Welcome Mamre Maulis
February 2008
by
I'm loving being the dad of two boys. I love children, and I believe they are a heritage, reward and blessing from the Lord (Psalm 127). I have always and continue now to desire the children the Lord will give me and I would never want to reject a child which the Lord has planned. This is the story of Mamre’s birth and the first few months of his life.
I have learned of the Lord that these things are sure: no one can stay his hand (Daniel 4:35), and that which can be shaken will be shaken so those things which cannot be shaken shall remain (Hebrews 12:27). And thus it has been with the story of Mamre Maulis. The weak and feeble things of this world have fallen away after paling in comparison to the Word of God who is made unto us wisdom, and righteousness, and sanctification, and redemption. He alone is Faithful and True.
Our first son Micaiah was born at about 38 weeks, which is universally considered “full term.” Micaiah has a wonderful testimony of the Lord’s love and healing of a CCAM, which can be read in The First Testimony of Micaiah Maulis. The labor and birth with Micaiah was without any complications whatsoever. Today, Micaiah is a completely healthy boy. He is named for the prophet who spoke in the name of the Lord and received affliction and died in faith, not having received the promises, but having seen them afar off, was persuaded of them, and embraced them, wherefore God is not ashamed to be called his God.
My second son was also born the same year. He is named for the tree under which the Lord covenanted with Abram who was the father of them that through faith subdued kingdoms, wrought righteousness, stopped the mouths of lions, quenched the violence of fire, escaped the edge of the sword, out of weakness were made strong, waxed valiant in fight, turned to flight the armies of the aliens, and also those who had trial of cruel mockings and scourgings, yea, moreover of bonds and imprisonment: They were stoned, they were sawn asunder, were tempted, were slain with the sword: they wandered about in sheepskins and goatskins; being destitute, afflicted, tormented; (Of whom the world was not worthy:) they wandered in deserts, and in mountains, and in dens and caves of the earth.
“And these all, having obtained a good report through faith, received not the promise: God having provided some better thing for us, that they without us should not be made perfect.” from Hebrews 11
After Micaiah’s birth, my wife and I planned her next pregnancy when we both agreed we were ready and prayed, asking the Lord for a child. We were ready to receive a child from the Lord as soon as we prayed, but we did not know when the Lord would choose to answer our prayer. Mai exclusively breastfed our first son Micaiah, but lactational amenorrhea did not delay her next pregnancy which began about three and a half months after Micaiah’s birth.
In the twenty-fourth week of the pregnancy, Mai went into labor in the middle of the night on October 3rd. I took her to the hospital in
We were told by the doctors, who expected him to be delivered at any moment, that at his gestational age, our child would have a forty percent chance of survival and that if he survived at all, there was a much higher probability of serious difficulties. The doctors only encouraged us that if his birth were able to be postponed, it would greatly improve the outcome for him. Doctors, perhaps by the nature of their work, tend to be focused on problems. We decided to focus on the solution, who is the one that is able to cause us to overcome, and who is not just able but who has promised by his word the things that we are assured of.
We were in the process of planning a home birth with a certified mid-wife, but we also continuously maintained care from an obstetrician. A level-2 ultrasound examination did not reveal any reason to expect complications. There were never any signs of cervical problems or known medical risk factors for pre-term labor, and we still do not know whether these resulted in Mamre's unexpected early birth. We did come to learn afterward that according to a study published in the British Medical Journal, short interpregnancy interval is an independent risk factor for extremely pre-term birth (odds ratio: 2.2). Mai also turned 35 during this pregnancy which alone is a risk factor with a reported odds ratio of 1.8. We had read about and learned of most risk factors for preterm labor and other complications in books and from childbirth education classes. None of the lifestyle and environmental risks were factors for us, and we had seen our obstetrician regularly to identify and manage any medical risks for which signs might have come up. Mai’s early labor and the speed with which it progressed surprised us all.
Our second son was breech at the time his delivery became necessary, and because the size of the uterus did not accommodate his birth through a lateral incision, a vertical incision or classic c-section was needed. One of the perinatologists advised us ahead of time about the risk of uterine rupture this poses to future pregnancies. Initially we failed to rationally understand the quantitative weight of that risk and for the sake of future children we considered rejecting surgery.
