I am excited to get to share this with you!!! Look After You by Elena Matthews was a fantastic book...
Without further ado here is Chapter 1... Make sure and enter for your chance to win a ARC ( to be sent on March 29th)
The birth of your firstborn child is supposed to be the best day of your life, a joyous occasion. Well that’s what twenty-eight year old Ava Jacobson thought. That is until her life takes a drastic turn for the worse and her daughter is born three months earlier than planned, weighing only two pounds, two ounces.
A distraught Ava is thrown into the deep end of motherhood and instead of being able to hold her baby like other moms, she has to sit back and watch her daughter fight for her life in the hospital’s neonatal intensive care unit, while her fiancé, Sebastian Gilbert is in the midst of a messy war in Afghanistan. Ava is left to pick up the pieces with the help of her only friend, Caleb Summers.
When her vulnerable state hits an all time high, she finds solace in an unexpected pair of intense green eyes. Eyes that belong to her daughter's doctor, Ashton Bailey, and she falls, like she has never fallen before. However, for the sake of Sebastian she desperately tries to fight against her newfound feelings for Ashton, but eventually the pull between the two is so strong that it is impossible for her to stay away.
Then when Ava is convinced things can't possibly get any worse, a cloud of blackness closes in on her as the secret demons of her past come back to haunt her, with news that will irreversibly shake her entire world forever.
As Ava’s roller coaster ride she calls life begins to circle the drain, she quickly learns that even through the darkness of evil, there is always that one person who will look after you and have the ability to pull you away from the brink of no return, when nobody else can.
Copyright © 2014 Elena Matthews
September 2013
Two pounds, two ounces. That's how much my baby girl weighed when she
was born.
That was ten hours ago.
This wasn’t supposed to happen yet. I was supposed to have another thirteen weeks of pregnancy before I gave birth to my baby. I was supposed to have her nursery painted in pink with teddy bears surrounding the walls, her crib assembled with gorgeous soft blankets. I was supposed to have a baby shower, being showered with gifts and guessing the size of my baby. I was supposed to have time to come up with a name or at least discuss the possibility of names with my boyfriend. I was supposed to work up until my maternity leave, have at least a month of waddling around like a penguin and complaining about back pain or Braxton Hicks contractions.
I wasn’t supposed to give birth to her by C-section ten hours ago without my birthing partner and my boyfriend, without any warning, without understanding why my body had decided it wasn’t fucking good enough to carry my baby full term, without having her in my arms like most other moms do the minute their
baby is born, without…without…without…fuck!
A nurse is wheeling me into the neonatal intensive care unit to see my baby girl. This is the second time I will get to see her since she was born. Well, the first time didn’t even last ten seconds before she was immediately taken away from me so the doctors could work on her breathing and get her ventilated. I couldn’t believe how small she was, but she was a baby, a real life baby with ten fingers and ten toes.
My baby.
Since the moment I took that pregnancy test and the window turned into a smiley face, she was a tiny thing inside of me, just a little blip. A couple of months later she was bigger than a blip, she was a bump, but I never really thought of her as a baby until I actually laid eyes on her beautiful face. Does that make me a terrible mother? I feel like one. I wasn’t ready, and I should have been; I should have been prepared for this.
I was so naïve about the preterm side of pregnancy and birth; that it hadn’t even crossed my mind. But why should it have crossed my mind? Every parent hopes and wishes for the perfect pregnancy with zero complications and for the perfect baby. Nobody ever contemplates the worst possible pregnancy outcome until it actually happens to you.
The only thing that had worried me was the morning sickness, and surprisingly that hadn’t really bothered me.God, I would do anything to swap giving birth to my premature baby with fucking morning sickness. Anything.
The nurse continues to wheel me through the NICU hallway, which consists of clinical white walls and huge glass windows that lead into the NICU rooms. There are so many incubators, each holding small and sick babies attached to tiny oxygen tubes, high dependency medical equipment and monitors.
I’m a little shocked. Considering this is a specialized ward for small and sick babies, I was expecting it to be full of crying babies and frantic doctors and nurses running around, but it is quiet, tranquil even, with the exception of the constant beeping sounds I can hear in the background.
