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Premature baby

Pre-eclampsia: born at 28 weeks

At 28 weeks pregnant, today was to be our last monthly visit with Jacqui, our midwife. From now on our visits would be fortnightly or at least that was the plan. We had no idea our world was about to be turned completely upside down.

On arriving at Jacqui’s office she took my blood pressure, then asked me to go pee on a stick for her. It would show any sugar or protein in my pee, a routine check. While I was in the toilet, unbeknownst to me, Jacqui told Ryan that my blood pressure was dangerously high and that there could be a problem.

Ryan came over to the bed and held me while I rubbed my bump and cried. Everything should have been fine, I felt fine. Ethan couldn’t be sick, I’d know wouldn’t I, how could I not know he was sick?

I was really worried that the sugar indicator on the stick would change colour, with my extreme needle phobia I was paranoid about getting gestational diabetes. The sugar indicator didn’t change but the protein indicator did, to an incredibly dark green. I knew it couldn’t be a good thing but I had no idea what it meant. I took the stick back to Jacqui and she simply said “thought so”. Then she got me to sit down again and pushed two of her fingers, up to the first knuckle, into my very swollen left ankle. When she took her fingers away the dents stayed there.

Jacqui got me to lie on the bed so she could listen to Ethan’s heart beat and have a feel around. She found his heart beat easily and as always it sounded strong, but when she felt my tummy she started to look really worried. Jacqui asked if Ethan was still moving as much as he had been and if I felt like he’d grown since our last appointment. I said yes to both, he was still moving a lot and I thought he’d grown. That was when Jacqui got an almost sad look on her face and sat down on the edge of the bed next to me. Jacqui told us that Ethan hadn’t grown since our 24 weeks appointment, my blood pressure was dangerously high, I had protein in my urine and I had oedema (swelling due to liquid retention). These symptoms all pointed towards my having pre-eclampsia toxaemia (PET) but it could only be officially diagnosed with a blood test. PET or not, I had to go straight into hospital or we were going to lose our wee man.

Ryan came over to the bed and held me while I rubbed my bump and cried. Everything should have been fine, I felt fine. Ethan couldn’t be sick, I’d know wouldn’t I, how could I not know he was sick? What sort of Mum doesn’t know their wee man is sick? With my blood pressure as high as it was I should have been passing out, having convulsions, suffering from migraines and all sorts of other horrible symptoms. I didn’t have any of these things, I just had swollen ankles, there was no way I could know just how sick we were.

Jacqui told us that I was going to have to have an emergency c-section, either in Nelson or Wellington, but either way, it would be tonight. Then she rang Nelson’s Maternity Ward and told them to expect us within the next 30 minutes. While Jacqui rang and cancelled the rest of her patients for the afternoon we headed back to Nelson. I rang work, said I was being admitted and wouldn’t be back. I didn’t go into any details, I couldn’t have if I’d wanted to, I could barely think let alone talk coherently.

We arrived at the hospital and made our way up to the Maternity Ward. They popped us into a room by ourselves and told me to lie down and try to keep myself calm – my baby and I were sick, I was possibly going to lose him and they wanted me to stay calm? how?!

Jacqui arrived at the hospital not long after we did. Before she got to us she’d arranged for an ultra sound to check on Ethan. We went to wait in the ultra sound waiting room while Jacqui headed back to Maternity to get some things organised. When we got to the waiting room they told us the machines were busy and that we’d have to wait 30 – 45 minutes before our scan. I’d managed to get my crying under control and psyched myself up for the scan but now we were being told we were going to have to wait. This scan that I was so scared to have because of what it might show was being delayed because they were “busy”. I burst into tears again, the stress was just about too much.

We walked back to our room and Ryan’s Mum arrived. The nurses got me hooked up to a blood pressure machine then Jacqui came back in and started explaining what was happening and what needed to happen. The major problem at this point was that they needed to do a set of bloods on me to check everything. My needle phobia kicked in and I had a panic attack. My blood pressure climbed even higher so the nurses rushed off and got a pill that should have brought it under control, the pill made no difference, my blood pressure stayed where it was. At this point Jacqui said she’d go and do some things and give me time to think about what I wanted to do and try to calm down a bit.

