You are not breathing. You can’t breathe. That is what it feels like 100% of the time when you have a premature baby living in the hospital. We had two, our sweet brother and sister twins, Colby Makana and Bellamy Ali’ikai Silva, whose arrival via sudden, unexpected and rapid vaginal birth at 32 weeks launched me instantly in the hardest, scariest, most vulnerable period of my life. It’s hard to admit feeling sad, scared or traumatized by the birth of my children, as it also is the single most extraordinary thing that has ever happened to me and the beginning of the greatest love affair I will ever have. But I realize now, almost 2 years later, that I have grief, fear, and trauma from our experience that I have never had a moment to process because I have been consumed by raising my miraculous baby twins.
Plans A, B, C and D of what we hoped for, expected, and were resigned to as possibilities about the birth of our babies were all gone the second my water broke. In Seattle, where we lived at the time, there were more restrictions than I expected dictating our delivery (all area hospitals required twins to be delivered– even vaginally– in an OR with required epidural, birth centers and midwives cannot delivery twins, etc.) At 2:00am the night after Thanksgiving 2012, I woke up on the couch (where I had been sleeping in a highly-orchestrated semi-sitting position for weeks) soaking wet. I felt no pains or sensations that I hadn’t already been feeling for months, and had just been to the doctors for a stress scan that day.
When I hollered to Ang that I thought my water broke, she said “Are you being serious?” We drove to the “big hospital,” (AKA “the baby factory” in the birth community), the parent hospital of the small, well-reputed neighborhood hospital where we had planned to birth. They handled premature births, complicated births. They had a Neonatal Intensive Care Unit (NICU). My heart was in my throat: please don’t come babies, please don’t come yet. It’s too soon. I had a towel between my legs and my phone iron gripped in my hand as Ang drove quickly and with more focus than I had ever seen, into the city.
At triage they told me I wasn’t in labor, but no one checked my cervix (!) before they admitted me to the Antepartum Unit where I would be staying for the duration. The doctor ordered antibiotics for me and lung-maturing meds for the twins and assured me that I would be here “hopefully at least a few weeks” and went on his way. A nurse got us settled in a room and told me that “You might go into labor later today”. It’s too soon. Please please please God, don’t let them come.
Ang went to go move our car from emergency parking to the garage, when suddenly the deepest ocean of pain I’ve ever felt overtook me and the nurse called the doctor. I was suddenly curled up on my side bearing a veritable mountain of crushing pain when I heard voices saying “She’s complete,” “Get the NICU,” and “Don’t push!” My wife had left my side less than 15 minutes before, and now I was being wheeled down a hallway by a half-dozen people as a nurse named Mandy reassured me that things were ok and I would get to meet my beautiful babies today and I could do this. Someone said they would find Ang and left the OR just as the anesthesiologist–a wonderful man who would stay for the entire birth chanting encouragement in my ear and, at one point, holding Ang’s hand—placed a spinal block and epidural.
Angels walked in the door. My amazing wife, eyes like saucers and swimming in a hospital gown and cap, came to my side and became stronger than I’ve ever seen her be. The OB on call, Dr. Brock, walked in and came right up close to my face and said “Everything is going to be ok. We have so many people here to take care of you and the babies. You can do this.” She smiled and told me she would like to honor my birth plan (she had read my chart!) and try for a breach extraction on Baby B, something many OBs will not attempt that had been so important to me that we had changed OBs 3 times. Two hours of pushing later, beautiful Colby, whose water had broken, came into the world. He was followed three minutes later by his sweet sister, sac still intact, via breach extraction.
I did it! For just one second, I focused on the explosion of love and pride and confidence and joy that is childbirth, but that second was eclipsed immediately by the “are they ok, are they ok, are they ok???” coursing through my veins.
I could not see my babies, they were in neo-natal care isolettes on the other side of the room surrounded by 7 or 8 people, and Ang. I couldn’t breathe. Voices told me yes, they are breathing, yes, they are breathing, they are breathing. They are breathing.
