Hannah PPROM at 12 weeks gestation

Hannah's brief story;-

I PPROM at 12 weeks. Was told I would inevitably have a miscarriage and even if I didn’t that the baby would only live for a few hours. Little Hearbeats helped me with stories of hope so that I knew that a good outcome was possible

My full story as follows; Finding out I was pregnant with my 2nd baby came as a wonderful surprise. I had had trouble conceiving my first and my husband and I were overjoyed with the thought of expanding our family. I had suffered with anxiety during my first pregnancy, but everything went so well that I decided to go into this pregnancy with nothing but excitement and joy. And that I did, until my 12 week appointment. The doctor, with worry on his face, told us he saw almost no fluid surrounding my baby. He ordered a NIPT test and referred me to perinatal. We went home shocked and sad but determined to raise the fluid level. I spent all of Labor Day weekend in bed drinking water, hoping it was just a case of dehydration.

At the perinatal appointment, the doctor noticed low fluid again (0.6 cm) and said that suspected cause was PPROM (preterm premature rupture of membranes; or water breaking early) but then sent me back to the OB for a sterile speculum exam to confirm. She briefed us on what it meant to have PPROM at 12 weeks. She said I’d have a miscarriage, stillbirth or that baby would live only a few hours because it was very unlikely his lungs would develop without fluid. She also told us my life was in danger because of the risk of infection. She asked if I’d like an abortion and I declined because it is against my faith and my little one’s heartbeat was still so strong. I was told to go home, take my temp every 4 hours and other than that just wait until I inevitably went into labor or developed an infection. We went home crying and praying.

When we went to the OB, the sterile speculum came back negative. They then just treated me as a low fluid case for a while, with the same prognosis. We found out later that the reason for the negative test was that I was not leaking significant amounts of fluid yet because the baby was not old enough to make lots of urine. At around 16 weeks I started leaking profusely, meaning the baby was peeing now and all the fluid he was producing was coming right out. The PPROM was confirmed. We prayed that If the Lord would let our son live that he would live a life of great service for the Kingdom of God but that whatever His will was, let it be so and help us get through it.

I talked to my older cousins Eric and Charity, who told me that my great-grandmother, Emily, had been told to abort their dad, Paul, when they noticed he had an irregular heartbeat, but that on her way home from that appointment she read the verse on a church sign, “Come to me, all you who are weary and burdened and I will give you rest” and she knew all would be ok. My Uncle Paul went on to lead a children’s ministry with his wife and kids and led many children to faith in Christ. Eric also encouraged me to reread the story of Hannah, my namesake, in the Bible, who prayed fervently for a son and named him Samuel. It was then I decided to name my son Samuel Paul and to pray Hannah’s prayer whenever I had the chance. The strength of my great-grandmother Emily and the biblical Hannah gave me tremendous hope and strength. I felt as though Samuel and I were part of a larger story that God was writing in my family and our family in Christ. At the same time, I knew that my son’s fate rested completely in the hands of the Lord and that even if the Lord decided to call him home, that He would give me the strength I needed at the time.

It was a long 11 weeks to make it to viability. I was told I’d never get there. They advised against bedrest because they said it wouldn’t change the outcome, but I stayed off my feet as much as possible. I joined PPROM support groups online and learned that in fact babies can and do survive early PPROM, even as early as mine. The stories were few and far between but they were there and that gave me hope.

When I finally made it to 23 weeks, neonatal and perinatal talked to me once more trying to convince me to stay home until baby had a better chance and said it’d be easier for me if I went home and let him die in my belly since his chances at 23 weeks were almost 0. I said no way, that we made it this far already, that if there was even a tiny chance he’d live with intervention I would take it. They admitted me, delivered my first round of steroids and antibiotics, and the hospital stay began. All they could do for me each day was monitor the baby’s heart and my temperature. They took ultrasounds every week to measure fluid and growth scans every 3 weeks. From 23-27 weeks I averaged around 1.5 cm of fluid. Then suddenly at 27 I measured 5.4 and got so excited that my levels would stay higher. They never got that high again though most weeks they hovered around 3-4 cm.

I prayed daily, did lots of crafts, went outside to visit my toddler and husband, and made friends with my nurses, who always stayed positive and hopeful with me, despite knowing our odds.

“My family and I I were surrounded and cared for by community near and far: the church body, our small group, family, friends, strangers, and volunteers who assisted us with our every need: brining us food, babysitting our toddler when my husband needed to study or work late, donating activities and crafts to keep my mind occupied, and sharing biblical wisdom.”

