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Colleen Higgs

@ Sunday Times Books LIVE

“Everything by heart” from Jacana’s Just Keep Breathing collection

My daughter turns ten today and as a way of acknowledging her birthday for myself, and what a milestone it is for me, I am re-publishing the story I wrote for the Jacana collection, Just Keep Breathing edited by Rosamund Haden and Sandra Dodson.

Everything by heart

I was so much older than most first time mothers-to-be. I wandered into bookshops and fingered through countless books about babies, feeling like an impostor. The world of motherhood a foreign country; I didn’t belong to it, nor it to me. I was hoping for a story to guide me into this hinterland, to teach me its customs and folkways. Little did I know that I would have to learn everything by heart.

At 29 weeks I thought I was having a stroke. I felt unbearably hot and nauseous, and the pain was excruciating – especially intense under my right rib. It was difficult to breathe, my skin felt too tight, I felt I might implode. It turned out that these were all symptoms of pre-eclampsia.

I gave scant attention to information in the pregnancy guides about complications relating to pre-eclampsia, out of a vague superstition that my full attention would only bring on this or one of the other dangerous illnesses outlined there. Pre-eclampsia is a potentially life-threatening condition for mother and child, which usually strikes late in pregnancy. Older mothers, especially those having their first baby, are more likely to develop it. Little is known about the causes of the disease or possible preventative measures partly because the window for studying it is very small; however, the best treatment is to deliver the baby.

I realised in retrospect that there had been signs in my pregnancy that something was not right. I’d been ill and tired throughout the 29 weeks, and had none of the positive symptoms described in the books. I’d had several serious migraines, but this pain so was extreme it was like an extended convulsion. All of these episodes seemed to happen on Sundays or public holidays, which meant house calls and paying extra for the heavenly relief of the 3 in 1 injection cocktail of Voltaren, tranquiliser and anti-nausea medication, that would blissfully ease the intense, prolonged pain and vomiting and finally bring sleep.

I was admitted to hospital on a Monday, and told by Dr J, my gynaecologist/ obstetrician, that he would try to keep my baby inside me for as long as possible. I wore a belt across my chest to monitor the baby’s heartbeat. She seemed to be doing OK. After the third pre-eclamptic episode, Dr J decided to do an emergency Caesar on the Thursday – May 30th, 2002, which would make Kate, my baby girl, 11 weeks early. When I first realised that my baby was going to be premature, that I was unable to incubate her inside my body where she belonged, I cried with guilt and sadness, feeling that I had let her down.

At the delivery, André, my husband, was at my head with the anesthetist, while the lower half of my body was hidden behind a curtain. Being very tall, André could see over the screen and witnessed the entire procedure, from Dr J cutting me open to the extraordinary moment when he pulled the tiny, bloody creature out. Kate looked nothing like the pictures of newborn babies in the books. She was tiny, almost fleshless, a newly hatched bird that belonged firmly in its nest. She seemed old and wise, unearthly. My entire being flooded with tenderness as I held and kissed her for a few seconds before she was taken away from me. André followed her and the paediatrician out of the room to the Neo-natal ICU. I saw her again only hours later, in the early evening, when I had recovered from the operation a little.

It’s easy enough, now, to give a factual account of what I experienced in hospital, but it’s not so easy to write about the inside of the experience, even less so to convey anything of what it might have been like for Kate. She underwent numerous blood tests in the form of pinpricks to her heels; she received several doses of antibiotics, iron drops to ward off anaemia, caffeine drops to make her heart beat faster, oxygen too, although she didn’t ever have to be on a ventilator. She had jaundice and spent 3 days and nights under UV lights in the first week of her life. She was given Surfactin to strengthen her lungs. She weighed 1080 grams – just over a kilo – when she was born and then her weight dropped down to under a kilo for a week or two.

The first day or so of Kate’s life I was sore from the Caesar, and my neck was painfully stiff from leaning over the incubator, from the tension of the whole experience. My breasts were enormous and tender and the only relief I got was from expressing my milk, which was pale brown when it first came in. At once it was sent off to the lab to be tested in case there was something wrong with it. I was ashamed as I waited for the results, unsure of myself, of my milk, of my role. When the lab determined that it was fit for Kate’s consumption, I was relieved, filled with joy. I had dreaded the worst. She was initially given 1 ml at a time from a tiny syringe suspended cleverly above her with an elastic band that led into a tube down her nose straight into her stomach. I became adept at filling the syringe, at feeding my baby in this way.

