A Mother and Daughter's Strength and Resilience

January and Drew found out they were expecting baby number two on Valentine's Day of 2023. At home, they had a son named Mason who was about to turn two. With a due date in October, they were excited to become a family of four with the addition of their new baby girl.

January's first baby was born at 34 weeks. There was no medical reason as to why, but her water broke. She had an unmedicated vaginal delivery with no complications. Her son landed some time in the NICU to learn how to feed, but did well and has been thriving since. Due to this reason, she asked her OB to have an ultrasound at her 16 week appointment.

January and her daughter.

January expected to go into a standard ultrasound with no surprises, but the ultrasound tech noted her placenta was low. After meeting with her doctor, they discussed the diagnosis of placenta previa. This meant that her placenta was covering her cervix. Her doctor didn't seem overly concerned because most previas resolve on their own as the pregnancy progresses. January was put on pelvic rest, which included no intercourse and restrain from lifting more than 30 pounds. Given January's history and new diagnosis, she was at high risk for preterm labor. She was instructed to go to the hospital if she had any spotting or bleeding; she also started to take progesterone to help prevent preterm labor and keep her cervix closed.

“Due to the previa, this pregnancy was a bit more anxiety provoking than my first. I followed the restrictions and tried to take it easy the majority of the time,” January said.

As she continued through the pregnancy, she had frequent cervix checks through ultrasound. Each ultrasound continued to show her previa, but her cervix remained closed.

One of the major risks for placenta previa is bleeding. If January's previa continued, she would need to have a scheduled C-section at 37 weeks, which is considered full term. If her symptoms changed, the C-section date may be moved up to 36 weeks.

After getting through the viability stage, the anatomy scan and hitting the third trimester, she and Drew felt more at ease with their baby girl's arrival.

Baby Girl's Arrival:

It was the first Saturday in September and January and Drew had a few friends over to watch football. Earlier that week, she was seen by a high risk doctor and her regular OB and everything seemed stable.

That Saturday evening, September 2nd, January’s abdomen hurt slightly. She went to the bathroom and there was no blood, so she decided to try and lay back down and go to sleep. She initially thought maybe it was indigestion.

The next day, when she went into the bathroom, she felt an excess amount of fluid come out and there was bright red blood in the toilet. She knew that she would need to go to the hospital. She woke her husband up and called their friends to help with their son, as both of their families lived out of state. Within ten minutes, their hospital bag was packed, their friends arrived, and off to the hospital they went.

January was examined by the labor and delivery doctor. It didn't appear that she was actively bleeding or that her cervix had started to change. Baby girl also looked great on the monitor. She was admitted and given magnesium and steroids. January and Drew were also accompanied by their Doula, Charity, who was also at their last birth. The bleeding stopped, but January was kept in the hospital.

January and Drew sat around and watched movies and called family to update them. They were glad it appeared she wasn't actively bleeding, which meant their baby girl could sit tight for a little longer. She was right around 33 weeks given her initial due date was October 20th.

On Monday morning, she was still required to be on bedrest and she received a second dose of steroids. Her doctor said if everything remained stable, she could go home soon on strict bedrest until her scheduled C-section, which was now moved to 36 weeks.

Later that evening at the hospital, January started to change positions and noticed she was bleeding again. It appeared to be a significant amount. The nurse instructed her to move back into her bed and lie down as the blood continued. January looked at her husband with concern and he began to make phone calls.

“The way we looked at each other was like we knew what was going to happen,” January said.

The nurse called in other nurses and they weighed the pad underneath January to determine how much blood she lost, which was estimated at 1L. The on-call doctor came in and made an immediate decision for a crash C-section. Baby girl looked great on the monitor, but they knew it had to be done.

Mira sleeping on her mom’s chest.

January was taken to the OR and baby Mirabelle was born September 4th at 19:43 at 4 pounds, 4 ounces and 18 inches long. She had Apgar scores of 8 and 9, meaning she appeared healthy. January had an estimated blood loss of 1.8L in the OR and had to be put under general anesthesia. After the surgery, Drew went up to NICU to be with their daughter and January was sent to PACU to recover.

