Josie’s Birth Story

I never thought I was “born to be a mom”. Until I was one. It’s taken me a bit to sit down and write this. For the first few months I was in a blur of newborn life, doctor’s appointments and the countless new medications I had left the hospital on. My anxiety was at an all time high, will this sleepless night raise my blood pressure? What about this very necessary cup of caffeine? Ah but her sweet face. All worth it, every second, every uncertain worry. 

July 4th, 2021. We were getting ready to head to a friend’s Fourth of July pool party. I had been experiencing what I thought was premenstrual symptoms. When I woke up that morning, to spare you the details, things weren’t as normal and it hit me like a ton of bricks. I’m pregnant, I know it. I took a test and… positive. It was a shock to say the least. Further, I was still having symptoms of an early period and so I feared I was miscarrying. I tried to explain it all to my husband but he was confused… “so you’re pregnant?? Or you’re not?!”. “I am according to this test, but something isn’t right!”

We went to the party where I was probably all but silent because I was so in my own head about what was going on. For the next couple of days I was cramping pretty badly and more on one side. I called my gynecologist: “better come in, we’ll need to rule out an ectopic”. The next few weeks were a barrage of ultrasounds… I think I had a total of 5 in my first trimester alone! After lots of “episodes” my OB felt we were out of the woods and baby was doing well at my 12 week ultrasound.

I felt great, maybe a bit tired, but thankfully no morning sickness. The next few months went by rather quickly and easily. I didn’t even feel pregnant. My doctor said my weight gain was “beautiful” and I continued working out and eating as balanced as I could. I loved being pregnant. I loved chatting with all my family and patients about every aspect. Everyone loved to hear that we weren’t finding out the gender. But, a boy was the consensus. And when I say consensus I mean EVERYONE told me I was having a boy. My family, my friends, my patients, even instagram followers would cold DM me when they saw a picture or video of my bump. I, though, knew it was a girl from day 1. Just a feeling, but I was sure about it.

Ultimately feeling amazing, there was just one thing that stayed with me for weeks… Braxton Hicks contractions. They started EARLY, around 16 weeks. My doctor wasn’t worried but she asked me a lot of questions at each visit making sure there were no accompanying symptoms that could point to premature labor. Nothing. Nothing. All good. Each appointment was great and I loved when I got to see baby at my routine ultrasounds. 

Then during a rather stressful week, at 28 weeks pregnant, I started having regular contractions about 3 minutes apart. They were painless but they lasted all night. Every 3 minutes. I called my doctor’s 24 hour line and the instructions were: you need to come in. You shouldn’t be contracting so regularly. In triage they determined that yes I was having regular contractions about every 3-4 minutes, but no signs of early labor. More concerning though, they said, they didn’t love my blood pressure and I looked “small”. Okayyyyy… I wasn’t really worried to be honest, just relieved that the contractions were nothing to worry about. I thought they were being overly cautious. 

After a few tests and an ultrasound, a nurse practitioner who I hadn’t met came into the room and said in these words: “You have preeclampsia and your baby is TINY. 3 percentile is considered severe growth restriction and your baby at 3.5. Are you SURE you don’t have any comorbidities?” I said no, I was perfectly healthy, had never been diagnosed with any chronic health condition and took no medication. She was almost accusatory and, being completely alone due to COVID restrictions and shocked by all this new information, I really didn’t appreciate that. I couldn’t help but think what a pregnant mom with no medical background in this situation must feel with no reassurance from the provider.

I called my husband who had been down in the waiting room for 8 hours, unable to come up to triage, and tried to explain all this new information. With no medical background, he was confused to say the least and I was barely audible over the sobs. Severe growth restriction?! How is this possible?! The baby had been developing perfectly at my 20 week ultrasound, my blood pressures had been impeccable at my visits and my weight gain “beautiful” in my doctor’s words. The only times I had seen this fetal growth restriction diagnosis in PA school, it had been associated with drug and alcohol abuse. I was so confused and devastated. The stern nurse practitioner said they probably won’t deliver you today but ultimately we have to decide if the baby’s chances are greater inside or out. I’m calling your OB now. My nurses were so kind. They tried to reassure me. One told me “don’t worry, babies at this NICU do great delivered at 28 weeks”. I must have looked like I’d seen a ghost when she said that.

