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What to Expect When You Weren't Expecting a Preemie

Photograph by Twenty20

According to the March of Dimes Premature Birth Report Card, about 380,000 or 1 in 10 babies are born prematurely in the U.S. each year. And for the mothers of these tiny little loves, the experience can be quite traumatic—especially if you have no idea what to expect.

While I'm not trying to scare any pregnant moms-to-be out there, I think it's important to share each others' stories so that in the unlikely possibility you experience any of these symptoms, you'll know to head to your doctor to advocate for yourself and your baby. If nothing is wrong, no problem, but if there is something wrong, you could be saving both of your lives.

So I reached out to some friends who had premature babies to share what their experience was like.

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The Birth:

Kristin K. was feeling great at 29 weeks until she felt her underwear get wet. She called the nurse triage line and they assured her that increased discharge is normal, and that if her water had broken she would know it.

At her 30 week appointment, she used the bathroom and saw blood. Looking back she considered it “divine intervention” because it was a one-time event and the bleeding caused concern in her midwife which prompted a physical examination which led to Kristin being admitted to the hospital immediately.

Her water had broken at 29 weeks.

Although Kristin didn't have any of the risk factors for PPROM (Preterm Premature Rupture of Membranes), she did indeed have this rare condition that only affects less than three percent of pregnancies. She was given antibiotics to prevent infection and a steroid shot to help her baby’s lungs to develop. She was hooked up to electrodes to monitor the baby and to measure any sign of contractions. Kristin was put on hospital bed rest for a month and miraculously managed to make it until 34 weeks, which is when premature babies have a much better outcome. At 34 weeks they induced her, and she delivered her son two days later.


Shauna D.’s pregnancy was deemed "low risk" at 20 weeks. She had strong contractions every now and again but chalked them up to Braxton Hicks. At about 33 weeks, the contractions increased and she noticed the baby seemed to be moving less, but she wasn’t in any pain. Again, she thought it was just Braxton Hicks. The contractions continued for a few days and she started noticing she was having them every few minutes. She eventually went to the hospital and discovered she was 70% effaced and dilated one centimeter.

At the hospital, her baby’s movement increased and the contractions decreased so they sent her home, but over the weekend she was in and out of the hospital. Six days later she had PMS-like cramps and started to bleed. When she got to the hospital they told her they wanted to induce, but it turned out to be unnecessary. She had been in labor for hours without knowing it and was already eight centimeters dilated and the baby’s head was engaged for birth.

Her daughter pushed her way into the world and let out a healthy cry. It turns out there was blood and meconium in her amniotic fluid—Shauna felt like her daughter knew she had to get out a toxic environment. She only weighed 3 pounds 14 ounces.

Shauna was in shock after the baby was taken to the NICU, she couldn’t believe she wasn’t pregnant anymore. When the nurses asked her if she wanted to go and see the baby, she told them no and that she wanted to go to her room. She wondered what kind of mother didn’t want to see her baby? She felt emotionally cold and alone. Where was the bond she had been waiting for? Over the next few days she began to feel more connected to her daughter, she wanted to hold her skin-to-skin and tried to nurse.


Kristin’s son weighed 5 pounds, 4 ounces which was a big baby for the NICU. He stayed there for a month where he was constantly hooked up to monitors. His mom stayed by his side from 8 a.m. to 9 p.m. at night and pumped eight times a day around-the-clock to give him her breast milk mixed with weight gain formula. She held him and untangled the machine cords threaded through his onesie to change his diaper. She worked with a lactation consultant, met with doctors during rounds, and participated in his physical, speech and occupational therapies. She wanted to do everything and anything she could for her tiny son.


Shauna’s daughter was doing well in the NICU, but was too small and sleepy to nurse or take a bottle so she had to have a feeding tube. There were lights and monitors that went off when her heart rated dropped. There was nothing specifically wrong with her baby—she was just small, weak and fragile. Shauna spent every day in the NICU while her husband was back at work and wondered if they would ever get to go home.

She became increasingly miserable caring for her baby who still weighed less than five pounds.

The Homecoming:

When Kristin was finally able to bring him home, she discovered how challenging it was to care for a preemie on her own. She had become reliant on the nurses in the NICU and her son’s heart rate would crash whenever he ate. They had to keep him hooked up to an oxygen tank that was really heavy for the new mom. She was so de-conditioned from being on bed rest for so long that she sometimes collapsed after squatting down to pick it up.

Her maternity leave ended just a few weeks after they were home because under the current laws her unpaid leave started the minute she was put on bedrest. Luckily, she had an understanding supervisor who gave her an additional month off to care for her boy. Kristin’s son was delayed in his milestones but he was caught up by age three. He does seem to get sicker more frequently than his peers and also has Sensory Processing Disorder which preemie babies are more prone to have, but overall, he is a happy, smart and very social four-year-old.


The day came when Shauna was able to bring her daughter home after 30 long days in the NICU. Things became even harder when she was home alone with her baby. She became increasingly miserable caring for her baby who still weighed less than five pounds. The baby cried all the time, threw up every time she ate and Shauna began to feel worse and worse. She lashed out with words at her husband. After weeks of misery, she was eventually diagnosed with postpartum depression. It wasn’t until she received treatment for PPD that she began to experience the mother-child bond.

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As her daughter grew, things improved and at about five months, Shauna began to fall in love. Now her little girl is 16 months old and Shauna is enjoying motherhood. Her daughter is doing well—she’s still small, but super healthy.


If you do end up having a premature birth, here are some tips from NICU nurse and new mother Katie M., whose own son was born four weeks early:

  • It's OK to grieve the loss of your perfect pregnancy/delivery. Most parents are not planning on a NICU stay, and it can feel devastating.
  • Ask for support. Friends, family, and specialized psychologists can be super helpful when dealing with such a horribly stressful situation.
  • Know that the care providers genuinely care for you and your baby/babies. They want what's best for your baby, always.
  • Ask to hold your baby, skin-to-skin if possible. Sometimes we get busy and don't realize that you haven't held your child in a while. So make sure to ask for yourself and your baby. Remember, you may be told no if your child is not medically stable enough to hold.
  • It's perfectly OK (and sometimes necessary) to take a break. Don't feel like you need to come in to visit every single day. Sometimes everyone needs to step up their self-care. Having a child in the NICU is unbelievably stressful. It's important to sleep, eat healthy, exercise, take care of you so that you may better provide care and advocacy for your little one.
  • Ask questions and speak up! If you don't understand something regarding the care of your child, just ask. Don't feel embarrassed to ask questions repeatedly. It's essential that you understand the plan of care for your child.
  • Advocate for your child whenever possible. You may notice something that's important that someone else may have missed. Do keep in mind, however, that you may not always agree with the care team. When this happens, explain where you are coming from, ask questions for clarity, and remember they are doing the best job they can for your preemie.

And remember that you're not alone—sometimes that's all the comfort we need.

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