By: Takema Robinson-Bradberry
In September of last year, twenty weeks into my second pregnancy, I was diagnosed with Pre-term Premature Rupture of Membranes (PPROM) a rare condition that occurs when the sac holding the amniotic fluid and baby ruptures before 37 weeks. PPROM occurs in less than three percent of pregnancies and its cause is unknown. Typically PPROM occurs later in pregnancy and most women with PPROM go into labor within 72 hours of the amniotic sac breaking.
The diagnosis came shortly after an extended business trip to New Orleans. Ironically, while in New Orleans I felt the best I had in months. My spirits were high from visiting with family and friends, taking African dance classes and soaking in everything about the city I had grown to call home. The day after returning to Little Rock, where we had moved the year before, I was shocked to learn at a routine appointment that my amniotic fluid was dangerously low for the gestational age of the baby. The perinatologist immediately ordered me on home-based bed rest with a prescription to spend more time “with my baby” and less time sending “blood to my brain” at work. Shortly after returning home from the appointment, I was shocked to find blood and was rushed to the maternity unit at Baptist Hospital Center in Little Rock, Arkansas and admitted to the antepartum unit where I would live for the next two and a half months.
Every day pregnant on antepartum is a victory, they say. Full of positivity and hope, the nurses told me encouraging stories of women who carried their babies to full term. There was a mom, they said, who lived in my very room, who carried her twins to 37 weeks just the year before. Family and friends called, sent flowers and cards. My mother-in-law flew in for a visit, and my husband brought my 2-year-old to see me every day after school. Phone calls and daily text messages from dear friends who knew the experience of bed rest kept me from losing my mind during those 41 days spent away from my son staring out the hospital window.
We nicknamed the baby boy “Maximilian.” We wanted to give him a bold audacious nickname that would stand up to his brother Kingston Toussaint’s name. More importantly, we wanted to humanize him for ourselves and the nurses and doctors. He was not an unnamed fetus. “Max” was our living breathing miracle baby called to this place and time with a God-given purpose.
During those 5 weeks and 6 days, I would go into active labor 3 times. Unbeknownst to me, outside of my room was an emergency labor station as the nurses and doctors prepared for the eminent birth of baby “Max”. Thankfully each time I labored, a combination of prayer and will, stalled the contractions. At 25 weeks and 0 days, my husband and friends surprised me with cake, ice cream and balloons. I had made it to a very important milestone – viability. Viability meant that I could now receive steroid treatment to strengthen the baby’s lungs should I deliver early and that the hospital would do everything possible to support baby Max when he came.
On November 8th, baby boy Bradberry, aka Max, was born. He came at 25 weeks and 6 days. Shortly after waking up from surgery, I was wheeled into the Neonatal Intensive Care Unit (NICU) to see him. There were tubes everywhere, through his belly button, down his throat and in his arms. There were lights, and machines and lots of alarms and noises. The memory is blurry, but I remember three or four nurses scurrying around his room – pushing buttons and administering medicines. I could look but I could not touch.
There is no preparation for delivering a 25-week-old 1 lb baby. Not even 5 weeks and 6 days on bed rest prepared me for the next 97 days of the NICU. During the next few weeks, our baby would overcome a dangerous e-coli infection in his blood, jaundice, and he would be given two rounds of intensive steroid treatment so his lungs could mature and he could be taken off the ventilator. Thankfully all of his head ultrasounds found no brain bleeds, and his eye exams were normal for his gestational age. It would be three weeks before I was able to touch my baby for the first time and four weeks before they took him off the ventilator and I could hear him cry. There is nothing more unnatural than not being able to comfort your baby when he cries. While the NICU encourages parents to touch their baby, preemies can easily become over-stimulated, setting off alarms by dropping their heart rate and oxygen saturations. I desperately wanted to hold baby Max, now named August Kamau Bradberry, but I feared doing anything that would cause him to have a setback. Instead I spent weeks sitting beside his incubator whispering prayers, singing songs, and telling him all about the exploits of his big brother Kingston.
After about 6 weeks, and shortly after coming off the ventilator, we were told it was moving day. We were graduating to the Neonatal Special Care Unit (NCSU) for babies that had stabilized. It’s also known as “step down” or the “feed and grow” unit. The nurses warned me that this would be the longest and most challenging part of the journey, and they were right. While overwhelming, in the NICU adrenaline and ignorance can be your friend. Things are happening very quickly and you are just grateful that your baby is breathing with the support of the ventilator. The NSCU, however, requires a level of patience and faith I never knew I possessed. There is time here to finally ask “why” and to contemplate what the long-term future will hold for your child. It is here that I forged relationships with my favorite nurses who helped me get over my fear of holding August. They encouraged me to be a part of his care and taught me how to navigate the many wires he was connected to, so that I could mother him in the smallest of ways — changing his diaper, bathing him, and eventually beginning to feed him. They also gave me a shoulder to cry on and filled me with encouraging stories about babies that they had cared for throughout the years that went on to live normal lives.
In order for preemies to go home they must meet three criteria 1. They must be able to regulate their body temperature. 2. They must weigh at least 4.5 lbs. 3. They must be able to bottle feed in under 30 minutes. We had accomplished the first two criteria, but after two and a half months of being feed from a tube, August was having difficulty adapting to the bottle. Exhausted emotionally, I dug deep and poured all my energy into getting August to eat. I rearranged my schedule to be there for as many feedings to provide him with the consistency of my presence. Within a week, the neonatologist recommended that I move back into the hospital to room-in with August and take over as his primary caregiver. Our journey through the NICU was coming to an end and we were transferred to the last unit to prepare to go home.
We had celebrated “Viability Day”, my 37th birthday, Thanksgiving, Christmas, New Years, and Valentines Day at the hospital. During the journey through the NICU, we were supported by our friends and family locally, nationally, and as far away as South Africa and Italy. We had also acquired a ton of new “aunties”, “uncles” and “cousins” from our new hospital family. August was being discharged from the hospital with a diagnosis of chronic lung disease of prematurity and would need to be supported on home oxygen and followed for the next several years by a pediatric pulmonologist. While not the outcome we wanted, we were grateful to have this beautiful gift that had already taught us so much about faith and the incredible healing power of God.
On February 15th, two days before my due date, we were discharged from the NICU. While August’s long-term developmental prognosis is promising, his lungs are still healing. On April 29th, August was taken off of home oxygen just in time for Mother’s Day.