My eyes start to fill up with panicked tears when we finally come to a stop at a pair of double doors. The nurse moves to stand in front of me with a sad smile and retrieves a small bottle of sanitizer from her pocket and puts a small amount into my palms. I massage the liquid into my hands, ensuring every inch of skin has been covered.
“Okay, before we go in, I need to warn you that when you see your daughter, it will be a shock, but you have to remember that the tubes you see are there to save her life, they will not harm her. The sounds from the machines are alarming at first, but you'll get used to them after a while.” She pauses briefly
before asking, “Are you ready?”
She looks to me, expecting some type of response, but all I can do is sob. She pushes me through the double doors and wheels me to my baby girl. Even though the nurse just warned me about what I would see, it doesn’t stop me from slamming my hands over my mouth in shock.
“I know sweetheart, I know it’s upsetting,” she whispers softly while placing her hand to my back, patting me gently against my hospital gown. Upsetting? Is this woman serious? This is the worst moment of my life. I stay silent as I continue to sob while I take in every detail of my daughter. She is so tiny, she can’t be much bigger than the size of my hand. She is naked except for the diaper that covers nearly every inch of her body. Her body looks almost transparent. You can literally see the network of blood vessels underlining her
skin.
She is lain on her back. One of her tube covered arms is lying beside her tiny body, the other arm is bent, with her little hand covering her face. That arm is covered with a bandage with a white foam board holding it horizontal. She has a breathing tube in her mouth, with strapping that sits just below her nose and across her cheeks, keeping the tube in place. Then the further I look down her body, I notice she has two blue pads with tubes coming out that have been placed on her protruding chest and two separate long thin tubes coming from her belly button.
I don’t realize how hysterical my cries are until the nurse holds out a box of tissues in front of me. I smile up to her sadly as I accept a tissue and begin to wipe my eyes.
“I'm sorry, I must look such a mess,” I mumble in mid sob.
“It's okay sweetheart, I can’t even begin to imagine what you must be going through. Would you like a glass of water?”
I can only nod. The lump in my throat that has formed through the tears has literally restricted my speech. Before I even realize she has gone, she holds out a plastic cup full of water, and I immediately start chugging it, hoping it may calm me down. After a couple of minutes, I begin to calm down, and the rational side of me starts to slowly return.
“Sorry…I…this…it's just a bit of a shock,” I say, feeling overwhelmed with my surroundings and the sight of my daughter. The nurse nods politely at me.
“I understand. It is very daunting. Let me give you a little run down, it might ease your nerves a little.” She begins to explain the mechanics of the tube and strapping that covers the majority of my daughter's face.
"The tube you see in her mouth is called an Endo-tracheal tube, and that is attached to the ventilator. It helps blow supplementary oxygen gently into her lungs and with your baby being so undeveloped and immature, she becomes tired and stops breathing more easily. The ventilator support is essential at this stage as it takes the pressure off her. The ventilator gives two types of pressures that help her to breathe. The PIP, which stands for Peak Inspiratory Pressure, inflates the lungs and the PEEP, which stands for Positive End Expiratory Pressure, helps keep her lungs open and prevents them from collapsing.”
She pauses for a brief moment before proceeding. “Did the doctor explain how your daughter has Infant Respiratory Distress Syndrome?” I nod, remembering the conversation I had with a neonatologist earlier in the evening.
“She was given surfactant replacement in her lungs within the first two hours of her life and her lung capacity has improved dramatically. It is likely she won’t need the power of the ventilator for much longer.”
I gasp in shock. “Will she be able to breathe on her own?” I frown at the realization of that. Surely that can't be right. “I mean she is still so tiny.”
“No," the nurse says. "She will still need consistent help with her breathing during her development. When her lungs are strong enough not to need the strength of the ventilator we will put her onto the CPAP, which stands for Continuous Positive Airway Pressure.” I nod as I allow the information to sink in. She continues.
“You see the monitor to your left?” I glance over to a vital sign monitor, and notice how the lines continuously move across the screen.