My OB came into triage at the crack of dawn, as soon as she received the call from triage. She was so reassuring. The growth restriction is likely due to the preeclampsia, she explained, which I hadn’t shown any signs of until now. They aren’t going to deliver but things are going to change, she warned me. Because of the increased risk of complications for me with the blood pressure and for baby with the growth restriction, I was to see her in the office twice a week for the remainder of the pregnancy. Once for a non-stress test to monitor the baby’s heart rate and once for an ultrasound to make sure the baby was receiving blood flow and wasn’t in distress. Rinse and repeat until… well until the blood pressure becomes a problem. We really need to get you to 32 weeks, she told me. The odds are higher then. 

We canceled travel plans and stayed close. I kept working but quit any workouts that were more than a brisk walk. I was still contracting every single day, but that was now the least of my worries. Twice a week I saw my doctors (there were now multiple) and each visit was uneventful. I monitored my blood pressures multiple times per day at home and they were perfect. I questioned if I really even had preeclampsia. It didn’t make sense. Still, I moved my shower up just in case. 

Around 35 weeks, on my last day of work, I noticed some swelling in my ankles… nearing the end, I thought, all normal. But when I got home my blood pressure was slightly higher than it had been. Well, better take it easy. The next day things kept creeping up and when I saw blood pressures I used to see in the ER, being admitted for hypertensive urgency, I went straight to OB triage. My blood pressure leveled out and I was sent home. The next day at my scheduled OB stress test: “you’re probably having the baby this weekend” she told me. Oof. Ok. That meant a sure NICU stay as I was less than 36 weeks and baby was still considered growth restricted. She warned me I wouldn’t be able to go see her for the first 24 hours because I would need IV magnesium to prevent seizures. She felt it important I was prepared for that, the worst part, she said. I was thankful she warned me. I was scared of the impending delivery and terrified for my baby. She added “Girls tend to do really well in the NICU”. “Girls?” I smiled. Her face went blank, I could see the look of “crap! I just ruined it”. But, to be honest, at a frightening time, this exciting news was welcomed. For a second I forgot about this shitstorm and thought: A girl. I knew it. A baby girl. I told no one, not even my husband.. He was convinced it was a boy.

For the next few days I skirted under 150 but ultimately on Monday night my blood pressure shot up and I had a severe headache. She told me to come in right away. My preeclampsia was now considered severe and the risk of seizures elevated. Baby had to come out. If you have a background in medicine you know, the ONLY cure for preeclampsia is delivery. Another ultrasound and “baby is still breech”, I’m told. A C-section. Ok, again the least of my worries. I chuckled a bit when I thought about my initial birth plan: no meds, soft music, no screaming, just meditating this baby out of me. HA. This birth is going to be anything but how I planned it. It’s okay though, healthy baby is all that mattered.

Once I was on the table my OB came in and held my hand. We both agreed we had waited as long as safely possible and now it was time to get baby out. My C-section was EASY. I joked with Jim that it literally felt like a massage. My OB talked me through the whole process as she was operating. My anesthesiologist stroked my face, reassured me and we chatted about my years practicing in the ICU. After surgery, “its a GIRL!”… my husband was shocked. Tears of joy all around. My OB yelled me her APGAR scores and they brought her over for a quick picture before she was whisked to NICU. The nurse said she looked great. 

Because of the blood pressure I needed to be on a magnesium drip for 24 hours post delivery to prevent seizures. I had already been on it for about 12 hours prior to delivery. My magnesium levels were starting to rise and I was out of it. It felt like being drunk, but not the good drunk… the I’m not feeling so good kind of drunk. We went to recovery and shortly the NICU nurse passed by. Baby girl started to lose oxygen by the time they got her to NICU and they were giving her some now. I told Jim: she’s going to be intubated. He went to see her shortly after. I could not due to the IV medication as my doctor had warned. He FaceTimed me from the NICU when he got there. She was intubated. She looked so tiny, so helpless. He was smiling ear to ear, just happy to see her, probably unaware that that machine was keeping her alive. He pointed the FaceTime to the nurse who was a follower she told me! She reassured me the baby was doing great, just needed some support as she was too lethargic to breathe on her own from all the magnesium that had crossed the placenta in the last 12 hours. I winced. I was feeling awful from the medication and the thought of her feeling that way too, broke my heart. 

