Having a preterm baby is not only physically daunting, but also emotionally challenging. No parent is fully prepared to be a parent, let alone parent of a preterm baby. But then again miracles happen.

 “Making the decision to have a child is momentous. It is to decide forever to have your heart go walking around outside your body.” Elizabeth Stone

The above quote aptly describes what it is like to be a parent. There is no greater pain for parents than to see their child suffer. And there is no telling to what length parents will go to save their children from harm. Therefore it is beyond imagination to contemplate a situation in which a preterm child is going through unspeakable pain, and the parents are reduced to being mute spectators, unable to do anything except perhaps pray. Here is a true account of how one set of such events unfolded some sixteen years ago.

Normally a pregnancy lasts about 40 weeks. A premature birth is when birth that takes place more than three weeks before the baby is due. In other words, a premature birth is one that occurs before the start of the 37th week of pregnancy. Premature birth gives the baby less time to develop in the womb. There are different categories of prematurity, and all these carry their own level of risks: extremely preterm (less than 28 weeks of pregnancy); very preterm (28 to 32 weeks); and moderate to late preterm (32 to 37 weeks).

In some cases the primary cause of preterm birth can be identified, but more often it is unknown or unclear. Complications, such as infection, and cervical incompetence increase the risk. Women with multiple pregnancies (twins, triplets or more) are also at a higher risk of giving birth prematurely.

Saroj Joshi, a Director of Valleyplus Pvt, and Kalyani Joshi imports Shera fiber cement materials from Thailand to Nepal, and have their office in Lalitpur. This article is about their ordeal during the period surrounding the birth of their miracle son Saurav, who was born as a preterm baby born on November 3, 2000.  The parent’s ordeal fortunately ended with a positive outcome: Saurav is now a healthy boy.  He studies at British School in Jhamiskhel in Grade 12.  Like any other teenager his interest changes.  At present he loves to collect shoes, and he has an enviable collection of shoes. Who knows what his next interest will be in a couple of years?

From the simple questions about his diapers to overwhelming medical procedures, we were in for a roller coaster ride that we never expected to take.

Saroj and Kalyani were in Bangkok when they were expecting their first child. Initially there were no problems during her pregnancy.  One day, in the 24th week of her pregnancy, she suddenly felt pain in her abdomen and spotted slight bleeding.  Kalayni thought it was false labor pain which is often experienced during pregnancy.  She told her father and her husband, both of whom advised her not to worry about it.  So she went to her work. At that time she was helping her father setup an international school in Bangkok. In spite of the pain in her abdomen, she continued working. When the pain continued unabated, she told her mother, who immediately took her to the hospital. “My mother told me, ‘It is not normal to have pain’ and maybe it was my mother’s instinct,” recalls Kalyani. We immediately went to Bumrungrad International Hospital, in Bangkok.   

On reaching the hospital they found that the doctor they were consulting was not immediately available.  Saroj kept calling the doctor. The doctor advised other doctors over telephone to give Kalyani medicines to delay the delivery.  Since the primary doctor was not going to be available, her case was transferred to another doctor who immediately came to the conclusion that Kalyani’s delivery could be delayed. Saroj said that they were very lucky to have the new doctor take their case. “She made us feel better when she said that this hospital has the best equipment for the baby, and that we were in good hands.”  

To make Kalyani and Saroj feel better, the doctor introduced them to two other parents who also had a premature baby.  The parents of a one-year old premature baby had come to the hospital for its regular check-up. Saroj recalls, “They were good people.  They explained to us about their premature baby and shared their experience with us. They advised us to trust the doctor and pray.”  

When the doctor said that the baby is going to be born soon, both Saroj and Kalyani were not ready. Kalyani said, “The thought of us having a premature baby never crossed our minds.  We were not prepared.  Since no one in our family had a premature baby, we were sure we would have a full-term baby.”  The doctor said there was no way to stop the delivery.

No one plans to become a parent of a fragile infant.  When the baby is born too soon, some parts of its body would not have fully developed, and this would mean that it would not be ready for life outside the womb. The doctor told them that since the lungs of the baby were not fully developed, the baby needed steroids before birth. The doctor said that it would take twenty four hours for the medicine to take effect. So they had to wait for twenty four before Kalyani could give birth to her premature baby. “I somehow managed to make through those twenty four hours. I needed to do that for my baby” Kalyani reminisces with pain.    

