A Crunchy Mama Finds Her Way in the NICU

By Lorrie Leigh
Web Exclusive, August 13, 2006

Eight years ago my first hospital born set of twins taught me everything about how I want to give birth. So, naturally, I had a homebirth the next time around. Over several years, I also became a childbirth teacher, birth and breastfeeding political activist, and apprenticed midwife's assistant with lots of experience under my belt.

Twenty-eight weeks into my third pregnancy, a preterm labor episode led to the discovery that another set of twins was in our future. My midwife and I stopped labor a la Spiritual Midwifery (vodka shots) and I set about staying in bed, consuming lots of protein to try to assure good birth weights, while trying to get to term. However, on June 29^th at 31 and one-half weeks gestation, I woke in the night to the familiar backache that let me know this time labor was not going to be stopped and that I was heading back to a hospital birth and a long NICU stay for our babies.

We walked in to the Emergency Department of a local Baltimore hospital with our midwife at eight centimeters dilated and ran smack into the chip-on-the-shoulder-about-home-birth nurse and puffed-up doctor scenario. Thankfully our first twin birth had taught both my husband and I how to say "We choose to…" and "We do not consent…" long enough and loud enough that the birth itself went as smoothly as could be expected in such circumstances.

Our baby Kalleigh literally fell onto the bed and cried, after the doctor released my waters, and the OB scrambled to hand her to the NICU team. My husband followed her to the NICU while I began to push Baby B, Leighanna. She came out blue and limp. The staff began a full resuscitation and she coded over and over. Personnel were streaming in and out of the room. My midwife and I were hearing whispers "cleft lip, cleft palate, webbing, polyhydramnios…" and I knew then our hearts were going to break. Our daughter Leighanna died in our arms three hours later from complications of a rare chromosomal abnormality. Kalleigh, her two pound ten ounce twin breathed on her own at birth requiring only a nasal cannula of forced room air for much of our stay, to save her strength for growing.

I was far more educated than most parents when they enter the NICU milieu. While on bed rest, I had reread everything in my childbirth library about prematurity. But in the NICU, I came up against a brick wall of fear, and hostility to anything not part of the usual protocols of that facility. To their credit, the neonatalogists accepted our high level of involvement. But, it is the nurses who make or break mama's success with breastfeeding, caring for and bonding with their baby. They stole our precious firsts like first bath, first dressing in clothes, first feedings, etc.; and from day one, resisted our natural parenting style. On day four I came home from the hospital without either of my babies. The first thing my husband handed me was the latest issue of Mothering. In it was a quote from the Dalai Lama, that we "must develop courage corresponding the size of the difficulties." It was exactly what we needed to hear given what we were facing. That and some favorite bible verses taped to Kalleigh's isolette inspired and sustained our NICU vigil.

On day five she sucked at the tip of my nipple on and off for several minutes. The nurse was very unhappy with me. It was clear that during "report" the next nurse had been forewarned because I received a lecture not to put her to the breast or expect that she would nurse because "here all babies have to start on bottles." I rearranged my life with the help of my tribe -- friends, family, former clients, home school pals and the local AP group -- who were caring for my other three children, so that I could be with Kalleigh 12-16 hours a day and fumbled for the best way to nurture my baby in a box.

During our two-month stay, we had no less than three full-team meetings and many smaller conversations with our team lead nurse about staff resistance. We continually insisted on complementary alternative techniques (Kangaroo Care, preemie massage, colorpuncture, Reiki healing…) that this conservative staff had never seriously tried or even heard of. We brought as much documentation from the scientific literature with us as we could and just kept repeating ourselves until it was written in her chart.

In the NICU my own instincts and observations of Kalleigh were often discounted. I started putting up little notes on her isolette. First, was a list of the signs of stress during Kangaroo Care to alleviate staff fears that I would unknowingly harm our baby. The next note was a set of rules for use of the pacifier. My rules were based on my reading of the scientific literature about pacifiers and preemies. I decided to consciously avoid "asking permission" to do things for my child. I would say, "I am going to …" and unless they could justify their opposition, I did. Eventually the nurses began to ask me "What is your plan for today?" I liked that it required them to acknowledge that I was ultimately in charge of her care.

Ten days after the birth I was kangarooing up to four hours a day and got her to suck on my little finger for 15 minutes. At one month in the NICU the lactation consultant dropped by during a kangaroo session and helped get Kalleigh latched on the breast. We got a few great sucking bursts and swallows. I felt such joy and pride for both of us! From then on I breastfed as often as she was alert and interested, avoiding negative, doubting interactions with staff by stealth nursing when no one was around.