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Approximately 15 million babies are born prematurely each year, accounting for about one in 10 of all babies born worldwide. South Africa accounts for approximately 84,000 with more than eight out of 100 babies born preterm. Premature births account for a quarter of all neonatal deaths with South Africa ranked 24th out of 184 countries.

South Africa has committed to the United Nations Sustainable Development Goals, to decrease neonatal mortality rates. While some progress has been made in the mortality rates, prematurity rates have not improved. Preterm births have increased up to 15% of all births. Many South African women are faced with this reality due to inequality, poverty, and lack of access to proper antenatal care.

These are just some of the reasons why EFCNI and partners thought it was important to have a preemie awareness day. World Prematurity Day was officially launched on November 17th, 2011.

In light of it being World Premature Day, we had the immense privilege of hearing and now sharing the experiences of Juliet Oppong-Omaoko in South Africa and Michelle Frierson in the United States. Both premature moms in two different parts of the world and socio-economic backgrounds yet eerily similar emotional, physical, and hospital experiences.

Juliet Oppang-Omakoe

I’ll never forget the distinct notes of panic in my friend’s voice when she called out to me as her water broke at 19 weeks. At the time Juliet and I both worked for a global broadcasting organization.

It was around mid-morning, and I was in the lady’s room when my high energy jolly natured friend burst into the lady’s room and made one of her usual silly comments about my dating life. We laughed and continued the banter as she entered the cubicle, and I washed my hands.

The sound of Juliet groaning, “Oh nooo…” followed by fear and panic-filled “Lebo!” Instinctively I knew we needed help and we needed it fast! I bolted out the door, instructed another friend to go to the bathroom as I tore down the staircase to get her Winfred. Thankfully Juliet’s husband Winfred also worked with us.

Twelve years later Juliet and I sat down for the first time to talk about and reflect on that fateful, life-altering day. A day that unleashed a series of events that tested, strengthened, and defined the Oppong-Omakoe’s faith, relationships, and lives.

Q. Do you remember what was going through your mind at that moment?

It’s all such a blur, hey. I remember the previous day a colleague had gifted me a box of decaf Earl Grey Tea, and I had just had my first cup right before coming to the lady’s room.

I do remember distinctly thinking that I had lost the baby. So, when we got to the hospital and the doctors were talking about cortisone shots…I just had so much going on in my head so I kind of zoned them out and focused on trying to process what had just happened.

Q. What do you wish you would’ve known about premature births before experiencing one?

Gosh. Everything! (She laughs) I wish they would’ve warned us that it was a possibility. I mean, I understand doctors don’t want to scare their patients, but we wouldn’t have been completely taken by surprise when it happened because we would have known that it was a possibility, but I knew nothing.

Q. Typically when it comes to preterm births all the attention goes to preserving the life of the baby, and it should. However, we seem to forget that mom also needs special care. Especially after an emotionally traumatic labouring and birthing experience. If you could change the way the healthcare system is set up, what would you change and or add to address the disconnect between the care of the baby and care for mom?

If I had the power to implement the change, I would start by having a midwife or doula that is trained in trauma counselling and can advocate on your behalf with a greater understanding of your mental state of being for both parents and the different treatment methods. As I said I remember the doctors talking about shots and using all these technical terms — talking about my amniotic sac refilling with fluid. I didn’t know what questions to ask. I thought that once my water broke the baby wouldn’t be able to survive. Turns out I had a tear in my sac. So, I was put on bed rest and hospitalised for five weeks. I was discharged but soon went into labour again at 24 weeks. It was just all so very mechanical and impersonal. 

I would also open a trauma centre near the labour ward. Childbirth is traumatic enough, let alone preterm childbirth.

Journalist, Conscious Parenting Mom Blogger, and Fellow at Embrace-A movement for mothers, Goapalelwe Phalaetsile, agreed with Juliet.

 ” After pregnancy, mental health care is critical because that’s when what we call the fourth-trimester kicks in, where the sleepless nights and healing process starts.

Most moms in South Africa give birth under traumatic experiences at public healthcare facilities where resources are lacking, which has an impact on them after giving birth where most experience postpartum depression. I think it’s important that mental health services are offered at ante-natal clinics as an option for moms.” Said Phalaetsile.

