My pregnancy started off just like most working moms- sheer panic! Once I got used to the idea of being a mom, my pregnancy was relatively uneventful. My doctor was aware that I had a short cervix, and I went to the doctor as told. After the baby and my cervix were checked during my anatomy scan in the second trimester, I did not have a physical exam from 15 weeks until 33 weeks. I never called the nurse except to ask for the results of my blood work and to maybe get a prescription for my morning sickness in the early weeks of pregnancy. I was very sick for the first 18 weeks of pregnancy, but by the time we knew that a boy, Henry Alexander would be arriving, pregnancy was uncomplicated and I looked forward to my due date- August 23rd, 2016.
Just before I left work for the Independence Day holiday on Friday, June 30, 2016, I made a list of the 10-15 items that I needed to complete for my small business before Henry arrived on or around his due date at the end of August. I had given myself until August 1st to prepare my office for my 6-8 weeks of maternity leave. My calendar was clear from August 15-October 3rd.
We had a relaxing holiday at home, and I even remembered to snap a photo of my little belly while we hung out in an inflatable pool for two on the 4th of July. On July 5th, I woke up to what felt like menstrual cramps. I remember thinking that was strange because I was seven months pregnant, and called my doctor in passing because I did not sense any distress or urgency.
I was in the Duval County Courthouse where I was working as a Criminal Defense attorney, when the nurse returned my call. In the anteroom of courtroom 405, I sat as she asked if my stomach was hard on either side when I felt the cramps. I told her it was. “Ok… those are contraction,” she told me. There was something in her voice… Panic? Exasperation? Concern? I got the message loud and clear, “you need to go home right now and put your feet up. Drink lots of water. It’s very, very hot and you are dehydrated.” I finished my court hearing and went home. I called my husband, my office and my mother and explained that I was to go home, hydrate and rest.
That night, we were excited to have my husband’s sisters visiting from out of town over for dinner unexpectedly. My husband made a delicious mushroom risotto and we enjoyed dinner and it seemed that my contractions had stopped.
At 4:00 AM on the 6th of July, I woke up suddenly feeling sharp pains. I drank a few glasses of water, and waited for relief. After about 30 minutes, I called my doctor’s practice and asked for the on-call doctor. About five minutes later, I got a call back from a doctor that I barely knew. It was a short conversation. “You’re 33 weeks. If you were 34 weeks we would not stop labor. Drinks some water and go back to sleep. The contractions will stop.”
“Ok?” I responded.
“But…if you see blood or fluid, I guess, you can come in to the hospital.”
I drank water. The pain didn’t stop. I got out of bed and tried to do some work. I remember that I wasn’t writhing in pain, but I was so uncomfortable and distracted that I couldn’t focus.
I called the doctor’s office again at 8:01 AM when the office opened. I left a message for the O.B. nurse conveying that I, “understand that I am not in labor” but something doesn’t feel right. When we spoke a few minutes later, the nurse asked how long the pain lasted and to describe the pain. Again, I was told to hydrate, but that if I saw blood or fluid to come into the hospital.
Around 9:30 AM, my business partner told me that I needed to go to the hospital as soon as possible. She couldn’t believe that I wasn’t already there. I trusted the medical professionals. If I needed to go to the hospital they would have said that. I felt like they didn’t want me to come to the hospital and that could wait to see them at my scheduled appointment the next day. My mom, a nurse and I spoke around 12:30 PM on her lunch break and she asked if I knew what Braxton-Hicks were. At some point, I spoke to my sister, also a nurse. She too felt that I was simply experiencing Braxton-Hicks and maybe getting some other infection or sickness.
I called the nurse again. She again asked how often and how long the pain was and for me to describe the pain. I was specifically told, “you’re not in labor because contractions last 60 seconds at least and you’re only feeling pain for 10-15 seconds.” She implored me to just sit tight and wait for my previously scheduled appointment on the following day (Thursday.) Because it was so hot out, she believed that I could have become more dehydrated simply by going outside.
Knowing that I “wasn’t in labor,” I latched onto the idea that I had an infection. I asked my husband to bring me cranberry juice. I thought maybe I needed to “get things moving,” and send my husband to get me a coffee. I chugged water. I called a few more times and spoke to the nurse at one point saying, “I know I’m not in labor, but I think something is wrong.”
Around 3:45 PM she finally acquiesced to me coming in for some testing and asked if I could get to her office (abut 20 minutes away) before the office closed at 4:00 PM. “I can’t drive and my husband isn’t home yet.” She again told me to just wait until my scheduled appointment, but that if I saw blood or fluid to come into the hospital.