When Jacqui came back she said she’d had an idea. What if they put a drip in my arm? That way they could take bloods whenever they wanted, give me medication if they needed to and I wouldn’t have to see any “pointy things”. Jacqui knew I’d seen one of the anaesthetists to discuss my phobia and it turned out he was on-call. He said he’d come down and do the drip if they could get me to agree.

While all this had been going on the nurses had been in contact with the Radiology Department. They were now refusing to do the scan until my blood pressure had been stabilised and brought down. This scan was to check on our wee man and they were refusing to do it, how could they? I got really upset and my blood pressure went up again.

After yet another blood pressure pill, Jacqui wandered back in. She said that Phillip, the anaesthetist, was here and he’d do my drip now if I agreed. I said I had to go to the loo first and every one said that was fine, no one seemed to consider the fact that I was going into a room with a lock and I might not come out. I had my pee then stood looking in the mirror wondering if I could unlock the door and go back out, I was terrified of losing Ethan, I was terrified of getting a drip, what was I going to do, I just wanted it all to go away and not be happening. After a while I managed to force myself to unlock the door and go back into the room.

After Phillip had finished putting the drip in, they bandaged up my hand so only my fingertips were showing. I slowly sat up and got myself comfy on the pillows. No one told me until later that they’d taken the blood they needed for testing at the same time they did the drip. That was a relief when I found out! This drip was a good thing, it meant no more pointy things and they could do everything they wanted to through it.

After about four blood pressure pills and then blood pressure medication through the drip, my blood pressure had now stabilised enough for the scan people to agree to see us. I was on total bed rest, so Jacqui appeared with a wheel chair and we headed off again. This time they took us in as soon as we got there.

As the guy was doing the scan he was taking readings of Ethan’s size so we’d know exactly how small he was. He started saying things like “That can’t be right” and looking worried, Jacqui went and watched over his shoulder and she started to get the same look he had. Then he went and got his superior to look at the scan too and he looked worried as well. Jacqui explained why we were having the scan and they looked slightly less worried when they found out his being small was the reason we were there. After we had the scan we headed back to the room and the ob/gyn registrar came to see us.

The registrar had been looking at the scan readings, the baby monitor readings, my blood pressure readings and the results from the bloods. Everyone agreed that I needed to have an emergency c-section but they were hoping they could wait long enough to transfer us to another hospital, probably Dunedin, in the Rescue Helicopter. Nelson Hospital isn’t equipped for premature babies as small or as in trouble as Ethan was. The registrar also needed to talk to me about having steroid shots to strengthen Ethan’s lungs before he was born. The theory was I’d have one shot, twelve hours later another one, then twelve hours after that I’d have the c-section. I freaked out, they’d promised no more shots, that was what the drip was for, why did I have the drip if they were still going to try and pointy thing me…they’d promised! The registrar explained that the shot needed to go into my leg or my butt muscle so that the steroids would go straight to Ethan’s lungs. As the registrar was leaving I heard Jacqui tell her to get the steroids organised, I’d be having them. I just looked at Jacqui and said “You promised no more” and she said “I know I promised but we need to do this”.

While all this had been going on I’d still been wearing the monitor that was checking Ethan’s heart rate. Every so often a nurse or Jacqui would rip off the printout and take it away to show someone, I assumed the registrar or the ob/gyn. Ethan may have been small but at that point his heart beat was still strong and healthy.

By this time, it had been decided that we’d be airlifted by Westpac Rescue Helicopter to Dunedin hospital. They had the facilities to cope with a premature baby in Ethan’s condition. I wanted to go to Wellington Hospital to have Ethan, that’s where my family is, but the Neo-Natal Intensive Care Unit (NICU) was closed due to GRSA and not taking new admissions.

