For April, experiencing the sudden and complicated very early births of her two tamariki taught her to hold on to hope, despite the odds.

April shares about the different journeys of her two extremely preterm births.

Spontaneous preterm birth at 24 weeks

April fell pregnant at 21 years old, she and her husband were incredibly excited to learn they were having a son. During an ultrasound scan at 22 weeks, April was told that her cervix was short, although nothing was done about it. A week later she started bleeding in the middle of the night. By the time she arrived at the hospital her cervix (neck of the womb) was already 4cm dilated at just 23 weeks. She was given corticosteroids to mature baby’s lungs and magnesium sulphate to protect the baby’s brain, as they started preparing for birth. Over the next few days April was told she had an ‘incompetent’ and ‘dynamic’ cervix, meaning the cervix was opening and closing. This continued for 7 days until April needed an emergency caesarean section when her waters broke and the umbilical cord had fallen into the vaginal canal.

Ongoing care and complications

April’s son Kaiden was born weighing 710g with meningitis (infection in the brain) and a brain bleed. By 6 weeks of age the infection spread and as he vomited and aspirated, an abscess started to grow inside his lungs. He was really sick and started to deteriorate fast. He reached the maximum respiratory support available, and April and Kaiden’s papa were told he would likely pass away that day.

But Kaiden held on, and after six weeks with little progress he eventually started to improve and was finally discharged home needing oxygen and a feed tube.

The following years have involved many hospital stays, with Kaiden needing oxygen until he was 4 years old and a feeding tube until he was 8, He has endured more than 80 airway surgeries to clear scar tissue that was blocking his trachea (wind pipe), but April has always felt beyond lucky to have him home. Despite some lingering health issues he is an incredibly determined boy, attending school full-time and an active member of his school Kapa Haka group.

A second pregnancy

After an unexpected wait of 8 years to fall pregnant again, this time April had a cervical cerclage or ‘stitch’ placed at 14 weeks when her cervix already seemed to be short.

April felt unsurprisingly scared; putting herself on bedrest as much as she could from 16 weeks and constantly worrying whether she would make it to ‘viability’ (the limit of survival is considered to be 23-24 weeks, also known as viability).

When April reached 22 weeks the local hospital team were worried that the stitch was not holding so she was given corticosteroids and transferred to Wellington hospital for their NICU support in case labour started and pēpi was born. Very unexpectedly something different happened this time – a uterine rupture, where the scar from April’s first caesarean section opened up. Another emergency caesarean section was required and their very small and very young daughter, Taylor was born, weighing just 623g.

This was the scariest time for April. Her anxiety was through the roof imagining how their daughter may need to go through all the scary complications that her brother had experienced. Thankfully Taylor’s NICU journey was a lot more straight forward!

Words of wisdom 

April feels incredibly blessed to be the mum of two wonderful tamariki that have literally ‘turned her world upside down.’ These experiences have changed her life drastically and she doesn’t know if she will ever fully recover from them, however she remains eternally positive.

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‘My advice, is to hold on to hope, even if it’s tiny, and be prepared for anything to happen. I had one pēpi with an extreme struggle at the start of his preterm journey with effects that are still apparent now. Then another that just seemed to blink and fly through.’

‘My son is now 9 years old, and my daughter is 16 months. They are both doing amazing despite their very early starts in life and health setbacks.’

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April leads a Facebook support group for New Zealand NICU, SCBU and NNU Parents. This is a private group for parents or guardians, whose pēpi have received care in these units. https://www.facebook.com/groups/nz.neonatal.support/

April has a connective tissue disorder. Conditions like these, such as Ehlers Danlos syndrome, may impact on the way the cervix works during pregnancy and increase the chance of spontaneous birth. It is also very likely that this condition contributed to the very rare complication of uterine rupture that April experienced with Taylor’s birth. If you have a connective tissue disorder and are pregnant or considering a pregnancy, let your midwife or doctor know and remind them to think about preterm birth!