One Who Goes Before Us
And the Lord, He is the One who goes before you. He will be with you, He will not leave you nor forsake you; do not fear nor be dismayed. -Deuteronomy 31:8
Tina* was 34 weeks pregnant and came in for a routine scheduled prenatal visit. “I haven’t felt my baby move in 2 days,” she said, “And he’s been moving less this past week.” She was a baseline anxious first-time mom. Every visit she asked lots of questions and was always worried if her baby was OK. Fetal heart tones were reassuringly 150s on the doppler.
“He’s fine,” I said. This was just another over-worried primip.
It was Friday afternoon and I was seeing my last few patients before the weekend. As I was about to send her off I thought, “Let me just put her on the NST [fetal monitor recording].” Tina had gestational diabetes that was well-controlled by diet and the Maternal Fetal Medicine doctors stated she didn’t need extra fetal monitoring. They recommended it only for higher risk diabetics and it didn’t typically start until 36 weeks. But I just decided to do one anyway. After a few minutes on the monitor, I saw the heart tones appeared flat and with a small deceleration. I sent her immediately for monitoring at the Birth Center.
When the nurses hooked her up to the monitor, the fetal heart tones were not ominous but not completely reassuring either. I called the Maternal Fetal Medicine consultant and she reviewed the strip. “She’s a diabetic so we won’t give her steroids. So just go ahead and deliver her,” she told me over the phone. I was surprised. That wasn’t what I expected. She was 6 weeks from her due date and It wasn’t the worst fetal heart tracing I’d seen. I thought they would tell me to admit and keep monitoring her. If she had not been diabetic, we would’ve probably given her a course of steroids and waited.
So I went into Tina’s room and told her I needed to deliver the baby now and via c-section. Tears began rolling down her face but she consented. She had chosen to see me for most of her prenatal visits and she trusted me. “OK,” she said, “Whatever we need to do. I trust you.”
We wheeled her back to the OR and as I scrubbed I second-guessed myself. Should I have monitored the baby longer? Was I delivering a 34-week preemie that didn’t need to be delivered urgently? Should I have tried to induce her instead of sectioning her?
The room was quiet as I started the surgery. Methodically I cut through the layers—skin, subcutaneous tissue, fascia, rectus muscles and peritoneum. And then as I went through the uterus, I called out, “Uterine,” giving a heads-up to the waiting Neonatologists. “Clear fluid,” I called as I entered the uterus. That was always a good sign.
As I pulled the baby out and placed him onto the drapes I was shocked. He was ghostly pale and there were two tight loops of umbilical cord lassoed around each thigh as if he had jumped into them and then they had been pulled tightly on both ends. He was limp and not breathing. Neonatology asked for the infant right away, rather than the usual delay for cord clamping.
I heard the Neonatology team working on the baby and I could hear the Neonatologist tensely calling out for equipment and then for blood. The baby was silent. No fetal cry. “Oh no!,” I knew something was seriously wrong. “Dear God, please help this baby. Save his life!” I prayed as I was closing the patient. The infant was quickly intubated in the OR and whisked to the NICU.
After the c-section was finished, we wheeled Tina to the recovery room.
“Is he going to be OK?” she asked. “Is he going to live?”
“I’m praying for him,” I told her. “And I’ll keep praying.”
I saw the next shift’s Neonatologist while writing orders.
“How is the baby? Is he going to be OK?” I asked.
She shook her head. “I don’t know. His hemoglobin was 2! I’ve never seen a hemoglobin of 2 before! His blood was like pinkish water. Even if he survives, I’m not sure about his brain function.”
A normal newborn hemoglobin is around 15. I’d never heard of one at 2 before. The fetal maternal hemorrhage test came back and it showed the baby had lost 340ml into the maternal circulation. It meant the blood loss hadn’t been a sudden event but had been going on over time but no one had known. He had bled more than double his blood volume into his mother’s circulation.
I pled with God. “You didn’t have me deliver this baby just to let him die! Please save his life. Please help him,” I earnestly prayed throughout the following days. He received multiple blood transfusions and seemed to stabilize. I saw Tina in the office and again told her I was praying for her baby.
“Will his brain function be OK?” she asked.
“I’m praying that it will be,” I replied. And I was. I continued asking God to not only save her son’s life but to protect his brain from damage.
The head ultrasound was normal and then the MRI. 3 weeks later he was discharged with a normal neurologic exam and no apparent problems. I told my husband, “God saved the baby and God saved me!” What if I had just heard the initial reassuring heart tones in the office and sent her home? There was no doubt that the baby would have died that weekend. God saved him.
There’s a saying, “It’s better to be lucky, than good.” But for the Christian, there is no such thing as luck—there are only providences and divine appointments. David says in Psalms 139:16, “Your eyes saw my substance, being yet unformed. And in Your book they all were written, The days fashioned for me, When as yet there were none of them.” Even before our parent’s DNA joined together to create us, God knew of our existence and knew all the moments of our lives. It’s not predestination but it’s perfect foreknowledge.
I rarely call up friends or family for advice. Why? Because I’d rather go to God and ask His help and guidance. Who better to entrust my life to and ask guidance from than the One who knew me before I even existed? Through maternal hemorrhages, emergency c-sections, difficult surgeries, and life’s uncertainties and challenges, God has always been with me. He prepares help even before I know I need it. God is the One who goes before me. He has never failed me and He never will.
* Not her real name
Gloria Kim writes from Westmont, IL where she lives with her husband Chris and their 3 children.