemie].

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My full term daughter was born on December 23, 2018 on a full moon. A cold moon. The cold full moon, and the first day of capricorn: the goat. She burst out with her robust cry weighing 8 pounds, and they put her on my chest so she could feel me and smell me. We laid there together for almost 30 minutes before I cut her umbilical cord.

Her name is Greta. She is very strong.

Her brother Elliott, a surviving twin who was born at 26 weeks, is now seven years old.

The surreal nature of my daughter’s birth was stunning— I laid there with this gigantic sweet baby whom I could touch and who was in the same room with me, and I couldn’t believe the sheer grace of the entire thing. That I could protect her eyes from the lights with my hands, that she could sense me, that she wasn’t immediately swifted away in an avalanche of terror, that there was no loss. I couldn’t stop crying. All emotions came overwhelmingly to the surface, and as someone who’s been called “stoic”, it was like being in a whirlpool.

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Everything about her strength brought me back to the precariousness of her brothers’, William and Elliott’s, birth.

From the minute of the positive pregnancy test my body awakened to the dread of what could happen-- what could finally come again— what would probably do me in for once and for all— the loss of another baby. And each moment of the pregnancy felt like a conscious decision that I could be putting another baby into a dangerous situation for the fact that they were living inside of my body.

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My body: the one that I still, deep down, blame/d for the death of my son William and for the prolonged hospitalization of Elliott. My angry and disorganized body. The body that could go haywire at 26 weeks and people could die from— that body. My friend Erika said she would make birth announcements that mentioned that nobody died; she got it. I just hoped I got that far.

So that’s the background.

There was this other half of me that had always longed for more babies despite my massive fears.

I found a doctor I trusted. We talked about the medical history. I pulled from my ancient knowledges to describe each medical intervention they used with my boys and tried to keep myself from describing my sons’ suffering as a result of the preterm labor. She said the Makena shot was a miracle. She said she’s seen a lot of success.

At 18 weeks, as we approached the danger zone, my high risk doctor joked that due to my advanced maternal age, previous preterm labor, and my (new and fun thing [kidding]) low-lying placenta, that we had our work cut out for us. I bit my lip trying not to worry, but spent the rest of the afternoon that day googling each condition, the likelihood of preterm labor associated with it, and crying.

I realized throughout the pregnancy that there was power in my body’s memory, and that I had pushed that part out of me— out of my conscious thought. I realized that my body remembered everything despite my desperate and elaborate attempts to eradicate it over the course of 7 years. And with the help of my partner and my doula, I tried to walk through the steps of acceptance that this was not the same, that it would not be the same, even if the darkest of fears felt as if it was omnipresent. When the labor hit and it was real, the emotions rushed to the surface again, even despite my knowing we were in the “safe zone” of being past 37 weeks. And by some grace, I was lucky enough to be able to experience giving birth to a healthy daughter. Through the entire pregnancy and the birth, I was able to start forgiving myself (maybe for the first time) for the things that were not my fault, possibly for the fact that historically I had only experienced trauma associated with childbirth and motherhood.

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The night before she was born I saw two falling stars.

Greta and Elliott <3

Greta and Elliott <3

There is something to be said for getting the chance to sleep in the same room with your baby the night they were born and to KNOW exactly what it feels like to not have that for 88 days, or ever. For being able to put her in a carseat and take her away from the hospital a couple of days after her birth, and remembering the carseat tests that kept your son from leaving for days. For feeling her suckle within the first hour of her birth—something I had never experienced. To put her in clothes you picked out (the nurses had dressed Elliott the first time, when I wasn’t there). To listen to her breathe unassisted, no wires or tubes: to hear her full cry even in those very first moments, a LOUD cry. Even in staying up all night with her for months on end— just you and your family— and no one to tell you some dire reason that she couldn’t sleep. For being able to make the first decisions for her, and not having to weigh what medical intervention would be the least likely to have long term consequences.

Pregnancy after preemies, for me, was like being repatriated with the things I never thought I’d experience having, and to have every moment of it be a godsend, but a godsend of which I was hyperaware. I sometimes think that only the parents who’ve experienced trauma have this “gift”: the gift of being able to recognize and feel gratitude for the very precious thing you have in front of you, to have your hopes realized in the form of a baby, to not have the capability of taking the fragility of that for granted. To be reminded of the strength of your babies that were forced to fight. To realize the absolute gift that babies are. I am filled with a gratitude that is just as wordless and powerful as the grief (and gratitude) that came with loss almost 8 years ago, and once again, I am speechless.

[Note: I’ve debated for months whether or not to write this blog with the understanding that this isn’t what always happens with a pregnancy after preemie. The intention of this is not to say that this is what typically happens nor that this was simple. I chose not to discuss the various issues that came up over the course of my pregnancy that were scary (in this particular blog). This is not intended to imply that only healthy babies are worthy. My hope was to convey the wonder and love that came back to me with my daughter, and existed wholly with my sons, albeit under different circumstances.]

