Walter's First Days: A Story of Fear and Hope

By Katrina Hinton-Cooper
Web Exclusive January 22, 2007

When Walter was born I expected to relax, lean back in my bed, and be waited on hand and foot by the caregiver for a couple of weeks. That's how it works here in the Netherlands; why should it have been different for me? I had an excellent team of midwives standing by and all the check-ups and ultrasounds had gone very well indeed. Walter was going to be small, we knew that, but well within the normal range. I had it all planned out—getting started with the breastfeeding, introducing him to our pets and the outdoors, showing him off to visiting friends, getting to know him, indulging him, loving him. But things don't always go as planned.

Walter was born three weeks early. The first contraction came at 2:39 a.m., two hours and thirty-nine minutes after the moment when he would not be considered premature and could be born at home, and 9 minutes after my husband climbed into bed. We'd been joking about that, saying to my belly that day, "You just need to hang on until midnight, you don't want to be born in a hospital." It was all in jest, though; we didn't really think he'd be early. After that first pang, I remember thinking, "Hmm, that was a weird, long cramp..." Several minutes later I thought it again, and by the third one I had my suspicions about what was going on. The contractions quickly got longer and closer together, and after a couple of hours I abandoned the midwives' instruction sheet: it said to wait until the contractions had been five minutes apart for two hours, then call. That was clearly not going to happen: they were coming closer and closer together and I realized time was running out.

When I phoned—far too early according to the instructions, but in my view not a moment too soon—the midwife said cheerily, "What we recommend in such a case is to get into a nice warm shower for a bit, and then wait an hour and see if the contractions are still happening." Grimly, I ground out, "I... did... that!" While the midwife considered this, a contraction came, and then another, and when the third one hit during our five-minute conversation, she said, "I'm on my way." My waters broke as I hung up the phone. While we waited for her, my husband gathered all the things on the list of necessities and jacked the bed up on blocks he'd purpose-built only a day or two before. I amused myself in the meantime by crab-walking back and forth at the foot of the bed. My fingernails punched nice little crescent shapes into the footboard.

The midwife, Thessa, arrived at about 6:30 a.m. The practice had an admirable policy of ensuring that each pregnant woman saw each of the five midwives for at least two appointments. That way a total stranger would not arrive at such a sensitive and significant time as the birth of a child, especially, as in my case, a first child at the tender age of 36. Nonetheless, I had never seen Thessa before—the regular midwife for that shift turned out to be out on maternity leave—but I absolutely did not care. All that mattered to me was that The Professional was here, and she was friendly, and she was going to Tell Me What To Do.

The details of the birth aren't so important. It was neither momentous nor traumatic. He did have the cord around his neck, but it caused no problems and was swiftly and efficiently solved. The whole experience went very quickly indeed—as soon as she arrived, Thessa calmly stated we'd have a look at me now, took one glance inside, and hurtled off down the stairs for her car, shouting behind her, "You're at 10 centimeters; I'm getting my bag!" By the time the assistant arrived, Walter was nearly in the open air. I'm not saying it was EASY—it was unbelievably hard, unbelievably painful. But, in retrospect, it was fast, and uneventful.

My little Walter was born alert, and received excellent Apgar scores: 9, 10, 10. He was, however, a little on the small side (2380 grams, or 5.25 pounds), and his body temperature was just a little lower than the midwife would have preferred. So while I sat against a pile of pillows with my husband, exhausted and beaming at this miracle, my son, feeling very unreal and yet completely natural and right, the midwife phoned a nearby hospital and discussed the case with a pediatrician. It was decided that Walter and I should both be admitted for two days of observation, so they could monitor his glucose levels and make sure everything was OK.

When we arrived at the hospital Walter was checked over and the staff became concerned about a keening sound he was making, which I hadn't known enough to be worried about. They told us that he was having a little trouble breathing strongly enough, and they took him to an incubator to watch over him. This was very hard for me, watching them take him away, but they told me to come downstairs and visit him after about an hour, and then as often as I liked. My husband stayed for a little while, then made his way home to take care of our poor puppy, who had been in her crate since the contractions got strong.

During Walter's first few hours in the incubator, the keening/grumbling sound got worse, so they gave him a chest x-ray and discovered a small hole in one lung. They told me this wasn't unusual, and was due to the difficulty he was having breathing: the effort to expand his lungs had torn a small section of delicate lung tissue. This in itself was due to his lungs being a little less mature than they would have liked to see; why THAT was is still a mystery, but the most likely theory is that I can blame it and his small size on my slightly-smaller-than-normal uterus. Air was found to be collecting in his chest wall, and a drain was inserted. They had to give him a small amount of morphine because of that—ironic, because avoiding any neonatal exposure to painkillers was one of the many reasons I opted to have him naturally, and at home.