“That monitors her heart and respiratory rate, pulse, blood pressure and oxygen saturations. As you can see, she has two umbilical lines coming from her navel." She opens up the door to the portholes of the incubator, places her hands within the small space, gently takes apart her diaper and points to two individual umbilical lines.
"One is an umbilical arterial catheter, which measures arterial blood pressure and allows arterial blood sampling. The second line is an umbilical venous catheter, where she is given the intravenous fluids and medication." The nurse follows her finger along another wire that is passed through the nose.
"And this line here is a nasogastric feeding tube. The thin tube is passed up the nose, down the esophagus and into the stomach. At the moment she isn't strong enough to feed through conventional methods, so she will be given her nutrition and oral medication through this tube until she is strong enough for the breast or bottle.”
I stare at my daughter, dumbfounded at the all of the information I have had to take in, in such a short amount of time. I feel even more overwhelmed than I did when I first walked in. It’s all too much.
Panic begins to squeeze heavily against my chest, and it makes it almost impossible for me to breathe as more tears continue to run down my face.
How did this fucking happen? I took all of the vitamins, did the regular yoga, everything that I was advised to do. I didn’t even indulge in a glass of wine for Christ’s sake. I was the perfect mother to be. How could this have happened?
“This is all my fault, but I don’t understand how, I did everything right…I did everything right…I don’t understand...” I gasp, as sobs rack through me. I continue to fight for each breath I take and through my panic I grip tightly to my gown, clenching it through with my fingers, trying to gasp for air, grasping for something, anything.
The nurse kneels down beside me and places her hands against my arm with her gentle touch.
“Oh, sweetheart this isn’t your fault. You can’t blame yourself. Your baby needs to you be strong. She needs her mommy to be strong. Do you hear me? I understand how upsetting this is but you need to focus on the fact that she is here and fighting for her life. She is in the best place at the moment. Of course, it's no womb, but we are definitely the next best thing. Just have faith.
We are doing everything in our power to keep her alive,” she says with a quiet hush, and surprisingly, I begin to calm down.
“Okay. Strong. Best place. Have faith. I can do that,” I say, repeating the words as a chanting mantra through my head, over and over again. I must be in some kind of trance because when I look at the nurse, I notice she is staring directly at me, awaiting an answer.
“I’m sorry did you say something?”
“Would you like to be alone with your daughter, Ava?”
“Yes, please. Thank you.” I watch my daughter in awe, taking in her delicate little hands as they slowly stretch, changing direction trying to get into a comfortable position. Once I'm alone, I wheel myself closer to her. My breath catches as her little toes wriggle slightly, and she kicks her legs out to the side. This happens two more times before she finds a comfortable position and stills. She looks so peaceful, so fragile but at the same time strong. I can see that she is already a little fighter, and it's breathtaking.
“Hey baby,” I whisper. I’m not quite sure if she can hear me, or not but that doesn’t stop me from talking.
“I’m your momma. You’ve put me through a lot during the past sixteen hours baby girl, but that’s okay. I’m sorry baby, I wish more than anything that you were still inside of me, keeping you safe, but it’s okay, we can make it work. I’ve tried to call Daddy, but he’s fighting the bad guys so you won’t get to meet him for a while yet. He will be devastated that he missed this.”
I bite down on my bottom lip and force the tears back, contemplating where her daddy is right now. I already knew he wouldn’t be here for the birth, but it still kills me that he doesn’t know his daughter has been born. I am unable to gain strength of my tears and the viscous circle of crying begins.
Sebastian is on a nine-month tour in Afghanistan. It’s his third tour. He is a front line infantry officer. He has been there for four months already, so I still don’t get to see him for another five months. That's five months without seeing his daughter. It was hard to accept when I thought he would be away for the first two months of her life, but now it’s even worse. It feels like a life sentence. I just wish I didn’t have to do this alone, without him. I miss him so damn much. I need him desperately. I called the American Red Cross earlier on, and they are currently trying to relay a message to Sebastian over in Afghanistan, but they told me it could take between twenty-four and forty-eight hours. I hate how I have to wait, but I don't have any other choice. It isn't as if I can call him on his cell. I'm lucky if I get to speak to him once a week and even then it's brief.
