Tag Archives: Ceasarian

31+6: C-section and first weeks in the NICU

As I type this, I am sitting on my bed in the Risghospitalet neonatal ICU (NICU) next to the crib where our 2 little babies Sophia and Olivia are sleeping, and occasionally squeaking and gurgling. I am finally able to articulate what has been the most mind-blowing experience of my life to date. So much has happened in the last 3 weeks, I hope I can give a sense of the experience, some of which is a little hazy now.

The girls napping in their NICU crib
The girls napping in their NICU crib 

 

After my last scan my doctor surprised me by deciding we would do the C-section on Friday 20th June, so the girls would be born at 31 weeks and 6 days. I was mostly prepared for that, but actually setting the date kind of freaked me out. The one baby was lying kind of under the other one in my uterus, making CTG monitoring impossible, so it was the safest option to get them out here in the world where we can see them. I had hoped for their sake that they could stick around in my uterus until 34 weeks but it was not to be.

I was scared about the operation, but had a meeting with the obstetrician, anesthetist and midwife the day before to discuss exactly how things would proceed. On Friday morning I arrived and went up to the maternity ward where I slipped into some stylish  Rigshospitalet-issue surgery wear, complete with white knee-high socks to keep my feet warm during the proceedings. The anesthetist came in to insert a presumably huge needle into my spine, which I tried not to think about. I had to fight the urge to run away, and the ever-calm husband Chris was smiling reassuringly. It was so weird sitting on this metal table bending my head towards my chest while a friendly man injected me full of drugs so I wouldn’t feel my bottom half. Around 9.30 am, the rest of the surgical team entered the operating room: several nurses, one of which held my hand and made small talk as if it was no big deal; 2 surgeons; an anesthetist; 2 pediatricians and all their entourage filled the room and I tried to focus on staring at the ceiling and not thinking of sharp shiny scalpels. 

At first the anesthetic made me feel awful, like there was a huge weight on my chest and I couldn’t breathe. That was soon accompanied by feeling like I would throw up. Apparently the drugs made my blood pressure very low for a minute there. At the same time, my extremities were going numb, so they were poking me and asking if I could feel anything. They announced ‘I just pinched you really hard on the leg and you didn’t feel it, so we are going to begin’. There was a weird little ceremony where we all agreed who I am, my social security number and the operation I was about to have and they were off, scalpels at the ready. I have to say I reckon spinal blocks are amazing, I felt hardly anything, very mild tugging as they were rooting around in my insides to yank out the babies.

First out was Olivia at 10 am, then her sister Sophia at 10.01, and Chris nearly dropped his camera watching them emerge into the world.

Chris went with the babies to the neonatal unit and named them and watched them being weighed and measured while I was reassembled. Olivia was 1.6 kg, and Sophia 1.4 kg at birth. The girls were fine, so they were put into a premature baby ‘crib’- a perspex box on wheels, with heated water mattresses under each baby, to help them stay at 37ºC until they are able to maintain their body temperature. They were connected to a heart rate monitor, a monitor to check oxygen saturation in the blood, and each fitted with a CPAP (continuous positive airway pressure) to blow air over their noses and encourage their little lungs to unfold and help them breathe. They each got a nasogastric tube for feeding them directly into their stomachs, and an IV of glucose for extra treats.

Meanwhile, upstairs in the maternity ward I was quietly crying for like 2 hours, waiting to get the feeling in my legs back so I could go down and meet my babies properly. I was so relieved that they were born, and overwhelmed by a surge of hormones and simply could no longer maintain control. Every time a nurse spoke to me I just burst into tears. Chris popped up quickly to tell me all was well and show me a picture (a lot more tears). A maternity ward nurse gave me some painkillers and a plate of food (leverpostej and rugbrød, only in Denmark) and instructed me to go downstairs. On my feet. Using my legs.  I thought she was kidding, like how am I supposed to walk right now?? But I could, with Chris’ help of course. First she removed the catheter I had for the surgery and instructed me to report back within 4 hours about my urinary proclivities. 

