NICU: A Personal Essay

NICU: A Personal Essay

Once we received news of the surgery, the rest was an agonizing blur. We were pushed upstairs to sign paper after paper with the anesthesiologist, releasing them of responsibility if they accidentally killed my baby. Having my newborn go through invasive surgery at only days old was one of the scariest things I have ever experienced.

A premonition

Woman's hand holding infant's hand

The sterile stillness of the hospital swallows me as I peer into the box. My newborn daughter is in the incubator, and there is something wrong. I feel powerless. As I reach over to grab her, I am jolted from my sleep and I wake up. During my pregnancy, this eerie nightmare plagued my sleep. I woke up unsettled and terrified each time. I prayed for a boy to prevent the unsettling nightmare from turning into a premonition. Little did I know, the birth of my first child would forever change my life in more ways than one.

My husband and I kept the gender of our child a surprise, planning to find out at birth. At 39 weeks, I was induced since I had signs of preeclampsia. After 24 hours of labor, my daughter arrived eagerly into this world. I was exhausted, but our first few moments together were magical. Once we were in the recovery room, I placed Valentina into the bassinet for a brief moment. When I looked over, I was paralyzed with fear. She had turned completely blue. As I shouted for the nurse, an eerie feeling of deja-vu washed over me.

The nurse struck the code-blue button on the wall, and Valentina was rushed to the nurse’s station. Since my daughter arrived quickly, she had an unsafe amount of amniotic fluid coating her lungs. I watched as the nurses struggled to put a tube down her tiny throat to suck out the remaining liquid. I have the gift of remaining calm and cool-headed during high-stress situations, but watching the hospital staff struggle was incredibly painful. It felt as if a part of me was now outside of myself, and I had no control over anything that happened. The nurses assured me that this was a relatively common procedure for babies who are born quickly, as the speed does not allow the pressure from the vaginal canal to drain the baby of the remaining fluid. Thankfully, our baby made a quick recovery. Later that day we were released from the hospital and were ecstatic to finally go home with our sweet Valentina.

Home from the hospital

Our time at home together was short-lived. Soon after we arrived, I was called and told to bring Valentina back to the hospital as she had jaundice. Much later I learned that jaundice can be treated from home. Returning to the hospital was disorienting. Valentina was placed in an incubator for over 16 hours under blinding lights. At the same time, my milk had started to come in. I had to pump, but I was not allowed to feed her. At a time when all I wanted to do was hold her, I could only watch. Finally, we were told that we could go home again, and I was grateful to finally be able to just be with my daughter.

My relief was temporary. The next day, every time I tried to feed Valentina she vomited green. I was terrified, and quickly contacted my pediatrician and talked to my night nurse. My pediatrician claimed I had probably overfed her, while my night nurse reassured me that it was the green juice I had earlier which could affect the color of breast milk. I was confused and exhausted, but I placed my faith in their expertise. Valentina continued to vomit green over the next few days every time I tried to feed her. The more I desperately sought answers, the more I only received questions. I grew exceedingly nervous and restless. At the same time, I noticed she was sleeping in longer intervals, which did not seem normal to me. I could no longer take it, and on the fifth day, I called my pediatrician. I told him I was either bringing Valentina directly to him or back to the hospital.

Infant with balled fist and hospital identification bracelet.

When we arrived at the pediatrician’s office, the doctor noted her belly was distended, and confirmed she was lethargic. My pediatrician told my husband and me to take Valentina to the ER with a request to run a specific test. Being back at the hospital again and on the ER floor with Valentina was traumatizing. It was the last place I ever imagined I would be with my less-than-a-week-old daughter. My autonomy over myself and my daughter had been ripped away from me. My interactions with hospital staff were strained. The more I advocated for my daughter and myself, the more I was met with resistance and judgment. My anxiety peaked as the hospital ran test after test with no results, every test except the one my pediatrician had requested. Finally, after exhausting all other test options, they ran that one.

The test revealed that Valentina had an obstruction between her esophagus and stomach, known as duodenal atresia. The obstruction was just big enough to let in a drop of liquid at a time, which is why once my milk changed from colostrum to mature milk, she was unable to take it and instead, threw everything up. We were told that the only way to treat duodenal atresia was surgery. She would be cut open and they would have to create a bypass, creating a bigger opening inside her tiny body. There was a 15% chance that she would eventually need a second surgery.

