The beginning of the end...

This past Sunday my water broke – at 20 weeks and 1 day – and we ended up at Labour & Delivery until Monday evening. What I happened to us is called PPROM, or preterm premature rupture of membranes.

I cannot even begin to describe how difficult, painful and confusing the past few days have been. Everything has been completely out of our comfort zone, and we are terrified about what the future holds for us and our baby. I'm not even sure where to start with all of this, so bear with me. This post is going to be so long. . .

I started experiencing contractions on Sunday, and gradually throughout the day they were getting worse. I had spoken to my doctor, and we were preparing to go to the hospital when my water broke. It was while I was sitting on the toilet for one last pee before heading out to the car. My contractions completely stopped after my water broke.

The good news is that our baby is still alive. The bad news is that there is absolutely NO amniotic fluid left inside of me anymore. Every time I stand up to go pee, what little fluid has replenished itself leaks out again.

We met with a perinatologist at the high-risk clinic on Monday. While they tried to be as sympathetic as possible, the news is not good. Basically, chances are "slim to none" of having a live, relatively healthy baby after all of this. Upon prodding to put a number to such a fluffy proclamation, they told us less than 10%.

We were given one of two options by the perinatologist: (1) terminate this pregnancy by inducing labour now or soon-ish; or (2) waiting and seeing what the future brings, which will likely bring either death or significant disability. Debating the options was agonizing. Not only did I want to make a decision that sat well with me personally, but I wanted to make sure that Mr. Legalosaur's wishes were also taken into consideration. I was so devastated and sleep-deprived that what the doctor was saying to me didn't make much sense. I must have sounded like a complete idiot, but I had to get him to repeat things over and over again because I couldn't keep anything straight in my head.

Here's what I now understand from our appointment with the perinatologist. . . Right now, I could go into labour at any moment. Labour before 24 weeks means certain death for our baby, as they will not intervene or resuscitate. Even if we can hold on until 24 weeks and 1 day (most women go into labour within 1 week of their membranes rupturing, although it is not unusual for women to hold on for 4-6 weeks after rupture at 20 weeks, it is not common), the first thing they will do is weigh the baby. If the baby weighs less than 500g, they will not intervene or resuscitate. If the baby is between 500g and 750g, they will make an evaluative decision based on the baby's responsiveness.

Best is if we can hang on to 25 weeks, and have a baby that weighs over 750g. But even if we make it to this benchmark, there is pretty much a 70% probability that this baby will die soon after birth due to pulmonary issues that are caused by a lack of fluid. Fluid is necessary for the baby to breathe in to help mature the lungs. Without fluid, the lungs are tiny and hard and will not be able to expand and fill with air. So, while other babies born at 25 weeks may be able to breathe after getting steroid shots, ours might not because he or she would have spent 5 crucial weeks of development without the benefit of fluid.

We also need to be concerned for infection. Fluid is crucial to protect the baby from infection. Not only can infection be fatal to the baby, but because it can also be very dangerous to me.

And, finally, if we are so lucky to fit in the small number of babies that survive after birth, there was a laundry list of disabilities that were listed off to us as likely or probable: club feet and hands, deformities to the head, brain damage and mental retardation, cerebral palsy, blindness, deafness, etc.

After much discussion and soul-searching, Mr. Legalosaur and I have decided to wait and see. This baby has been such a fighter throughout this whole pregnancy. To induce labour now and sign this baby's death certificate does not sit right with us personally. We were told over and over again by the doctors that we need to make the right decision for us, and not to worry about what other people would think or would do. We also need to make sure that if we do want to wait and see, and the baby survives, that we think about the lifetime of medical appointments and disabilities that we would have to deal with. Are we ready as a couple to care for a child with demanding medical needs? I don't know – this is not something you seriously consider when you look at each other and decide to start a family. What I do know is that I could never live with myself if I let this little fighter go. Luckily, Mr. Legalosaur feels the same way.

I am not ready to say good-bye to this little one, not yet.

A couple of things that completely threw me for a loop. First, apparently PPROM is quite common where a woman has had continuous bleeding in a pregnancy. I had no idea. Secondly, if this baby dies in utero and is born still before 25 weeks, it is possible that they will not be able to tell us whether the baby is a boy or a girl. What happens, I guess, is that the baby's body gets dehydrated and babies look very similar at this stage. We had chosen not to find out the gender of the baby because we wanted a surprise. Unfortunately, if you tell the ultrasound tech you do not want to know the gender, they do not even look for it in your scan, and they take no pictures of the baby's sex organs. So, despite my desperately wanting to know NOW what this baby is, there is no way for us to find out. We will just have to hope that if he or she is born still that we will be able to see the gender. It breaks me apart to think that we may have lost our chance to know whether this is our son or our daughter.

We will meet with a neonatologist next week to discuss in more detail what types of preemie issues we might be dealing with, in addition to the specific issues that will arise from the lack of fluid.

If you have made it this far, thank you. I may sound fairly coherent in this post, but the reality is that I am broken and I can never be repaired. I have cried buckets full of tears. On the one hand I am trying to cling to some hope that we will beat the odds and be one of the success stories. On the other hand, the realist in me is preparing for the death of our child and we are exploring burial options. And yet another side of me is trying to research as much possible so I understand the disabilities that we may be facing if this baby proves to be the fighter that he or she has been throughout this whole pregnancy. We are scrambling to buy some micro preemie outfits, because even if our baby is born dead or dies soon thereafter, I do not want him or her to be naked.

This all just feels like a bad dream that I cannot wake up from. Mostly I ask myself "why me, why us, why our baby?" I feel like I'm being punished for something, but I'm not sure what. I am so angry at my body for failing this baby. Unfortunately, I don't think there are any answers or any comfort that I can find in this situation.

I'll keep you updated as and when I can, but I don't know how often that will be. Pray for us, we need all the help we can get.