So Chris helped to stagger to the lift and down the hall to the neonatal unit. In our room there are 2 beds and the babies in the crib in the middle of the room, and since there weren’t many admissions that week we could have a room to ourselves. 

I was a wreck so after meeting my babies and crying some more, I passed out. When I woke up I was struck by the immense pain in my abdomen. Never having had surgery I had no idea what pain level to expect, and let me assure you, it was pretty epic. I was given painkillers every 8 hours, alternating between paracetamol, ibuprofen and morphine. I swore like trooper the first time I tried to get up and found that my abdomen was a burning mass of pain and weakness. Chris had to pick me up out of bed and help me out to see if I would detect my bladder yet – sadly no dice, my brain had no idea I had to pee. So I got another catheter for the next 24 hours to give my bladder a chance to come online. This was not so bad, but I wouldn’t recommend it. I guess it was a combo of pain, blood loss and general mind-altering change in my world at the arrival of my babies, but the next day is a hazy memory. 

Luckily, Chris was really into his role as dad to the little ones, even though he also had me to look after, he was smiling all the time. He was watching the nurses in the neonatal unit at first, learning the ropes of caring for 2 little preemie babies, and I was lying in bed alternately moaning and sleeping.

When I emerged from the morphine haze on day 2 after the operation, I was amazed to find that the neonatal unit wasn’t what I had feared and expected from all the reading I had done online.

Rigshospitalet NICU is actually a calm, quiet place, not the hellish mass of screaming babies, bleeping noises and harsh lighting that I had pictured. Our room is in Team 1, which deals with preemie and older sick babies. There are rooms with 2 families per room, separated with a room divider. There is a bed and a closet for each mother and there is a shared bathroom and a cupboard full of the medical and baby care supplies you need (nappies, gauze, syringes, cotton balls, nasogastric tubes etc). The rooms are meticulously cleaned every day and the supply cupboard restocked. There are monitors that bleep when the heart rate or oxygen saturation drop below healthy thresholds, and when that happens, a nurse comes immediately. 

The room in NICU
The room in NICU

Chris and I spent the next days learning from the nurses how to take care of the babies, and I would occasionally just look at them and cry, happy that they are here, alive and healthy but sad to see them all tubed and connected to machines. The nurses record all the info for the babies: their temperatures, poo and pee schedules, how much milk they eat and digest, and other observations, and there are 3 nursing shifts per day. At each shift, the new nurse familiarizes themselves with the babies, and comes to meet and discuss the plan for the day. 

The doctors also come by every few days to check on the progress and tell us what they think. They usually listen to their breathing and poke them gently to check their circulation, and make other observations that I’m sure are beyond my understanding. One kind doc palpated Olivia’s stomach and declared ‘I see she has a soft tummy’ and Chris and I were both like ‘what? Soft tummy?? oh my god! What does that mean??’. He was like ‘Yeah that means that her tummy is soft, that’s all’. Duh, parents.

Olivia in the 2nd week
Olivia in the 2nd week
Sophia 'Can't you see I'm napping?'
Sophia ‘Can’t you see I’m napping?’

The general atmosphere has been one of patience and understanding from the nurses: they take time to explain how to do things, and comfort me when I have a particularly hormonal tearful day, and they really care for the babies. I feel really lucky to be in Denmark right now. We are given the role as parents, and not made to stand by helplessly on the sidelines. So now we are both able to change and clean our babies, and feed them my expressed breast milk through the nasogastric tube using syringes. This last thing was scary for me at first since you have to check the stomach contents by gently sucking out what is in there with a syringe, and then detaching the syringe plunger and pouring milk into the syringe, which then drips into the stomach slowly. Then at the next feeding you repeat the process, checking how much of the last meal they digested. 