At 4:08 PM, I went to the bathroom. I saw one tiny speck of blood. Finally. I was so excited to have a “legitimate” reason to go to the hospital, that I just grabbed my purse and told my husband, “we’re leaving.”
As we drove to the hospital, it was the first time that day that I had been in front of a clock. I felt uncomfortable, but I finally realized something… I wasn’t feeling the pain every 30 minutes or so for a few seconds. Whatever it was, I was feeling it for a solid minute, every two minutes. “Oh $#!@” I thought.
We got to the hospital and had no clue where to park. Our hospital tour was not scheduled until the end of July. My husband just left the car in the pick-up lane. We asked security where to find maternity, and I vividly remember that he paused to say “hello” to someone for what felt like forever. “Third floor,” he finally said.
We got to the locked doors of the maternity ward and my husband hit the intercom. “My wife, something is wrong, please help!” is all that my husband could say. “What?” the nurse asked. “I am a patient of Dr. so-and-so. She told me to come in if I saw blood and I saw blood.” It was about 4:48 PM when we arrived.
“Ok. We will be right there.”
They lead me into the antepartum room, and had me put on a gown. I should note, this is my fear – giving birth in an open bay with a ton of strangers around me. I go to put on the gown and I was so flustered that I put the gown on backwards. “Oh, honey…” the nurse said sympathetically when she saw me. I was a total mess.
She hooked me to a monitor and I clearly remember her saying that the baby’s heartbeat looked good, and I immediately felt much better knowing that. But she also said that I was definitely having contractions for more than a few seconds. “How intense are those?” I asked her. “That’s a question for you. How bad is the pain?” she asked.
As I started to say, “I’m at a seven” the pain escalated. “Okay, now I’m at an eight…maybe a nine, OK I am at a ten, I am going to throw up!” Three puke bags of mushroom risotto later… my doctor walked up to the bed.
“What are you doing here?” she asked with genuine concern. “I don’t know!” I told her exasperated. I was also compelled to say, “just so you know, we are supposed to go on our babymoon tomorrow to the Ritz in Orlando. Are we going to make it?” She smiled and let me down gently, “you’re not going anywhere. I’m going to check you then do an ultrasound.” Dang.
A few seconds later, I hear her say, “OK, I see a big bag a fluid!” That’s not good, I thought. Then she dropped a bomb, “you’re seven centimeters.”
The panic set in. “Am I having this baby tonight?” I asked. “You’re having this baby right now,” she said. I turned to my husband, “Call my mom, call my dad, call my sister, call (my business partner).” Shell-shocked, he swiftly left the room.
At my last appointment, I learned two things: (1) that my son had been breech for the last few weeks, but was expected to turn around 34 weeks; and that (2) if you don’t get an epidural before seven centimeters that your window of opportunity generally closes. The only question left at that moment was whether I would be delivering right then and there naturally or if I was about to be sliced open. I was not mentally prepared for either scenario as I thought that I had seven more weeks to make these decisions and pump myself up for labor.
“I feel a head, but let me check.” Please don’t be his head. Please don’t be his head, I started to chant in my own head. She used the ultrasound machine and said, “Oh no, that is his butt.”
At that moment, I realized that there were about ten people in the room because everyone started moving at once. The sweet nurse put surgical socks on me, another woman handed me paperwork, which I signed in about two seconds. (I assume that those were the consent documents, but honestly, I read nothing.)
In the chaos, my doctor sat down on the bed and took my hand. “This is not your fault,” she said, “sometimes these things just happen.” She told me a lot of information, but she specifically said that the neonatologist was coming to speak to me and that I would want to pay attention to this conversation.
A lovely young woman came to my bedside in scrubs. My husband is suddenly noticed was back, but frozen in shock sitting next to me. When she walked up, I started to cry. “Is he going to live?” I asked. The neonatologist looked at me and then my husband and gave the most judicious answer, “the survival rates are very high. If he is doing well, I will show him to you. If he is not doing well, I will take him straight into the NICU.”
From that moment, I simply waited for my son to cry. I also started to worry about the major surgery that I was about to have. A very charismatic anesteiologist and his not-as-charismatic apprentice came into the room and told me what to expect. They wheeled me into the operating room and my husband was given scrubs and led to another room to wait while they did the spinal block. The charismatic anesthesiologist was telling jokes and distracting me by talking about Cape Cod while said apprentice tried a few times to correctly do my spinal block. Ouch.