In the tense atmosphere of the impending birth, we were mindful of the pressure to make a decision even without complete understanding. We knew we had to act responsibly for the life already entrusted to us and ensure he had the best chance of survival. We were certain to make clear our desire to do everything we can to save him.
The doctors had advised us that because he was breech and fragile, that a surgical birth was going to have the best result for him. Nevertheless, they were not certain they would have time to operate if the membrane ruptured, but neither did they want to remove him earlier than necessary.
Because classic c-sections are rarely performed in modern obstetrics, there are few studies of large patient series with pregnancy outcomes after prior classic cesarean surgery. We had time to find the results of a study that showed one case (0.6% incidence) of uterine rupture and 9% incidence of asymptomatic dehiscence among 157 post-classic c-section pregnancies. Although the chance of some form of morbidity shows significantly, we began to understand the implication of this was risk management and surgical delivery rather than forgoing subsequent pregnancies altogether. The partner of the perinatologist who advised us of the risk of uterine rupture assured us in agreement that the risk was not by any means so great as to render future pregnancies ill-advised. This came as a tremendous relief to us because with the understanding that the potential risks were low to Mai and any future children we might have, we felt completely at liberty to do everything to ensure the survival of this baby.
Our hearts are fixed, trusting in the Lord. Our hearts are established, we shall not be afraid. We trusted in the word of the Lord concerning the fruit of our vine, for it is written,
Blessed is every one that feareth the LORD; that walketh in his ways. For thou shalt eat the labour of thine hands: happy shalt thou be, and it shall be well with thee. Thy wife shall be as a fruitful vine by the sides of thine house: thy children like olive plants round about thy table. Behold, that thus shall the man be blessed that feareth the LORD. The LORD shall bless thee out of
Furthermore, the prophet Malachi declares in the word of the Lord:
Bring ye all the tithes into the storehouse, that there may be meat in mine house, and prove me now herewith, saith the LORD of hosts, if I will not open you the windows of heaven, and pour you out a blessing, that there shall not be room enough to receive it. And I will rebuke the devourer for your sakes, and he shall not destroy the fruits of your ground; neither shall your vine cast her fruit before the time in the field, saith the LORD of hosts. Mal. 3:10-11
By the fear of the Lord, in the path of his ways, the tithe of our increase is his, and the promise is ours. We shall see our children’s children, even those of this tree whom we shall raise in the righteousness of God which is by faith in Jesus Christ.
The Lord is faithful and our son was not cast before the time came for him to be ready to be delivered on the evening of October 8th. At that time the doctors advised delivery due to impending risks, and we agreed that the time had come.
He did not know whither he was going, but we knew that God was calling him to go out to a place which he should after receive for an inheritance. We knew that he was coming into this world. We did not know what this world would hold for him, but we knew that he would be an heir with us of the same promise, because we judge him faithful who has promised. Therefore we determined to endure as seeing him who is invisible.
Amen, our fruit was not cast before the time, but he was delivered after six days, in the twenty-fifth week. He came out and took his first breaths. His eyes were open. He was a healthy boy who was only younger than many that are born. He weighed one pound and twelve ounces and was thirteen inches long. We named him Mamre. For an explanation of his name, see The First Testimony of Mamre Maulis.
The first few days, Mamre appeared to be doing very well on life support. Nevertheless, we were told to expect a “honeymoon” period and then a roller coaster. The doctors were sampling, testing and monitoring more things than we could keep track of ourselves.
The nurses were maintaining his blood sugar levels by testing and using insulin. He received transfusions to replace the blood taken for tests and to ensure sufficient hemoglobin against other possible causes of anemia. He went through courses of medication to close a Patent Ductus Arteriosus and had edema as a side effect for which he received Lasix, a loop diuretic. For the first few weeks he experienced Hyperbilirubinemia which was treated with phototherapy. Ultrasound imaging of his brain showed only one small, grade I intraventricular hemorrhage which stopped on its own. For the first few weeks his nutrition came from intravenous “TPN” fluid and lipids through an umbilical catheter and later a peripherally inserted central catheter (PICC).
At a few weeks from birth, he had a response indicated by low white blood cell count and high C Receptor Protein (CRP) levels which caused the doctors to fear an infection, and he was started on antibiotics right away. After a few tense days the blood culture returned negative, and it was determined from a culture of lung fluid that the response was instead due to pneumonia. We wrecked the NICU’s running record of 127 days since the last incidence of Ventilator Acquired Pneumonia (VAP). Mamre continued to receive antibiotics to help fight the pneumonia.