Late in the afternoon I suddenly noticed that the registrar had come in and taken the printout a couple of times in a row. Not long after that she and Jacqui came into the room. Jacqui sat on my left side and took my hand while the registrar came and stood by my right side. Jacqui said that they’d been watching Ethan’s heart rate and he was starting to show signs of major stress. His heart rate had started falling right off the scale then slowly climbing back up again, now the climb back up was starting to take longer and longer. Holding off on doing the c-section was no longer an option, Ethan needed help as soon as possible. They also let me know that Wellington NICU had agreed to take Ethan, they were re-opening for admissions and he would be one of the first.

It was arranged that the Westpac Rescue Helicopter would come to Nelson with a NICU team and they would take Ethan back with them to Wellington once he was stabilised. All we had to do now was wait for the NICU team.

The Wellington team arrived in the operating theatre around 9pm and everything got under way. Because I was having a general anaesthetic Ryan wasn’t allowed to stay in the theatre with me, so he gave me a kiss, told me he loved me and joined his parents in the observation room. Jacqui stayed with me and held my hand while I went to sleep and at 9.39pm Ethan Campbell Sherriff made a rather rushed entry into the world. He was 1lb 11oz and 33 cm long.

Ethan was taken to the Special Care Baby Unit (SCBU) where he was stabilised. When Ethan was finally ready to head for Wellington I was wheeled out on my bed so I could have a first look at him before he left. Unfortunately, the travel incubator was so large and he was so small I couldn’t see him from my bed. The original plan had been for Ryan to travel to Wellington with Ethan. However, my condition deteriorated enough for them to decide he should stay with me instead.

On the 13th of May, after two days of total bed rest and medication, it was agreed I was well enough to travel to Wellington. My blood pressure had finally stabilised and my oedema, which had doubled after the c-section, had subsided enough for the hospital to be happy to move me. So, Ryan and I were off on the Life Flight to meet our now two days old son.

Ethan was in Wellington’s NICU for a month. While there he lived in an enclosed, humidified incubator, at 12 weeks premature Ethan couldn’t regulate his own body temperature and his lungs and skin needed the moisture. He had to cope with high blood sugar levels, low blood sugar levels, ultra violet lights for anaemia, blood transfusions and so much more. Because he was so early Ethan suffered from chronic lung disease and initially needed a ventilator to breathe for him. After a week he was moved onto CPAP, this meant he was breathing for himself but had constant oxygen through nasal prongs. At one point Ethan’s lungs collapsed and he needed to go back on the ventilator, but it was only for a few days. Initially Ethan’s system couldn’t cope with any “real” food and he was hooked up to multiple drips feeding him nutritional liquids. At seven days old he was introduced to expressed breast milk, starting with 1ml four hourly and slowly the number and size of feeds were built up.

After our month in Wellington, during which time Ryan and I stayed at the incredible Ronald McDonald House, we were transferred back to Nelson’s SCBU. We spent the next two months there. This was where Ethan had a lot of “firsts”. He made it out of his incubator where he only wore a nappy, into a hospital bassinet wearing actual baby clothes. He had his first bath, learnt how to drink from a bottle, moved on to low-flow oxygen (the tube ran under his nose but had no prongs), and had his first ride in a pushchair, just to name a few. Before being released to come home in August Ethan had a return to Wellington NICU where he had a double hernia operation, seemingly a common thing for premature boys.

The week before Christmas 2005 Ethan finally came off his oxygen, it had taken seven months but he got there. Not having to try and keep his tube in place was a relief for all of us, Ethan had got very good at ripping the tape off and it was an ongoing battle.

The 11th of May this year was Ethan’s third birthday. He has come through everything that has happened with no long term problems. Despite the need for high levels of oxygen when he was first born Ethan has no sight or hearing problems, at 12 kilos he is still on the small size for his age but what he lacks in size he makes up for in energy. Ethan has developed into a bubbly, talkative, energetic, lovable wee man and despite everything that happened, we wouldn’t change a thing!

The doctors, nurses and midwives at both Wellington’s NICU and Nelson’s SCBU do an incredible job. During such a stressful time it’s nice to know your precious wee bundle is in the best hands and receiving the best care available. We owe them all a very big THANK YOU!