"Sunshine" - 17 March 2010

My pregnancy with Sunshine was far more fraught than that with Storm. In between the two, I had miscarried for the second time. I had carried to 12 weeks. Some investigations had been carried out, but because the miscarriages weren’t concurrent, no one was too worried. I was delighted to find out I was pregnant again just a few months after miscarrying, but very worried about making it past the magic 12 week mark. I had no early problems, although I put on very little weight in the first trimester – about 1kg total.

At 20 weeks, I was told that baby was small for dates. At that point, I had never even heard of intrauterine growth restriction (IUGR), and knew nothing about the reasons behind it. As no one seemed worried, I just assumed that they meant I was having a small baby. Looking back at her scans today, I can clearly see the pointers – her abdominal circumference (AC) was already measuring 2 weeks behind the rest of her growth at 20 weeks. Her other growth measurements were over a week behind what would be expected for her gestational age.

At each subsequent appointment, my doctor made the same comment – “She’s really going to be a tiny little thing”. Then he would ask me the same set of questions, the answers to which he could easily have found in my notes.

How large was your first baby?

2.6kg

Ah, so you have small babies.

Although I had told him my son was pre-term at our first appointment, he never asked again when he was delivered. When I had my notes transferred to a new doctor, I discovered that he had never noted anything I had told him about my previous pregnancies apart from the simple number of live births and miscarriages.

And you had a natural delivery with no complications?

Yes, although my placenta was very calcified and atrophied at birth.

Don’t worry, dear. That won’t happen again.

Well, it did. With cherries on top. Sunshine continued to lag behind, particularly in AC. My labour started at 38 + 6 days, at which point I had gained a total of 10kg and was seldom even wearing maternity clothes.

Once again, I had been experiencing very strong Braxton-Hicks contractions from about 28 weeks. Due to these, I have no real idea how long my labour was, as it was impossible to tell a real contraction from a practice one. Perhaps there were a few that I missed, but the one that made me realise I was in labour came on so strongly that I fell (luckily onto a carpeted floor). Geo and I rushed – I wasn’t feeling good at all, and guessed there wasn’t much time to get to the hospital.

When we arrived, I was examined, told that I was only 2cm dilated, and I should walk around or perhaps go for a shower to relax. I started walking down the corridor toward the bathroom. About 10 steps down, a wave of pain hit. I backtracked quickly, and as I walked back into the room my waters broke. By the time I was lifted onto the bed for an examination (I couldn’t stand), Sunshine was crowning. No doctor had arrived, so she was caught by the midwife on duty, who never had a chance to touch either of us before she was out. She was blue, no breath sounds, no movement. They rushed her straight to NICU – I didn’t get to hold her or even a chance to ask if she was alive. My husband raced off with the nurses.

A nurse remained to help me deliver the placenta. She gasped when she did, but I was in shock from the speed of the delivery, so didn’t ask questions. There had been 45 minutes between leaving home and her being taken to NICU. When the doctor finally arrived, the nurse told him the placenta was in very bad condition. I heard him say, “I know”.

When I finally got to see my girl, she was covered in tubes and wires. My paediatrician told me that she was a clear case of asymmetric IUGR, with her tiny abdomen and normal sized head and limbs. She had aspirated meconium at some point prior to birth – enough time had passed for her to develop a nasty lung infection. She weighed 2.3kg – well below the first percentile for weight for her gestational age. Although she looked like a fairly normal (if tiny) newborn, she acted like a prem baby. She battled to breathe, had to be tube fed, was jaundiced, had trouble with her blood sugar and couldn’t regulate her temperature.

1 day old

She turned out to be a real little fighter, though. In a week, she had recovered enough to be discharged, with many caveats. She has had some effects from her stressful time in the womb. She is very prone to infection, particularly of the chest and throat. At 18 months, she had her tonsils removed. At the time she weighed just over 6kg. Her weight and height are still low, but finally reached normal limits in the last couple of months. She is now 34 months, and at 11.5kg and 84cm, she is on the charts at around the 5th percentile. She is not a great eater (perhaps a side effect of the many throat infections), but is a very happy, bright little girl. She is doing very well at pre-school, now that she is consistently well enough to attend with her brother. She is agile beyond belief, often terrifying me with her bravery. So we got off lightly.

The doctor charged us full price for the delivery.

Coming home