Three years. Time truly goes so quickly. Three years ago today our little munchkin was born. In honor of James’ third birthday I want to share a his birth story with you. Some of you read it last November on World Prematurity Day, but many of you are new to 22w6d. I want you to have the opportunity to see how it all started, and understand a little more about why I do this. My hope is that James’ story will have a positive impact on someone. Perhaps his story will give someone hope in their preemie’s journey, or help them to recognize risk factors in their own pregnancy. I know James has a purpose, and maybe by sharing his story we can start to recognize it.

We found out I was pregnant with James on Friday, April 2, 2010 (Good Friday). I remember I wanted my husband to make me a margarita that evening. I was a couple of weeks late and thought I should do a pregnancy test first, just incase. I was absolutely stunned to see a positive result and did another test right away. We were speechless. The next morning I did a third pregnancy test, and was still shocked at the positive result. We had the pregnancy confirmed at the doctor’s office on Monday, April 12. My doctor mentioned a higher risk of complications because of my age (38), but assured me everything should be fine, as she was 37 with the birth of her first child.  We were beyond thrilled. We had been waiting for this moment for 6 1/2 years.

On Friday, April 16th we experienced our first complication. I had some spotting and unusual discharge that day and saw the doctor in the afternoon. We heard the heartbeat for the first time – lots of joyful tears! Dr. Stevenson put me on a progesterone supplement and did some blood work. They called the next week and said my progesterone level was very low and I should continue taking the supplements. Low progesterone was likely the cause of my spotting.

A couple of weeks later we made our first visit to the ER. I was certain I was having a miscarriage and cried all the way to the hospital. After answering what felt like a never-ending barrage of questions they did an ultrasound. There were tears of joy again when I finally heard that tiny heartbeat. We met Dr. Dew that Saturday morning. She was the OB resident on duty at Baylor University Medical Center. I was so thankful for her honest, yet kind manner. We would see her again in the ER, and she would ultimately assist with James’ delivery.

Over the next couple months I continued to have a lot of spotting, which resulted in some bed rest, another visit to the ER, several extra appointments with my doctor, and several appointments with a Maternal Fetal Medicine specialist. About 5 weeks before James was born I saw the specialist for the last time. He declared me “too healthy” to see him anymore. I enjoyed my pregnancy during those next five weeks. There were no complications, no morning sickness, nothing unusual was happening. I started talking with Dr. Stevenson about my birth plan (which was supposed to be completely natural), and getting ready for our baby boy. My one frustration during that time was bladder control. I was having small amounts of leakage but was told that was common with a tilted uterus, and I thought nothing more about it until July 28th.

On Wednesday, July 28, 2010, our lives were changed forever. It was the beginning of what would become our preemie journey. I do have to back up one day however. On July 27th, after about 5 weeks of what finally felt like a normal pregnancy, I had another unusual discharge. This one was very wet and included a piece of tissue. I thought it was odd, but I had a similar experience previously and was told it was a normal part of pregnancy. So I went about my day as I usually would. That afternoon I didn’t feel well and began spotting again. I decided to leave work early and called my doctor on the way home. The nurse advised me to keep the appointment already scheduled for the following afternoon.

On Wednesday I stayed home from work and spent the morning and early afternoon lying down. I was relieved when my husband called and said he’d be able to go to my appointment with me. While we sat in the waiting room we discussed where to go for dinner that evening. We had no idea we’d be leaving the doctor’s office and going straight to the hospital.

Once in the exam room the nurse asked how I’d been feeling. I explained what happened the previous day, and although reluctant at first, I gave her a plastic bag containing the piece of tissue I had saved. She left the room with the small bag, and within just a few minutes she returned and took me for an ultrasound. I wasn’t concerned at first. I had numerous ultrasounds in this office, with the specialist, and in the ER. I became concerned during the ultrasound. James wasn’t moving. We heard his heartbeat, but he wasn’t the squirmy little guy that had been difficult to track down during previous ultrasounds. The tech didn’t say a lot when I commented on how still James was. Within a couple of minutes she excused herself to go speak with my doctor. She returned quickly, indicating Dr. Stevenson would talk with us back in the exam room.

I knew something was wrong when Dr. Stevenson entered the room without a smile. She explained that my water broke and there was no amniotic fluid surrounding James. What I thought were issues with bladder control had been a slow leak of amniotic fluid, followed by a complete rupture of my membranes. She explained the risk of infection for me and for James, and because of that I was to be admitted to the hospital for bed rest. She emphasized that I could be there a long time, I was just 22 weeks yesterday. Dr. Stevenson wanted us to make one stop for a high level ultrasound at a doctor’s office next to the hospital – she called already and the doctor was waiting for us – then I was to go to Labor and Delivery to be admitted. She would be by that night to see me. And with that information we began a hurried, tearful drive to Dr. Magee’s office.

Dr. Magee was an amazingly calm force during the chaos of that evening. He spoke slowly and deliberately. He gave us the bad news first, and prefaced it with “I’m only going to say this once.” Then he gave us some hope, and told us it was still possible to have a good outcome. He smiled and said he would see us again, as he was the doctor who did the ultrasounds for patients on the Antepartum floor.