As my delivery team remained at the bottom of my body for the passing of the placenta and monitoring for hemmorage, I remained fixed on the backs of the medically-masked heads bobbing around my babies, crying and praying and unable to do anything. My angel OB Dr. Brock noticed my anguish and asked the NICU team to bring me my babies. They brought me Bellamy in the arms of a nurse for about 8 seconds so I could kiss her before they whisked her back to her isolette and out of the room, gone. I never saw Colby, he wasn’t stable enough for 8 seconds of mama love. I watched my babies and my wife leave that OR without me and I couldn’t breathe, as though my lungs and my very heart itself had gone with them.
When your premature baby is living in the NICU, “new parenthood” is not anything like it’s supposed to be. You expected to be getting the hang of nursing and learning to read their poop cues and cries. Instead you are learning to touch with only the most gentle pressure, not strokes, no caresses, because their under-developed nervous systems cannot tolerate touch yet. It involves studying your baby’s face through the eye holes of a CPAP (or ventilator) to learn what he looks like. It means waiting for a team of doctors to tell you that maybe today is they day you can hold your medically fragile baby for the first time, for a few minutes only because she will probably have “de-sats”, episodes when her body stops breathing for a moment. It entails choices like “do I consent to let them place a PICC line catheter into my baby’s heart to spare her the near-daily pricks and bruises from new IVs?” and whether or not to be there when they place it. Your soundtrack is not white noise machines, baby coos and lullabyes; it’s heart and oxygen monitor beeps and alarms.
You get visitors, and they scrub in and out with medical grade soap and gaze for just a few minutes at your infant, who is practically invisible under the wires, breathing masks, swaddles, feed tube, and eye mask that protects him from his bilirubin jaundice lights. They tell you he is beautiful, and you beam with pride even though you both know they couldn’t spot him in a lineup. You cannot nurse, or even bottle feed for a while, because your babies are too young to suck. You pump in a dark room while you inhale lunch that you don’t even want, desperate for more drops of liquid gold to emerge from your stubborn breasts that are not being stimulated by an infant’s nurse. You watch your baby eat your milk from a tube through his nose.
You cry a lot. You cry every night when you have to leave your children and drive away for a few hours of sleep and a shower. You cry when there is traffic in the morning and your chest is too tight because you can’t get to your babies. You cry when you miss the doctor you were trying to track down because you ran down to the cafeteria. You smile a lot too, while gazing through the holes of the isolettes, when they open their eyes. You smile and laugh with the nurses, these amazing angels who have perfected the art of being tender and loving without being maternal so as not to interrupt the bonding you are doing.
Eventually your baby doesn’t need the IV, or the feeding tube. She took 30 milliliters this morning! He made it through the night without any de-sats! They gain weight, and you get to do skin-to-skin every day. Then there comes a day when the doctors tell you your baby is strong enough, big enough to go home. Colby and Bellamy, still barely 5 lbs, came home with us on December 13, 2012, more than a month still before their due date. I was terrified. Without machines to tell me my babies were breathing, how would we know if they weren’t? Prematurity steeps you in fear and powerlessness, and it took me months shake the feeling that my babies were fragile and in danger.
As I finish this post, Bellamy and Colby are racing around our living room in some kind of chasing game. It’s really loud and messy in here, and it’s going to be a long day. I relish the averageness of this day. They turn 2 next week, and I can now finally open myself up to think about what we went through as a family in their earliest days. Many extraordinary people have helped us along this journey of the first two years with twins, but I hold especially deep my heart those medical professionals, friends, and family members who helped my children become strong, healthy babies and supported us during that overwhelming time.
I would also like to extend a special recognition of The March of Dimes, the tremendous organization that provided a parent support person, family pizza nights, Santa visit and professional photography during our time in the hospital.
Supporting medical access, prenatal care, and pregnancy education is crucial to reducing premature birth. Here’s how to support prematurity and birth complication prevention. To support the amazing work the March of Dimes is doing with families and sick and early babies, click here.