Mamre was started on a high frequency oscillatory ventilator (HFOV) right after birth, and at this point he was moved to a synchronized intermittent mandatory ventilator (SIMV) with pressure support before later being weaned on a nasal continuous positive airway pressure (CPAP) machine. Once he was initiating breaths on his own with the CPAP and later with a high-flow nasal cannula, he had occurrences of Apnea of Prematurity and Bradycardia. At one point he was returned to the SIMV because of too frequent apnea, but he was again weaned and afterward occurrences of apnea and bradycardia were much less frequent.
By the end of November, Mamre was over 3 ½ pounds and growing fast on about 28 ml of breast milk every three hours. His ability to tolerate milk was a good indication. He had a minor hernia but had avoided necrotizing enterocolitis. An Electroencephalography (EEG) study was done which showed normal activity. At this point, Mamre was breathing on his own with only the help of a nasal cannula and oxygen levels just slightly over atmospheric air. He was maintaining his body heat on his own, and had good strength. An ophthalmologist examined his eyes for the first time and saw everything looked good. The development of his eyes was a critical hurdle because of the threat of Retinopathy of Prematurity (ROP) which ultimately never showed beyond the earliest stages and then fully regressed.
Towards the end of December we began preparing for Mamre to come home. At this point he was staying in a room in the NICU for less critical babies. The main challenge he had to overcome before coming home was with feeding. The doctors were determined to see him routinely take a sufficient quantity of breast milk from a bottle before declaring him ready to go home. By early January, Mamre was taking milk from a bottle consistently, and we stayed overnight at the hospital with him on January 8th. The following day, we brought Mamre home with us.
An oxygen tank and low-flow cannula supported him with a tiny amount of supplemental oxygen, and we used an alarming pulse-oximeter to monitor the oxygen saturation of his hemoglobin and his heart rate. We were given what seemed like a very aggressive feeding schedule which proved incompatible with Mamre, but weekly weight checks confirmed that his growth was more than enough on his own schedule.
At 20 weeks old, Mamre is growing strong and healthy. His corrected age is approaching six weeks, and he’s well over nine pounds now. He recently saw an ophthalmologist, a pediatric cardiologist, a pulmonary specialist, and his pediatrician who all gave good reports. Mamre is no longer requiring any special medical treatments, therapies, medications or supplemental oxygen. We and the medical professionals will continue to watch his progress in the coming months and years but none of us have any evidence to cause us to expect any kind of difficulty for Mamre in the future as a result of his prematurity. He has had an extraordinary beginning to his life, and now he is prepared for the rest of it at liberty because of Christ’s great mercy and power.
I want to revisit something I wrote at the beginning of this story. I wrote, citing the epistle to the Hebrews, that those things which can be shaken will be shaken so that those things which cannot be shaken may remain. When a threat to our son came up, the things of this world offered us only uncertainty. We turned to the Word of God, because Jesus said, “Heaven and earth shall pass away: but my words shall not pass away.” We focused on the one who is able to cause us to overcome, and who is not just able but who has promised by his word the things that we are assured of. That is an important thing to know.
We have no right to simply defer that God is in control and that everything will be alright. The prophets were telling
When a young child dies, the ones who loved the child most feel the most pain. We hurt more than our neighbors who may be saddened at the news but soon forget what has happened. The deceased child feels no more pain, and has no more sense of injustice, cruelty, or of the ruthlessness of death. That child will never live to see their own child die. Therefore it is not the death of the child that is evil, but the works of those who remain.
“Wherefore I praised the dead which are already dead more than the living which are yet alive. Yea, better [is he] than both they, which hath not yet been, who hath not seen the evil work that is done under the sun.” Ecclesiastes 4:2-3
Some people take comfort believing that children are innocent or knowing that at least a just God would not hold a child accountable for their sin. Jesus said of the children that, “Their angels do always behold the face of my Father in heaven.” Jesus also said to those who wept for the one child of God who was innocent, “Weep not for me, but weep for yourselves, and for your children. For, behold, the days are coming, in the which they shall say, Blessed [are] the barren, and the wombs that never bare, and the paps which never gave suck. Then shall they begin to say to the mountains, Fall on us; and to the hills, Cover us. For if they do these things in a green tree, what shall be done in the dry?”
