PPROM
I became pregnant with my first child, Gabriel, In July of 2007. Everything went along tickity boo during that pregnancy until my water broke at 33 weeks and 6 days during a visit to Prince George (my home town). The night before my water broke we crashed at my mother's house (it was vacant because she was in Mexico) before making the two hour trip back to city we were currently living in.
33 Weeks and 6 days.
At about six am I turned over in bed, not an easy feat with 50 extra pounds, and was embarrassed to feel myself pee the bed. Luckily I was wearing a pad and quickly rushed to the bathroom. I emptied my bladder and was about to go back to bed (convinced that there shall be no further instances of incontinence now that my bladder was empty), when I was confused to discover that, after standing, another large gush filled my pad. It was then that I realized that it hadn't been an embarrassing case of incontinence, but something more ominous. Fifty thoughts ran through my mind at once, the first thought being "what does it feel like to have your water break"? the second thought being "its too early". I wandered back to the bedroom where Scott (my husband) lay asleep, oblivious to the drama that was unfolding around him. I hesitated in waking him because a part of me truly couldn't believe that my water could have broken so early. After a few moments I decided that I couldn't ignore the possibility and prodded Scott awake. "I think my water broke" I remember that he seemed much calmer than I felt was warranted in the situation. "did you have a bloody show"? he asked. I immediately responded "no". He smiled and said "then you're fine, go back to bed". He turned over, convinced that I was overreacting, but I wasn't going to let this go so easily. He wasn't a doctor after all. "I don't think you have to have a bloody show to have your water break...I'm phoning my sister".
I decided I would phone my sister Michelle, she had birthed three babies, and if anyone would know, she would. I got ahold of her on the second ring and immediately knew something was off. Her voice sounded strained, a little off. "were you still sleeping?" I asked. "No, I've been up for hours". I remember thinking that she must have a cold or something because she just didn't' sound right and I even stated as much to her. Her silence was deafening, "you haven't heard, have you?" she asked. Hadn't heard what I wondered. Before I could ask she stated, "Aaron killed himself". Aaron was my sister's brother in law. Her husbands youngest brother. He lived with them in and I had just seen him a few months earlier. My voice stuck in my throat and I suddenly felt like an idiot phoning her for such a stupid reason. After all, the chances of my water breaking so early was slim to none. I expressed my condolences and was about to hang up when sisterly intuition caused Michelle to ask what was wrong. I then explained the situation and she told me to get to the hospital as soon as possible, she told me that they could do a test to check to see if my water had broken. I promised to keep her updated.
I rushed upstairs and told Scott we were heading to the hospital, my thoughts racing from my baby back to Aaron. He had driven himself off a cliff. Disbelief ruled all. Shock from all the less than stellar events began to set in. The one stupid thought that kept playing over and over was how when one life ended another would inevitably begin. Even then, a part of me believed my baby was on his way.
After taking the scenic route to the hospital... (did i mention Scott was beginning to panic) we finally arrived and I told the maternity nurse what I thought had happened. She looked at me with an accommodating, but doubtful look and said the doctor would see me in the assessment room. After hearing my story the doctor stated that it did sound as though my water had broken and he did a few tests that, of course, came back inconclusive.
Instead of sending us home (since we lived an hour and a half away) he phoned the obstetrician on call and she said to admit me, and it would become known within 24 hours whether or not my water had indeed broken. I was wheeled to maternity and told that if I felt anymore gushes to page the nurse and she would do another swab test to confirm whether or not my membranes had ruptured. Because I hadn't felt any gushes for a while Scott and I began to believe that I had indeed been hysterical to believe that anything was wrong. Assured that everything would be alright he headed off to Walmart to get us some over night clothes for the hospital (we didn't have anything since we hadn't planned to stay in Prince George the night before). While Scott was shopping in Walmart I had another large gush of fluid and it was then confirmed, by three nurses nodding their heads and speaking in unison, that I was indeed ruptured. I love how doctors and nurses speak to one another as if you aren't in the room. "what does that mean?" I asked interrupting their less than private meeting. The nurse glanced over and merely stated "your water broke". I was then left alone to try and contemplate what the hell was going to happen now. When I asked her what that meant, I hadn't meant the literal translation; I wasn't a complete idiot! Soon there after Scott arrived back at the hospital and I told him that it was confirmed. My water was broken. Dr. Preston, the one who admitted me, and the one who would later deliver my son, came in and informed us of protocol in this sort of situation.
He told us that in some cases the rupture if small enough could repair itself and I could go on with the rest of my pregnancy, on bed rest, but at least to full term. I would have to stay in the hospital because I would need antibiotics in order to prevent a uterine infection and I would receive steroid shots that would help my babies lungs to develop. If worse came to worse, they would induce me and I would deliver my baby within a few days. My head was reeling from all the information but I was still coherent enough to mention that I had a recently discovered heart murmur. He told me that he would mention it to the on call obstetrician to see what, if anything, should be done.
