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Tag Archives: scary pregnancy

Prematurity on TV: Black-ish Season Finale

10 Sunday Sep 2017

Posted by frannyritchie in Delivery, Early Days

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babies, black-ish, high risk pregnancy, pre-eclampsia, preemies, preemies in the media, pregnancy, pregnancy in the media, scary pregnancy, television

I’ve seen a few episodes of the American sitcom Black-ish, which will be returning for season4 on 3 October (in the US. in the UK, who knows? I saw the finale at 10 am in the morning on ITV. I think.).

Season 3 had centred on the late-in-life pregnancy of the female lead, Rainbow, and the finale gave a mostly-accurate depiction of a sudden, scary turn: she developed pre-eclampsia and delivered the baby two months early (so about 32 weeks gestation).

I wrote about prematurity as depicted by Pampers  a couple months ago – in general, I would say, pop culture doesn’t have much of a track record addressing prematurity. Which makes sense: prematurity is not telegenic. Preemies can be ugly or scary or just a bit too….fetal…to be comfortable to look at. They are tiny and fragile and hooked up to all sorts of crap.

Black-ish did a pretty great job with the maternity stuff; everything they said about pre-eclampsia was correct, and the parents’ fear and panic was pretty on point too. But then the show was stuck with a premature baby that they had to deal with, and that’s where I thought the show went off the rails a bit.

First of all, that baby was gorgeous. Small, but chubby. Not hooked up to any breathing apparatus. No long lines, or lines of any description. No incubator. Just a few monitoring devices so we knew this was Not a Normal Baby.

I mean, I understand. I thought Daphne was gorgeous straight out of the womb. In the first picture ever taken of her, she has one eye just cracked with Not Impressed expression that remains her trademark seven months later. Watching from the operating table, I saw the nurse hold up my tiny 2 lb baby and I knew that things couldn’t be that dire or they wouldn’t be hoisting her up like Simba for photo ops. But really, to the untrained eye, she looked pretty raw. I had that picture printed but my mother suggested I not send it to my grandmother. I look at it and think, ‘damn, my baby is a fighter’ but in retrospect I can see how other people would just react with alarm.

Preemies are alarming. But the show could easily have circumvented the need for a close-up by showing an incubator (also called an isolette), or by simply reporting on his condition. Instead, they made it look like the scary part was over. Anyone watching would see that baby and think ‘oh, that’s not so bad, he looks fine.’

I realise I am complaining about a sitcom, and I shouldn’t hold them to documentary standards, but the experience of having a premature baby doesn’t end a couple days postpartum. The fact that the girls were early is still very much with us seven months later (five months adjusted), and will likely stay with us forever, in the form of soft teeth of poor vision or attention or behavioural disorders. We are very lucky that the biggest thing they faced in the NICU was ‘smallness’ – they were just really, really tiny. Daphne was so small that, for a long time, she kept cutting off her own airway when she moved her head. She just didn’t have the strength/maturity not to.

September is NICU Awareness Month. The show originally aired this spring, but it seems fitting to me to talk about it now, after it ran in the UK. Most NICU babies are, in the grand scheme of things, Just Fine. But they are fine because they have the benefit of an incredible amount of care and support and science: they NEED incubators and long lines and various unpleasant, humming machines, and for a television show to skip that part of it – while demonstrating the very accurate fear and anxiety of the parents – is to do NICU babies, and neonatology in general, a disservice.

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So let me tell you about this horrific pregnancy I just had.

30 Tuesday May 2017

Posted by frannyritchie in pregnancy

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31 weekers, high risk pregnancy, identical twins, little squishes, preemies, pregnancy, premature, premature babies, scary pregnancy, sIUGR, twins

It turns out I have a lot more to say about parenting in the abstract – having branded myself, officially, as a Mummy Blogger (ugh) I’m all of a sudden at a loss for words.

You guys, I am never at a loss for words.

So I decided to go for it. 


The girls at about three weeks old (34 weeks gestation)

I’m writing this because even three months removed from the actual pregnancy, it looms over me, as I imagine it does for other women (and men, and people) who have dealt with a scary or high-risk pregnancy. I would have loved to read my story six months ago and I would love for it to be a source of strength for families at a different stage of their own experience.

Lucky you, though, I decided to save miscarriage and the NICU for another day.