I hadn’t planned to have the birth alone. Caleb; my best friend, was supposed to be my birthing partner but as luck would have it he was flying over the Atlantic Ocean for a business trip to London. I managed to get hold of him when I was in labor, and he is currently on standby for a flight back to the states. I wanted to tell him not to rush back, but when the tears forced through, I realized I needed him.
I am suddenly startled when a doctor in a white coat joins me and takes hold of my daughter’s chart.
“I’m sorry, I didn’t mean to startle you, Miss Jacobson.” My heart is pounding in my chest, and it takes me a moment to compose myself. When I look up to him, I can’t keep my eyes off him. He has the most unusual green eyes I have ever seen.
“I’m Doctor Bailey, I am one of your daughter's neonatologists.”
“Hi,” I say, with a small smile.
He crouches down to the wheelchair level, and I can’t ignore the patter of my heart, beating a little faster when he does. I didn’t realize doctors could be so good-looking or so young for that matter. He honestly can’t be any older than thirty.
“I’m not going to bore you with medical jargon, I know you’ve been through a lot, so this will be brief. Your daughter is stable, doing brilliantly. She has responded well to the surfactant replacement, and her breathing is improving remarkably. Her X-rays confirm that. Her blood pressure is normal for her gestation. She is, however, showing early signs of Jaundice.” He pauses on a sympathetic smile.
“In simple terms, the liver produces a yellow chemical called bilirubin. Bilirubin is a waste product of the breakdown of red blood cells, and in preemies they seem to accumulate more red blood cells than your average person. Because they have an immature liver and kidneys, it prevents them from breaking the bilirubin down efficiently, therefore, producing the jaundice and causing the skin to have yellow pigmentation. It can be fatal if not treated.
“We're going to keep a close eye on her for the next twenty-four to seventy-two hours. If her bilirubin level continues to rise we will proceed with phototherapy, which will help dissolve the bilirubin and change it from fat soluble to water soluble so it is able to be excreted in the urine and the stools."
He stands, and I just continue to stare at him, dumfounded at the information. My mind is in such a whirlwind that it's quite possible I will forget what he said in a couple of minutes time.
“I’m going to examine her now, take a blood sample and check her vitals, and then I’ll be out of your hair.” He smiles down at me before turning towards my daughter and opening up her medical chart.
“That’s okay, I don’t mind,” I state softly, finally finding my voice as I follow my gaze from him to my daughter. I can see Doctor Bailey from the corner of my eye as he sets her chart back into the little pouch on the side of her incubator, and then goes to work by opening the small isolate doors on the incubator and examines her. Soon enough he begins to draw blood from her umbilical catheter, and it makes me wince slightly. I've never been great with the sight of blood.
“Have you thought of any names for baby Jacobson?” he asks as he continues drawing blood, obviously trying to help fill up the silence.
“Um, no, I haven’t thought about names, it all happened a bit too quickly.” What kind of mother am I? I haven’t even come up with a name for my daughter, and I have absolutely no idea what the hell I'm supposed to call her. My tears begin to fall again.
“Oh, I didn’t mean to make you cry, I’m so sorry,” he says sincerely. He takes the tube of blood and shuts the doors to the incubator, reaching over to pass me a tissue.
“It’s fine,” I say breathlessly through a sob as I accept a tissue. “It's just a sore subject, I’ve been like this all day.” I wave my hand in front of my face as if it isn’t a big deal. It is. It's a huge deal.
“Your body has been through a lot, it’s normal to feel all of these emotions, and as for the names, you’re not the only one. My sister-in-law was exactly the same, it took her about four weeks to decide on a name for my nephew.” He smirks, before continuing. “What I’m trying to say is you shouldn't be so hard on yourself, the name will come, and if not, Baby Jacobson isn’t so bad.” He raises his eyebrows, with half a smirk. “It’s better than Stir Mix-a-Lot, which was my nephew's nickname for four weeks straight.”
