A/N: This is the first 'proper' post I wrote for the blog, and it was all about attempting to get all of my feelings down about what had happened. Since then I've written up way more concise versions of my birth story as guest posts which you can check out HERE.
I hated being pregnant.
There, I said it. Now, don't get me wrong, I was overjoyed at the idea I was having a baby. I couldn't wait to meet him or her (the sonographer wasn't sure). But the process, well, that was a different matter entirely. The morning sickness, the bad back, the mood swings, the constant fretting about whether or not the baby was moving... By the time I reached my EDD (estimated due date - 20/12/2014) I was desperate for it all to be over.
Marianna had other ideas.
Christmas came and went and I still hadn't had so much as a twinge. I had two membrane sweeps done by the midwife, and was assured that, though I wasn't at all dilated, there was almost no chance of me needing my induction appointment on New Year's Day (day 40+12, in line with Aneurin Bevan Health Board policy). I wasn't so sure, and spent hours reading conflicting opinion on the internet on the risks of post-term pregnancy. Before I was pregnant I hadn't even known it could be a problem. By the time I was nine days overdue I could quote statistics gleaned from the limited research available from memory.
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| First scan picture. |
Post term babies can be bigger, and the bones in their head better fused, making deliveries more difficult and increasing the chances of
foetal distress. More worryingly the placenta is at greater risk of deterioration. When this happens the baby can be starved of oxygen, blood and nutrients leading to malnutrition and / or foetal distress. Kind of a no win situation with that one. The possibility terrified me.
So I learned that though it's relatively rare for babies to actually arrive on their EDD, the much quoted truism that first time mothers are typically 5 to 8 days overdue isn't grounded in reality (
source). In fact first time mums are more likely to give birth slightly
before their EDD. So I tried to comfort myself with the knowledge that in France the EDD is calculated to be roughly a week later than it is in the UK (
source). When day 7 passed uneventfully I took to reading articles about the guesswork involved with due dates (which was no help as I knew my conception date), and reading articles like
THIS one from the Guardian, about the US phenomena of 'Ten Month Mamas' who refuse to be induced and let nature take its course.
The thing is, I didn't find any of this comforting. For every story floating around on the internet of successful 40+12+ deliveries, there seemed to be another of a baby arriving stillborn. And lines like 'nature knows best' mean little to someone who once studied childbirth mortality rates throughout history. Nature doesn't give a fig if
my baby and I survive, so long as the number of successful deliveries is high enough to keep the human population going. What's more, those stateside mums were being constantly monitored in hospital. I'd had my baby's heart rate checked for 30 seconds on day 9 then been left to my own devices. We're lucky enough in the UK to have sophisticated medical care - what I couldn't understand was why I wasn't being offered more of it.
By New Year's Eve I was a complete nervous wreck, unable to sleep for fear something was going to go wrong and constantly on the verge of tears. When I didn't feel any movement for a few hours that afternoon I rang the emergency number and was told to come to the hospital to be put on the foetal monitor. Sitting in the waiting room was awful, knowing that if something was wrong every minute I sat there impotently was another minute closer to losing the life inside me. Thankfully once I was hooked up - undoubtedly due to it easing some of the stress - Marianna started kicking like it was can-can revival night. My mum told the nurse I'd been reading all sorts on the net and worrying myself, and she said it was all scaremongering, and that as they were really busy I should go home, get some sleep, and return at 10am for my scheduled induction.
The relief was overwhelming and I felt calmer than I had in days.
Next morning my mum and dad drove my partner and I to the hospital. My mum was going to be my birth partner, so A was only coming to see I got settled and hear if there was any chance the induction would 'take' in the immediate future. So we arrived, I went to the loo to do my urine sample, then heaved myself onto the bed to wait for the nurse. She arrived about 5 minutes later to hook me up to the monitor for half hour before they began. Almost instantly it was obvious that something was wrong - it was my heartbeat showing, not the baby's. When she said "I'm just going to call the doctor" it felt like the bottom was falling out of my stomach.
My mum told me it was probably just to check something; A looked white as a sheet, the night before had been bad enough. The doctor arrived in less than a minute, fiddled with the monitor for a few seconds then told me we were going straight to theatre. I asked her rather pitifully if everything was going to be alright as they wheeled the bed hurriedly down the corridor - I hadn't even taken my shoes off - and she just gripped my hand and said, "We're going to try our best."