Later that night the obstetrician came to examine me and to tell me what was going to happen in the next 24 hours. She went over the steroid shot information once more and said I would receive an ultrasound to determine amniotic fluid levels, and if levels were good they would keep me in the hospital for as long as possible. I would have my temperature checked every three hours to ensure I hadn't developed an infection and before they induced me (if they had to induce me) she would very much like to get the echo done of my heart. To say that this doctors bed side manner was somewhat lacking would be an understatement. She told me the facts in a cold, calculated manner explaining everything in under five minutes. In her little speech she told me what to expect from a 34 week old preemie.
"At this gestational age its a toss up to whether their lungs will be developed enough to breathe on their own, even after the steroid shots, so don't expect to hear your baby cry, and don't expect to hold him after birth. He may need to be intibated which will be performed by the NICU nurses, he will have to be put on antibiotics right away, and he may need a tube in order to eat. Because he is so gestationally young the chance of infection is high and he could develop one at any time. You should expect that he will remain in hospital up until your original due date. Babies being born at 34 weeks have a 95% chance of survival". Did that mean he had a chance of not surviving? Then she rushed on to the explain what could happen if they induced me and I had aortic stenosis (what the suspected due to my murmur). She said the stress on my possibly weakened heart could cause heart attack, stroke, or my lungs to fill with fluid effectively drowning me. "Hopefully", she stated, "we'll have time to get the echo done on your heart before your baby is born". I blinked in surprise...hopefully....?
After she left I looked at Scott and was again amazed by how calm he looked. "aren't you scared?" I asked. He shook his head and said "i get to meet our son soon, how could i be scared about that?" Little did I know he was freaking out. I suppose being a cop makes it so you can hide your emotions quite effectively.
Induction
Finally on March 13th, two days after being admitted to the hospital for preterm premature rupture of membranes, I received an ultrasound to measure my amniotic fluid levels. They were so low they decided to induce me that night. There was a mad scramble to try and set up an ultrasound for my heart and get a cardiologist to review the film before they set labour into motion.
Two hours later the doctor came back with news that she had finally managed to get me in an echo. The test took a little over an hour and in the end they discovered that I did have an aortic bicuspid valve defect, but that it wasn't aortic stenosis and it wouldn't affect me during the birth of my child. Unfortunately no one told me that my congenital heart defect predisposed me to having a child with a congenital heart defect (Gabriel's younger brother was born with one...but that's another story).
At 9 pm that night I was induced. My labour was hard and fast from the beginning and on top of it I was in back labour. I remember thinking that the pain was just too much to bear. I repeatedly asked for an epidural and they repeatedly told me that it was too early for one and that from the look of the contractions (which never got closer than three minutes apart) I wasn't progressing. So instead they gave me a shot of morphine and told me to suck back on the laughing gas. Now the reason they never checked to see how far I was dilated was because the obstetrician forbid it. If labour didn't take and the induction failed then the constant checking of my cervix could cause infection and I would have even more problems to deal with.
The nurses were so convinced of my lack of progress that after 12 hours they sent my husband to the cafeteria to get something to eat. Ten minutes after he left I began to throw up, and a resident who had been following my case and had come to check on me, decided that she would check me against doctors orders. She soon announced that I was 9 centimeters dilated and the nurses better page the doctor. The doctor wasn't the only one called, Scott was also paged and he later told me how he sprinted up three flights of stairs to get back to my room. He made it before the doctor did, but I also told him that if he left my side again I would murder him. Needless to say with our next child he was not allowed to leave the room, no matter how tired or hungry he became.
After the doctor arrived he told me it was time to start pushing. It took five pushes and 20 minutes to get Gabriel into this world. Meanwhile four NICU nurses and the paediatrician, along with three of his residents waited in the back of the room to receive my son. There were also the two induction nurses, the maternity resident who had been following my case, the nurse who had originally admitted me and her two student nurses, and the delivery doctor all crammed into the induction suite. It was a regular birth party. After Gabriel was born he was rushed to the back so quickly I didn't even get a glimpse of him.
Now, I knew that I shouldn't expect him to cry. I was warned multiple times that he may not be able to breathe on his own, but as a mother you don't really have a choice to whether or not you are going to listen for your child's first breath. I remember peering around Dr. Preston as he tried his best to distract me. I knew then that it was taking too long for Gabriel to cry, I began to panic. All I could think was "he can't die". The word "breathe" became a mantra in my head as I prayed to whatever god might be out there. I looked at Scott and could see that he was listening for the cry as well. I never wanted anything so badly in my life but to hear my child scream his little lungs out. Finally, after what seemed an eternity, we heard him. His cry rang throughout the room and I collapsed backwards onto my pillow from exhaustion and relief.
My baby was alive. He was alive. And today he's a happy, healthy 3 year old!
