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Krystal's avatar

Thank you for sharing this. While I fortunately never had to experience my children in NICU care, it's comforting to know people like you are in charge of care.

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Marika Páez Wiesen's avatar

This is such a compelling story with so many themes. A mom in my life just had a psychological breakdown necessitating admission to hospital. In the past year she had a very pre-term birth, a long and stressful NICU stay, then a few months later the baby had a very serious case of RSV and almost died.

Mom’s fears isolated her from family in the name of “ keeping the baby safe”, but ultimately may have done more harm than good. :(

Your end comments comparing yourself with unwed and mothers dealing with addiction bring up the theme of health as morality. We often confuse and conflate “healthy” with “moral” and “good choices” when the reality is often more complex and we often have less control than we wish we had.

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Susan Landers, MD's avatar

Hi Marika. I do not equate health and morality. In my experience, unwed teen mothers rarely attempt to do everything correctly where their pregnancy is concerned. That is a reality of the teen mind, not immoral behavior.

Yes, for some mothers, having a high risk pregnancy and an extremely premature infant requiring NICU care can create a negative stimulus too large to tolerate. For others, it develops their strength. Did the mom you mention possible have vulnerable child syndrome?

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Nancy E. Holroyd, RN's avatar

Thank you for sharing, not just your experience as a neonatologist, but your personal experience as a frightened laboring mother. Knowing the risks does not make it easier to deal with challenging personal medical experiences.

When my infant underwent open heart surgery for a complete A/V canal defect, I knew all the risks as I had cared for babies that occasionally died before, during or after the procedure. My husband would tell me to stop worrying and give me the statistics of why I shouldn't be concerned--they never helped.

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Susan Landers, MD's avatar

Totally right. We always worry. Sometimes more than nonmedical moms?

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Kathleen's avatar

Thanks for sharing! Such a good read ♥️ You are a wonderful doctor and mother!

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Susan Landers, MD's avatar

Aww, thanks Kathleen.

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Catherine Wilde - SoulCareMom's avatar

Susan, this was absolutely extraordinary — both as a deeply personal story and as a powerful reflection on the complexity of life, medicine, ethics, and motherhood. The way you brought us into those moments — the heartbreak, the responsibility, the vulnerability, and ultimately your own experience as both physician and mother — left me with tears in my eyes.

Thank you for sharing your heart and your humanity so beautifully. Your words are a gift. 💖

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Susan Landers, MD's avatar

Thank you, Catherine, for your kind words. Great encouragement for me, a new writer, from you.

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Marta Arandia's avatar

Thank you for sharing your story. I am caring for a client that has experienced premature rupture of membranes at 20 weeks and is in the hospital. Everything is hanging on a thread and I am doing my best because this is my first client with PPROM. Your story and the lessons you drew from it are so important and inspiring. Much gratitude 💕

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Marta Arandia's avatar

And I am feeling a bit lost. 😞 She has already been counseled twice about funeral provisions but there’s still hope she continues the pregnancy.

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Susan Landers, MD's avatar

If her membranes seal back over, and her fluid increases, there is hope. Even if no fluid remains and the baby develops severe pulmonary hypoplasia there is hope with mechanical ventilation and inhaled nitric oxide (to reduce PPHN). But this will be a long haul, either way. I hope that she is hearing the truth about what is ahead of her.

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