In February I gave birth to two extremely tiny identical twin girls, Fiona (at 1.3 kilos or 2.9 lbs) and Daphne, who weighed in at 820 g (1.8 lbs). They were 31 weeks gestation and had suffered from selective intrauterine growth restriction, or sIUGR. Both were small for 31 weeks, but Daphne was barely on the charts – she was somewhere near the 0.1 percentile, whereas Fiona was somewhere around the 9th or 10th percentile. That is also small enough to be considered growth-restricted, and the NICU consultants told me she was probably also somewhat compromised in utero.

We were diagnosed with sIUGR at about 16 weeks and had weekly ultrasounds to monitor growth and, more importantly, blood flow in the umbilical arteries. The gist of sIUGR is that one baby has a larger share of the placenta than the other, but it is also common for the smaller baby to have a narrower umbilical artery and/or a bad connection between the artery and the placenta. In Daphne’s case, she had a cocktail. She had All The Things. It wasn’t a great situation. Once diagnosed, we had a target C section date of 32 weeks, though I held out hope that we could make it to 34 if we were lucky.

Every week, we would watch the blood flow in the umbilical artery to make sure, essentially, that blood wasn’t backwashing into the artery between heartbeats. When that happens, intervention often follows fairly swiftly.

Things were going pretty well, actually, until the 23rd of December, when I had a bleed. I was 23+6. As my legs shook and the midwife put in an IV, the doctor stood above my bed and said ‘I don’t think we will deliver these babies tonight, but that is just a feeling.’

They never figured out what it was, but after about three hours the bleeding just….slowed, and eventually stopped. I spent the night in Labour & Delivery drinking water, staring at the blue computer monitor, and schlepping back and forth to the toilet. When a nurse in green scrubs brought me tea and toast the following morning, I sat with the tray in front of me and sobbed.

The following week, there was backwash in the umbilical artery and it was time to consider laser ablation surgery. The procedure was effectively a selective reduction. While in rare cases, the smaller twin thrives after connections to the bigger twin are severed, in most cases, the little one doesn’t make it; instead, the larger one gets more time in utero and a substantially mitigated chance of profound disability. Our little one – already named Daphne – was so little that we had to assess her chances of survival at about three weeks behind her gestational date. So when she was 28 weeks, we looked at statistics for 25 weekers.

At 25+4, we went to London to meet with a specialist. The procedure is not performed past 26 weeks so it was absolutely our last chance. We knew the moment might come but it was an agonizing weekend. There was a very real possibility that, without intervention, neither girl would make it. But there was an equally real possibility that both girls would be just fine. There was no right answer, but we went to London having decided that the procedure was the best thing for our family. I was so sure we were going to do it that I had already contacted grief counseling services at our local hospital.

And then, magically, everything looked fine.

My husband had by this point taken to carrying around a thick stack of scholarly articles covered in pink highlighter, and I had taken a case-study approach – I had scoured the internet for similar stories. So it was both alarming and gratifying to see a team of six medical professionals from around the world clustered around the ultrasound machine, all trying to figure out what the fuck was happening in my uterus. Spoiler alert: they decided that 32 weeks was still a reasonable goal, and that 33 was not unimaginable, and sent us on our way. We got Japanese food and almost missed our train.

I’ve tried to be succinct here, so I will skip the part about how I had another bleed, spent another weekend in hospital, got put on monitoring, and then ultimately delivered due to complications entirely unrelated to sIUGR (high blood pressure and reduced foetal movement).

We delivered at 31 weeks via emergency c section, and our girls spent 9 and 10 weeks in the NICU respectively. Despite the fact that that is a helluva long time, they had relatively straightforward experiences, or at least it could have been much worse.

Today the girls are 15 weeks old, or 6 weeks and 2 days, adjusted. Both have begun to smile but prefer to look quizzical, gifting me infrequent but radiant open-mouthed grins. They have largely held their growth curves but I am optimistic that they will nudge up a few percentiles in the next few months. In short: it all sucked but we appear to be coming out the other side. At this point, my day-to-day experience of these babies is like any other woman with six week twins, and the most amazing thing is how quickly the NICU has faded behind us.

If you are a stranger on the internet in the throes of a scary pregnancy, and I can be of use, please let me know.

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