Preterm

>
> I feel her kick for the first time. I've felt other fetuses kick
> before on other pregnant women's bellies, but this time is special.
> The child is mine. A thrill goes through me and a silly grin wraps
> around my face. It's Friday evening, Sarah has malaria and I've
> just started her treatment. Leaving Sarah, who wants to rest, I go
> spend some time with Franklin and boast about my strong, athletic
> little daughter. After a little singing and worship, I return home.
>
> After checking the IV drip with a flashlight and being satisfied
> it's running well, I crawl into bed and fall fast asleep.
>
> A gentle shaking startles me from a profound slumber. My heart
> sinks at Sarah's words.
>
> "I'm all wet down there, what could it be?"
>
> I try to reason that maybe it's urine but my heart tells me
> different. Her bag of water has broke. The pregnancy is only 21
> weeks, too early too survive if she delivers now.
>
> I pull on some shorts, grab a flashlight and head up to the
> hospital. I bring back the portable ultrasound. I place the jelly
> on her belly and confirm my deepest suspicions: our little daughter
> has almost no amniotic fluid around her. However, her heart is
> still beating normally and she is still kicking if not screaming. I
> take the ultrasound back, but halfway there realize I've left my
> keys at home. After making the return trip I pick up my obstetrical
> textbook and try to find the pertinent passages.
>
> It's not encouraging. Most women with preterm rupture of membranes
> and fluid leaking deliver within less than 2 weeks and the outcomes
> are not good. I take the book home and discuss the bad news with
> Sarah. We pray and both toss and turn all night long. Drums pound
> in the distance as someone is mourning a lost loved one. Sarah has
> just a little more leaking through the night and by morning it seems
> to have stopped.
>
> Saturday morning. I give Sarah some yoghurt, hang up some more IV
> fluids and head out to church at 8:30. The doors are shut. It's a
> cool desert morning, but the sun is starting to heat things up. I
> sit in the shade along the rough brick wall in the dust. I'm
> reading a little when I sense a presence beside me. I look up. A
> tall, poorly dressed man stands proudly to my right clutching a
> tattered Bible. As he greets me I recognize him as the husband of
> one of our patients who explained to me yesterday that he's a
> traditional healer from up north.
>
> We start talking. I soon discover he is a man of God if not a
> prophet. He can barely speak French, but his words have a power
> that can only come from above. I confide in him and ask him to pray
> for Sarah. My spirits are uplifted.
>
> After the teaching in the first part of the service, I head home to
> check up on Sarah. She's vomiting and not feeling good. I stay
> with her. I look back at the passages in my obstetrical book and
> see a section saying that if there is at least one pocket more than
> 2 cm deep, than the outcomes are surprisingly better. I go back,
> get the ultrasound and to my joy find a 3 cm pocket and another 2 cm
> pocket. The heart still beats well. Maybe there is hope that Sarah
> won't lose the pregnancy.
>
> We both start to plan. If she hasn't delivered in two weeks we'll
> change our plane tickets and head to Denmark to arrive when the baby
> is 24 weeks and has a chance of living with modern intensive care
> nursing.
>
> We rest all afternoon as I try to control Sarah's nausea and treat
> her malaria.
>
> She starts to have contractions that night. Some bloody discharge
> discourages us again. I sleep only fitfully. When I wake up, Sarah
> informs me the contractions stopped halfway through the night. I
> repeat and ultrasound and our girl is doing fine, if anything it
> seems like there is more fluid inside. Hope rises...then falls as
> the contractions start again after breakfast. Sarah is in agony.
> She is moaning and tossing in pain. She vomits frequently. I try
> anything and everything to control the pain and vomiting. Nothing
> works.
>
> I am at her side almost constantly. She grasps my arms in vice
> grips every time the contractions hit. They are getting closer and
> closer together. She had more bleeding. I'm afraid, but repeat the
> ultrasound. The baby's heart is still beating well. But then a
> contraction hits and I see the heart beat start to slow. I'm losing
> it. It seems almost to disappear, then miraculously, as the
> contraction ceases, the heart slowly picks back up. She's
> suffering. Her heart can't take much more. The cervix is opening.
> It's just a matter of time.
>
> I prepare some towels and basins. I have a bottle of water handy.
> We start to talk of what to do with the body. Where will we bury it
> and what will we use as a coffin. Our conversation is interrupted
> every couple of minutes by severe pain and writhing as I sit
> helplessly by watching my wife suffer, knowing the outcome of her
> suffering will be an extreme loss. There's nothing I can do but be
> with her.
>
> The cervix is dilating. I can feel the bottom of our daughter. She
> is coming out butt first. A few more contractions and Sarah says
> "It's coming!" I reach inside and touch the tiny leg and foot. I
> grasp and gently pull as my daughter enters a world she'll never
> know. Her heart is still beating under my fingers. She fits in the
> palm of my hand. Every part of her is perfect. There are no
> malformations. She has Sarah's nose and my long skinny legs and
> arms. Her mouth is open as she tries to get air into her
> undeveloped lungs which will never be able to extract the oxygen she
> so desperately needs. Her little ears will never hear. Her closed
> eyes will never open. Her heart starts to slow down. But as I
> touch her tiny hand, she curves her fingers in an attempt to grasp
> my gigantic finger. She does this several times. She is getting
> colder. It's all over.
>
> I burst into uncontrollable sobbing. I hold her and watch her and
> examine her every little perfect human part over and over. We take
> pictures. Sarah lays her on her stomach. While she can curl up
> into the tiniest ball, when she's stretched out she's way longer
> than I could've imagined. We wash her, tie off the umbilical cord
> and cut off the placenta. I place her in an old mayonnaise jar and
> seal the lid tightly. I dig a hole under the small tree with the
> red flowers just outside our door. The dry soil is rock hard. I
> use the hose to wet and loosen the dirt. I get down about two feet
> and bury our girl in the soft mud. Sarah shovels in the first few
> piles and I finish. I read from I Thessalonians 4 about the
> resurrection and place a huge, porous stone over the top of the
> little grave as a marker.
>
> It is finished.
>