I went into labor in the sixth month of my pregnancy when my son had reached 25 weeks gestation. My medical team tried everything they could to push my pregnancy into the third trimester. Unfortunately, I learned, there aren’t many ways to stop labor, especially when the underlying cause is a mystery like mine — and like 50 percent of all preterm labor cases, according to the Centers for Disease Control.
The doctors pumped me full of magnesium sulfate, an IV drip that causes flu-like symptoms. It didn’t work. “We’ll try Trendelenburg,” my doctor said. That sounded reassuringly official. No, I learned. Trendelenburg is simply an upmarket term for “holding you upside down to prevent the baby from coming out.” When the doctors reach into their bag of medical tricks and pull out holding you upside down, you know they are out of ideas.
They tipped the bed 30 degrees so my feet were above my head. Leveraging gravity to keep the baby in worked just as well for me as it must have for women in medieval times. For two weeks I vomited upside down, brushed my teeth upside down and prayed upside down.
Max arrived at 27 weeks and four days gestation. He was huge by micro-preemie standards: 2 pounds, 10 ounces. “Look! Quick!” a nurse yelled, holding him aloft before she disappeared into the neonatal intensive care unit (NICU). I cried. He did not.
In the NICU, his medical team promptly ventilated him but used so much pressure, his lungs’ air sacs burst. The doctors were forced to insert four tubes through his ribs. Pneumothorax tubes, as they are called, do not herald good news. Neither do brain bleeds, and he had a couple of those in quick succession. Gazing helplessly at him through the plastic window of his Isolette, my husband and I named him Max, because he was so mini. We thought it would imbue him with strength and fortitude.
While Max struggled for life, I struggled to remain sane. We’d lost a baby girl the previous year at 28 weeks gestation. I couldn’t figure out why this was happening to me. Worse, the doctors couldn’t either. I did everything right! I walked regularly and joined a prenatal yoga class. I gave up sushi, soft cheeses and wine. I choked down kale. Yet, somehow my womb of doom failed at the most basic of all human endeavors, keeping a baby safe, inside, for 40 weeks.
My baby blues erupted into full-blown postpartum depression. My medical team was ready for it and noticed quickly. It was hard to miss. I cried as they discharged me to go home, to live in a separate house, town and ZIP code from my baby. I cried as I pumped reluctant breast milk. I cried at Max’s bedside, where I was not allowed to touch him until he stabilized. Everything felt wrong and surreal.
Now that I was no longer being held upside down, the rest of my life had flipped into Trendelenburg.
The depression meds eventually kicked in. The meds stopped the tears but not the anxiety I had over Max’s condition. His prognosis changed hourly, and every tentative step forward was followed by a firm step back.
Fortunately, the NICU nurses urged me to participate in Max’s care, even when he seemed too fragile to touch. I was encouraged to touch his head and his feet. I pumped milk and could hold the bottle that sent this milk, mixed with the NICU’s formula my husband and I called Preemie Miracle-Gro.
Slowly, he got better. The pneumothorax tubes were removed. After a month, he traded the ventilator for less-invasive breathing assistance, a CPAP. He grew so much he could stay warm without the Isolette, which we had nicknamed the French fry warmer.
As slow as Max’s progress seemed to me, my tiny baby was healing and growing far more quickly than I was. While he grew and fought, I shriveled. Anxiety bloomed unchecked on the crumpled heap of my former confidence. I couldn’t sleep. What if the phone rang and it was the NICU? What if something happened and I wasn’t there?
When Max graduated out of intensive care and into the regular NICU, I met Nurse KelIy. Kelly had a son named Max, too — and her Max had been a micro-preemie. She showed me pictures of her son playing with his siblings. It was there that a doctor made the mistake of telling me the odds of Max developing cerebral palsy. I latched onto these statistics, stamping everything as an omen of CP.
“Did you see that twitch?” I asked Kelly. “Is it CP?” Kelly asked me to sit down. Her Max, she said, had cerebral palsy. I couldn’t believe it. That little boy whose pictures proved him to be so full of joy? Yes, she said.
“So,” she asked me. “What if? What if your Max develops CP?”
“It would be terrible,” I said. “He’d be sick and …” I remembered the pictures of Kelly’s Max. I’d never seen a more beautiful smile. In one picture, he was playing soccer.
“You’d still love him, right?” she asked. Of course, I snorted. “And you would protect him and get him everything, every service, he needed?” Obviously, I said. “And that wouldn’t change, whether life was easy or hard?” I scoffed openly.
“Well, then,” she said. “It sounds like he has everything he needs.”
I considered this and was quiet a moment.
“He’ll have a good life,” Kelly said. “Because you’re his mama. And you’re a good mama.”
And here she’d touched the live nerve that twitched at the root of all my real anxieties for Max’s future.
Was I enough? A real mama would have been eight months pregnant, encapsulating him in a safe, perfect amniotic world while he peacefully floated, nonchalantly growing lungs and eyebrows.
“I’m not enough to get him through whatever happens to him,” As I said this aloud, I realized this is what I had been feeling since those first labor pains.
“And you’re wrong,” she argued. “I see you in here every day. Whatever happens with your Max, you’ll make sure he’s OK. Because you love him and you show up for him.”
The best advice I’d ever gotten wasn’t technically advice. It wasn’t even revelatory. It was something I simply needed to hear, something I’d lost in the traumatic delivery room: the belief that we had everything we needed to be OK.
Because I loved Max and showed up for him every day, we could face whatever challenges life threw at us, and Max would have a good life.
It’s been 15 years, and he has.