From the beginning, Saroj and Kalyani wanted to have their baby through natural delivery.  It is often seen that premature babies are delivered through Caesarian (C-Section).  But Kalyani gave birth to her son naturally.  “It was a long natural birth.  I thought I was going to die.  The baby was very small, and could not push himself out.  The doctor had to suck him out with a help of suction” says Kalyani.  Since it was an emergency case, the delivery room was packed with two sets of doctors.  One doctor was working on Kalyani, and the other doctors were ready to take care of the baby as soon as he was born.  

As soon as the baby was born, the doctors rushed the baby to Neonatal Intensive Care Unit (NICU) within the hospital.  “When I saw the baby, he was covered with an oxygen mask, and had tubes all over his body. It was very painful. The baby was so small.  He was only one kg when he was born, but in an hour his weight was reduced to seven hundred grams” recalls Saroj. 

“Saurav’s lungs were not fully developed, so he was not able to breathe on his own. There was no proper communication between his brain and lungs.  His brain would sometimes not send message to his lungs to breathe.  So every time the oxygen meter would beep, the nurses would rub his foot or sometimes shake the baby hard.  It was really difficult to see them do that to our child” recalls both Saroj and Kalyani.   

A community full of love and support will help new parents be the best advocates, nurturers, and champions for their precious little ones.

Saurav was hospitalized for three months. “Throughout my pregnancy, I took excellent care of myself and did everything right, but suddenly found myself in preterm labor. When my boy Saurav was born three months premature, I didn’t know how to be his mother. We were often physically separated from each other. During my time with him, I was terrified of hurting his tiny body. I didn’t understand the NICU language. I didn’t understand the wires, machines, alarms or numbers. I had to stand back and let others take care of my newborn baby. I could not protect him from the pokes, prods and emotional distress he endured. Needless to say, I was a mess.”

Kalyani recalls: "Most parents dream of the moment their child is born, and of holding it within seconds after the birth. But for my husband Saroj and me, it was a very long time before we were allowed to cuddle or caress our precious little boy. From the simple questions about his diapers to overwhelming medical procedures, we were in for a roller coaster ride that we never expected to take."

"Saurav is a miracle" because generally babies born before 22 weeks prior to the due date have almost no chance of survival as their lungs, heart and brain would not have sufficiently developed by that time. Kalyani adds, "But thanks to God, the wonderful doctors and nurses, and medical advances, our son is doing wonderful. Saurav is now sixteen years old, and has no signs of cerebral palsy, vision or hearing problems, or other disabilities common among premature babies. I have been told by our pediatrician, NICU doctors, nurses, and therapists that Saurav is truly a miracle."

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These are few helpful tips that could help parents of premature or preterm babies:

  • Preemies should receive 100% breast milk diet. Fresh breast milk can be life-saving for fragile infants. Mothers should begin pumping as soon as possible. To establish and sustain her milk supply, every mother of a preemie needs support from her partner, family, and should have good and healthy diet.
  • Learn your baby’s cues. Premature babies can become critically ill fast. You may know before anyone else when something just doesn’t seem right. If you sense something isn’t quite right, voice your concerns and make sure they are addressed.
  • Ask your baby’s nurse to teach you how to provide basic care for your preemie. Preemies need to feel their parents’ touch. When you cannot kangaroo your baby, hold hands and read to him/her. Smile at your baby. Sing to your baby. Bring in special blankets. Hang up family photos. Play soothing music. Celebrate the smallest of milestones.
  • Read and learn everything you need to know about your preemie’s health or condition. Reach out to other NICU families.

Parents of preemies need support from their family and community. If you know a family with a baby in the NICU insists on showing them some love. A community full of love and support will help new parents be the best advocates, nurturers, and champions for their precious little ones.

James Elgin Gill, born on May 20, 1987 in Ottawa, Canada is the youngest premature baby that survived in the world. He was 128 days premature (21 weeks and 5 days gestation) and weighed 1 pound 6 ounces (624 g) at birth.