January woke up with a significant amount of pain in PACU. Drew had come down to see her and Charity was also present. Drew had taken pictures of their new baby girl and January immediately thought she looked like their son. As January recovered, she continued to bleed. She was moved to the regular OB floor where January felt her pain was not under control and she was concerned with the bleeding. Her vital signs showed she had a high heart rate, low blood pressure and a fever. Given her history in healthcare, January started advocating for herself that something wasn't right. Her husband was also very concerned given his wife's concerns. The charge nurse and physician on call came in to evaluate her after several conversations with the nurses. The physician manually removed a 1L clot from her. In total, she had an estimated blood loss of 3.8L. She required several blood transfusions and 1:1 nursing care. On Tuesday morning, January received four blood transfusions. Her hemoglobin was still low at 6.3. She was given an additional two blood transfusions and iron.

“I’ve never felt so tired and weak in my entire life,” January said.

On the evening of September 5th, January was finally able to meet her daughter, Mirabelle. She was in the NICU in the incubator keeping warm. She was so relieved that they were both okay, given everything they had endured already.

January holding Mira, skin-to-skin.

“When I was able to hold Mira the first time and have her skin-to-skin, I remember feeling a sense of relief because she was okay and so was I. I knew skin-to-skin had so many benefits for our girl and myself. Holding her brought me to a calm place, and I could tell it did with her, too.”

As the week progressed, January worked on getting her milk to come in and recovering from the C-section. Each chance she and Drew had, they went to see Mirabelle in the NICU.

January was discharged from the hospital Friday while Mirabelle stayed in the NICU. January was still expected to not lift given her C-section. As January and Drew navigated her being home with a toddler, Drew's Mother, Lori, came and helped. The first week, January and Lori drove back and forth to the NICU so January could be there when the doctors made their rounds and to do skin-to-skin with Mira.

When January was cleared from her surgery, she began driving herself and extending each visit a little longer as she started to feel stronger and started to heal. Each day, January focused on skin-to-skin and promoting that bond between her and Mira. Mira was taken off CPAP/Oxygen within a week of being born. Her IV site came out quickly and tube feedings started. With January's milk coming in, this was given to Mira through her feeding tube. The week of 34 weeks gestation, January started working on breastfeeding with her and working closely with lactation. Her first feed, Mira latched for eight minutes and did so well. The NICU team was shocked she was able to latch. Mira picked up on feedings faster than what January and the doctors expected. Within seven days of starting feeds in January, Mira took 70% of her feeds from breast or a bottle. January knew they were getting close to being discharged.

January breastfeeding Mira.

Saturday, September 23, January was at the hospital again with Mira. The doctor and nurse said they were considering discharging Mira on Monday given her ability to take oral feedings so well. Mira's feeding tube was removed, so that the rest of her feeds were breast or bottle. January was elated, but also nervous. She called her husband and they knew they needed to start preparing to go home. There were a few more tests that Mira had to pass, but she did so with flying colors.

January and Mira cuddling, skin-to-skin.

Monday, September 25th, the doctor and nurse practitioner came in and told January it was time for Mira to go home. While January was warned on the weekend, she was still surprised. The month of September had turned into a blur, but she was finally seeing the light. She called her husband to tell him the news. That morning, January fed Mira with the excitement of finally being released with her daughter. The nurse reviewed discharge information with her and they packed up Mira. January, Drew and Mira left the hospital that afternoon, feeling excited that her older brother, Mason, would finally get to meet his sister.

January, Drew, Mason, and Mira.

Mirabelle Patricia Plantage was released from Advent NICU after a three week stay. She surprised everyone with her ability to come off oxygen, parenteral IV nutrition and transition to breast and bottle feeding in the short time she did.

Together, January, and Mirabelle endured many challenges throughout the month of September, but they came out on the other side stronger and more connected.

“Our story is what we will live to tell, and I hope that someday I can tell the story to Mira to show our strength and resilience.”

Mirabelle Patricia Plantage was named after January's grandma, Patricia Strelow. September 25th, the day she was discharged, is also the day Patricia Strelow passed away two years ago.

The day Mira was released from the hospital.