After the NICU: What Meaning do You Take with You?

After Elliott was discharged from the NICU and on quarantine, I was left with a lot of time to think. For me, having lost William and spending so many days bedside in the NICU with Elliott, it felt like my entire world had been scrambled into something almost unrecognizable in comparison with what it had looked like even months prior. Transitioning from the "survival" mode of everyday getting to the NICU, making medical decisions, consulting with doctors, nurses and therapists, working towards Elliott's various discharge goals and witnessing Elliott's progress to medical stability was difficult. I had gotten used to the fast-paced nature of the NICU, made friends with his nurses and doctors, become accustomed to the idea that every day could present a new challenge; I even had my favorite places in the hospital to get coffee or take a break from being bedside.

We shifted to a life of being at home on quarantine, adjusting to the day to day, getting used to troubleshooting issues that presented themselves on our own, spending precious alone time with Elliott and starting the process of mourning. All of the events of the past few months started to solidify in my memory, and I started to understand just how this story would profoundly change my life story. But what would that look like? Would this story transform our family into some kind of tragic example of loss? Would we fade away from our friends and family? Was there anything powerful we could take away from it, that, maybe, we wouldn't want to lose, even as painful as the experience was?

When Elliott was about six months old (three adjusted) the peace lily we had put in his room bloomed:

It bloomed in a pairing of two petals, uncommon for peace lilies, which normally  produce one white petal in their flowers.

It was a twin bloom.

When John and I saw it, we were astounded. We felt comforted by it, as if it was some kind of a signal that the earth knew what had happened, that what happened was not to be forgotten. To me, it was also a symbol that despite having gone through that pain, we had somehow been able to move forward. And though it wasn't the way we would have ever chosen to move forward, it had revealed different aspects of ourselves that maybe we hadn't ever noticed before, or seen as a strength. It reminded us that he would always be with us; that our time with him had changed us forever.

Post-traumatic growth is a newer idea in the psychological community. The premise is that after an individual goes through a traumatic or challenging life experience, they then, oftentimes, experience positive psychological changes (Tedeschi, R. & Calhoun, L., 2004). In other words, when you go through an experience in which everything you thought you knew or could rely on is somehow taken away, one oftentimes finds ways of coping with that experience by developing new beliefs or discovering inner resources that before that moment in time were not apparent. Recent articles have shown that, in fact, post-traumatic growth is often more common than the development of PTSD after someone goes through a traumatic experience.

The NICU seems to have the ability to burn away the things that perhaps seemed important in the past, but no longer hold meaning for parents. I don't know a single NICU parent who doesn't understand the very profound value, the gift, of being able to witness your child take a breath unassisted, or swallow without choking, or make eye contact even for a few fleeting moments. Things that for many parents, go (blissfully) without notice.

Oftentimes, for NICU parents, the love that we hold for our children becomes very "operational". In other words, it becomes a very deliberate act of noticing and interacting with our little ones. We go to the NICU, we make decisions and advocate for them, we learn how to participate in their therapies, and accept the problems that present themselves along the way. Love, then, is not just an idea that we have about our relationship, there are actions involved. Prior to having gone through the NICU experience, if you had asked me if I thought I could get through something as challenging, I likely would have told you that I couldn't. That I did get through it in itself is very powerful, and, for me, gave me a sense of just what parts of my sense of self would survive the NICU experience; and it was comforting to discover that it was love that survived it all. It was also awesome to see that my partner had that same sense, and that I could rely on him to carry on on the days that I couldn't.

Despite the pain and anguish of going through an experience that quite literally takes your breath away, perhaps in the survival of that, we find the parts of ourselves that are the most resilient. And I feel gratitude to my boys for having highlighted that for me with their fortitude and grace. Each year, around this time, I get reminded of it when I think to myself about the ways in which I want to move forward in the coming year.

To other NICU parents: what do you DO with the experience of having gone through the hospitalization of your baby? How does your experience make itself known in your day to day life? Have you ever been surprised at how this experience has changed your sense of self or your relationship with your little one(s)? Was there anything of value that you could find in the NICU experience?

References:

Barr, P. (2011). Posttraumatic growth in parents of infants hospitalized in a neonatal intensive care unit. Journal of Loss and Trauma. 16, 117-134.

Spielman, V. & Taubman-Ben-Ari, O. (2009). Parental self-efficacy and stress-related growth in the transition to parenthood: a comparison between parents of pre- and full-term babies. Health and Social Work. 34(3), 201-212.

Taubman-Ben-Ari, O. & Kuint, J. (2010). Personal growth in the wake of stress: the case of mothers of preterm twins. The Journal of Psychology. 144(2), 185-204.

Tedeschi, R. & Calhoun, L. (2004). Posttraumatic growth: conceptual foundations and empirical evidence, Psychological Inquiry. 15(1), 1-18.