Cintia Dicker emotionally recounts the birth of her daughter Aurora

At twelve weeks we discovered gastroschisis [uma malformação gastrointestinal congênita]* in the morphological examination, done when I was still in Brazil. From that moment on, in a sequence of tests to check for chromosomal alterations, we discovered that it was a girl. My feeling has never deceived me, I knew it from the beginning-she laughs.

Every time Pedro and I thought of a possible name, Aurora would come up. I thought she was strong, with a beautiful meaning [do Latim, representa o nascer do sol, o raiar do dia,] and Pedro always liked it too. So we had no doubts about the choice.

When we learned of the existence of gastroschisis, we also discovered that, for the safety of the baby, Aurora should be born between 37 and 38 weeks and via caesarean section. Shortly after birth, our daughter was due for surgery, so the entire medical team needed to be available. The ideal period would be the week of Christmas, days in which many travel, but coincidentally the dream team had found a date. The team consisted of my midwife Viviane Monteiro, surgeon Gilmar Stulzer and Jofre Cabral, pediatrician and medical director of the neonatal intensive care unit of the Maternidade Perinatal, in Rio de Janeiro.

We didn’t know about this condition and I was very scared because I didn’t know what the surgery would be like and also her recovery. I kept searching the internet for answers, something I don’t recommend because it scared me more.

Like all surgeries, hers also had risks. In many cases, it is not possible to place the bowel at once, requiring more than one surgery. But the reference doctors in gastroschisis are in Brazil and they trusted me a lot. That’s why we left Europe: knowing that she would be in the best hands and taken care of, and that’s more than enough.

I blindly trusted the professionals who were fundamental for everything to go well, always positive and confident that everything would work out. Besides them, my husband Pedro has been my strength. In all moments of despair, it was he who calmed me down and comforted me in some way. There were many doubts and insecurities pounding in my head: what would the delivery be like? Would I see the guts of him out of him? What would intensive care be like? Would the operation work? I knew I had to be strong for her and he reminded me. And I was, or at least I tried to be.

I have a lot to thank Cris Stringhi, my holistic therapist who helped me through alternative therapies like Reiki [feita com a imposição das mãos, a terapia reikiana busca canalizar energia para pontos vitais do corpo, trazendo bem-estar físico e mental]. When this whirlwind of questions invaded my head, I tried to focus on another matter, so as not to deposit any nervousness on Aurora. This was the reason for my decision to drive to the hospital and thus occupy my head.

Aurora was born on December 26th and, like many others, the day before I was at home to receive relatives and friends. I was 37 weeks pregnant, had no contractions, no risk of the baby being born. And there we went to listen to the music of the duo Anavitória. In the hospital we had the company of several friends who – surprisingly – took the cards to play lock. There were so many loved ones gathered in the room, so much laughter, that I didn’t have time to think ‘what’s next?’ When the surgeon arrived, his reaction was, “With this vibe, you can’t go wrong.” And it didn’t happen.

The atmosphere in the delivery room was calm and pleasant. The anesthesiologist Flávia Cirilo is a great friend of hers and she also acted as a photographer. Pedro held my hand the whole time. I didn’t think about my surgery at all, all I could think about was Aurora.

She was born at 21:00. I could have her in my arms. Aurora came into the world beautiful and huge. I was able to give her a kiss before sending her to surgery. At that moment, her heart made a knot and she did for the next thirty minutes. The procedure was over before they even finished my C-section. Everyone in the room was cheering because it was a very successful case. It was a mix of feelings at the time: ‘He’s fine, but where is he? I want to see her!. At the same time, Pedro and I were talking into each other’s eyes. Our daughter was fine.

The next day I was able to see her in the ICU. And so the most intense and painful days of my life passed. Seeing her in her incubator, walking away without her, but at the same time feeling enormous gratitude to the entire team who took such good care of my baby. I realized that there was the best place for her. Again I tried to be strong for her, but only touching her through a small window with my hands full of alcohol, not being able to pick her up, was hard to control. Adding to the hormones of a puerperium, it was bath time that I would collapse, but get out of there, put on the strong cape, and carry on. I thought of the children who were in the hospital, fighting for their lives, and their strength is much greater than we can imagine. And that gave me strength.

In intensive care it went very well. She spent the first five days on whey only and it broke my heart to think she was hungry. Aurora evolved, day after day, until she needed general anesthesia to get the drip through. Again, a knot in her heart, but she held on and her life normalized from then on.

My head was completely turned towards her. There were 16 days from 9am to 10.30pm in ICU with emotions running high. I suffered from baby blues, had no time to rest, and could only think a little about myself when Aurora came home. Due to lack of rest, I felt a lot of pain in the caesarean section scar and had a little inflammation, which resulted in the need for antibiotics and treatment.

Luckily we have overcome all the difficulties and being at home with her is the best feeling. Aurora was born big at 4,030 kg and 54 cm, a big girl with a big hunger (laughs). In the morning the routine is tiring. She wakes up every three hours and nurses for about an hour and a half between naps that take place at her breast. At first I chose to bring my mother to help me and not need a nanny.

I went through a lot of learnings that wouldn’t fit in a text, but a few points I want to mention: living has a new meaning, this is the greatest love in the world and I do everything to make my daughter well. I learned to value my mother and all ICU mothers differently for their inexhaustible strength.

I will enjoy this family time a lot, I will spoil my daughter and I am planning to go back to work soon. Who knows with her?”

*What is gastroschisis?

Dr. Gilmar Stulzer, surgeon responsible for the care of the daughter of Cintia Dicker and Pedro Scooby, briefly explains the case.

“Gastroschisis is a defect in the formation of the abdominal wall, in which the baby is born with the intestine completely outside the abdominal cavity. In these cases, surgical correction of the defect should be performed as soon as possible to minimize the risk of infection, which could endanger the child’s life. Shortly after her birth, Aurora was promptly assisted by the pediatric surgery team under the responsibility of Dr. Gilmar Stulzer and the abdominal wall defect was corrected, contributing enormously to the excellent evolution of this case.”

According to pediatrician Daniela Anderson, specialized in Neonatology and Child Intensive Care (Pediatric Intensive Care), “gastroschisis occurs in utero and usually involves the exit of intestinal contents through the orifice, which is exposed to amniotic fluid during pregnancy .

Unlike the other abdominal wall defect, which is omphalocele [protrusão de vísceras abdominais através de um defeito da linha média na base do umbigo]in gastroschisis there is no protective film of the intestinal loops that dissolve in the amniotic fluid and, due to this, an inflammatory reaction is formed, such as a thick inflammatory membrane or film that covers the intestine.

From the moment it is discovered during pregnancy that the child has this malformation, the pregnant woman is referred for delivery to a referral center where there is a neonatal intensive care unit, with a pediatric surgeon prepared to receive the child and perform adequate treatment surgery to reinsert the exposed organ parts into the abdomen and close the hole”.