A mother of two shares the challenges of keeping her second child alive before and after he was born.
WORDS RACHEL KWEK
It is heart-warming to see how healthy Nathan is now. When he was born, he was a mere 1.029kg. Mothers who have had premature babies would be able to identify with the pain of not being able to hold them once they are born and of watching them lying helplessly in incubators. One such mother, Wee Ling, shares the story of her tumultuous pregnancy journey.
A Bumpy Start
Before Wee Ling even found out she was pregnant, she was diagnosed with a urinary tract infection, severe fatigue and vertigo, which saw her being warded. When she found out she was expecting, she got very worried that the medication she was on would cause harm to her unborn baby despite her gynaecologist’s assurance that they were safe. Then, five weeks into her pregnancy, Wee Ling’s doctor discovered a cyst in her ovary when she experienced bleeding and went for a check-up. To make matters worse, the vague diagnosis made her very anxious; she thought it had existed before conception and felt guilty for not going for pre-conception scans.
A subsequent consultation with a private OB/GYN and her own research revealed that the cyst was a corpus leuteum cyst, a by-product of ovulation that is harmless if it contains only fluid and disappears by the end of the first trimester. Hormone medication, injections and almost-weekly visits to her doctor’s became the norm for her. Wee Ling prepared herself mentally for a keyhole operation to remove the cyst as it continued to grow quickly and she had frequent instances of light bleeding throughout that period. “Thankfully, just after the first trimester,” she says, “the spotting stopped and the cyst disappeared.”
Kept on Tenterhooks
Just when Wee Ling thought she could put her mind at ease, she found herself bleeding again after an instance when she overexerted herself. It was a Sunday and her obstetrician told her to go to the 24-hour clinic at the hospital first. However, as she was only 15 weeks pregnant, they couldn’t do much. Shortly after leaving, she started bleeding much more heavily and decided to head directly to the hospital where her doctor was based. Other than monitoring the bleeding, nothing much could be done. Though her baby’s heart rate was still strong, she said she was prepared for the worst. A detailed scan the following morning revealed that the bleeding came from the sub placenta. She also learnt that she was having a boy. Her doctor instructed her to have ample bed rest as that was the only way to try to keep the baby safe.
With neither family support nor a domestic helper, it was hard for Wee Ling as she had to take care of her three-year-old toddler, but for the baby, she and her husband canvassed as much help as possible.
Recounting how she and her husband had to make middle-of-the-night trips to A&E because of her sudden bleeding, she said, “It was very torturous. We were starting to get a little numb, really.”
When she went back to the hospital for review a week later, she told her doctor she was not optimistic about what could be done to save her baby if she bled very badly as the potential for a baby born under 24 weeks to survive is very low.
Planning the Next Move
Amid the uncertainty, Wee Ling planned ahead. She realised that her baby would need specialised care in a neonatal intensive care unit (NICU) if he made it past 24 weeks. “We definitely couldn’t afford that at the private hospital we were in and I didn’t want to check myself into another hospital with no medical records at the last minute if I really needed to deliver prematurely,” she says matter-of-factly.
18 weeks into her pregnancy, she called another hospital and managed to book an appointment with a renowned high-risk pregnancy expert, once he learnt she was experiencing bleeding throughout her pregnancy. The doctor told her she had partial placenta abruption – an uncommon and serious complication in which the placenta peels away from the inner wall of the uterus; this potentially deprives the baby of essential nutrients and causes the mother to bleed heavily.
With medication, weekly injections and strict bed rest and by restricting her movements, Wee Ling managed to make it to week 26 when the bleeding mostly died down. She steeled herself to try to keep the baby in for as long as possible when a detailed scan revealed uplifting news – her baby was completely healthy.
Unfortunately, before she hit week 27, she started experiencing frequent painless contractions. On the third day she had those contractions, she decided to check herself into the hospital where she was put on various anti-contraction medication for several days before being discharged.
However, she had to rush to the hospital again when severe bleeding recurred. “Throughout my short pregnancy, it was just unbelievably surreal to be bleeding while I was pregnant. The two just didn’t go together!” Wee Ling mused. The medical team at the hospital could not determine the reason for the bleeding but she suspected it was the placenta issue again.
To keep her spirits and hopes high prior to delivery, Wee Ling had searched online for success stories of 27-week premature babies, but in her heart, she prayed that her baby would not survive if he were to have any debilitating conditions due to his premature birth. “It’s such a heartbreaking thing for a mother to wish for, but the last thing I want is to cause my baby to live a compromised lifestyle because of me.”
The Alarm Went Off
On the third evening she was hospitalised, she felt a gush of blood coming out. To her dismay, the nurses were quite dismissive when she informed them as the baby’s heartbeat was normal. She insisted a doctor do a check-up on her. “Call it maternal instincts but I had a really bad feeling about it,” Wee Ling recounts.
Eventually, a more senior doctor ascertained she was indeed bleeding a lot and her doctor was called in. He decided to deliver the baby via a Caesarean section that very night. Perhaps due to her severe anxiety and side effects from the epidural, she was trembling uncontrollably throughout the operation and thereafter. However, she felt very assured that her doctor operated on her together with the registrar on duty. As her husband could not go into the delivery ward with her, Wee Ling says her only consolation was the anaesthetist who spoke to her throughout to check on her condition and update her on her baby.
After more than an hour, Nathan was born at 27 weeks and two days old on 28 August 2014. Thankfully, with a little help, the 1.029kg newborn cried loudly. The anaesthetist assured Wee Ling that her baby was doing well. Once delivered, Nathan was handed to the neonatologist on duty and Wee Ling did not even get to take a look at him. When her husband went to see her and accompany her to her ward, he told her that her doctor said it was a good thing that they delivered the baby then; a blood clot weighing 1kg (as big as the baby) was found behind her placenta. “I had an almost irrational fear that my placenta would suddenly detach and result in an emergency C-section that would be unable to save my baby. Though there’s nothing to celebrate about delivering a preemie, I felt almost vindicated that I had pushed for medical attention that night,” Wee Ling says.