Penning this story down as I realised that my PPROM birth story is scattered all over the blog. Sincerely hope that my story and many others’ will encourage someone who had to walk a similar road.
PPROM – Preterm Premature Rupture of Membranes
PPROM is defined as a condition that occurs in pregnancy when there is rupture of membranes (i.e. the membrane sac holding your baby and the amniotic fluid breaks open before you are actually in labour). It’s defined as PPROM when such condition occurs before 37 weeks of gestation.
It was a normal day for me.
Normal as in – normal to see blood; normal to see more blood.
It was my first pregnancy. Excited, wide-eyed and totally ignorant of the world of pregnancy; Kim & I were thrown into a whirlpool of events which saw us going through one of the darkest moments in our lives.
I started spotting right from the moment the doctor confirmed my pregnancy. Subsequently, the spotting progressed to severe bleeding during 11-12 weeks of gestation. I was ordered bed rest and took leave from work to rest as much as possible. Subsequently, blood clots in the uterus showed signs of dispersing and thus I went back to work for about 3 to 4 weeks.
Lo and behold, bleeding started again at week 19-20 weeks of gestation. It progressed to heavy bleeds which almost shocked the life out of me. Every time it happened, thoughts of losing my precious baby came into my mind. That’s it – my baby is gone – or so the worse of me thought.
But God is good. He preserved my little life throughout the non-stop bleeds. I probably saw more blood than I ever did it my entire life! Yes, it’s worse than the monthly woman’s cycle.
Going back to my normal day.. I was back at home after a week’s stay at Thomson Medical Centre. By then, I was used to checking if the bleeding had worsen or lighten. But something was different… The bleeding seemed to have lighten and it’s giving way to some form of clear fluid. I had absolutely no idea what that was and thank God for 2 well-meaning friends (J&J)who rushed me to consult another obstetrician.
It was a tough time in the doctor’s clinic. After a check up, he ruthlessly drew up a table for us. He announced that my water bag had burst and I might go into labour any time.
I was crying nonstop. What does that mean!?? What is a water bag to start with? I was clueless on what he was saying given that this was our first pregnancy. All I could remember was this chart which he drew up: Probability of baby’s survival vs Potential Complication vs Cost Involved. The odds were totally not in our favour given that I was only at 21-22 weeks of gestation.
Upon his advice and the lack of any form of pregnancy insurance, we rushed to the local hospital – KKH – to get me admitted. I was admitted late at night and I cried myself to sleep. Kim couldn’t stay with me given that it’s a shared women ward. It was one of the most difficult night in my life. The unknowns await the daybreak. Doctors and nurses flew in and out of the ward; busyness went on around me and I was positively sure the little life in me was still beating strong too. Series of tests, scans and questions confirmed the situation. Rare as it might be; this hospital had seen such situations before — PPROM.
Given that it’s a public hospital and I was in a subsidised ward, scores of doctors visited me throughout the first few days. A few offered the option of terminating the pregnancy. Due to the many unknown factors, your baby could be born with severe disabilities, cerebral palsy, deformed limbs, damaged lungs and would require resuscitation upon birth – so they said. The list was endless. Counsellors were sent to us to prepare us for the worse should we choose to continue with the pregnancy. I burst into tears the first time a junior doctor (without much EQ) came to me with the termination option. Subsequently, I stared defiantly at any other doctors who suggested the same option. They knew my answer before they hear me. It pierced through my heart that I have to choose an abortion when my little one seemed so alive and putting up a fight. I don’t have the heart nor right to choose his end. But of course we had to be prepared for the worst of the future too. It was beyond reasons that we did not hesitate in not giving up on him. Come what may, his heart was beating strong inside me and that’s enough reminder that I wouldn’t give up as long as he held on to living.
Doctors pretty much left me alone thereafter. They started the usual protocol of handling similar cases. I was on IV antibiotics immediately when I reached the hospital and subsequently on oral antibiotics when there seemed to be no signs of infection. Infection and labour signs were 2 key things the doctors were looking out for then. I settled into my little corner in the ward. I was in the general gynaecology ward and made friends with my neighbours to wind away the days. We were filled with hope when I finally crossed 24 weeks of gestation! It was the week of viability. The week that doctors would save my little baby if he was born then. Prior to 24 weeks, it won’t be “viable” for the baby to survive in the outside world.
I was “promoted” to the obstetrics ward thereafter. It’s emotionally tougher there as my room mates were mainly mothers who came and went after delivering their little ones. I was constantly reminded that I could not go home; I needed to stay in this fight of survival with my little life. The longer baby stays in my womb, the better it is for him. It’s frustrating to hear neighbouring new born babies’ cries after a while. I retreated to a corner bed by the window; into a routine of weekly scans; 2x to 3x per week of blood tests; medicine and complete bed rest.
The best part is probably food. For one who enjoyed food, it was a fortunate thing. I ate almost 5 meals a day in a desperate attempt to increase my baby’s birth weight. As we had no idea when he could be born, it would be ideal to get him as much nutrients as possible. Contradicting as it might sound, it got to a point that I almost hated eating. This would sound weird to those who know me well. I love food. I could memorize the daily hospital menu to the dot. It tasted horrible after 2 to 3 weeks. I got anyone who is visiting to get me food from outside the hospital. It seemed to be a chase against time to increase the weight of my little boy.
