Joshua’s story – a premature baby and a testimony of courage

Joshua 1 mth old – in NICU

This is the complete, unedited account of Joshua’s parents (I first mentioned about Joshua and how his story has been an encouragement to us days ago in a blogpost: Steroids – to take or not to take?) Joshua’s parents wish that to encourage all parents facing the threat of permature labour with their story:

My wife was confirmed pregnant in Dec 2011. We were so happy then. We did the first thing that all would be parents would do and that was to find a good gynae. As with most Singaporeans, we opted to go to a private hospital as we believed a private hospital would provide the best medical care for the mother and the baby. We went to Thomson Medical Center and since then, we had been going diligently for our gynae visit. Before each visit, we were always filled with anticipation and after each visit, we were always filled with joy as we saw our baby boy in the ultrasound scan.

On my wife’s 20th week of pregnancy which was also the week for Oscar’s test, our gynae mentioned that our baby boy seemed to be a bit of a smaller size. However, she mentioned that sometimes, babies size varies but they would eventually catch up in the course of the pregnancy. She did not sound too concern then but she arranged a full scan 3 weeks later to be sure that everything was going fine. We were not too worried then as what we had never heard of complicated pregnancies among our friends

3 weeks later, we went to TMC in the morning for the scan. The sonographer did a full scan of the baby and with the results, we went back to see our gynae. The prognosis is that my baby was suffering from severe IUGR (Intrauterine Growth Restriction). From the full scan, it was detected that the blood flow from the placenta was not flowing well to the baby. This means that not enough nutrients and oxygen was going to the baby and thus the baby was not growing well. It was severe because it happened at 23 weeks which was very early in the the pregnancy.

Our gynae was actually kind enough to arrange for a second opinion and quicky arranged another scan by a specialist in fetal risk assessment in the afternoon. However, the prognosis was still the same. Our gynae advised us that it was highly unlikely that the baby will survive through as the baby was only 23 weeks 3 days old. Even if he did, there would be other complications such as whether the baby would have mental disabilities, physical disabilies etc as there was always a risk if the baby was born too early. Also, the cause of the IUGR was unknown. It could be infection of the placenta, genes disorder, chromosone issues. Sometimes, the cause can also be unknown. Thus, our gynae advised us to terminate the pregnancy. This was because, the risk of all the disabilities would be there for such early birth and that we did not have time to wait for the results of what was the cause. We had to make a decision fast as the legal period of terminating a pregnancy is 24 weeks. After 24 weeks, no doctor in Singapore would carry out the termination.

As our gynae did not do termination of pregnancy, she referred us to another gynae in Raffles Hospital that very evening. We went and the prognosis remain the same and the option of termination is also being offered to us.

That day is a Wednesday. We have only 2 days to make a decision and the operation would be carried out on that Saturday if we decided to terminate. Furthermore, we have to attend a counselling course the very next day and have a cooling period of 48 hours before the operation can be carried out.

That very night was the most devasting night of our life. We had to make a decision fast but we were not sure if the decision we make was correct. All of would be parents wish to have a healthy baby. Several questions went through our minds that night. What if we terminate the pregnancy but in actual fact, if we have continue, the baby would be fine ?

What if we continue with the pregnancy and the baby was born with disabilies? Would we have the courage to support him through his life ? What would happen to him and who would take care of himĀ  if we would to pass away in the future ?

The questions ran through our minds. The very next morning, we went to seek another opinion from another gynae. He is Dr Lai Fon Min from “A Company For Women” at Camden Medical Center. He is highly recommended to us by a friend of my sister-in-law. He used to be consultant and head of Antenatal Risk Assessment Unit at KKH until he went into private practice. He is now a visiting head to KKH. He is kind enough to meet us early in the morning at 8am despite his tight schedule and that we make an appointment with him the very night before at 1130 pm !!!

He gave us his professional views and even though he gave us the same prognosis that my baby boy is suffering from IUGR, we felt comforted by his words. He mentioned that termination is one option. Or, we can let nature take it course and with proper management of the pregnancy, things could turn out to be better. We told him our agony that we are being limited by the time period to decide whether to terminate the pregnancy. He told us one thing that woke us up. He mention that if we would to carry on with the pregnancy and if the baby turn out to be a still born, would it not be the same as terminating it now? Thus, we infer that what he was trying to tell us was that we should not feel pressure to terminiate the pregnancy and let nature take its course.

After the visit, we decide to carry on with the pregnancy as we came to a conclusion. We did not chose to be the parents of my baby boy. It is him who has chosen us to be his parents. We do not have the authority to terminate his life. We should leave the ultimate decision to him. This is what spur us to carry on with the pregnancy.

From then on, we went twice a week to KKH (Dr Lai refer us to KKH) for ultrasound scan and once a week to Dr Lai ( We had engaged him as our new gynae).

It was until week 25 that we were given more bad news. During one of the scanning session, it was detected that there was reverse blood flow. It means that some of the blood is flowing backwards to the placenta instead to the baby. Under normal circumstances when the pregnancy is 28 weeks or more, doctors would have no hesitant to deliver the baby as reverse blood flow is quite bad. Even Dr Lai say that we have to be prepare in the next 6 days.

6 days passed but things remain the same during our ultrasound visits. We were a bit happy then….

It was on week 27 that we were given even more bad news. High level of protein is detected in my wife’s urine and this is usually an indication of onset of pre-eclampsia. As time goes on, my wife would have high blood pressure and if the pregnancy was to continue, the mother’s life would be at risk. The only treatment is to quickly deliver the baby. From that day onwards, it was really monitoring her blood pressure every day. If there is a significant increase in blood pressure, she would have to deliver straight away.

Times passes and we finally waited till Week 28. My wife was warded on that Monday (18/06/2012) and a cesarean delivery was planned on Wednesday morning 8am. However, on Tuesday, as I was driving home from hospital at around 10pm, the hospital called me saying that Miyan has to deliver that night as the CTG scan detect that the baby’s heartbeat was quite weak. I rush back to the hospital and Dr Lai was activated that midnight.

My boy was born 20th June 2012 at 1.00 am, weighing 644 grams. He spent 63 days in neonatal ICU and 43 days in SCN (Special Care Nursery). We went through ups and downs during those 106 days and we also met a lot of other brave parents during those days and realise that we were not alone. Even though Joshua (my baby boy’s name) is being discharged, we know that there are still a lot of unknown challenges ahead of us that we have to face with him as he is still a premature baby with IUGR. However, we are prepared for all the challenges and right now, we are already happy that he is home with us, sleeping soundly in his own babycot. Everyday with him is a blessing to us.

 

PS: I would be glad to share Joshua’s photo with you but I have only photos of him when he is 1 month old as I do not have the courage to take photos of him when he is born as he is really tiny then.

Best Regards

Joshua 1 mth old – I need you. With your love, I will press on

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