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A three hour surgery

Once we received news of the surgery, the rest was an agonizing blur. We were pushed upstairs to sign paper after paper with the anesthesiologist, releasing them of responsibility if they accidentally killed my baby. Having my newborn go through invasive surgery at only days old was one of the scariest things I have ever experienced. After a three-hour surgery, the surgeon stepped out to give us an update. He told me that they had cut open Valentina’s tiny body and removed her appendix. The surgeon had to rearrange her organs. I was livid. The surgeon had never asked my permission, and now all I could do was listen to what had happened to her. The pain was unbearable. He told us that Valentia had been admitted to the NICU.

While Valentina was in the NICU for recovery during the next few weeks I hated to be pulled away from her side. As a full-term baby, having her in the NICU amongst premature babies was unsettling. The recovery was painful. Due to the intensity of the surgery, I could not hold or feed her. The only thing I could do was watch. I felt helpless and powerless. For five days she received her nutrients from an IV. We would spend 14-16 hours a day at the NICU, leaving only to sleep because it was not allowed there. Despite the supportiveness of my family and friends, I perceived any attempt at asking me to leave the hospital as taking me away from my daughter. My time in the NICU was isolating, as I could not communicate my experience to others who had never felt the pain of such a quick separation from their newborn child.

A healthy daughter and a new career

Infant hand with hospital identification bracelet holds adults finger.

Today, I am grateful that Valentina is a happy and healthy four-year-old. She has not needed a second surgery but her birth changed my experience not just as a mother, but as an advocate for others. Long after the surgery, I learned that duodenal atresia was a condition that should have been caught during my pregnancy as it is often a marker for chromosomal issues and Down’s Syndrome but my doctor made a mistake. He missed it entirely. While knowing in advance would not necessarily have made my experience easier, the shock and pain I experienced at finding out immediately after Valentina’s birth was scarring. In addition, I eventually learned the reason her vomit was green was due to bile, which as a new parent experiencing heightened emotions I did not realize at the time. There was so much information I didn’t know. I was so focused on advocating for my daughter, that I did not realize no one was advocating for me. The impact of Valentina’s surgery on my health embedded itself in my existence for a long time. After her birth, I needed to attend therapy and started medication for anxiety. I lived in constant fear and anxiety for my daughter, that anything could happen to her.

While a birth journey is wildly beautiful, it can at the same time be scary, intense, and a road riddled with unknowns. My journey with Valentina changed me. I realized that you have to be your best advocate, but that you should not have to do it alone. Our medical system does not present options to expectant parents, often diminishing their judgment and intuition about their own children. Oftentimes, expecting parents are unaware of all the choices they can make. Thus with the birth of Valentina, my dream to be a doula was also born. The isolation and pain I experienced after Valentina’s birth is something I never want another parent to experience. My connection with my daughter is one of the most magical and beautiful things I have in my life. As a doula, I want to help parents trust their connections with their children. My mission is to educate and empower other expectant parents so that they have the wealth of knowledge and tools to make the best decisions for themselves and their families. My long-term hope is to create an empowered, informed, supportive loving community

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Keira Moré headshot

Keira Morè is a doula, childbirth educator, lactation educator, NICU peer mentor, wife, and mother to two beautiful children. Pivoting from a career in the fashion industry, her powerful experiences with the birth of her first child inspired her to become a doula. Experiencing firsthand the inequities and limitations of the medical system as a parent transformed Keira’s perspective of parenthood. With her work as a doula, Keira infuses compassion and integrity to empower birthing people and their families. She centers her work on informing and educating expectant parents so that each family can make decisions that best serve them. Currently, Keira resides in Los Angeles with her lovely family. During her downtime, she is building a beautiful garden with the help of two very avid little gardeners. Connect with Keira through her Instagram – @noa.doula

Selecting Your Birth Team

Selecting Your Birth Team

**This is a repost of a classic Informed Pregnancy Project article.

“Doulas are not only for mothers planning an all-natural birth, but for mothers planning or investigating all kinds of birth choices. The doula movement is all about options, information and nonjudgmental support. Doulas are hired for all scenarios, including scheduled cesareans.”

