‘I never doubted that Julene was going to make it''
Please save my baby. That was all Sandy Darrell could scream when she started to deliver her baby daughter at just 25 weeks and three days pregnant.
What made the moment even worse was that the road to parenthood had been a long one for Mrs Darrell and her husband Steve, a police officer.
After trying to conceive for two years, they stopped taking the fertility pills they had been taking under the care of obstetrician Dale Wilmot.
“We said it would happen in God's time,” said the Berkeley Institute teacher.
Miraculously, it did. Mrs Darrell discovered she was pregnant the day before the couple's third wedding anniversary. The baby was due in late February. Naturally, after what they had been through, they were a little nervous, but that abated when they reached the second trimester.
It wasn't until a routine sonogram at 19 weeks that they noticed that something was wrong.
“The technician noticed that my cervix had dilated,” said Mrs Darrell. “We had to rush over to Dr Wilmot's office so he could take a second look.”
Mrs Darrell was diagnosed as having an incompetent cervix. This is a condition where the cervix has become slightly open and there is a risk of miscarriage because it may not remain closed throughout pregnancy.
She was given a cervical cerclage, where the cervix was sewn closed to stop the baby from being prematurely delivered and put on several weeks of bed rest.
The plan was for her to be air-ambulanced to a hospital in the United States when she reached 25 weeks.
Unfortunately, at exactly 25 weeks , on November 7, she went into labour and had to be air-ambulanced to Holtz Children's Hospital, a division of Jackson Memorial Hospital in Miami, Florida.
At Holtz, they managed to stop the contractions for a short time, but by Sunday morning they had started again with a vengeance.
“She [the baby] was right there and I had to deliver,” said Mrs Darrell. “When she was coming, the only thing I kept screaming was 'please save my baby'. It was very emotional. It took about five minutes for her to be born.”
Julene Darrell weighed just 1lb 11oz and was 12.25 inches long.
Unfortunately, Mr Darrell was elsewhere in the hospital getting a new security pass and missed the birth of his daughter. Mrs Darrell only got a glimpse of hair before the baby was whisked away by the medical staff.
There are a lot of things that can go wrong for premature babies, especially when they are born as early as Julene.
Baby fat doesn't come in until after the 30th week of gestation, so Julene could not regulate her own body temperature.
She was also at risk for brain bleeds and aneurisms because her brain was practically connected by a string.
Her lungs hadn't developed yet, and she needed help to breathe.
She couldn't produce her own blood so she needed constant blood transfusions.
Premature babies can also have problems with their eyes and heart, but luckily Julene never needed heart or eye surgery.
From the start Julene had two things going for her, she was black and female.
Statistically, premature girls do better than boys, and black girls do better overall. The first sign that Julene had a fighting chance was that she cried when she was born.
The Darrells had been warned that she probably wouldn't. She was given an eighty percent chance of survival, but it would be a long time before Julene could go home to Bermuda.
“There are three main things in order for the baby to be discharged,” said Mrs Darrell. “The baby has to be able to maintain her temperature.
“They also have to be able to breathe on their own without a machine. They can't have any defects in the oxygen saturation in their blood.
“She can't have any apneas and bradycardia, that is sudden drops in heart rate. She has to be able to feed on her own as well and not through the tube.”
It was four months, only a few days before her original due date, that she was able to achieve all these milestones. Her parents are now overjoyed to be back in Bermuda with her.
“When she was born a lot of people had this misconception that, okay she is born, she can just come home now,” said Mrs Darrell. “Really, she was developing outside of the womb.
“When you see her you are seeing what would have been in the womb. The lungs are the last to develop.
“She had no baby fat. One of the things my husband noticed she didn't even have nipples. She didn't have eyelashes. Her hairline was down to her eyebrows. Her eyes were more on the sides.”
“I never doubted that she was going to make it, because of the journey that we had prior. But it was hard to see her going through the different challenges.”
Meanwhile, Mrs Darrell was able to pump breast milk which was given to Julene through a tube.
In the early days she only needed a couple of cubic centimetres, not much more than a couple of drops. Her mother said proudly that she is now up to 80ccs.
Unfortunately, on three separate occasions the Darrells had to stop feeding Julene in the hospital, because oxygen from the continuous positive airway pressure machine helping her breathe, was bypassing her lungs and mixing with the food in her stomach.
“That was hard,” said Mr Darrell. “You want your baby to put on weight, and they tell you you have to stop feeding her, it hurts. They have to put an intravenous therapy line in her, every time they stop feeding her to give her the artificial calories.
Overall, Julene did very well and grew and put on weight.
She has not had any complications since being out of the hospital. One of the things the Darrells credit, in part, is a revolutionary, relatively new, preemie therapy called 'kangaroo care'.
Unfortunately, after Julene returned home, her mother had to struggle to get the extra months maternity leave that was needed to take care of Julene.
Although Julene was born four months ago, developmentally she is the age she would have been born had she been born on her due date in late February, essentially only two weeks old.
And premature babies, because of the complications they can suffer afterward, need extra attention.
“There were no precedents in the law to justify giving me extra time off,” said Mrs Darrell.
Some people didn't even understand why Mr Darrell needed to take time off to be with his baby in the hospital in Florida.
“Employers have to be mindful that both parents have to be there,” said Mr Darrell. “Just one person there would have been a lot of stress for one person.
“Just the two of us together was stressful. And when she was sick, she couldn't go into see the baby, so someone else had to go. Being the parent of a premature baby is like being a rollercoaster. Every day is different.”
Mr Darrell hoped that the new hospital would have facilities to deal with premature babies so parents would not have to go off the Island.
“If they had a hospital here I could have easily gone to work and seen her in the evening.
“When you go away with a preemie there is no set for how long you will be away.
“Some are discharged and have to stay for follow-ups for months afterward.
“This is something Bermuda has to step up their game. It would certainly save the insurance companies tons of money. The airambulance ride alone is something like $15,000.”
Useful website: www.prematurity.org.
The Child Development Programme in Bermuda has a special support group for premature babies and their parents.
For more information telephone 295-0746.