New kid on the blog - part I

You know how sometimes time simply seems to fly? It appears as if on Monday you received a wedding invitation from a couple, on Tuesday you attended their wedding, on Wednesday they told you they are pregnant, on Thursday you received an sms that went something like 'Blessed with a baby boy/girl weighing xx kg. Mom and child are doing well.' and on Friday you get an email (from the child, no less) saying, "Uncle/Aunty, please come for my 1st birthday." How does that make you feel? (Yeah, old, I know.) For most people, that's how fast and smooth the baby section of their lives seem to go. Of course, not everyone has it fine and dandy. There are also couples that are advised to terminate their pregnancy due to complications, or those who have to deal with the baby's and mother's lives being in danger, or those whose babies have to be in the ICU for months. But then these things are so rare and they always happen to other people, don't they?

Well, that's what we used to think too. Until the day Viv and I woke up to realise that we were the other people.

So the story starts on 9 Sep 2010 when Viv opened the birthday gift I gave him. It was a small box and inside was what looked like an iPod. But it wasn't an iPod. It was a positive home pregnancy test. (Yeah, I know. Cool way to break the news to your spouse. Touching and disgusting all at the same time.) I was toying between this and a highly dramatised version of a popular Bollywood scene of the 80s - "Main tumhaare bache ki ma banne wali hoon." but chose this one finally, because it meant that I did not have to buy Viv a separate birthday gift. I told him that this gift was so great that I did not owe him any more birthday gifts for the next decade. And he actually agreed.

We were elated. I was particularly excited because my sister, who lives in the US, was going to have a baby boy at the same time as I was going to have a baby girl! (Yes, I know. My mom shook her head at us and said, "Hey bhagwaan, main kahan jaaun?") We spent hours on the phone comparing symptoms ("Ooh you threw up breakfast? Yeay, me too! Same pinch!"). The first few months went by the usual way - throwing up, clothes getting tighter, wearing loose tops so no one at work suspected it till it was time to tell them, weird cravings (fortunately for Viv, no mood swings), etc. Speaking of weird cravings, the weirdest I had was for baby food. Yes, you read that right. And not just any baby food, but Cerelac (original), the baby food that I had had as a baby. Poor Viv went to Mustafa and got me three tins. (Yeah, he's a keeper. I know.)

We went for the usual doctor visits and everything was looking great. Until that one particular day when the doctor seemed to be frowning at the ultrasound. He measured the head and abdominal circumference, and the femur length a few times. His brow deepened. We asked him what the matter was. "The baby looks a little small.", he said. Small? So what? Babies are supposed to be small, aren't they? Besides, not all babies are born the same size. Some are just small. So we were not too worried. Until the next visit when the baby seemed to have fallen further behind in growth. The doctor asked us to go for a more detailed scan. The detailed scan said that the baby was fine structurally, but she was definitely very small. The case was classified as severe IUGR (intra-uterine growth restriction). IUGR is when the baby does not grow at the expected rate, and it can happen to a variety of reasons ranging from placental problems to chromosomal abnormalities.

"So what's next?", we asked the doctor. He said that he would continue to monitor the baby's growth, but suggested that we go see a specialist for a Doppler test to check if the blood flow through the placenta was all right. So we went to the specialist and that's the point where the faint lines of worry on our brows so far started to deepen. The specialist took a really long time scanning me, and then called another doctor who also spent a really long scanning me, and finally they said that they suspected that the baby had a heart condition called coarctation of the aorta. I still remember clearly what he typed in his report to my doctor - "Irrespective of the reason for the IUGR, prognosis looks poor." Then he turned to ask us what our religion was. It was a really strange question to ask, I thought. It was only later that I realised that he was trying to find if we had any religious restrictions regarding termination of the pregnancy. Termination?? I could not believe I was listening to someone talk about termination while my baby was kicking inside. But we had to be practical. If the baby really had complications such as a possible chromosomal disorder and a heart problem, what kind of quality of life were we promising her? The specialist left the decision to us but he was leaning towards termination.

We called my doctor and told him everything. He asked us if we were for termination. We said we needed some time to think about it, and that's when he told us that we had two days to decide and go through it because I was already in week 24, after which termination of a fetus is illegal in Singapore. Two days to decide whether we wanted to kill our baby?! I need not describe what Viv and I were going through. We decided to go for an amniocentesis the same day and try to get the results as soon as possible, even though normally it takes a few days for the fast results (that looks for a few common chromosomal defects) and a few weeks for the full results. Amniocentesis is this really scary test where they poke a needle all the way into the womb and collect some fluid right next to the fetus and test it for genetic abnormalities. We figured that if the test indeed showed a serious problem, we would at least have a solid reason if we went for termination instead of a 'suspected heart condition' in the baby. Amniocentesis has a 0.5% risk of miscarriage so there was a chance that even if there was nothing wrong with the baby, the test could do something to her! But this was really the best we could do so we went for the test. I had a screen in front of me where I could see the very long needle approaching my baby as the doctors carried out the test. Worse, they did not get any fluid at the first attempt so the test had to be done all over again!

I asked the doctor how the termination process would work if we opted for it. He said they would induce labour. Induce labour at 24 weeks?! I was to go into labour and give birth to my dead baby?? Only I know how I managed to keep myself from breaking down right there.

We were to get the FISH (Fluorescent In Situ Hybridization) test results in two days' time. This meant that if the results were poor and if there indeed was a serious genetic problem, we would go for termination the very same day. I went home, stayed in bed all day and bawled my eyes out, something I can't ever remember doing before. Meanwhile, Viv asked our doctor if we could get a second opinion on the scan. Our doctor recommended someone and got us an appointment for the next day. This doctor also scanned me for a very long time but did not say anything till the end. And what he said gave us the first ray of hope for the first time in several weeks. "I see no coarctation whatsoever.", he said. No coarctation whatsoever. Two contradicting opinions. Both experts in their field. What were we to do?

This doctor did say that he detected a hole in the baby's heart but it was something that could only be studied once the baby was born. He also said that if we were to keep the baby, I would need to go on immediate bed rest. The baby, if she survived, would most likely be premature and would need ICU care for months. He warned us of the ICU costs in the private hospital where my doctor was. Apparently a bed in the neonatal ICU can cost about $1000 a day. Yes, you read that right. $1000 a day! He showed us a picture of a similar case - an Indonesian couple who had twins and spent $100,000 on hospital bills. Bankrupt, they moved back to Indonesia.

So we went back to our doctor the next day who had the amniocentesis results with him. "The results are bad..." I heard him say. "Bad?? The results are bad??" My world came crashing down. "Back!" he quickly clarified. "Back, Sayesha, back. The results are back!! And everything looks fine." There were no genetic problems reported by the FISH test, although we would still need to wait a few weeks to know if there were none of the less common chromosomal defects. So, at that point in time, the only thing we needed to consider was the coarctation of the aorta. He left the decision to us. Though the test had ruled out major genetic disorders, severe IUGR still carried the risk of intra-uterine death. Add to that the possibility of the heart problem (coarctation and/or the hole) and the underlying reason for IUGR, which could be anything, and eventually manifest in anything.

We came back, called our families, and spoke to each other at length. And finally we made our decision. We would not voluntarily let our baby go. There just didn't seem to be enough evidence for us to opt for the worst. The baby was actively kicking, she had always been a kicker. Though I would have given anything to ask her what was going on inside, or to be able to deduce from her kicks what she wanted us to do, that was not to be. So in the end, we decided that if the baby was meant to leave us even before she met us, we would let it be her decision to make, not ours.

Read New kid on the blog - part 2.