After about 36 hours I finally got to go down to NICU to see her, but wasn’t able to hold her yet. Although no longer intubated, she was still hooked up to too many things and was in “NICU A”. When she gets downgraded to B or C I could hold her, I was told. I sat next to her incubator and just watched her. She was still super lethargic. She’s not even supposed to be here yet, they told me, the sleepiness was normal. She underwent so many tests, so much poking and prodding and echocardiograms and brain ultrasounds. Part of me was relieved I had missed some of it but devastated at the thought of her being alone. The next day, finally, I could hold my newborn baby, 3 days after she arrived. I cried and said “I’m your mommy”. Her eyes shot open and she looked all around trying to find the familiar voice. I’ll never forget that moment.

Jim and I took out our phones when I was back in the room to look at our list of baby girl names. None of my favorites seemed to fit her. We stared at photos of her and racked our brains. “Josie”, I said. “Really?!” Jim was surprised because it wasn’t on our very long list. “Should we name her Jocelyn or Josephine??” We liked both but she was just a Josie. We both felt it. Josie James.

A day before I was supposed to be discharged, we were preparing for a week or so at home without Josie. My blood pressures had been monitored every 4 hours and they’d been perfect since I delivered. But this time, I was woken up from a nap and it was… HIGH. Well it remained high for the next 5 days. I was so frustrated and scared. I never considered that the blood pressures would elevate again post delivery. They kept adding medications but it kept flaring. Every time I heard the blood pressure machine coming down the hallway my heart would race, my cheeks would flush, I would sweat. I can still hear it now. 160 they would tell me… try to relax and we’ll take it again… 180. I could not relax. I was in full on panic mode. Finally after being maxed out on 2 blood pressure medications my doctors and I came to the conclusion that I was having a major stress response each time they would check my pressure and I needed to get out of there. At one point they told the nurses, stop taking her blood pressure, it’s only making things worse. Once it was under 160, they sent me on my way. For reference, normal is less than 120. But we were in agreement, as long as I was in this tiny room listening to this blood pressure machine being rolled down the hallway, I could not calm down and we were never going to get this under control. 

At home things did calm down and eventually after a few weeks I was off medications. But, to this day, a year later my blood pressure is sky high when I go to the doctor. My heart races the second I see the cuff. The whole experience really scarred me. While normally I wouldn’t care about a little “white coat syndrome” as we call it (that’s when someone’s blood pressure is normal at home but high at the doctor’s office due to the stress), I can’t help but wonder what this means for future pregnancies?

10 days after delivery, Josie was coming home, weighing 4 lbs and 13 ounces. I called my mom and asked her to get the next flight to Miami. I don’t know how to take care of a baby, let alone one that weighs less than a bag of flour. 

The following 6-8 weeks were amazing and scary. Josie was perfection and we were learning how to feed a little peanut that was still meant to be inside my belly! She slowly got the hang of it and slowly gained weight. My anxiety remained high. At some point I had to stop monitoring my blood pressure because the stress was making things so much worse. Even now, writing this, my ears are hot and my heart is racing. 

Josie is the sweetest, kindest, funniest little almost one-year-old. She loves tofu and broccoli and she likes to give her daddy raspberries. She loves her kitties and is ready to walk any moment. We lay in the park under the trees every day and she babbles about I don’t know what. She’s completely caught up, according to her pediatrician… you would never know all that she went through. Life is so different with her here. Everything I cared about has changed. My priorities are night and day different. She has changed our lives in a way we never thought possible. We were never sure we wanted kids… and now we dream of giving her brothers and sisters.

The thought brings me so much worry. What are the risks of doing this all over again? What could it mean for me or for a future baby? Will all of this happen again? Or will things go smoothly? Will I have the easiest pregnancy ever or will the fear set me up for 9 months of stressful doctor’s visits? Ultimately none of these questions matter, though, do they? The miracle of life trumps it all. Because I never thought I was born to be a mom… until I was one.