Our little miracle, Chase Michael Lewis, was born by emergency C-section on 11 January 2006.  We were extremely blessed that God saved our baby boy.  I was right outside the hospital when Chase’s umbilical vessels burst as he descended down the birth canal. He was delivered within 15 minutes of the rupture and revived after intensive resuscitation efforts. The postpartum diagnosis was vasa previa with velamentous cord insertion. He miraculously recovered and, after eight days in the hospital, we brought our beautiful baby boy home.  (Yes, that's an International Vasa Previa Foundation bracelet on his arm!)

            We were in Myrtle Beach over Memorial Day Weekend 2005 with my parents when my stomach felt funny.  I thought it was from eating too much good food, but I decided to take a pregnancy test before we signed up for another triathlon.  On 30 May 2005, my husband James and I were thrilled to find out that we were going to have another baby.   I appeared to be blessed with a very uneventful, complication free pregnancy like my first pregnancy.  I was happy with my prenatal care from the Midwifery Clinic at Womack Army Hospital at Fort Bragg, NC so I returned there for care.  In September, we had an ultrasound and found out we were going to have another baby boy.  We decided to name him Chase.  We found out our first son, Keegan, was breech the day before he was born.  Doctors attempted an external version which failed so Keegan was born 15 Jul 2004 by C-section.  Throughout my second pregnancy, my only concern about having a VBAC (Vaginal Birth After Cesarean) was Chase turning head down since Keegan never did.  I was happy when my midwife said she thought he was head down and I was ecstatic on 5 Jan 2006 when we saw that Chase was head down during an abdominal ultrasound at my 38 week appointment.  I went back to childbirth class, read “Husband Coached Childbirth,” and looked forward to a normal delivery.

            Other than failing my Glucose Screening Test after eating peanut butter waffles with Keegan, my only problem during my pregnancy was heartburn.  Chase was a very active baby with a strong heartbeat which I loved to hear during my appointments.  We thought he would arrive on 15 Jan, so we went to the zoo with friends on Sunday before he arrived.  On Monday, I taught water aerobics and Tuesday I started having menstrual like cramps.  On Wednesday, 11 Jan, during my 39 week appointment, the midwife checked me and said I was dilated to 2 cm, 80% effaced, my cervix was ripe, and Chase was at zero station.  She thought that Chase would arrive within the week.  She stripped my membranes and I had more period-like cramps at home that afternoon and a little spotting.  Around 5:00 pm, my cramps became more painful.  I had never labored before so I didn’t know if they were contractions or not.  By 6:30, they began to really hurt and were much closer together.  At 7:00, James put Keegan to bed, but he wouldn’t go to sleep.  We got him out of bed and he began to imitate me as I tried lying on an exercise ball, curling up on the floor, taking a warm bath, and lying on my side.  I thought I must be having false labor or be in early labor because the pains were so irregular.  (I was amazed that women endure this much pain before real labor even starts.)  I lay down on my side and concentrated on counting fetal movements.  When I couldn’t feel Chase moving, we decided to go to the hospital.  The contractions were 30-45 seconds long and two to three minutes apart.  At 7:45, I called a friend to meet us at the hospital and take Keegan in case I was admitted.

            On the way to the hospital, I called my parents to tell them we were enroute to the hospital.  We arrived at the hospital about 8:45.  I stopped every few feet in pain from the contractions.  Just before entering the hospital, I felt a wet gush which I assumed was my water breaking.  When I checked in at Labor and Delivery, the nurse told me that triage was full so I should go sit in the waiting room.  I knelt on the floor while James and Jenean tried rubbing my back to decrease the pain.  I went in to the bathroom and saw that my underwear and shorts were covered in blood.  James found a nurse who told me “some spotting is normal.”  When I told her this was definitely not spotting, they took me to Labor and Delivery Room 9 for triage.  The nurse listened for Chase’s heartbeat which was down to between 60 and 80 beats per minute (a newborn’s heartbeat is normally between 130 and 160 bpm).  The nurse called for assistance and immediately a large number of doctors and nurses arrived with an ultrasound machine which confirmed his low heart rate.  Based on the blood loss and my previous C-section, Dr. Brown suspected that my uterus ruptured.  I remember one of the nurses telling me that they were going to do a lot of things very quickly.  The medical team quickly prepped me for emergency caesarean.  The nurses emplaced a catheter and IVs while the nurse anesthetist conducted his assessment.  The last things I remember are being pushed quickly down the hall to the operating room and hearing the anesthetist say I would be going to sleep soon.  I was in so much pain that I could not wait for the general anesthesia to take effect.  My last conscious thoughts were praying to God to save my baby boy.

            James had been alone in the labor and delivery room praying and in tears for what seemed  to him like an eternity when a nurse came and told him that Chase had been born and that they were working on both Chase and me.  Later she returned to say that Chase was alive but he was not breathing on his own and had been placed on a ventilator.  She  took James to the family waiting area in the NICU (Neonatal Intensive Care Unit) and told him that I had a placental abruption and that Chase had the umbilical cord wrapped around his neck twice.  Around 2230, a doctor came out and told James that Chase was in very critical condition.  His initial APGAR score was two; his heart was beating, but he was not breathing, no movement, no responsiveness, and blueish-gray in color.   One of the NICU doctors told James that they gave Chase heart compressions and oxygen, injected him with medication, and gave him a blood transfusion to save our baby boy.   