My husband finally came into the O.R. and turned into an excited boy. He was asking a million questions, specifically whether he could watch. The anestesiologist got serious and told him – “I’ve been doing this for a long time. If it were my wife, I wouldn’t.” He did. He took pictures. I have seen my insides…but I digress.
After a few tugs, and long silences, Henry Alexander Rainka arrived at 6:10 PM…about 75 minutes from the time that I walked into the hospital. He was 4 pounds and 10 ounces and 19.5 inches. He cried and we got to see him for quite a few moments. I was stitched up and started on pain meds with strict orders to stay in bed for 12 hours.
My mother-in-law showed up quickly, and I was grateful for my husband to have someone to be with in when he went to the NICU without me. I counted down the minutes to 6:10 AM, and did not sleep at all. Apparently, I made a few work-related phone calls and sent emails, all of which I had to explain and apologize for later!
My family and friends were shocked and my mother was beside herself. My parents live in Massachusettes during the summer and she had company. She was planning to drive back in a few weeks well before the due date, but wasn’t prepared to make the drive. She wanted to fly, but my parents over-thought things and decided to close down their house and drive back in a few days. She was so scared knowing about premature birth from her time as a nurse, and disabled by fear that we hardly spoke until she arrived back in Florida. Henry was her first grandchild and I know she will always regret not being there for his birth, but of course she had no reason to think he would arrive so soon.
The same doctor who was on call the morning before showed her face and had the nerve to say, “wow, you really wanted to have that baby yesterday!” Bitch. Before the 6:00 AM shift change, I convinced the nurse to let me get out of bed and go to the NICU. Thus began the 3-minute hand washing process every time we wanted to see our son due to the sterile environment that is the NICU.
Seeing my son for the second time was a joyful and fearful time. He was a very swollen, tiny and perfect little boy, but connected to so many tubes. Since Henry was our first child, we did not wholly grasp how small he was. When I saw him for the first time in the NICU, he was 4 pounds and 5 ounces, but the few friends and family who saw him later told me that they had never seen a baby that small. The amazing nurses introduced me to the NICU and showed me where we could bring things for him to wear and anything that we needed while we were there. As I listened to the nurses, I tried to familiarized myself with the very loud sounds of the NICU. All of the constant beeps and chirps were nothing compared to the sound of the alarm telling you that your child’s heart stopping, temperature droppings, or when he stops breathing.
My doctor was extremely gracious and admitted me for the full three-days so that I was close to my son. The on-call doctors came to the NICU to check my scar and check-up on me, which was awesome because every time that we left the NICU, there was a long process to get back into the NICU, and precious time lost next to your child’s bedside.
When your child is in the NICU, energy is the most precious commodity. Your child not only has to learn how to eat, but also how to regulate temperature and breathe earlier than he would have in utero, but learn with the burden of gravity. Henry was working extremely hard to do all of these things seven weeks before he would have naturally done them. Every calorie consumed was like gold, and the doctors and nurses did everything possible to conserve his energy.
As new parents, you are typically handed a baby and the feedings and diaper changes are all on you. Not so in the NICU. This conservation was achieved by not touching or disturbing him for three hours at a time. Every three hours, he was woken up, his diaper was changed, sometimes tests would be completed at that time or his IV would be moved. Then he was given 20 minutes to eat either by tube or by bottle, and whatever time was left, we could touch him and love on him.
We had to be mindful of the doctors and nurses’ effort, so we asked for permission. On the first day of his life, we got to touch his hand for a few moments and admire him. On the second day of his life, I got to hold him for a few moments. On the third day of his life, his father got to hold him and he got to change his one of his microscopic diapers and I learned how to feed him in the isolette. On the fourth day, he was at a rave… just kidding. His eyes were covered, and he was put under a blue light due to high levels of biliruben.
On one of the first few days of his life, a nurse told me that the neonatologist was looking for me and my husband. I went to the NICU only to be told that they were not letting anyone in or out due to an emergency. No one would tell me what was going on and the neonatologist was still looking for us. He casually walked into the reception area while we were waiting for the NICU to re-open. He wouldn’t say anything unless we were both in the room. I was terrified that the “emergency” was related to Henry.
A few seconds into the conversation he made it clear that Henry was fine. He explained the roll of the NICU and what to expect. In no uncertain terms, he told us that our son would be staying in the NICU for several weeks. He then had the audacity to lecture me about my role in this and the fact that I cannot have another child for two years because our next child would likely be pre-term also.
On the fifth day, his eyes were uncovered and he looked at me with relief that he could see again. Then we got to put clothes onto him for the first time. Finally, that day we learned how to feed him outside of his bed after working with the speech therapist on his sucking swallowing and breathing.
