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B'Sha'ah Tovah

by Sariya Daniels

I never understood why someone wished a pregnant woman "B'Sha'ah Tovah," a Hebrew phrase indicating that she should deliver her baby "in a favorable hour." A simple Mazel Tov always seemed more fitting. That is, until last year, when doctors performed a life-saving C-section on me, to deliver my premature baby in one of the only few hours in which he had left to survive.

Along the road of my tumultuous pregnancy, at just the right moment, yet another complication always seemed to arise. I would despair at the news of each new woe, always thinking, "Why is G-d doing this to me as I'm trying to bring a Jewish child into the world?"

I remember traveling to North Shore Manhasset Hospital last August for what I believed was my routine Level II sonogram. My obstetrician simply said that while it is possible to perform the sonogram at his office, since the hospital had more sophisticated equipment, he sends his patients there instead. Okay, I thought, until I learned that my friend who also used this doctor had all five of her children's Level II sonograms at the office, not the hospital. Nevertheless, the anticipation of learning whether I was carrying a son or daughter overshadowed any gnawing feelings I had.

Later that day, I learned I was pregnant with a boy, and accompanying the news, the maternal-fetal medicine physician offered me amniocentesis for further testing. "Only 29," I thought, "why are they offering this to me?" The doctor quickly explains that there seems to be some sort of obstruction in the baby's urethra, causing some fluid retention in his kidneys. My husband and I declined any procedure that could risk my pregnancy, and with that, the doctor filled out some incidental findings, such as estimated weight and amniotic fluid levels, and told me to return in six weeks to see if this problem "clears up on its own."

Fast-forward six long weeks of other seemingly unrelated complications and discomforts. I am back at North Shore Manhasset Hospital for my follow-up. More bad news. The kidney dilation has increased. After jotting down whatever incidental findings their standard forms require, the specialist instructs me to return in four weeks for another follow-up.

The next visit brought a sigh of relief. At 30 weeks gestational age, the obstruction had resolved on its own, the dilation was near normal and my baby's estimated weight is a healthy 4 pounds so far. "Great," I mumbled under my breath, joyfully exiting the hospital's white corridors. Still short of breath from the asthma I suddenly developed a few weeks before, I scrambled for my inhaler, and then phoned my mom to share the good news.

The asthma had come on suddenly. At the end of my sixth month, at my last opportunity for travel, my husband and I spent a couple of weeks hiking in Italy and Switzerland. Those hikes, though leaving me a bit short of breath, may have saved my life. Then, the day after I returned to New York after sitting in one position on an airplane for over ten hours, I stopped breathing after drinking a very cold glass of water that "went down the wrong tube." Thank G-d, my breathing, though labored, returned, and my doctor, together with a pulmonologist, diagnosed me with pregnancy-induced asthma. I was told it would probably disappear after I delivered. I could hardly wait for that day.

The asthma meant more sonograms and non-stress tests. Sometimes once a week, sometimes more. I am told that this is standard protocol for asthmatics during the last trimester. At my 32-week visit, my doctor looks worried. "I want to do growth studies on you next time," he says as he returns my sonogram photos to its folder. I had always sensed something was very wrong, that my pregnancy was not going to go to term. I constantly told my husband that this pregnancy was killing me. He always dismissed my premonitions as "just nerves."

"This baby is not thriving," I screamed into the phone at my husband two weeks later in the midst of my next office visit. My husband was whisked away from a surgery he was performing only to hear the worried voice of my obstetrician. Both doctors, they discuss the possibilities. My doctor explains that the baby is supposed to grow a half a pound a week in the last ten weeks, and he fell off the curve. He, unlike most babies, actually had a neo-natal curve, thanks to the sonograms taken at North Shore Hospital.

Those incidental finding were the only data truly needed to save our baby. All the findings of kidney dilations were just G-d's red herrings. My asthma was also just a miraculous means to ensure that I was assiduously monitored, at least once a week. Without that, the baby's failure to thrive would not be caught in time. And, just as quickly as it set in, at the point in pregnancy when I needed it most, it disappeared right after I delivered.

The ominous, lurking danger was actually insidious. All along, I had a blood clotting disorder I knew nothing about. It causes strokes and embolisms in pregnant women, and in absence of blood thinners injected into a pregnant belly each and every day, it clots off the baby's blood and nutrient supply. First, it causes a fetus to remain small so it requires less blood to survive, next shunting blood from other organs to ensure a supply to a fetus' brain and heart, next causing cerebral palsy and finally, fetal death. I had no idea of any of this, just a vague premonition that something was terribly wrong. G-d, however, in his infinite wisdom and compassion, did everything necessary to ensure that our baby made it, against every odd.

By the time this condition was caught, a Doppler study revealed that our baby was shunting blood to his brain and heart and his amniotic fluid was dropping sharply as his kidneys were shutting down. He was delivered emergently in time for that to be reversed, once he got ample oxygen and nutrients. The following morning, dazed from the morphine to blot out the pain of the Cesarean section, my doctor told me that if he had let my pregnancy go even a few more hours, he "would have shot himself." Our tiny baby would not have made it.

Along the way, each ailment was only a means to reaching a perfect end. The cortisone I took twice a day to treat the asthma caused our son's organs to develop rapidly, especially his lungs. Yanked from my uterus prematurely, at only four pounds, two ounces, he was miraculously breathing on his own and scored a nine out of nine on his Apgar test. Thank G-d, today he is a perfectly healthy, bouncing ten-month old, weighing nearly 19 pounds.

And so, I wish every pregnant women, and those who will become pregnant one day, "B'Sha'ah Tova."