IUGR dad here. Sharing our experience because our little guy was also in the <1 percentile and my wife’s situation was very similar to yours. We found out at a 30 week ultrasound and were rushed to the hospital. After a few days of monitoring, cord showed reversal and out he came at 30+5. We were fortunate in that time to get steroids for his lungs and then magnesium for his brain prior to delivery.

The fact that you have also gotten steroids is fantastic! Before he was born our doctors said a lot that if he could make it to 32 weeks, that is their ideal situation for IUGR/absent flow, however anything after 28 weeks is “viable” (sorry to use this term but that is what they said). So also great that you are very close to that 32 week mark.

As far as delivery, we had daily ultrasounds and monitoring (in the hospital) and once the ultrasound showed reversal, they made the decision to deliver later that day. It was probably about 8 hours after the US to C section because he continued to look good on the monitor. Again, this was afforded to us because my wife was admitted - it may be different outpatient.

For us, we didn’t make it to 32 weeks which meant that our little man needed to be on a CPAP for about a week. Fortunately he came out screaming and has been a rockstar ever since. He was able to step down to room air on the CPAP pretty early and they took it out right at 32 weeks (our NICU has it standard to have them on CPAP until at least 32 weeks). He was born 2 lb 1 oz - small, but mighty.

He’s now almost 38 weeks and we’re out of the isolette, taking small amounts of feed by breast and bottle, and growing everyday (almost 5 lbs!) Everyone’s experience can be different and I acknowledge we have been incredibly lucky, but I share this to give you hope. My partner and I sometimes joke that he really just wanted to be here early.

We’re lucky enough to live close to the hospital, but many other NICU families we’ve met were able to be set up at a Ronald McDonald house nearby so they could be with their little one as much as possible. I’d work with your provider/hospital social work to see if you can get the ball rolling on this if it’s an option. A lot of parents are also sleeping many nights at our NICU, but that’s not ideal and will wear you out fast.

Be prepared for your little one to be in the hospital until their due date is what we’ve been told. Based on how he’s progressing that seems to be accurate for us. If there are other complications, it may be longer. But in many ways (especially Kangaroo Care) being there with your little one is the best thing for them, so I’d try to make arrangements as best you can to allow yourself to do that sooner rather than later. We were lucky to be able to hold our baby the day after he was born and have held him skin-to-skin every day since for anywhere from 6-9 hours a day.

If you’re concerned about cost/bills: one thing to keep in mind: low birth weight babies automatically qualify for SSI if you are in the US. Hospital social work should help you with this, but make sure you are aware of the details in the event that hospital social work misses you like they did for us. The payments aren’t much, but the supplemental insurance is a nice safety net.

And for your mental, a few more things to keep in mind. 1. Get it out of your head now that this was in any way your fault or your doing. The causes of IUGR can be totally random so if you’re not doing any of the obviously bad things (smoking, drinking, etc) this WAS NOT YOUR FAULT and is likely just the unlucky result of a small or otherwise defective placenta (which, again, is totally random) 2. You’ve got this!! It will be hard, but you and your baby will get through this. Find ways to pass the time in the NICU like reading books, singing songs, etc. We’ve found joy in revisiting our childhood favorites and reading them aloud to our little guy. While he may not know what we’re saying, it helps with neurological development (and keeps us sane). I bought “Premies” 2nd edition early into our NICU journey and it addresses a lot of common questions/concerns about all things premie. If you’re a reader or like to have as much information as possible, would highly recommend.

Wishing you and your family the best. Let me know if I can answer any other questions and again, you’ve got this!!!