I don’t know how he does it, but he actually manages to get a bubble of laughter out of me. It's the first feeling of happiness I’ve had since before I gave birth to my baby girl.
“Seriously? As in Sir Mix-a-Lot?” I ask, surprised, wiping my runny nose as delicately as possible with the tissue.
“As wrong as it sounds, yes. She changed the Sir to Stir as he was a very wriggly baby.”
I smile up at him before looking back at my daughter. She is currently stretching her left arm with her tiny fingers wriggling around.
“It seems you got yourself a wriggler too, she looks as if she is trying to reach out to you.” He points towards her arm that has gone all opera style with her stretching.
“You think so?” I ask, through a smile.
“Oh yeah, definitely, she says so herself.” I can’t help but choke on another laugh when her index finger curls up, moving towards her as if she is saying ‘come here’.
“I wish I could hold her, even if it’s just to hold her hand,” I say as I look intently at her. “Well it's a little too early to hold her, but you can definitely hold her hand.”
“Really?” I breathlessly mouth as I graze my hand over the plastic of her incubator, wishing it were her hand I was actually touching. He unclips the porthole to the incubator and opens the door.
“Well as long as you’re well sanitized, to avoid any infection for your baby, then you’re good to go.”
I move my arm upwards a little apprehensively and place my hand through the porthole. I look back up towards Doctor Bailey to ensure I’m doing it correctly, and with a nod of encouragement from him, I look back towards my beautiful daughter and gently graze my finger within the base of her hand. I stroke it in delicate circles until she grasps it so tightly I actually gasp in shock.
“Baby girl, you’re so strong,” I say through uncontrollable tears. I can’t believe it. I am actually holding my daughter's hand, and it feels incredible. After a short while my eyes become such a blurred mess that I have to remove my hand from the incubator, so I don’t poke her in the eye or something. I gently close the door and turn the latch securely in place. I glance back up to the doctor and smile.
“Thank you,” I whisper, in awe. He has quickly become my favorite person. He let me hold my daughter's hand. He has made my day just that little more bearable and he even managed to put a smile on my face.
“No problem.” His gaze lasts a little bit longer than is usually regarded as socially acceptable, but his eyes are so bright and beautiful that I could get lost in them for hours. His hand touches my shoulder, and he lingers for a few seconds with a soft squeeze before walking away, leaving me winded and quite possibly electrified. His touch was like wildfire. The moment his fingers touched my shoulder my entire body almost exploded. It was strange. I have never felt like that with anybody.
After a short while of just gazing contently at my baby girl, the nurse who brought me in, comes back.
“Sorry to interrupt doll, but we should really get you back to your room, it’s been a long day and you need your rest. Plus your midwife said you're having trouble expressing your breast milk, she wants to see if you have more success a second time round.”
I was advised for the first forty-eight hours that I needed to hand express my breast milk rather than express from a pump, so I tried earlier on, and I don’t know if it was the stress of today or because I am so exhausted, but I couldn’t express a drop. I have been told that breast milk is better than formula for premature babies as it helps with nutrition and can provide antibodies from infections. I am absolutely devastated that my daughter will have to usedonated breast milk until I can express my own. My body is just letting medown in all aspects lately.
I press my fingers to my lips and linger them against the incubator, just where my baby girl's head is resting.
“Bye, baby girl, I’ll be back soon, Momma needs some rest. I love you so much, keep fighting for your momma, please.” I weep as the nurse wheels me out of NICU, and towards my room.
When I get settled back into my bed, the midwife assists with my hand expressing and even though it's still a struggle, I manage to express a little until I began to express thin air. I hope with a good night’s sleep I can express more because I don’t know how much more of this I can handle, my body rejecting everything.
The nurse leaves me to get some sleep, and as I allow sleep to evade me, the phone I have clutched in my hand alerts me to a text message. I smile when I see it's from Caleb.
Caleb
I’ve just boarded. I have a connecting flight into Dallas, then Dallas to Seattle, but I will be with you as soon as I can. Love you. Xxx
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