Friday 20 March 2015

Most Difficult Decision: Baby Number Two After Preemie?

In May of 2014 we had the joy of welcoming a second son into our lives. Though he too was early, he was perfectly healthy at 5lbs 2oz and able to come home right away.

The decision to have another child following our first experience was an incredibly difficulty one. We knew the risks of having another preemie were high, and that we may not be so lucky with the outcome. Because my preterm delivery was unexplained, there was little I could do that would assure I made it to term. But we also knew that even though there was a 30-35% risk of another preterm delivery, there was also a 65-70% chance that everything would be fine. Stats were not entirely compelling to us having lived through every 2-10% chance materializing against us when Elie was first born. If you are the unlucky 2% that's all that matters. We debated for well over a year. People tried to assuage our fear but few had similar experiences. Ultimately we believed strongly that things would be okay, even if he or she came early. Elie was healthy and thriving and we believed the same would be true for our next child. But we accepted that things may not be perfect. We accepted that we may have challenges and that our next child would also arrive early. We didn't expect it, but we accepted that was a risk, and decided to expand our family with all that information in mind.

A prior preterm delivery is one of the strongest predictors of subsequent risk. Because of that, I was referred to a high risk specialist who followed me closely throughout my pregnancy. I had my cervix measured at several times to watch if it was thinning early (it did).  I was prescribed progesterone from 16 weeks on, taking it until I was 34 weeks pregnant. Because i had been fit and exercising throughout my first pregnancy, I avoided anything strenuous and did everything I could to rest my body. We brought in a nanny 1-2 days a week to help me care for my youngest while Ryan was at work. Everything we could do to lighten my load we did.

When I left my 34w appointment I cried. I felt like I had won a lottery. I knew things would be fine from that point on. At 36w4d I started contracting. It was irregular so I stayed home from work the next day and tried to relax. After a long day it ceased and I reluctantly agreed to go for dinner. I started contracting regularly in the car and realized that it was going to happen that night. We called my in laws and asked them to come watch my son. I struggled with leaving him because I knew life as he knew it would change. I hugged him, and with contractions less than 3 minutes apart we drove to the hospital. I delivered 45 minutes after checking in and my beautiful son Noam arrived healthy, without complication. I have a photo of Ryan holding him for the first time and it is the happiest I have ever seen him. We both knew our baby would be fine and the fear and shock we experienced with our first just wasn't relevant.

The decision to have a second child following a very early preemie is an individual one. There is no right answer. I struggled with what to do, and for whom I was making that decision. I felt such responsibility for this new child's life that I didn't want to make any decision without thinking about the impact to them. We were lucky. Both our kids are healthy. Elie has finally caught up and no one would every know he was early. He is bright. He is physically healthy and strong. And my youngest is the same. He may be small but that might also just be genetics.

My sons are incredible, and we are so grateful that we live in a country (and a city) that makes prenatal care a priority. There is no right answer. It is yours to make. Don't let anyone tell you it is an easy choice. For us it was the right choice. Know that it may be the right choice for you too.