Q. How can family and loved one’s best support and care for a woman who has experienced preterm childbirth?

Each person is different. Some people might want you to sit in their grief with them while others like myself might prefer to process their grief privately. That doesn’t mean that I don’t need or want support, it just looks and sounds different. It’s so important that you support people how they want and need your support, not how you want or think they need it. Grief is not linear and there is no time limit to it, so be gracious and patient.  

After a five-week stay in the hospital, Juliet was sent home. A few days later she was rushed to hospital and gave birth to their son Jaden at 24 weeks. Jaden lived for a couple of hours but left an undeniable impression. “I’ll never understand why God allowed for this to happen – I may never know and I am okay with that,” said Juliet. She attributes her survival to her Christian faith and her husband’s unwavering support.

Michelle Frierson

Q. You don’t hear a lot of women talking about their fertility or preterm birth experiences, yet you were so open about your journey, and on social media! What prompted you to use your experience and pain to help other women?

When I initially shared my journey a few years ago, it was therapeutic for me to talk and write about it – it helped me heal. I needed to address my thoughts, my guilt, and what truly stole my joy. After two months of documenting what happened, I wanted others to know that I was fine with my daughter Gia’s early arrival. That I was SO happy to have her and was beyond grateful that she’s healthy!

 Reflecting has helped me recognise ALL the positives and bury the negatives. I’m no longer blaming anything or anyone (including myself) for “my body failing to do what it’s supposed to do.” God is SO good, and I am certain that I delivered Gia EXACTLY when I was supposed to. Instead of reminding myself of the things I missed out on or didn’t get to feel, I choose to thank God that I was able to experience pregnancy for the 32 weeks and 3 days I was able to.

Q. Let’s talk about the things you missed. I remember reading a post you wrote on Gia’s due date about grieving your pregnancy and the missed milestones. Can you share a little about that with us? 

Preterm labour robbed me of things others may take for granted or not think twice about. I LOVED being pregnant. I fully embraced my growing belly/body. I didn’t care if I gained weight, I wasn’t concerned about stretch marks. To me, it was ALL worth it. I loved carrying my baby, protected and safe inside of my womb. Going into labour early took those safe feelings away from me. I wasn’t ready to “not be pregnant.” I wasn’t ready to see my body shrinking back down when I was looking forward to 8 more weeks of growing.

 I was angry that I didn’t get to do a maternity photoshoot. My dream during pregnancy was to let my belly grow to 36 weeks, and then capture the memory of the amazing thing my body was doing – growing a human! I was upset that I didn’t get to celebrate my body or my unborn baby at our baby shower. My shower happened without me – back home in Chicago – and I joined briefly via FaceTime from the NICU in Atlanta. All the “fun” things you experience during your third trimester, I didn’t get to experience. 

I found myself feeling jealous of the mommy’s who carried full term. Envious of those who got to experience the feeling of being “over” pregnancy and “wanting to get this baby out!” We’d visit Gia every day, and I’d see parents nonchalantly taking their baby home after a two day “normal” pregnancy stay and I’d think to myself… “wow… they don’t realize how blessed they are.”

I didn’t get the luxury of having my baby crying in the hospital room with me. I didn’t even know if or when she cried. What if I was missing out on being able to console her? I remember being so exhausted and in so much pain, yet the guilt I felt for choosing rest versus going to visit her was greater. All the little things that I missed out on that someone experienced with “normal” pregnancy and childbirth haunted me!  It was crippling.

Q. Typically when it comes to preterm births all the attention goes to preserving the life of the baby, and it should. However, we seem to forget that mom also needs special care. Especially after an emotionally traumatic labouring and birthing experience. If you could change the way the healthcare system is set up, what would you change and or add to address the disconnect between the care of the baby and care for mom? 

I wish there were more “personal” discussions between myself and the hospital staff. I had little interaction with doctors and nurses outside of the standard care – checking my incision site, asking if I needed medication for pain management, making sure I was fed and hydrated, etc. Some people might read that and think “you just said you got standard care.  You should be happy about that.” Grateful I was, however, I was also longing for discussion and education. 

 I felt a HUGE disconnect after Gia was born. Although I knew she was in the best hands in the NICU, I wasn’t educated on how she was doing (I received general “she’s doing fine” responses each time I asked) and I had no clue what to expect when I finally got down to the NICU to see her. 

