Elsie Rose is three weeks and 3 days old. For each of the 24 days that she has been alive, we have been thankful for her. For her strength and her courage, and her stamina too. We are thankful that we were given a few extra weeks of a stressful pregnancy. We know that things could have been so different for her, and for us. Those last few weeks made a huge difference.
The first time the doctors told us they wanted to deliver our baby prematurely was a huge shock.
We were used to pregnancies that lasted at least 41 weeks, if not 42 and a couple of extra days on top. I was prepared for a baby in late November, even entertained ideas of sharing my birthday. A baby delivered at 34 weeks terrified us.
This baby was IUGR. Growth restricted. Deprived of oxygen and nutrients, so that internal organs were immature. Too small. Not ready. Better out than in.
At 34 weeks growths scans estimated the baby to weigh around 3lb.
At 34 weeks our baby would fair better than very premature babies, but less well than the average 34 weeker, due to the growth restriction.
At 34 weeks our baby would require time in the special care baby unit, a part of the hospital we had been lucky enough to avoid so far.
At 34 weeks we would not take our baby home as soon as we were used to.
At 34 weeks, my body was not ready to deliver.
At 34 weeks, I still had 8 more weeks of pregnancy left to go. I needed more time.
I got more time.
We were lucky. It was decided that we would get those extra weeks. Baby was to be delivered at 37 weeks.
We were told then, and are still told now, that 37 weeks is ‘term’. Despite new research and guidelines stating that 39 weeks is now considered full term, we are still told that 37 weeks is ok to deliver a baby. And our hospital policy was that babies with IUGR, well under the 10th percentile for growth (on a customised growth chart) are to be delivered no later than 37 weeks. And so it was to be.
At 37 weeks, our baby was born weighing a respectable 5lb 5- but considerably less than the ‘average’ baby born at that gestation.
At 37 weeks, our baby did not need time in the special care unit, by the skin of her teeth.
At 37 weeks our baby was able to come home with us the next day, despite hindsight telling us for sure she should have stayed a little longer.
At 37 weeks, my body was not ready to deliver.
At 37 weeks, I still had 5 weeks of pregnancy left to go.
I needed more time.
My baby was not premature. But my baby was not ready. And today, on World Prematurity Day I know that we were incredibly lucky to have made it to 37 weeks rather than 34 weeks. We know that there is much to be learned, still, about what causes premature birth. We also know that there is a lot to be said for those last few weeks.
Late premature babies are not the same as full term babies. Early term babies, as Elsie is classed, are not the same as full term babies. Early term babies with IUGR as very like late premature babies. It is hard to get people to understand this.
On discharge from the hospital, Elsie was unable to maintain her body temperature. She was unable to regulate her blood sugars. These are things that the average 37 week old baby is able to do.
Steroid injections prior to delivery helped to mature her lungs, which almost certainly kept her out of the special care baby unit.
Elsie has found feeding difficult. Once her tiny mouth was able to latch on, sucking quickly exhausted her and at three weeks old she still only feeds for around 5 minutes at a time. Before she was a week old, Elsie did not open her eyes, nor did she wake up to feed. Now, she will wake for a feed, but she is still too small and too tired to feed for long. Her weight loss after birth was significant enough to warrant the threat of tube feeding in the hospital. Today, she is still not really keeping up on the percentiles of the growth charts, so that threat is still very real.
Those last few weeks make all the difference. Babies who are born too early, no matter how early that is, need a little extra care. They need a little extra understanding. They need a little extra time. To find their feet in the world. To make their mark. To discover what it’s all about.
We were lucky. Our baby made it to 37 weeks where many do not. Our baby came home straight away, where many cannot, and too many never do. Our baby’s additional needs are- so far- minimal, where many will need special care for a long time. We were lucky, and so we are spending this day thinking of all the families who were not so lucky. Of the precious babies who are simply too small, and too sick. Of the babies who were not quite so small, or quite so sick. Of the babies who are misunderstood.
Those last few weeks make a huge difference.
Be educated on IUGR: Magic Foundation, IUGR Awareness
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