            About 2330, I woke up in the ICU and asked about Chase.  The nurse said “he’s alive and the doctors are working on him.”  James called me from the NICU to tell me he had seen Chase.  He was hooked up to a ventilator, umbilical arterial and venous catheters (UVs), IV lines, and monitors. I asked the nurses to take me to the NICU but was told I must recover first.   When James arrived in my room in Mother Baby Unit, I called my parents, but was too upset to speak;  in tears, I handed James the phone to explain Chase’s condition. Around 0200, MAJ Larson (head nurse) came in because she’d heard that I was very upset. Thankfully, she instructed my nurse to take me to the NICU where I saw Chase for the first time.  He was beautiful even if he was covered with tubing, needles, and a ventilator. 

            The next few days were a blur of visits to the NICU, talks with doctors and nurses, phone calls with friends, and lots of prayer.  Early Thursday morning, several of the doctors and nurses who assisted with Chase’s delivery and resuscitation stopped by my room to talk with me.  One doctor said that God must have something special in store for our baby boy because it was such a miracle that he lived through his delivery.  Another said that she was absolutely amazed that he made it.  Their descriptions of Chase immediately after delivery were very scary- completely limp, less color than blue, not moving.  The doctors were amazed at how fast he improved.  He received two blood transfusions during his first 24 hours which greatly improved his condition.  By Friday, he was able to breath without the ventilator. He was still on nasal cannula to assist but he was gradually weaned off completely.  The NICU nurses all told us that we had quite a fighter; they had to repeatedly retape his IV lines because he kept pulling them out of his arms.  On Friday afternoon, I was allowed to hold Chase for the first time.  The nurses carefully wrapped all his tubing in a blanket so that I could hold him.  Friday afternoon his doctor told us that he couldn’t make any promises but he believed that Chase would make it. 

            Dr. Brown, the doctor who performed the C-section, drew a picture to help explain what happened and how fortunate we were. The picture showed a baby with its umbilical cord attached but the cord ending before reaching the placenta.  This was the first time we ever heard about vasa previa- a rare but deadly condition affecting about 1 in 3000 pregnancies with a mortality rate of 75-98%.  The gush that I felt right outside the hospital was Chase’s blood; he lost about 25% of his blood when the unprotected veins ruptured as he neared the birth canal.  Over the next few days, my mother researched vasa previa on the internet while at our house with Keegan.  She found the wonderful International Vasa Previa Foundation website (IVPF.org) where we read that vasa previa is a condition in which the fetal blood vessels for some distance do not run through the umbilical cord where they belong, but instead run freely and unsupported through the membranes, crossing the birth canal beneath the baby.   The otherwise healthy baby usually dies rapidly from the vessels tearing when the cervix dilates, membranes rupture or if the blood vessels become pinched off as they are compressed between the baby and the walls of the birth canal.  She read some of the stories of vasa previa miracles and angels which reinforced how fortunate we were.  We learned that up to 98% of babies with undiagnosed vasa previa die due to blood loss during labor, while almost 100% of diagnosed cases live if the mother is put on bed rest and a scheduled C-section is performed prior to her due date.  After reading the stories and statistics, I could not understand why checking for vasa previa was not part of routine standard of care checks.

            On Saturday, I was released from the hospital but received another blessing by being switched to boarder status so that I could stay to feed Chase once he was allowed to eat.  The nurses removed his UV and let me hold him again.  James and I went home for dinner, a shower, and a short visit with Keegan.  When we returned, NICU nurses told us to bring the crib from my room down to the NICU. I got to hold Chase for almost an hour and found out that he might get to eat that night.  On Sunday at 0200, Pat from NICU called my room to tell me to come feed Chase. When I arrived, I found out that the doctor approved Chase breastfeeding.   Chase latched on and nursed for about 20 minutes.  After that feeding, I returned every three hours to nurse Chase and the nurses began gradually weaning Chase from his IV.  Sunday morning James got to hold Chase for the first time.  At 2 pm Chase was released from the NICU to Mother Baby Unit.  He weighed 6 lbs 15 oz up from his 6 lb 9 oz birth weight.  We spent another four days in Mother Baby Unit so Chase could finish his antibiotics and continue to be monitored.  On Thursday, he was released.  We were very excited to bring our baby boy home. 

            I am so thankful that our baby boy is alive and well.  I’m thankful most of all to God for saving him.  I’m also extremely grateful to all the doctors and nurses who quickly delivered and then resuscitated, revived, and cared for him.  I’m thankful to my friends and family who prayed for us and helped us through the tough days. 

            I can’t help but think of all the what if’s.  What if I hadn’t been right outside the hospital when his blood vessels ruptured?  What if the doctors and nurses hadn’t taken action quickly and done such a good job?  What if we didn’t have such wonderful friends and family to pray and care for us? 

            But also, what if I’d known about vasa previa and asked the doctors to check for it during my ultrasound?  Or, what if checking for vasa previa was part of the routine standard of care checks?  How many babies would be saved every year? Please help spread the word about vasa previa.  Tell everyone you know.  Encourage expectant moms to ask to be checked for vasa previa.  Better yet, encourage doctors to check all pregnant moms for vasa previa.  Read IVPF.org for more info.  It only takes a moment to diagnose life...