The Two Week Wait
10 Questions To Ask Your Care Provider
Pregnancy After Miscarriage: How Long to Wait Before Trying Again
Bleeding In Pregnancy
Birthing Your Placenta : Active Management versus Physiological Management
When To Stop Breastfeeding | Australian Birth Stories
5 Common Postpartum Experiences
In this week’s episode I interview Fizz who birthed her first baby at 23 weeks and six days. She takes us through the trauma of her unexplained premature labour, the shock of seeing her micro-preemie and the groundhog day of NICU life which, all things considered, was a relatively smooth journey for her and baby Ernie. She successfully breastfed him till 18months and despite her PCOS diagnosis, fell pregnant again quite easily. She was closely monitored but made it to full term. It was during her postpartum that a series of events led her to an ADHD diagnosis which was life changing in the best possible way. With a renewed sense of self-awareness, Fizz fell pregnant again, went off her medication and prepared for a positive birth with no induction or epidural. Baby Sid arrived on a stormy Melbourne night, an experience that Fizz describes as “really lovely.”
Fizz and Tristan were living in Sydney when they first fell pregnant. They drove to Melbourne to surprise their families with their news but when they went to their dating scan, there was no heartbeat. What followed was a challenging fortnight of scans and blood tests and eventually the diagnosis of a missed miscarriage.
Months passed without conceiving and after seeing a specialist, she was diagnosed with PCOS and was told she had a one in a million chance of conceiving. Fizz was eventually referred to a fertility specialist who talked her through her options; she chose ovulation induction through injection which was promptly successful.
“I opted for private care with an obstetrician and I saw him once a month. He was happy to do scans to reassure me when my pregnancy symptoms dipped and I worried about the baby. My first trimester was very straightforward; I was tired and had sore boobs but apart from that I was fine. We told our family and close friends early because we really valued their support during our miscarriage and if it happened again, I knew we didn’t want to do it alone.”
Fizz was in Melbourne for work at 23 weeks pregnant when she lost her mucus plug. She sent her obstetrician a text and he told her not to panic and reassured her that it commonly grows back.
“It was in the back of my mind and then I flew back to Sydney and when I got home I went to see my OB and everything was fine. Two days later I started having period pain cramps and I had a bloody show. I called my OB and I had a scheduled appointment on the Monday – I was 23+5 – so he told me to take a panadol and rest. I went to work as normal on the Monday and I was having lunch when I started to get quite distinct early labour contractions. I packed up and left work and Tristan picked me up. The doctor did an internal and my cervix thin and 1-2cm dilated which was concerning. I was scared but I was naive; I just thought they’d give me something to stop the contractions.
“My OB told me I was going to have a premature baby, that I could expect a few months of bedrest and then months in the NICU. We went straight to the hospital and up to the maternity ward, thinking I was going to have weeks of bedrest. They gave me more nymphetamine to stop the contractions but they weren’t working. They gave me progesterone as a last attempt to ease contractions. I made it through the night and the next day they gave me a steroid shot. By the evening I couldn’t sit down, I was having a lot of contractions and by 10:45pm I requested to see the pediatrician.
“Because Ernie was pre-viability, the doctor took us through the possible risks and things that can happen. We wanted our baby to be saved but he would only save him if he was born in good condition. They knew he wouldn’t cry but if they could get him intubated, they would do it immediately after birth.
“My hind waters broke and I started getting a lot of pressure. They pushed me into the birth suite, my OB walked in and then it was full steam ahead; my waters were broken and on the next contraction I started pushing and he was delivered into Tristan’s hands and he let out the tiniest squeak which everyone was so amazed by. They counted to 40 till they cut the cord because he needed all the blood he could get. He was so tiny sitting in Tristan’s hands and his skin was translucent and that was when I really wondered if it was going to end well. They put him in a plastic bag for warmth because he had no skin at that point. Tristan went with him but he had to sit outside while they intubated him; I can’t comprehend the panic he would have experienced, just waiting and not knowing.
“They gave me the syntocinon shot and they started gently pulling on the cord and it kept breaking; it must have been so underdeveloped that it just kept snapping off and I just felt gushes of blood. They rushed me off to surgery and removed the placenta in a D+C style operation. I was lying there shaking, not knowing about my baby, I had lost 1L of blood…it was awful.”
Fizz was back in her room when she learnt that Ernie was successfully intubated and as she was getting her head around everything that happened, she started expressing colostrum and her three-hourly milking sessions had begun. Within hours she was wheeled around to the NICU to officially meet Ernie.
“It was really confronting going to the NICU; I was scrubbing in and when we saw him he was so tiny; he didn’t fit the smallest of nappies. It was scary and incredible and it was still a beautiful moment – I was meeting my baby! Once I was discharged from hospital I would wake up, take Tristan to work, go to the hospital, I’d go out for lunch and go for a walk, then I’d pick Tristan up from work and we’d go in for the evening. The start was very much sitting there, staring at him, hoping he would improve. He was there for 96 days and then he went to special care for three weeks before we took him home.”