I had durians too. It was the season for durians! Thank God I love durians! My parents-in-law and mum smuggled lots of them in and I feasted them with my neighbour who was in a similar condition as me. We had an open durian party once when there were just 2 of us left in the 5 persons ward. It was a rather silly sight thinking back; 2 mummies-to-be gorging themselves with durians in a desperate attempt to increase the weight of our little ones.
It was not easy being on complete bed rest but I got permission for toilet breaks and that kept me sane and clean at least. I settled into a routine of waking up at 6+am; waited for the doctors’ rounds; a quick shower; breakfast; popped pills, blood test; scans; mum visiting with lunch; occasional visitors; nap; books; laptop; prayers; music on ipod (iphone wasn’t that available then!); Kim visiting daily after work. It was tough on him then that he had to drive to and fro Johor for work daily.
Minutes became days became weeks became months. We were not complaining because we held the hope that a day passed with my baby snuggled in my womb is a day gained. It’s a easier hospital stay when your thoughts are filled with a hope for the future. An intern doctor touched my heart while I was on bed rest too. Thank God for sending angels.
The tougher times came when I was close to 29 weeks of gestation. Baby’s heartbeat started showing signs of deceleration and took longer to recover. I was a pack of nerves when I had to be pushed in and out of the delivery suite. Inside the delivery suite, I had less freedom. Strapped onto the CTG machine 24/7; no toilet breaks; on/off bleeding started. It was a super uncomfortable small bed and no visitors were allowed except spouse (it was the height of H1N1 then). Being “released” from the delivery suite every time felt like a victory won in a battle. The feeling was indescribable. Crawling back to the hospital bed which I called home for weeks was so comforting. But most importantly, I knew that a little more time had been bought for my baby. The doctors were trying to delay the birth as long as possible.
Finally on 31st July 2009; Kim came visiting with some of my favourite snacks. We had planned to have a quiet mini celebration for our dating anniversary. It was our 12th years of being together.
I was once again in the delivery suite having “failed” the CTG readings again. We thought this would be the same as before……but we thought otherwise.
The CTG machine showed readings which were scary. Baby’s heartbeat was showing severe signs of distress. We were so thankful that our favourite obstetrician happened to be on duty in the delivery suite on that day. But she had an emergency caesarean to perform. She came into the suite; reassured me that they will continue to monitor. After what seemed like hours, the junior doctors were at a loss after futile attempts in examining for dilation. I almost wanted to scream my head off and tell them to back off. but of course I held my tongue. I wasn’t on any epidural then and thus I knew there wasn’t much dilation to start with.
Finally, our favourite doctor came to the rescue! After a quick examination, she said to us: “this is it. We are going to deliver your baby.” At her command, the nurses and doctors sprang into actions. They were quick! In minutes, they prepared me and pushed me into the operating theatre. Just before I left the delivery suite, I saw more junior doctors poring over my thick files and stole quick glances at me being whisked down the aisle. I felt like a specimen once again.
I was told to sign some paperwork (without my glasses) and then off I went into the operating theatre. It was similar to the many drama serials I have watched before. There were at least 8 to 9 people in the theatre. All performing different functions. I was trembling and shivering by then. It was a cocktail of emotions and nerves. I was so cold and thankful that a nurse put a warm vent next to my shoulders. I wasn’t ready for an emergency c-sect no matter how my mind was told. But of course God and the team were in control. Within minutes; the operation was completed. As expected, I did not hear a single cry from my baby. I found out later that he was whisked off immediately to be resuscitated and that he was seriously ill at the point of delivery.
The doctor went out to inform Kim gravely that our baby was with the neonatal team and that I was otherwise fine. My job was done; now my little one had to fight for his life. I didn’t know what was going on; but a sense of peace came to me. It was a simple sense of knowing our baby will be saved and be just fine. I was told that many were praying for us.
Little did I know that many things went on behind the scene to save my boy’s life. His birth prognosis wasn’t good. Kim witnessed the mini operation they performed on the sides of his lungs to drain out accumulated fluid. His little body was full of bruises due to resuscitation efforts. The small ventilator wasn’t enough to open up his lungs; they switched to the biggest one to help him breathe better. Of course, he was hooked onto numerous tubes/wires and etc. He was on morphine to help him with the pain and shock. I wasn’t told all these till much later. My poor husband had to wash away his tears every time he came back from the NICU. He bravely reassured me that baby was doing well.
I told myself not to cry when I first visited him. I touched his little hands and held my tears. We needed to be strong for him. But it seemed like he was stronger for us.
Xi En was a fighter; He fared better than expected by the doctors. He improved daily and slowly progressed to less dependency nursery.
After enduring 11 weeks in my womb with negligible amniotic fluid, 2 blood transfusions, multiple cocktails of drugs, arduous lessons on breathing cum drinking milk, 60 over days of hospital stay – Xi En was ready to go home with us.
He is such a mighty warrior. Born at 31 weeks of gestation; 1.27kg – he is now a 3+ years old healthy boy; feisty at 12kg. He enjoys speaking in Mandarin mostly; spurt words beyond his age; loves running and tearing the house apart. Though still lagging in weight gain, he is otherwise cleared of all birth complications and all development milestones are on track.
He is our little fighter of faith; testimony of God’s grace and miracle. My little hero!
N.B: To all PPROM mummies – if you are reading this story because of PPROM and you needed someone to talk to or just some survival tips in the hospital – please feel free to contact me at firstname.lastname@example.org