I met a woman, Charli, who was also going through PPROM in one of my support groups, and we would write to each other, encourage one another, share our fears and pray for each other’s babies. For a person who had spent a better part of my life as somewhat of an introvert and sometimes a loner, I never felt alone and began to form deeper relationships than I have ever had in my life. By the grace of God I never went into a depression in the hospital though I am prone to it. I consider that one of the many miracles of this time.

Once the doctors saw I made it past 30w, they scheduled a C-Section for 35+1 (baby was breech and unlikely to flip, which was the reason for not attempting vaginal). Though most PPROM babies are delivered by 34, they thought they wanted the extra week so he would be a candidate for ECMO (advanced life support) should he need it, and 35 weeks is the minimum age and 2kg the minimum weight for the machine.

We almost made it there but on Jan 26 I started having contractions. They thought it was Braxton Hicks at first but got more painful over the next couple of days. On the 27th I lost part of my mucus plug, but still since my contractions were so sporadic the nurses said it didn’t necessarily mean anything. Then by about 10 pm on the 27th things started progressing. My contractions went from every 30 mins to every 20. Once they hit 10, the OB was called in, I was given my second round of steroids and the whole delivery and transport team was summoned (a neonatologist, respiratory therapist, advanced life support nurse and MFM). My husband dropped our toddler off with family, rushed over, and then I was prepped for my C-Section. I took deep breaths and remembered to stay calm. I prayed with my husband. And as the spinal tapped in I entered a state of relaxation and prayer.

When they got to the baby I waited for a cry. I had been praying that even though I was told it probably wouldn’t happen, that he’d let out a lion’s roar cry. The neonatologist had told me not to expect it and still in so many words told me to prepare for my baby’s death even though we’d made it so far gestationally.

As I was waiting for the cry, I looked to my left and realized my husband had left the room which meant so had the baby! It happened so quickly I didn’t even see them leave to the resuscitation room. The nurse (a strong believer who had encouraged me so much whenever she was assigned to antepartum during a shift) rushed in with my husbands phone and showed me a video of a loud lion’s roar cry the baby had started wailing right when he left the OR! I burst into tears. My husband was kicked out of the room and came back to me to be with me while they finished putting my insides back together. We cried and thanked Jesus for that cry.

Once we got back to my hospital room, neonatal came to talk to us. They said even though he came out crying and breathing, it looked like his lungs did have some degree of hypoplasia but that they were able to stabilize him with 100% oxygen on a conventional vent while they prepared to transport him to the level IV NICU at the Children’s hospital so he could start a high frequency ventilator. They finally let my husband see him and then whisked the baby away into the night.

It was a long waiting period waiting for my husband to get to the children’s hospital and for him to be let in. Finally a few hours later, I got the call that he was in and briefed. They had made the switch to the high frequency vent and had already lowered his oxygen settings to 30%! They also had him on nitric oxide and helium for extra support, but he was stable and that was a sheer miracle.

29 days later he was home. By the grace of God he has no ongoing lung issues at all and the only thing we are dealing with is a club foot, which has been corrected with casts and a tenotomy and now just braced for a while to keep it that way to keep it that way. He is an alert, calm, sweet baby who loves staring at his mom, dad and big brother. The likelihood of this outcome when we first broke our waters was so slim they didn’t even want to give me a percentage because there’s no data for 1st trimester PPROM, but from reading percentages from 13-14 week ruptures I know our chances were as close to 0% as possible. BUT GOD.

Since his birth, several doctors have said he has changed their minds about how to approach early PPROM, my complex care coordinator is going to write a book of hope that includes Samuel’s story to share with other pregnant mamas, other PPROM moms have written to me saying Samuel’s story gave them hope; and many people have been deeply moved by the way God has performed such a miracle in our lives.

My husband and I realize how incredibly merciful He has been to us, especially since most women who PPROM around the same time as me prayed just as fervently for their babies to live, but ultimately the Lord decided to call them Home. This included my friend Charli and her darling baby girl Evie.

We don’t know why our baby was chosen to live but we will never stop sharing his story and sharing the tremendous hope the Lord has given us through this experience. Nor will we ever stop telling Samuel of the blessing and calling on his life. Ultimately, I think our journey can be summed up by Proverbs 3:5-6:

“Trust in the Lord with all your heart, and lean not on your own understanding. In all your ways acknowledge Him, and He will direct your paths.”

Our Samuel fighting another day in NICU

Our Samuel is now 6 months old....