Fizz went on to exclusively breastfeed Erine till he was 18months – an amazing feat! She saw a psychologist to work through her trauma and used rapid eye movement which was resoundingly successful. They moved back to Melbourne and Fizz met with obstetrician Rachel Ryan at Epworth Freemasons to discuss her risk of another premature delivery if she fell pregnant again.
“Since being in the NICU, I know what can happen and I didn’t want to put us or a baby at risk. Rachel was really confident that I wouldn’t deliver early and she was happy to support me through the pregnancy considering I would be classed as high risk. She monitored me very closely, I was on fortnightly visits and cervical scans and they would tell me the cervical length after each appointment. I was also on progesterone, twice daily. Once I made it over the 24 week I was relieved; I was on pelvic rest so no exercise, sex or heavy lifting. By 34 weeks I really started to relax and then I got to 36 weeks and I was done; I was swollen and still looking after Ernie was 21 months but developmentally was only 17 months.
“At 37 weeks my waters broke in a big gush and it just kept coming. Within a few hours we went to hospital even though I had no contractions. They admitted me and monitored me – it was only 5am so they encouraged me to rest – and at 8am the obstetrician who was relieving Rachel came and saw me and said: Right, let’s get you hooked up to the drip and get this baby out. It was really different to spontaneous labour and I got to 6cm before I had the epidural; not long after that I delivered. It’s a lot different pushing out a full term baby and they were coaching me through it; it was a typical induction, epidural birth. At some point his heart rate started dipping so they used the vacuum to deliver the head and then his shoulders got stuck so they had to manoeuvre him and he was a bit flat when he was born. They put him on my chest and they were rubbing him; they took him onto the table to give him oxygen and they put him on the stats monitors and it took me straight back to the NICU and I kind of lost it then, thinking that it might be Ernie’s experience all over again. He let out a big cry and coughed up mucus and then he was fine.”
“It wasn’t until after I got pregnant with my third and started looking into birth, that I realised I had a lot of trauma from that birth. Having the epidural, pushing on my back and hearing that beep; it was all related to my birth with Ernie.”
In December 2019 Fizz had the mirena contraception inserted and was subsequently overwhelmed with an array of new and alarming symptoms.
“It was like someone had flicked a switch in my brain; I was noise and light sensitive, my tolerance was so low and I was a completely different person. I was screaming at my kids, I couldn’t handle the light on in the room, I couldn’t even have the radio on. I knew something wasn’t right but I thought I was experiencing anxiety. My obstetrician took it out and I expected to go back to normal but I just didn’t. Then covit hit; I was jittery and jumpy and had a shortened temper. I booked an appointment with my psychologist and she’s known me forever, she’s been seeing me since I was 15. I was sitting in the bathroom on a zoom call with her. I told her the story of the mirena and the symptoms and she said You’ve got ADHD. She went through the list of everything I was feeling and the symptoms of ADHD and it was like tick, tick, tick. I’ve always been worried about what people thought of me and I’ve always constantly tried to do the right thing as a mother, it really struck a chord with me. I am incredibly hyper focused; I was inattentive and naughty in school and yet when I went to uni and I was doing something I loved, I thrived. I was unravelling my whole life; it was like a light turned on and everything made sense. It was comforting and although I had a brief moment of Could life have been different if I was diagnosed at school? It just felt like a really great realisation.”
When it came time to conceive her third baby, Fizz knew she would have to stop her ADHD medication, but she’d learnt what triggered her and knew what lifestyle changes she had to make to ensure the transition – and her daily life – would be as smooth as possible.
“I was excited to be pregnant and I learnt to control the things I could control. That said, it was definitely hard, I won’t lie.”
Fizz chose to go with her trusted obstetrician; she was still on progesterone but had less cervical scans because she hadn’t had any concerns with her second pregnancy. It was a challenging pregnancy; Fizz definitely felt older, she had awful morning sickness till 20 weeks and when it eased she was overwhelmed with pelvic girdle pain. At 34 weeks she discovered the baby was breech and after trying multiple techniques, she had an ECV at 36 weeks which was successful.
Fizz was 38+2 when she went into labour; the longest of any of her pregnancies. She was determined to go into spontaneous labour and take things into her own hands and experience a positive birth.
“We were lucky enough to do an in-person hypnobirth class and that set the tone for the birth that I wanted. I was offered an induction but I declined and I’m really glad I made that decision. The boys were in daycare and I did the groceries, I started getting some niggles and after a couple of hours it was obvious that it was on. I was so lucky – I got to labour at home but I was aware that my births were quick, I listened to my affirmations and had a shower and got the boys ready to take them to my parents. When we got to the hospital labour had slowed and I got my obstetrician to check me; I was 4cm so she encouraged me to stay and see how things progressed.”
Once her waters broke, labour progressed quickly and she laboured beautifully.
“Towards the end I started involuntarily pushing and they couldn’t trace the baby’s heart rate so they put the clip on her head. She was born in 12 minutes which was really quick. I pulled her between my legs and put her on my chest – she had to go off to get a bit of oxygen quickly – but she was back to me. It was just a really lovely experience.”
Spontaneous premature delivery, Progesterone, ADHD, Ritalin, Three vaginal births, Micro-preemie, Induction, NICU
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