In the first ten days or so she lay in plain sight in an elevated open incubator against the back wall of the NICU. She was kept warm by the heated incubator and covered with a miniature space blanket when she wasn’t being held. She was naked except for a tiny nappy and a great number of tubes and monitors attached to her body. She cried seldom, but when she did it was a peculiar sheep-like bleat.

One morning, while sitting in the plastic chair next to the incubator holding her next to my skin, I looked down at her and noticed that she had turned very white, almost blue. She was cold too. Time stopped for me. The paediatrician was called and she was given a life-saving blood transfusion. I can’t remember what it felt like to be in the moment of the ordeal. I have forgotten how hard it was. At the time, I coped by taking everything one day at a time, one hour at a time. I didn’t plan or think ahead about next week or next month, or the end of my maternity leave.

While in the NICU, I watched other mothers who skillfully changed nappies and used special cotton buds and lotions and wipes. I hadn’t bought anything for my baby, not wanting to tempt fate. While we were in hospital André did the first baby shopping: prem nappies and Kate’s first toy, a small, soft purple Eeyore. I was shell-shocked, unprepared. It was enough witnessing her incubation from the outside. With the help of nurses, the paediatrician and other mothers, but mostly just by watching her closely, I began to figure out what she needed minute by minute. And what I was able to do.

Kate’s birth brought an overflowing of gifts: babygros, vests – even an embroidered one – hats, blankets, hand-knitted jerseys, booties, dungarees, miniature sheepskin slippers, a plastic bath chair, a pram, a cot and a house full of flowers. All who knew us seemed to welcome her into the world.

I remember sitting in the NICU next to the incubator drinking tea about a week after Kate was born when the convener of the antenatal classes phoned to tell me that the date of the first meeting was postponed. At first I didn’t know what she was talking about, then I started to cry. “My baby has been born already,” I told her. She was kind and sympathetic, which made me cry even more.

The first night I had to leave Kate in the hospital and go home was particularly bleak, the world wet and cold, the drive up Hospital Bend to Woodstock too far. My whole being resisted leaving, my arms felt too empty, too light. For two months I lived in a nether-world of driving up and down to the hospital and sitting next to her incubator, holding her or simply being with her while observing the goings-on in the NICU, seeing babies leave and new babies arrive. All the time I was away from Kate I felt like I was in a transit lounge – unreal, in-between. I felt present only when I was with her. Everything else was preparing, recovering, gearing up for, resting.

Every time you enter the NICU you have to wash your hands in order to cross the threshold into the sacred place, the place beyond the glass windows, beyond ordinary daily life. Friends came to see Kate when she was a little bigger and I was allowed to carry her to the window for a few minutes to show her to them. Once, when a dear friend came to see Kate, a nurse who had become quite possessive of her took her away from me, and held her up to my friend. I insisted on taking her back into my own arms. As soon as I did so the nurse in turn insisted that Kate be taken back into the NICU as she had been out of it long enough. In those first weeks I had to submit to the authority of the NICU nurses, and had no option but to give Kate back to them when they told me to. I wasn’t allowed to hold her for too long in the beginning. When she was sick with a gastric infection in the first weeks, I wasn’t allowed to pick her up at all. I could touch her, but only with my hands through the little doors in the side of the incubator. My back and upper arms tired and stiffened from the odd positioning.

Those early months were about existing in the present, not thinking, but observing, listening, sitting still, learning a slow, meditative patience while she grew gradually bigger and stronger. Almost imperceptibly she gained a few grams each day and took in a little more milk while I sat at her side, her attendant mother, guardian angel, witness, nurse. It became a meditation — being there for her. Being. There.

I remember drinking coffee in disposable cups from the hospital coffee shop. I remember the smell of popcorn, which the nurses often bought to eat at quieter moments. I remember how long the nurses’ shifts were – 12 hours. One older nurse told me, “The best way to be a mother is to learn to trust yourself. Listen to that inner voice. Trust it.” She told me this late one night when we were the only adults in the NICU. All the sick and premature babies were in their cots and incubators and it was dark and quiet except for a beep now and then and the humming sound from the electronic equipment.