The best moment so far was when I held my babies the first time. We are so lucky, we get to do daily kangaroo care, where we hold the babies skin to skin for an hour or two, just cuddling and soaking up the oxytocin. It is the most incredible feeling I have ever experienced, the sense of love and connection in the moment with this vulnerable perfect little being. And it’s as addictive as crack. It’s really great that we have the opportunity to bond with our babies even when they are connected to machines, and apparently it speeds up their exit from the NICU. So it’s good for both babies and parents. Plus there is a constant supply of new baby smell – amazing and calming, even better than new car smell. 

Baby snuzzling
Baby snuzzling
Dad doing kangaroo care
Dad doing kangaroo care

In the first week when holding them I would sometimes have the feeling of burning close to the C-section incision, other times it felt like water was dripping down my skin. It was really weird and I thought maybe there was something infected or wrong with the wound. But it turns out that the nerves reattaching can sometimes create some unexpected sensations. Now I am pain-free and slowly getting back to walking with a straight spine and trying to relocate my abdominal muscles to their rightful place…

It’s been adorable to see Chris in his new role as a dad, holding a tiny baby and smiling like he just won the lottery. Between that and caring for me while I recovered from surgery,  he is surely winning the husband of the year award.

People may wonder what do you do all day long hanging around a NICU? Sounds boring? Well actually, you end up being pretty busy. I started expressing breast milk using a double electric breast pump on the day of the C-section, and have kept up a strict schedule since then, milking out every 3 hours to encourage milk production enough for 2 babies. I take a 6 hour break at night to get a bit more sleep while I still can, and there are nurses to help with nappy changes and feedings in the middle of the night. So with 10-15 minutes per session that’s over an hour a day simply expressing milk (when my milk came in I walked around looking like I was smuggling torpedoes). In between, we have feedings and diaper changes. In the first 10 days, we did feedings every 2 hours, since the girls were losing some of their birth weight as their digestive tracts adapted to this harsh new world. Now we have stretched it to every 3 hours since the babies are able to digest better and are eating all their food and putting on weight, having just peaked over their birth weights. Then we also clean their cute little faces, and comb their hair, which is silky soft and gorgeous, and give them clean woolen hats, and the nurses replace their CPAP paraphernalia. In between I like to do a lot of baby watching, and just stare at them in amazement. Since all phones have to be on airplane mode in the ward, we have to leave to check messages out in the hall, and I tend to want to rush back to the babies, as if an entire nursing staff couldn’t possible manage without me hovering around…

After 3 weeks here, I am starting to find it more difficult, but it helps to know there is no alternative. The machines make sudden bleeps when any of the stats drop below threshold, and the constant noises can make me quite jumpy after a while. But I know the babies need to be here until they are big and fat, and strong enough to breathe on their own, and no longer stop breathing on occasion. So I try to go outside an hour or two a day and breathe non-hospital air and get some perspective. One of these days I will not have a team of nurses to help me and give me advice, so I am going to make the most of my time here and try and learn to be an observant mom, since there will be no monitors at home, just good old looking at your baby. I really look forward to just picking them up, and not worrying about a mass of cables in the way. 

Olivia 34+5
Olivia 34+5
Sophia 34+5
Sophia 34+5

At this point we expect to be here 3 to 4 more weeks, probably at least until the end of July. It is crazy to imagine that, but I know I can manage, and I am just taking one day at a time. I miss the babies whenever I am away so I am so glad I get to live here with them, as much as I miss my home. I know it will be very special when we all finally go home together.

This week’s highlights:

  • Olivia and Sophia both weigh more than they did at birth (1.7 and 1.8 kg approximately) and they have started sucking pacifiers, a gateway drug to breasts for premature babies 🙂
  • We removed the heated mattresses since the girls are able to remain at 37ºC, their brains have developed the ability to regulate their body temperature
  • The girls are learning to breastfeed so I am sitting with each of them twice a day so they can get the hang of it

  

Advertisements