Our American boy

11 October 2019 is a date that changed our lives forever. After a five-day mini break to New York and Boston, I was 23 weeks and 5 days’ pregnant when I boarded the plane to fly home to the UK. However, moments before take-off I suffered a placental abruption and was taken by ambulance to Massachusetts General Hospital in Boston.

I spent 17 days between a high-risk labour and delivery unit and a pre-/post-partum ward being monitored closely and unable to leave the hospital. I’d been given a course of steroids to strengthen our baby’s lungs and had endured three rounds of a magnesium drip which involves being nil by mouth and an initial surge of magnesium pumped around your body followed by a constant flow for 24-48 hours each time – this is to protect the baby’s brain in the event of a premature birth. After a period of stability we were hoping to get a med-flight home around 26 weeks so that we were home for Christmas - unbeknown to us, our son had other ideas.

A traumatic birth 

On Friday 25 October things took a turn for the worse and I was back on the high-risk unit and on another magnesium drip until Sunday morning when I was stable enough to return to the ward. On Sunday 27 October 2019 at 3.30pm, totally unexpectedly, my waters broke and at 4.45pm I gave birth to a miracle baby boy at 26 weeks exactly, weighing just 2lb 2oz (964g). 

The birth itself was incredibly traumatic: Alfie was born face-presented (1 in 1,000 chance) and, due to the speed of labour, this wasn’t known until mid-way through delivery at which point it was too late for a C-section. It also meant the heartrate probe that would normally attach to the top of a baby’s head, attached to his forehead leaving him permanently scarred. 

The words “we have five minutes left to get this baby out” will stay with me for the rest of my life. 

There were nine doctors and nurses in the delivery room with us – a team for me and a specialist neonatal team for Alfie. Just like that, I’d given birth and my baby was intubated immediately and rushed off to the neonatal intensive care (NICU). All I could think about was whether I would ever see him again.

Wires, tubes and goggles  

Three hours later we were able to meet Alfie for the first time. He was in an incubator, his tiny body just 32cm in length and wires/tubes entering what felt like every part of him. His face was severely bruised from being face-presented and it was difficult to make out any facial features. He had goggles over his eyes to protect him from the UV lights and a SteriStrip across his forehead where the surgeon had repaired his wound. 

After a few hours I was taken back to the ward where I would spend the next two nights. I remember walking past other rooms and seeing mums cuddling their babies while I lay there awake for most of the night trying to comprehend what had just happened.

Cares and cuddles 

First thing on Monday morning in the NICU we were introduced to Alfie’s nurse who instantly made us feel safe. She calmly explained the monitors, alarms, tubes and everything that she was doing. She explained the concept of “care time” which happened every three hours. This was when Alfie’s vital signs were taken, his nappy was changed, wires/tubes were cleaned/replaced and we could touch him briefly through the portholes of the incubator. Human contact for the first few months needed to be minimal to replicate being in the womb and to enable the brain and other major organs to develop fully. At first these care times were terrifying, but as time went on they became the best part of the day.

48 hours after Alfie was born and slightly more stable, I was finally able to hold him for the first time. His skin was so fragile where it hadn’t fully formed and he was unable to maintain his temperature for long. I managed to hold him for about seven minutes but his oxygen rate kept dropping so we returned him to the incubator. I was able to hold him another two times that week for about 30 minutes in total.

When Alfie was about two weeks old he was finally able to be held for about 30 minutes a day and this gradually increased as he became stronger. The three-hour windows between care times gave an opportunity to sleep, eat and understand as much as possible through reading hospital literature about premature babies, as well as keeping family and friends updated back home, finding comfort in familiar voices.

At 26 weeks’ gestation, Alfie falls into the 5% minority of premature babies classified as Extremely Preterm. As such our NICU stay of 102 days was somewhat longer than the average seven days. Most notably, Alfie had respiratory distress syndrome so he needed oxygen support for the first 48 days of his life and he suffered a significant intraventricular haemorrhage (bleeding around the brain). The bleed thankfully resolved itself, however we don’t yet know of any long-term effects either physically or mentally. 

Home at last

On 10 January 2020 Alfie and I were med-flighted back to the UK which was a fairly traumatic experience involving three flights in 24 hours and Alfie going back on oxygen. He spent two weeks at East Surrey hospital where we learnt to breastfeed after three months of pumping and we eventually went home on 23 January – 10 days before my due date.

In the first six weeks from discharge we had 15 different hospital appointments with different specialists, as well as shielding Alfie to help him build up an immune system after so long in hospital. When Covid-19 hit we had already been in lockdown effectively for the past five months. Having a premature baby is incredibly scary and lonely in itself, but to go through our experience in a different country followed by a global pandemic has without doubt been the hardest experience of my life. I am thankful every day to our NICU family for saving our miracle boy.

Thanks to Kerry Myles for sharing Alfie’s story and video with us.