Hidden pain of being father of preterm baby

As the World marked World Premature Day recently, Julius Ng’ang’a could not stop flashing back to his own experience as a father to preterm babies.

Nine years ago, he sat in a chapel to ask God to spare the lives of his wife and unborn babies who were at that time fighting for their lives.

Ng’ang’a counts himself lucky that despite the doctors ruling out any chances of survival for his sons, his belief proved how strong his faith was as both his wife and children came out alive.

Most times, people focus on the well-being of the mother of a preterm baby, but Julius’ story is a clear indication that men or fathers are the unsung heros to both mother and baby as they shoulder the burden of not only being present, but also ready for any eventualities whenever things don’t go as planned in the delivery room.

Ng’ang’a and his wife, Mary Mwaniki were expecting their second born twins after initially losing another unborn set through a miscarriage. “It was like God was replacing the twins I had previously lost. We were overjoyed because I had asked God to replace the lost twins and my prayers were answered. We, however, had the fear of another miscarriage and so we were very cautious, looking out for any signs of danger,” he says.

Emergency delivery

The father of three says during their last two prenatal clinics, their doctor had warned them of the unstable nature of his wife’s blood pressure, which was abnormally high and she was placed under strict monitoring to ensure she remained stable.

At 31 weeks, his wife’s legs extremely swelled, and she became unusually irritable and he knew something was not right, so he took her to the hospital to confirm whether everything was fine.

The hospital visit coincided with their last prenatal clinic and they hoped to go back home as they awaited the delivery day, but this never happened as the doctors immediately declared that his wife’s life was in danger and needed to undergo an emergency CS. “The doctor told us that we only had 24 hours to save my wife’s life. He was very blunt about the limited chance of my children coming out alive from the procedure,” he says.

He adds “For a minute, I saw the world shuttering before my own eyes as I stared at possibilities of losing my children. I turned to prayers as consolation and sought refuge at the hospital’s chapel.”

And while he was emotionally drowning, Ng’ang’a could not afford to lose his strength and hope since he had to be strong for his inconsolable wife.

Another challenge Ng’anga’s wife also faced was low blood platelets and the doctors needed atleast 24 hours to acquire platelets from her own blood, time which they did not have if they were to save her.

However, luck was on her side as the doctors informed them of available platelets that had been prepared for another patient, but had just passed away. The platelets were given to his wife instead.

The theatre miracle

“The two hours my wife spent in the theatre were the longest in my life. While the doctors were not optimistic, I was full of confidence that they will make it alive,” he notes. And true to his faith, the doctors informed him that the procedure was successful and his wife and children, albeit premature were alive and well.

Ng’ang’a says when he first laid his eyes on his newborn boys, lying in the incubator at the nursery section, he had a cocktail of emotions and did not know whether to be happy, sad or angry as the babies were too tiny and could not even fit on his palm.

Even though the babies were breathing, Ng’ang’a says he felt like they were too fragile to be in the world. “Out of the experience, I decided to name them Victor and Vincent to signify the battle they had to fight to leave the incubator healthy. I hoped the names will later tell their story of resilience to victory,” he adds.

His wife was later discharged, but had to leave the infants at the hospital where they stayed for 40 days.

Nganga says the hospital became their second home as they spent most days at the facility tending to the babies.

As a father, he had to be part of his children’s lives and he would make sure he visited them every morning before he reported to work, spared an hour during lunch time and was there every evening while his wife spent the entire day at the facility. “I would spend many nights watching them and wondering whether they were still alive. I would wake up in the middle of the night to check whether they were still breathing. We would rejoice when they added a gram of weight. These are small milestones really matter in the life of a preterm baby,” he says. Ng’ang’a says having preterm babies changed his perspective on pregnancy and parenting, which has he describes as very delicate.

The World Health Organisation (WHO)defines premature babies as babies born alive before 37 weeks of pregnancy are complete.

There are three sub-categories of preterm babies based on gestational age; extreme preterm, which is less than 28 weeks, very preterm, which is between 28 and 32 weeks while the moderate to late preterm babies are born from 32 to 37 weeks.

 Nichodemus Odongo of Nairobi Hospital says 15 million preterm babies are born every year globally meaning one in every 10 babies is born prematurely. “In Kenya, 183,000 children are born prematurely annually while here at Nairobi Hospital, we receive between 300 and 400 preterm babies every year,” he says.

Odongo says each year, the number of preterm babies keep increasing.

Odongo, the hospital’s director of strategy and innovations says the society needs to be made aware that preterm babies can grow to become heathy children and live normal lives, contrary to outdated beliefs that perceived such babies as weak and incomplete.

“One of my children was born at 21 weeks, and I can attest that these babies grow to become ordinary children. He has a healthy body and is very bright,” he says.

Common causes of peterm births

 Anne Thogo, a nurse at the hospital’s Neonatal Intensive Care Unit (NICU) says there are myriad reasons that might cause preterm births.

She says one of the reasons for preterm delivery is urinary infections, which is as a result of low immunity making the mother prone to infections making the contractions come early thus early delivery. “Other underlying issues that can contribute to preterm birth, include traumas on the stomach, hormonal imbalances, medical and pregnancy conditions, such as high blood pressure and in some instances, tobacco and alcohol use,” she says.

She says once the baby is out of hospital, one of the most important care routines is to keep the baby warm through the kangaroo care.

She notes contrary to previous years where this duty was solely for mothers, fathers can also offer kangaroo care to their children. “Kangaroo care makes the baby feel the warmth and both mother and father can do it. That is why there has been the introduction of kangaroo father care where we encourage fathers to be part of taking care of their preterm babies,” she notes.

The nurse says father’s kangaroo helps the babies familiarise themselves with father’s voices, as well as promote father-infant bonding.

The Ministry of Health says the preterm birth rate currently stands at 12 per cent with 193,000 babies being born prematurely each year.

Direct pattern complication

The health Cabinet Secretary Susan Wafula says Kenya loses 13,300 children under five years due to direct preterm complications. “There is inequality in the survival rate across the world. In low-income settings, half of the babies born below 32 weeks die due to lack of feasible, cost-effective care. Preventing these deaths is a public health priority,” she says.

Wafula says the ministry encourages the high impact kangaroo care, which is a proven innovative health solution to preterm and sick newborns.

New guidelines launched by the WHO, recently also insisted on the need for babies born before term to be given skin to skin contact by their mothers or caregivers immediately after birth, without any initial period in an incubator.

The guidelines also provide recommendations to ensure emotional, financial and workplace support for families of very small and preterm babies, who can face extraordinary stress and hardship, because of intensive caregiving demands and anxieties around their babies’ health. “Preterm babies can survive, thrive, and change the world, but each baby must be given that chance,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.