Mandy: “A nightmare, my placenta suddenly stopped working”

“Pregnant, absolutely pregnant!”, I thought when I had just done the test

Overwhelmed with joy, but panic also flew to my throat. “We have to move! We've just booked a holiday! By the time we go on vacation, I'll be eight months pregnant”. I had consciously stopped taking the pill, but I hadn't dared to dream that I would get pregnant so quickly.

Spots on my chest

After eight weeks, I developed a strange, red, painful spot on my left breast. At first, I thought it was an inflamed gland and decided to wait and see. But after a few days, the pain worsened and the spot became redder. I decided to call the doctor. I was able to come in and went home with a prescription for antibiotics. “It's not common during pregnancy, but it really looks like mastitis,” the doctor told me. “Of course,” I thought, “this would happen to me”. I started the course of antibiotics for one week. After I had finished the course for a week, the pain and redness persisted. So, I went back to the doctor again. This time I was given a stronger course of antibiotics. If I saw no difference after five days, I had to come back, because there might be something else going on. I tried not to worry too much, so I pushed aside scary thoughts. My mother had breast cancer two years ago, after all. Yet, I had to return because this course of antibiotics also did not work. I was referred to the breast clinic where I could get an appointment the very next day.

Mamapoli

Once at the clinic, I had a consultation and my breast was examined. A trainee doctor examined me and he thought he couldn't feel anything. “Thank goodness,” I thought. But just to be sure, he called another doctor because, after all, I was pregnant and my glands were a bit more swollen. The other doctor came in and to my great alarm, she did feel something. I had to get an ultrasound just to be sure, and I was able to go straight through. They indeed saw something there. I was given the choice: wait a bit longer or take a biopsy of the spot now. I chose the second option. After a week, I got the results and it was a (benign) fibroadenoma. My goodness. I had already read all sorts of scary horror stories on the internet about breast cancer during pregnancy. But I still had to have a mammogram just to be sure, to rule out if there wasn't anything strange elsewhere. This could only be done from 20 weeks on, as the radiation was harmful to the baby as long as it wasn't fully grown. So I had to wait a while before it was time.

20-week ultrasound

The 20-week ultrasound went well and we were told that we were having a 'beautiful, slender girl'. Straight to the mammogram, which hurt terribly with those sensitive breasts. Fortunately, everything was fine. That chapter was closed. The weather got warmer and I started to retain more fluid. I was tired, but that was to be expected: I was pregnant, it was 35+ degrees and we were in the middle of moving. Friends and family helped us with the move and my partner set up the pool in the garden of our new home. Meanwhile, it was 40 degrees and I was almost 30 weeks pregnant. I was about to burst from all the fluid I was retaining. I went to work and was preparing for my maternity leave, which would start the following month. Then I had the 30-week ultrasound...

30-week ultrasound

My friend worked at sea and was away. My mother accompanied me to the midwife. The midwife could tell that I was retaining a lot more fluid compared to the last time she saw me. I lay down and the baby was clearly visible on the screen. I started feeling uneasy when I saw her face. “Hmm,” she muttered. “Your baby is a bit on the small side.” I started sweating profusely: “Should I be worried?”, I asked. She measured again and again, but the results were the same. “I'll send the data to the gynecologist in Almelo, just to be sure. The baby is scoring well below average. If you leave now, you can still go through the main entrance.” It was the first time I had to go for a check-up in the evening. I had to travel all the way to Almelo, even though it was already 8:00 PM.

When we arrived at the department, I was connected to the CTG and was going to have an ultrasound

It was busy in the department, so I had to be patient until the gynecologist had time. At 10:30 PM, I was picked up for the ultrasound. Two gynecologists reviewed the results and confirmed that the baby was very small: around 1000 grams. “Your room is being prepared and you'll start with lung maturation immediately. Tomorrow you'll have another ultrasound and then we'll discuss what to do next.” The doctor looked at me. “My room is being prepared? Lung maturation? Help, this isn't right!”, went through my mind. Then I was calmly taken to my room. There I was, without any belongings, without clothes, in the hospital. Meanwhile, my mother had to go home, she had to work the next morning and nothing was clear yet. I called my boyfriend and he would come first thing the next morning. This was the beginning of a rollercoaster...

“You will have an ultrasound at 10 o’clock,” the doctors said the next day

I hoped that Ramon would make it. He had to come from den Helder. Eventually, my friend arrived just in time with a huge bouquet of flowers. The measurement was the same again: around 1000 grams. It depended on the umbilical cord or the placenta. Tears appeared. I was taken back to my room and a doctor would come to tell me what was going to happen. The gynecologist said that she was going to call the hospital in Zwolle to ask if there was room for me. The baby was so small that I had to go to a specialized hospital and then Zwolle was the best option for us. Soon I got the green light and off I went, to Zwolle. It was Friday afternoon, I would get another extensive growth ultrasound on Monday and then a lot would become clear. Until that time, I would be on the CTG twice a day. Two more days to wait... We were told that they would try to keep the baby in as long as possible. They hoped to reach 37 weeks. So six more weeks to go. "Six weeks staying in Zwolle? And doesn't the baby need to come out? She's not getting anything and she's already so small?", all sorts of thoughts raced through my head.

