The birth of a premature baby rips up parenting rule books, from skin-to-skin contact to comparing children | #parenting


Parenting expectations and parenting reality are rarely the same. Nothing could be truer when you become a “preemie mum”, as I found out when I unexpectedly gave birth at 32 weeks, an experience I’d like to share ahead of World Prematurity Day tomorrow.

Before having Ella, I had spent the previous 17 years working with babies, young children and their families as a nanny and within other areas of the childcare sector.

This meant that I felt that I would be OK as a mother in terms of the practical side. I was confident in my abilities in what to do with a baby and I was very much looking forward to putting all my years of experience into practice. I thought I knew what I was doing.

Then, on my first day off in four months, my waters broke. My ideas of what motherhood was going to be like changed the instant Ella was born prematurely.

She was placed on my stomach for less than a minute, before being whisked off to the special care baby unit (SCBU). Due to complications with myself, I had to wait seven hours before I could go to see her, and it was 48 hours until I was allowed my first cuddle as a mum.

The stress and worry were like nothing that I had felt before. These were not at all how I thought my first hours of motherhood would be.

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My mum-guilt was extreme. I felt like a complete and utter failure – and worse still, I thought everyone else would think so, too. I cried an ocean of tears during those hours.

It was extremely draining, both physically and mentally. All that I had previously learnt about babies was shelved as a preemie mum.

Each night, I had to say goodbye to Ella and come home, because at the time the hospital didn’t allow for parents to stay. The hospital was 12 miles away – not far for a routine appointment, but when you are leaving your baby behind, it feels like a million miles.

Coming home each night was the hardest part. I wondered if the midwives were playing a cruel trick on me when they first told me what was going to happen.

I can’t imagine how Karen Surgenor and David Cox must feel. It was reported last month that the couple from Paisley, near Glasgow, had been forced to make a 174-mile round trip to Kirkcaldy in Fife every day on public transport – taking two trains and a bus – to see their premature twins Cole and Harris, because there were no beds at hospitals closer to their home. An NHS spokesman admitted their local Royal Alexandra Hospital had been “very busy” and they had turned to “the nearest hospital with available space” instead.

Fast facts: Premature births

An estimated 60,000 babies are born prematurely – classed as before 37 weeks – in the UK every year, amounting to one in every 13 babies.

Pre-term labour can be planned and induced as it’s safer to be born sooner rather than later, perhaps because of a health condition in the mother, like pre-eclampsia, or in the baby. Often, the cause of pre-term labour is not known.

One in 10 of all premature babies will have a permanent disability such as lung disease, cerebral palsy, blindness or deafness.

A boy born in the US at 21 weeks and a day, weighing less than a pound, has been certified as the world’s most premature baby to survive. Curtis Means, delivered in Birmingham, Alabama, last year was just 420g (14.8 ounces). Guinness World Records confirmed last week that Curtis, who is now doing well at 16 months old, set the new record.
A quarter of stillbirths and a fifth of premature births in England have been linked to poverty, race, weight and smoking, and could be avoided, says a study in The Lancet. Experts found 24 per cent of stillbirths, 19 per cent of live premature births and 31 per cent of live births of smaller babies were attributed to socio-economic inequality, and would not have occurred had all women had the same risks as those in the least deprived group.

The chances of survival still depend on which week of pregnancy the baby was born in.

The NHS has set a target of halving stillbirth and neonatal death rates, and reducing levels of premature birth, by 25 per cent by 2025.

Wednesday 17 November is World Prematurity Day, a movement to raise awareness of premature birth and the devastating impact it can have. Visit bliss.org.uk or tommys.org for more information.

Kirsty Ketley having a rare moment of physical contact with one of her two premature babies (Photo: Author provided)

Ella was fed through a tube. I still expressed milk for her – pumping every few hours, and through the night. I was ridiculously exhausted and it was hard to pull myself out of bed. But I told myself that had she been at home, I would have been waking to feed her anyway.

In a bid to feel like a real mum, I made sure I did all her “cares” when I was with her, including feeding her through the tube, even though it wasn’t how I had ever thought I would feed my baby. Ella was finally allowed home after four weeks – four weeks before her due date.

Before we could leave the hospital, we had to be shown how to do CPR, just in case. Although we were excited to finally bring her home, this made me feel anxious. She was no longer attached to a heart rate monitor, and instead I ended up constantly checking that she was breathing. Again, I didn’t expect to be like that.

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Some people may think that it gets easier once you are home, and in some ways it does. Being in your own home and finally getting to go out for a walk, go to groups and see friends were all things that I felt I had been missing out on, but it was still hard going.

We had to manage Ella’s severe reflux and a cow’s milk protein allergy that she developed. This resulted in a miserable few weeks for all until diagnosis and medicine, but it was not unusual for premature babies, we learned.

She also needed extra checks with both the health visitor and the paediatrician, so the first few months felt like we were constantly either at the surgery or hospital. I already felt cheated out of the beginning of my maternity leave, so needing to have so many checks meant even less time for all the fun things.

I was also in a permanent state of worry, which took until she was discharged from the paediatrician, aged two, to ease.

Kirsty Ketley with her daughter and son, who have been grown into happy, healthy children (Photo: Author provided)

Preemies take longer to reach their milestones than babies who are full term. They get assessed by their “corrected age” – how many days, weeks and months have passed since their due date, rather than from the day they were born.

While I was fully aware that all babies develop in their own time, sometimes I found it hard seeing other babies, who were Ella’s actual age, reaching their milestones long before her.

I didn’t think I would be the kind of mum who compared her child with other children, but my feelings of guilt made me that way.

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For years, working as a nanny, I had helped to implement and follow strict routines with the babies I cared for. I thought I would do the same with my own. I was wrong.

While I made sure we got a good bedtime routine sorted, I found myself following Ella’s cues more often and being much more relaxed about routines than I had expected to be. I was so grateful and happy to have her home, that being tied to a set routine just didn’t feel right. It worked well for us, and it is something that I now talk about with parents in my consultations.

It was a difficult decision to have another baby three years later. When my son Leo was also premature, arriving at 36 weeks with sepsis and a collapsed lung, there was another SCBU stay.

Going through premature birth twice was traumatic and it has taken several years for me to heal mentally. Time in an SCBU highlights the fragility of life and gives you strength you didn’t realise you had. It changed how I thought I would parent, but it didn’t make me less of one.



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