Eating was a battle. The suck-swallow-breathe action that we all naturually do when we are born full-term, is taught by wonderful speech therapists to preemies. He sometimes got the hang of it and sometimes he just couldn’t get it right and lost all of his energy. After several sessions with the speech therapist, he slowly figured it out. On the 18th day of his life, his feeding tube came out.
We were there as often as possible so we wouldn’t miss that hour of time with our son every three hours. We fought over who got to change his diaper and who would feed him. Every so often we would be able to welcome a visitor to see Henry, but only two people could be by his bedside at one time, and at least one parent has to escort visitors. You can only have two different each day. The psychological pain of turning away friends and family who wanted to visit Henry was tough. People were so excited for us, and some were miffed that they were not welcome into the NICU. It became a little uncomfortable and daunting to have to turn people down, so we stopped communicating with the outside world for a while. It was the worst time to retreat from our loved ones.
During this time, we constantly feared the monitors indicating a bradycardia or “a brady” as the nurses called it. If Henry’s heart rate dropped, the machines would make a sound that I will never forget. In fact, everyone in the NICU could hear every child’s monitor when something bad happened. The struggles of the NICU are rarely private. You hear the pain and struggle of every child and their family. We got to know our neighbors and our hearts broke hearing the babies who struggled to be weaned off of drugs and alcohol, or when our neighbors had bad days.
Henry was finally put on a five-day protocol for release, meaning, if he could go five consecutive days without a brady, he would be discharged. We were on the five-day protocol for about 12 days. At one point, we got to day four and while I was feeding him, the alarm sounded. I totally lost it. My husband and I just sat there crying until the nurses firmly, but respectfully told us that we would have to wollow in our sorrow elsewhere. Henry needed positive vibes only.
So, we took a short break. One of the biggest lessons of the NICU is self-care. You have to take care of yourself to take care of your child. We went to work, we saw friends, we re-grouped.
On the 22nd day of his life, we got to see Henry without tubes and wires attached to him when they were changing his leads. Finally, we started to see ourselves not sitting at a hospital bed, but home without the machines and noise. On the 24th day of his life, we got to give our son a bath.
Finally, 28 days later, on August 4th, there was no more vacancy in our nursery, and Henry was home! Not long after he came home we dearly missed the wonderful nurses that we had spent nearly a month getting to know.
I have reflected a lot on the summer of 2016. It’s no mystery what happened to me, although my doctors “don’t know” because they lack the data to say specifically. They lack the data because they didn’t look at my cervix after 15 weeks, which was mid-March. Despite knowing that there was an issue with my cervix, that there are options available to address said issue to prevent pre-term birth, no one looked and everyone chose blissful ignorance, including me.
Since sharing my birth story, I have learned that OBGYN care in the United States is a shame. First and foremost, I don’t believe that the risks are openly discussed. There are a lot of things that can go wrong during pregnancy, labor and delivery. I can see that advising emotional, pregnant woman could scare pregnant women. The general feel of OBGYN care is that providers seem to want to downplay the risks for fear of overreaction. The only problem is, the rates of pre-term births are unacceptably high.
According to the World Health Organizations, “[t]he problem of preterm births is not confined to low-income countries. The United States and Brazil both rank among the top 10 countries with the highest number of preterm births. In the United States, for example, about 12 percent, or more than one in nine of all births, are preterm.”
Name nine friends, one of them will have a preterm birth. Bravo to our world-renowned neonatologists, but they shouldn’t be so vital to the survival of American babies. As a first-time mom, you don’t know what you don’t know unless you’re in the obstetrics field. I have asked friends later in their pregnancy specific questions about their care, and more often than not my type-A, intelligent friends have said, “oh, I don’t know,” or, “my doctor hasn’t discussed that with me.”
I have asked health care professionals why there are not more ultrasounds or physical exams for third-trimester appointments, and the answer is generally the same – insurance doesn’t generally cover it and/or it takes too much time.
A quick look-see of a cervix takes what? 30 seconds? 28 seconds? 28 seconds could have my son 28 days in the NICU. It could have prevented me from having a ceserian section and permanent scar and nerve pain.
I am a firm believer in the need for women to speak up, ask questions, question their doctors who may be following a policy or procure that (unbeknownst to them) only benefits their employer’s bottom line.
Additioanlly, you can support the March of Dimes.
Why I support the March of Dimes
Since that time, I have come to know and support the March of Dimes. The March of Dimes is committed to improving the health of women and babies and preventing pre-term birth
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