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  • Premature Birth and Neglected Maternal Mental Health
  • Naomi Rendina

Eight years ago, my daughter was born ten weeks premature. Young and with no reason to believe I was at risk for any complications, I suddenly developed pre-eclampsia, a complication of pregnancy characterized by high blood pressure and proteins in urine. Shortly after submitting my routine urine sample at my prenatal appointment, I overheard my physician, just outside my exam room door, ask the nurse how far along I was. I knew something was wrong. When the physician entered the exam room, he immediately asked if I had any pains or headaches. Despite not having either symptom, he proceeded to put me on strict bed rest. I gave both blood and urine samples before calling my mother and husband. Shortly thereafter I left in an ambulance for a hospital better equipped to handle thirty week fetuses. My blood pressure was dangerously high, and my liver and kidneys were beginning to fail. The baby needed to be delivered; for her sake and mine.

Given an anti-seizure medication with hope to delay delivery, but antibiotics in case delivery became unavoidable, the obstetric team informed me that I needed to immediately delivery the baby. When I arrived at the second hospital, more blood work and urine analyses determined that my body could afford a little more time. I received the first of two steroid shots that aimed to help develop the baby’s lungs and digestive system in anticipation of her early arrival. Ideally, delivery would be 24 hours after the second injection. The high risk obstetric team of residents and attendings lacked physicians who mastered compassionate bedside manner. Instead of viewed as a young woman terrified of losing her baby, I was made to feel like I was yet another patient. Although on an opiate derived drug known to make patients not feel well, an anesthesiology resident asked me to sign the consent form for surgery so that it was out of the way if it became too emergent of a situation. I’m positive that my signature resembled an illegible scribble because between hysterics and being so drugged, I struggled to comprehend what was going on.

Once determined that I could handle a little more time, and after I received the first steroid injection to help the baby, I was given a corner room in the hospital’s labor and delivery wing. The nursing staff was kind and compassionate. A rollaway bed was placed in the room so there was enough room for both my husband and mother to stay with me. I needed them both there. During what felt like forever, but I’m told was only hours, multiple high risk obstetricians came in to assess the situation. The baby was measuring two weeks small, and the obstetrics team let my husband and I know how skeptical they were about her survival. Later that night, an ultrasound revealed that our baby girl was “practicing” breathing. That was a great sign.

Over the next few days, I developed HELLP syndrome, another complication that includes the breakdown of red blood cells, elevated liver enzymes, and low platelets. My blood pressure [End Page 208] was dangerously high, but stable, and a crash cart sat outside my door. I moved to the antenatal wing in hopes I could hold on for as long as possible and delay delivery. While in the antenatal wing, a neonatology fellow spoke with my husband and I in my room, and offered my husband a tour of the neonatal intensive care unit (NICU). This Fellow came prepared with statistics, visual charts, and a patient and kindhearted bedside manner I have yet to see matched. He told us statistics about preemies of all gestational ages, worst and best cases for her gestation, answered questions, and took his time. It was hard to mistake how much he cared when he was in no hurry to leave, and genuinely wanted to make sure we were prepared. I at least had read the complications chapters of pregnancy books. Because of that neonatology fellow’s information, we were as prepared as we could be for a premature baby. In reality, nothing prepares you...


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pp. 208-210
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