our adoption story #6: bringing baby home and placement

Today, I’m writing about the placement process. Adoption takes many, many steps. With infant adoption, in general, the process goes:

• initial application
• home study
• training and waiting
• matching with an expectant mom
• birth and placement
• post-placement supervision
• finalization

Our process was a bit different than most because we were matched with a baby who had already been born. Placement, or the paperwork that gives the adoptive parents the rights of parenthood, occurs when the baby is discharged from the hospital. Most babies are discharged within 48 hours of birth. That wasn’t the case for us. Sumner spent 152 days in hospital and we weren’t allowed to take placement until his discharge — just like any other adoption. It created a strange time of limbo for us. We were his parents in every way, but while he was in the NICU we didn’t have final decision making authority. The odd thing about our situation was the time between birth and placement. Part of the reason placement occurs after discharge is due to keeping the financial stuff clear. The birth family’s insurance is responsible for birth to discharge, while the adoptive family’s insurance is responsible from after discharge onward. You can imagine that no one wanted us to incur the bills associated with such a long NICU stay, especially since we would have lots of bills for his ongoing care.

Our last 24 hours in the NICU went by in a flurry of preparations to get us ready to go home. We were originally planning on having Sumner discharged on Tuesday, November 26th. This would have been exactly one week after his g-tube placement and laser eye surgery. However, Tuesday was supposed to have a really bad snow storm and we didn’t relish the idea of driving almost 70 miles home, in a snow storm, with a baby on oxygen and who would probably need to eat but who was partially fed via g-tube. I’m pretty sure that’s how horror movies start.

When I saw the forecast, I asked that day’s nurse if she could help us to convince Sumner’s doctors that it would be okay to discharge him a day early. She was more than on board for getting us the heck out of there. The biggest hurdle was calling Sumner’s eye doctor and asking her to come in for his eye exam a day early. Thankfully, she really liked Sumner and had already told me that she would be willing to do so if it looked like we might be able to get an early discharge.

We also had to call the adoption agency to make sure that our case worker could come down and do our placement paperwork with us that morning. The hospital couldn’t legally let us leave with him until they had a copy of the paperwork saying that he was, in fact, our son. Since we had kept her informed of Sumner’s progress, she was aware that his discharge date was coming soon. Plus, she didn’t want to drive in a snow storm either. With all of our ducks in a row, we were ready for the last couple of steps.

We decided to “room in” with Sumner for his final night in the hospital. Rooming in is when the patient is removed from all their monitors and the parents are completely responsible for taking care of their child without the night nurse popping in and out all night. It’s sort of a practice run for going home. We weren’t required to room in because we had been doing all his care for some time, but having him off his monitors was magical. That night we took him on a good-bye tour of the NICU floor to visit with our favorite staff members without having beeping announce our presence. (We did another tour the next morning to for the day staff. When you’ve been around as long as we were, you make friends!) We did have to briefly hook him back up to his pulse-ox monitor for his carseat test. The hospital required him to sit in his carseat for an hour without having a desaturation event. Sumner rocked it. Plus, we got to hang out with his primary nurse who had been with him the longest.

The day of discharge was a bit stressful and hectic. As you can imagine, we didn’t get great sleep that night. Sumner’s feeding schedule then was every three hours at 9 PM, 12 AM, 3 AM, and 6 AM. Justin did the 3 AM and 6 AM meals, but still. We had moved out of the Ronald McDonald house the day before, but we still had to pack up the rest of Sumner’s and our belongings and load up the car. You would be amazed by the amount of stuff you can accumulate in 152 days at the hospital!

At last, our caseworker came to do the placement paperwork with us. Some people opt to have a placement ceremony with members from each part of the adoption triad there — birth parents, adoptive parents, and the adoptee — but we had decided to have this particular ceremony. (For lots of reasons that would be the subject of another post entirely.)

We had to see many of his doctor’s for one last sign-off. His GI doctor was particularly frustrating because she acted like his discharge was a sudden thing and we had been working towards it for several weeks. She actually wanted to keep us longer, but our primary doctor told her no. We had to have the sutures for his g-tube cut. The surgical team had said that Justin or I could do it, but neither of us felt comfortable doing it. So, we had one of his primary doctors do it. At last we were ready to go and not a moment too soon!

The snow had already started falling by the time we were in the car. This was the exact scenario we were trying to avoid. It took us over two hours to make the drive home as the roads turned to slush quickly, but we made it!

Once we were home, we called the oxygen supply company to have his concentrator, filling station, and tanks delivered. Thankfully, they were able to come out that night. With Thanksgiving only two days away, we were are little worried that something might get lost in the shuffle of changing insurance and changing names. Oh, yes… I didn’t mention that. All of Sumner’s paperwork had his birth name on it which wasn’t legally his name once the placement paperwork was done. Talk about fun!

At the end of the day, we were all home from the hospital and officially a family. It was exhausting and amazing all at once!