Just as we are not naïve, but know the things the Lord has said and we appeal to him in terms of his word and covenant to obtain those great and precious promises which we shall inherit, so also shall he deliver his promise to those who hold the truth in unrighteousness, because that which may be known of God is manifest in them for God hath shewed it unto them.
“For the invisible things of him from the creation of the world are clearly seen, being understood by the things that are made, [even] his eternal power and Godhead; so that they are without excuse: Because that, when they knew God, they glorified [him] not as God, neither were thankful; but became vain in their imaginations, and their foolish heart was darkened.” Romans 1:20-21
Let me tell you by his word what you can be assured of if you have not received reconciliation by the terms of his covenant. You can be assured that God has appointed a day in the which he will judge you in righteousness. You will give an account of yourself to God. His judgment will be so thorough, you will give an account of every idle word you have spoken.
The prophet Isaiah spoke of Christ and said that “he will magnify the law, and make it honourable.” Jesus did this when he affirmed the law (Matthew 5:17-19), and raised the standard of its interpretation (Matthew 5:22, 28, 37). Jesus magnified the law so that hatred in the heart is equal to murder, a lustful look is equal to adultery. Jesus said that whosoever committeth sin is the servant of sin. And he said that you cannot serve two masters.
Do not think to yourself that you will be able to justify yourself before a holy God the same way you justify yourself among men, for the Lord has said that everyone who is proud of heart is abomination to God. “For from within, out of the heart of men, proceed evil thoughts, adulteries, fornications, murders, Thefts, covetousness, wickedness, deceit, lasciviousness, an evil eye, blasphemy, pride, foolishness: All these evil things come from within, and defile the man.”
Be assured of these things: “the fearful, and unbelieving, and the abominable, and murderers, and whoremongers, and sorcerers, and idolaters, and all liars, shall have their part in the lake which burneth with fire and brimstone: which is the second death.” “For the Lord Jesus shall be revealed from heaven with his mighty angels, in flaming fire taking vengeance on them that know not God, and that obey not the gospel of our Lord Jesus Christ: Who shall be punished with everlasting destruction from the presence of the Lord, and from the glory of his power.”
The word of God tells us your fate with such fearful words as the following:
- “Shame and everlasting contempt” (Daniel 12:2)
- “Everlasting punishment” (Matthew 25:46)
- “Weeping and gnashing of teeth” (Matthew 24:51)
- “Fire unquenchable” (Luke 3:17)
- “Indignation and wrath, tribulation and anguish” (Romans 2:8,9)
- “Everlasting destruction from the presence of the Lord” (2 Thessalonians 1:9)
- “Eternal fire...the blackness of darkness for ever” (Jude 7,13)
Revelation 14:10,11 tells us the final, eternal destiny of the sinner: “He shall be tormented with fire and brimstone...the smoke of their torment ascended up for ever and ever: and they have no rest day or night.”
Amen, the Lord resists the proud, but gives grace to the humble. “[As] I live, saith the Lord GOD, I have no pleasure in the death of the wicked; but that the wicked turn from his way and live: turn ye, turn ye from your evil ways; for why will ye die?”
If you are willing to turn from your evil way, to humbly acknowledge your grave sin before a holy God and repent, the Lord has said that he will look to him that is poor and of a contrite spirit and who trembleth at his word.
If you are willing, then you may receive the wonderful gospel that God commendeth his love toward us, in that, while we were yet sinners, Christ died for us. “For the wages of sin is death; but the gift of God is eternal life through Jesus Christ our Lord.”
These are the terms of his covenant by which you may be reconciled:
He [was] wounded for our transgressions, [he was] bruised for our iniquities: the chastisement of our peace [was] upon him; and with his stripes we are healed. All we like sheep have gone astray; we have turned every one to his own way; and the LORD hath laid on him the iniquity of us all. Isaiah 53:5-6
He was taken from prison and from judgment: and who shall declare his generation? for he was cut off out of the land of the living: for the transgression of my people was he stricken. Isaiah 53:8
“If thou shalt confess with thy mouth the Lord Jesus, and shalt believe in thine heart that God hath raised him from the dead, thou shalt be saved. For with the heart man believeth unto righteousness; and with the mouth confession is made unto salvation.” Romans 10:9-10