When I finally got to the NICU, the nurses were amazing. There was one NICU nurse in particular, Stephanie, who went above and beyond taking time to explain everything to me, answer all my questions, etc. She cared about my physical, mental, and emotional well-being just as much as she did Gia’s. I will never forget that or her!  To this day, three years later, she’s a dear friend.

Q. Studies have shown that mothers typically blame themselves and internalise their preterm birth experience. I remember you shared on Facebook some of what you had internalised about yourself and your body. Can you please share some of those narratives with us? Also, how and when did you reconcile those narratives with yourself? 

 When you’re pregnant, your first ‘job as mommy’ is to protect your baby, keeping him/her healthy and safe inside of you. That means, and is not limited to proper prenatal care, eating healthy, taking vitamins religiously, sleeping well, giving up food and beverages which could harm your baby or aren’t beneficial to your unborn child, etc…

I did all that! Stopped coffee and any caffeine (soft drink), immediately. I started a prenatal vitamin before I even had my first doctor appointment. Googled what to eat, and what to avoid. Started sleeping 8 hours at night, stopped taking bubble baths/hot showers, etc. I mean, I probably took it to the extreme, but there was nothing I wasn’t willing to give up or do to keep my baby healthy and growing inside of me. 

Imagine doing everything “right” and still going into preterm labour with no explanation, resulting in your beautiful baby having to stay in the NICU alone. You beat yourself up for it, or at least I did. Going into preterm labour feels like you failed your very first task as mommy. Your body didn’t do what it was supposed to do. It didn’t keep your baby safe for long enough. You question everything: could you have done anything differently or better, rested more, ate more vegetables… What about that ONE time you forgot to take your prenatal vitamin before bed?

 You wonder if people are as disappointed in you, as you are in yourself. I apologized to my daughter every single day she was in the NICU, and for every night I had to leave her alone and in someone else’s care. I wouldn’t allow myself to be happy or smile – I wanted to punish myself for being a failure. I suffered from severe, untreated because I was in denial, postpartum depression. It wasn’t until her due date, October 8, that I was able to reconcile those feelings. I took the time to reflect on the situation, made a conscious effort to forgive myself aloud, and decided that I needed to focus on our blessings. Shifting my thought process was life-altering.

Q. What advice would you give a mom who is just starting their grief journey and is wrestling with feelings of guilt as they mentally, physically, and emotionally struggle to reconcile their traumatic experience?  

Forgive yourself and do not hold any unnecessary grudges against yourself. I know first-hand how difficult it is to not blame yourself or think your body failed you; however, I encourage other women to do better than I did and at least try to give themselves grace. Know that you are not a failure, you are an amazing woman and mama, and that you are not alone!

Many women can relate to you and will offer support – including other NICU mamas. I made a few good friends during our stay whom I keep in touch with to this day. There were also other women I spoke to every day in the NICU, and never again once we left. But even those women, I am grateful for. We helped each other through the journey without even knowing.

Although your emotions are running wild and the trauma feels unbearable at the moment, you can and will get through it! Always remember… you are amazing, your body gave birth to a miracle, and you are stronger than you’ll ever realize!  You are allowed and deserve to feel happy – ALL the time, even if you find yourself in preterm labour or the NICU. You are not to blame!  It’s all part of your journey and I promise you that you’ll come out of this feeling more grateful, brave, and stronger than ever!

Q. How can family and loved one’s best support and care for a woman who has experienced preterm childbirth?  

 Leaving the hospital and being at home without your baby is one of the hardest things a new mom will go through. In general, I think we forget how much of a life-changing experience childbirth is – be it full term, preterm, vaginal delivery, or caesarean section.  Whether you are discharged from the hospital after 2-3 days or after a NICU stay, that’s when the next phase of the parenting and healing journey begins. 

 We need a separate discussion on postpartum depression, but one of the most beneficial things for someone to educate themselves on is postpartum depression. Awareness of the symptoms – some obvious, others subtle – can aid in a new mom getting a diagnosis and seeking the treatment she needs. 

Offer to attend her postpartum doctor visits with her, encourage her to tell her doctor how she is feeling and what she is experiencing. Tell her it’s normal to feel these ways because it is!  It’s just that nobody talks about it. Remember that when you’re talking to someone who is going through this, they already feel judged and ‘crazy’, so delivery is key!