We spent Wednesday night in Labor & Delivery. I was hooked up to a monitor to watch for contractions, and Andy made numerous phone calls informing family of the day’s events. Nothing felt real that day, or for many of the days and weeks that followed. This wasn’t supposed to happen. I kept all of my appointments and did everything the doctor said to do, yet we found ourselves in an unimaginable situation that we weren’t even a little prepared for.

Dr. Stevenson met with us that night and came back the next day. She explained that at 23 weeks gestation they would do the first of 2 steroid shots to help with lung development. She also explained that at this hospital, between 23 and 25 weeks gestation it is the family’s choice of whether or not we want the doctors to do life-saving measures. They would have a neonatologist meet with us to explain some of the common issues and risks in the NICU, and we would be able to take a tour of the NICU. As we spoke Dr. Stevenson asked questions and took notes. “You’ll be 23 weeks Monday, right?” “No,” I started to say, “not until Tuesday,” but I couldn’t get the words out. There was literally something stopping me, and instead of correcting her I nodded in agreement. I’ve never experienced anything like that before or since. I believe that was one of the defining moments that contributed to James being here with us today.

The next few days were, thankfully, uneventful. We had wonderful friends and family who came to visit and called to help pass the time. We learned the routines of the nurses on our floor and knew what to expect from them each day. We met with the neonatologist, who said if we could make it to 30 weeks their job would be a lot easier and we’d have a greater chance of taking our baby home. So that was the new goal, 30 weeks gestation.

James, seven minutes old.

Andy spent every day and most nights at the hospital with me. On Monday, August 2, he decided to spend some time at home. It looked like we were in for a long hospital stay, and financially we weren’t prepared. He needed to make some phone calls and find ways we could save money over the coming months. I had a new nurse that day. She was a Labor and Delivery nurse who was covering on Antepartum as they were short-staffed. Mid-morning I asked about the steroid shot, wondering when they would be giving it. She would check the doctor’s orders and let me know. Just before lunch she came back with the shot, and the monitor. At 23 weeks they begin monitoring the baby’s heart rate for longer periods of time. They want 20 minutes of a steady heartbeat each day. The nurse explained that they would monitor me from the nurses’ station, and that the first few times can be difficult.

It was very reassuring to hear his heartbeat and watch it on the screen in front of me. After several minutes the pace slowed briefly, then picked back up. The nurse came to my room quickly, readjusted the monitor, and started my 20 minutes over again. After several minutes it happened again. She readjusted the monitor and had me change positions. This continued for about an hour before they decided to move me to Labor and Delivery. They explained that I would be monitored on a more sensitive machine and once they were able to get the 20 minutes they needed I would return to Antepartum. I called Andy to let him know what was happening. He told me about some of the calls he made, and said he’d be there before long.

In Labor and Delivery the results weren’t any better. James’ heart rate dropped many times over the next few hours. They tried changing my position several times, but it didn’t help. Each time he was able to recover and his heartbeat returned to a normal rhythm, but they were concerned that one time it might not. Dr. Dew was on duty that day. She had been in contact with Dr. Stevenson throughout the afternoon. Around 3:00 they began talking about the possibility of delivering James. I called Andy and explained the seriousness of the situation. Just after 4:00 they told me Dr. Stevenson was on her way.

First Photo of James in the NICU

There were lots of tears as I watched the commotion of nurses moving about my room. They were kind and encouraging. They asked if he had a name yet, and told me what a strong name it was when I said, “James Alexander.” When Dr. Stevenson arrived she explained that James had a better chance of survival if they delivered him now than if they waited. His heart rate was too unstable and he might not continue to recover each time it dipped. Within minutes I was in the OR receiving an epidural. Andy was at my side, holding my hand. When she delivered James I couldn’t see him and he didn’t make a sound. My heart sank when she said he weighed a pound, then sank further when she corrected herself and said 15 ounces.

After a few minutes a nurse came and told us they were able to intubate him. Was there a chance they couldn’t? That thought never entered my mind. What else could happen that I didn’t even know about yet? That’s when the seriousness of the situation truly hit me. A few minutes later a nurse asked Andy if he’d like to see him, and Andy disappeared briefly. Shortly after that they rolled James past me – they were taking him to the NICU. I tried to lift my head so I could see him, but there wasn’t much to see besides a rolled up blanket. Just as they continued on their way his little arm came up and moved back and forth, like a little wave. Everyone noticed and stopped what they were doing for a couple of seconds. Looks of uneasiness and fear softened as sounds of “aww,” broke the silence. We were all captivated by this tiny baby boy.

James went on to spend 160 days in the NICU. He had several surgeries, countless blood transfusions, more complications than I want to remember. It was scary and for many days the chaplain stayed close by our side. James had the best doctors and nurses who fought for him every step of the way, and did everything they could to help him survive. Ultimately James beat the odds. He’s a happy, energetic little three-year old. We still have our challenges, but he’s here. He’s here and he’s perfect.