Another growth ultrasound

The gynecologist was immediately very clear. "It doesn't get worse than this. Your placenta is at the end of its rope. We're not talking weeks anymore, but days." OH-MY-GOD. DAYS?! The baby was otherwise healthy as far as could be seen, but she was busy using up her reserves. I then had to be on the CTG twice a day. If the baby's heart deviated, I would get a cesarean section immediately. The baby wouldn't be able to tolerate labor-inducing drugs. I was fine with everything, as long as the little girl was born healthy. I was literally on edge every day wondering if today would be the day. But it dragged on and on... The uncertainty was exhausting, and to make matters worse, I suddenly developed extremely high blood pressure. I received medication for this. Despite everything, she continued to do well. My partner eventually went back to work, because by then it had been 10(!) days without incident. Family and friends came to visit me to pass the time.

It was that far

My father had been visiting and when he walked out the door, the nurse came in to hook me up to the CTG so I could get some sleep on time. Once on the CTG, I noticed that the baby wasn't very active. “She must be asleep,” said the nurse. Lie on one side. Then on the other. No change. Everything in me felt that the time had come. The nurse was in touch with the gynecologist and the lines of communication were short. It felt like the longest evening I had ever experienced. After all, having been on the CTG for three hours, suddenly the gynecologist was at my bedside. “This is the moment we've been waiting for. We need to deliver the baby.” Phew... Was I happy? Yes. Was I scared? Yes. Was I relieved? I didn't know. The only thing I knew for sure was that I had to call Ramon. The nurse told me that a room was being prepared for me. There I could calmly call my boyfriend. Then I was prepared for the cesarean section. I hoped my boyfriend would be there on time. And he was.

On August 14th at 01:22 AM, our beautiful daughter Mila was born

She weighed 1310 grams and was about 38 centimeters long. I heard a tiny mini-cry. It sounded like a little kitten, but it didn't matter because she was making a good sound! I saw her briefly through the screen and then she was immediately taken away. There she went. 'Take good care of her,' I thought. I was stitched up and surprisingly calm. At some point, I heard that she was doing 'very well'. Phew. What a relief. When I came out of the O.R., I started crying so hard. There they stood: my partner with our daughter next to him in the incubator. I got a big kiss from my partner and then I saw her. How beautiful she was. So small, but such a beautiful girl. All the bells and whistles. I was allowed to touch her briefly. I put my hand through the window of the incubator. She immediately grabbed my finger. A little jolt went through her body. Our miracle. My hand was almost as big as her entire body.

The bedroom

After I regained feeling in my legs and was allowed to leave the recovery room, I was briefly taken to see my girl. My parents and in-laws were there too. They each got a turn to admire the little lady. The next day, I was finally allowed to hold her. She was doing so well. There she lay, snuggling on my chest. My boyfriend sat next to me. We were complete.

To our own hospital

After a few days, she was allowed to move from neonatology to the high care unit. She stayed there for several days and after a week, she was transferred to Almelo. This made a big difference for me, recovering from a cesarean section, as I could be with my little girl in no time. She became quite ill shortly after the transfer. She developed a high fever and was short of breath, which meant she needed some breathing support for a while and was given an IV with antibiotics. It was a tense time, but she recovered well. After two days, she was fine again. Day in and day out, I did kangaroo care with her. Slowly but surely, she became stable and the tubes became fewer and fewer. She was allowed out of the incubator and placed on an 'open table'. She used this for one night and then she was able to move to a crib.

In the end, she only had the monitor and her tube feeding left

If she was stable for 72 hours, she could be taken off the monitor. And that happened. She weighed 1850 grams and thus only needed her tube feeding. Drinking from the bottle went relatively well, but it took a lot of energy out of her. She could go home when we felt comfortable administering tube feeding. We were trained for this. We were ready. She was allowed to come home. We were finally complete.

Home

Once home, we received additional post-incubator care for a total of 16 hours. "I have never taken care of such a small baby before!", said the maternity nurse when she saw my daughter for the first time. She weighed 1.8 kilograms, which is of course not much. The weeks flew by and our little doll was doing well. She no longer needed the feeding tube, so now she was really free from all her tubes. I went back to the hospital after six weeks for the results of the placenta investigation. There was no explanation for why it wasn't functioning. I was somewhat relieved about this for the future with another pregnancy, but on the other hand, I didn't understand why this happened to me. I had followed all the "rules" during the pregnancy. It was inexplicable. Mila is developing well. This is a question that has been haunting me since the moment of admission. The premature birth has had a major impact on us. All the uncertainties, tension, and sorrow were truly a rollercoaster.

MANDY