In the days before modern medicine and hospitals, laboring women would often be supported by other ‘wise women’ in their communities, who held and passed along the knowledge needed for the next generation to assist women during the process of labor and birth. These women were among the earliest ‘doulas’ – women whose sole role was to provide comfort, encouragement and wisdom during a woman’s labor and birth. The idea of the modern doula began to gain popularity from the studies of Dr. Marshall Klaus and John Kennel during the 1980s, which clearly showed the benefits of the presence of a doula during the labor process. DONA International was founded in 1992, and the role of the doula became a legitimate profession, with prospective doulas required to complete extensive training and assist in multiple births before becoming certified. In the past 20 years, one birth at a time, doulas have secured their role as an instrumental component in the birth team. People commonly think of doulas and midwives as having similar tasks, when in reality the midwife is a licensed care provider in charge of the mother and baby’s health while the doula’s focus is on supporting and promoting an environment of calmness and confidence in the mother.

As reported in many studies, the presence of a doula has many health benefits (less medical interventions, faster labors, easier breastfeeding) and the presence of a doula also highly increases birth satisfaction for the new mother. Doulas are not only for mothers planning an all-natural birth, but for mothers planning or investigating all kinds of birth choices. The doula movement is all about options, information and nonjudgmental support. Doulas are hired for all scenarios, including scheduled cesareans. In current maternity care, women often feel rushed during OB visits and sometimes are too self-conscious to share concerns, questions or fears with medical personnel. This is one of the gaps that doulas can fill.

One of the greatest benefits of hiring a doula is that doulas are well-read, informed and trained in medical terms, and understand routine hospital protocols along with the risks and benefits of various medical interventions. Doulas do NOT make medical decisions for their clients, but they do help clients to make informed decisions. In all up-to-date facilities across the country, doctors and nurses welcome the presence of a calming and professional doula. There is no role confusion; doulas are not there to take over the care of the woman, but to add to it. Doulas and nurses complement each other. During the process of hiring a doula, mothers should not feel shy to interview as many doulas as they feel they need to find their ‘match.’ An interview should be free of charge and commitment and usually last around one hour.

Some of the important points for a family to consider in hiring a doula are:

  • How much experience does she have?
  • How many births has she attended?
  • Is she a mother herself?
  • How many births does the doula take a month?

The answers to these questions may mean different things to different mothers-to-be. A mother may feel comfortable with a newer doula based on a personality match, and hiring the most experienced doula is not always the best fit for all families. The last question in the list is a very important one. Obviously, a doula willing to “book” 8 births in a typical month is much more likely to need to send a back-up doula to your birth than a doula who only schedules 3 births. A busy schedule may also affect when the doula joins a laboring woman, or how tired your doula is when she joins you for your birth.

  • Is the doula certified?
  • If so, by what organization?

DONA International is not the largest, but is by far the most respected doula organization worldwide. DONA has been training and certifying doulas for the past 22 years in 23 countries. If a doula is not certified, ask her to read and practice according to the DONA code of ethics and scope of practice, easily found at www.dona.org.

• How many prenatal visits will the doula provide prior to the birth? And after the birth? Not all doulas have a set schedule of visits, but the majority will do two prenatal meetings that last around 2 hours each, and one postpartum visit that lasts around 1 hour. The prenatal meetings can often substitute for a public birthing class.

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• When does the doula join the labor? Some doulas come when mothers first call; others come when labor is more established. Mothers should think about what they want and the doula should be willing to adjust to that, not the other way around.

• How much does a doula charge? This is a difficult question, as prices vary a lot. A more experienced doula will usually charge more, as will a doula with more services to provide (for example, prenatal yoga, nutrition help, or postpartum doula services – like doing laundry, watching the baby while you nap, or helping you and your newborn perfect your ‘latch’ for nursing.) In Los Angeles, doulas can charge anywhere between $500 and $3000. Some doulas work on a sliding scale, and most of the national organizations will help women to find doulas at no cost or low cost. The idea is that every woman that wants a doula should have one. Insurance companies are also starting to reimburse for doula services, so ask your insurance provider if a doula’s services are covered by your plan.

To find a doula in your area, please go to www.binibirth.com.

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Ana Paula Markel is a childbirth educator, doula trainer, practicing doula and volunteer in international birth organizations. She is also the mother of four children. In 2008 Ana founded BINI Birth, a center in Los Angeles dedicated to the childbirth education field, doula training, parenting classes and green pregnancy retail.