Twice a day I visited her, every morning from about 8 till about 3 in the afternoon and then again at night. Before my night visit I would sit close to the fire in my great grandmother’s chair, deriving some comfort from it. André bought coal and wood and made the fire in the small Victorian fireplace in our Woodstock home each cold, wet night that winter. I would relax slightly as I stared silently into the flames between mouthfuls of supper, bracing myself for the drive back to the hospital. Our dogs lay next to the fire all night. The wooden floorboards near the fireplace were pocked with black scorch-marks from decades of popping coal. I would leave André and the dogs and head out into the rain. Cape Town winter rain is more than just weather – it can feel endless, a permanent submersion, frightening for a non-native. No matter how cold or wet it was outside as soon as I entered the NICU, I would overheat.

Almost daily, new faces, new mothers arrived. I became a fixture, nearly invisible, in my daily vigil. In three days the other women gave birth, got the hang of things and went out into the world with their babies who were kitted out in new clothes and receiving blankets, matching baby bags and new car seats. I stayed on and on. After several weeks of sitting there day after day, I knew most of the routines; I could have acted as an NICU assistant. I remember the nurses gossiping crossly about a twenty-something mother who only visited her baby every two or three days. I also saw that there were far more challenging misfortunes than being premature. There were babies who had to be ventilated; there were babies who were much sicker than Kate. A baby with spina bifida came to the NICU in preparation for a long and highly specialized operation. She was much older than the other babies in the ward.

One of my most traumatic experiences was attempting to breastfeed Kate in the hospital under strict supervision. She had to learn to feed before she could be released from her hospital sentence. I would try and fail. Well-meaning nurses weighed her before and after a feed, and there would be regretful shakes of the head, no – she didn’t take anything in. Other nurses, many of whom hadn’t ever had a baby of their own, offered me nipple caps, suggested different positions for her head, demonstrated how latching is supposed to work, but between us all we couldn’t get it right. Eventually, thanks to a kind word from an older nurse who had two of her own children, I realised that Kate needed to bottle-feed or we would be in hospital much, much longer. I pumped my breasts, milked myself several times a day and stored the milk either at the NICU or at home in the freezer. Determinedly, I taught my baby to drink from a bottle.

Kate’s first bath was in a 2-litre ice-cream container. Before then I washed her body inch by inch with cotton wool and warm water. How light she was and how small, so small she fitted into my hand. I’ve forgotten or mostly forgotten those tiny nappies and knitted caps and what being on red alert was like.

When we brought Kate home she weighed just two kilograms, still smaller and lighter than most babies are when they are born. I had been deeply apprehensive that I would need to monitor her breathing constantly, that I would need a gadget to tell me that my baby was still alive. But when the time came I trusted the connection between us enough; I knew that she knew how to breathe. She slept in our bed, snuggled between us, and, tiny as she was, I knew that I wouldn’t roll over onto her. I had the strangest sensation of both sleeping and being aware of her at the same time, cradled next to my body. I felt archetypal, animal, like a great lioness with my cub at my side, my body a source of warmth and food and comfort.

As I write this Kate is five and a half. She delights me every day with her passionate will and her own particular self, the same powerful creature who was evident from the first moments in the incubator. Together we got through. She was a survivor then and she is a survivor now.


Recent comments:

  • <a href="" rel="nofollow">tiah</a>
    May 30th, 2012 @09:52 #

    What an ordeal. The line about the ice cream container really rams home how small she was. You are both fighters. Well done.

  • <a href="" rel="nofollow">Helen</a>
    May 30th, 2012 @12:05 #

    The first time I read this, years ago, I cried so hard I couldn't breathe. But I re-read it eagerly today, and cried again, but this time able to appreciate the writing on one level, and the personal knowledge of Kate the entire intact human child I know on another. Congratulations to you all on this milestone.

  • <a href="" rel="nofollow">Phillippa Yaa</a>
    Phillippa Yaa
    June 1st, 2012 @19:02 #

    How you touch people with this story Colleen! The ordeal of it! And you and Kate thriving. Really a brilliant window into the human heart.

    I loved being part of that project! It was really a gem on the literary landscape, not celebrated enough and I hope they're going to tell us if they're going to pulp those books.


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