It was then I realised that this wasn't just a precaution, this was serious. In theatre I could scarcely breathe for panic, gripping the nurse's hand with a death grip as I was stripped and had a catheter inserted while the anaesthetist began putting me under general anaesthetic.
I don't know how I'll live if my baby dies was the last thought I remember having before coming around in the recovery room.
I was so relieved when I came around to find a tiny baby girl waiting for me. Anthony and my parents had been allowed to dress and bottle feed her while I was out, and they let me hold her for a few minutes. It was at this point that a photographer from the local paper came in to take some photos for their New Year's Day babies feature. I kept repeating my job title and asking Anthony to make sure they printed it - in my drug addled mind this was going to serve as a birth announcement, and everyone at work would know and not ask me questions about it. Why they wouldn't be able to recognise me from my name and photo is a mystery!
After that Marianna was taken up to NICU, and I was taken to the recovery ward. Thankfully I don't remember too much about it because what I do remember was awful. There were no pads for the bed so I just had to lie in my own pool of blood, and when I was hauled out of bed to sit in the chair for a bit the pain relief drip in my hand literally 'pinged' free. The nurse decided I must have pulled it out myself and refused to replace it for hours.
My mum, Anthony, and my mother-in-law (who was amazing and sat listening to me ramble on about God only knows what for hours) were kicked out in the evening and I was left to my own devices. I couldn't move to help myself, yet alone a newborn, but when a nurse came to check on me later she said she hadn't known my baby wasn't with me until I used the time to ring my friends and tell them what had happened. (It was a small ward so they could obviously hear.)
Throughout the night the phone would ring periodically at the nurse's station and my stomach would flip with nerves. What if it was about Marianna? About 5am it actually was. I heard it, and braced myself for the nurse to come and tell me. Marianna had had a fit. I asked if she was alright, the nurse said she didn't know. To my mind I was asking if she was alright as in, was she alive? I got completely hysterical, rang my mum and Anthony to come down, then my poor friends in an attempt to keep calm as I still couldn't sit or anything.
Everyone arrived just as the nurses were changing over - one came in my cubicle to say she wouldn't let the doctors from NICU talk to me until my bedside table was tidied up, and that I shouldn't still be on pain relief via drip. At that point I just lost it completely, crying and sobbing and telling her I didn't care about anything but my baby! Marianna was okay, the fit wasn't serious, and NICU were amazing with her, just as the doctors and surgeons were with me. The recovery ward was just out there on its own...
What I learned later, when I'd finally been moved onto the regular maternity ward (roughly 1000x better run than the post-op recovery maternity) is that I came close to not living myself. It turned out that my 'silly' fears had been justified. I'd suffered a placental abruption which had put the baby into severe distress and caused me to lose a lot of blood and be given transfusions. I hadn't had any bleeding nor experienced any pain - the surgeon, an amazing woman who I can never thank enough, came to see me a few times before I was discharged, and told me that there was no clotting behind the placenta so it must have happened just as I arrived at the hospital, some 21 minutes before my daughter was born.
She also said that though they had all feared the worst, Marianna was something of a miracle baby. She came out breathing on her own in spite of all the meconium she'd swallowed, and was initially only taken to SCBU for observation, though she ended up having to stay there for 19 days. I was told later that first time mums are never given morning appointments for induction because an overnight stay is almost inevitable anyway - somebody, somewhere had been looking out for her!
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| Hooked up to everything the day after being born. |
The point though, as far as I'm concerned, is that they shouldn't have had to. Current thinking within the midwifery community is that a baby is not truly overdue until 42 weeks (
source), and unless you live in a health board which offers elective caesarean sections you won't be induced until between 7 and 14 days overdue in the UK (depending on specific health board) without good reason. Induction is risky in itself, and statistically there is little argument for a blanket introduction of significantly earlier induction dates.
What there is argument for is better monitoring of post term pregnancies. The research on calcification of the placenta is fairly patchy and outdated (e.g.
source), but it is a fact that the longer the pregnancy goes on, the more likely the placenta is to deteriorate. So much health care in the UK is a postcode lottery, and pregnancy is no different. In one part of the country you would be induced at 41 weeks, in another you have to wait until 42 - what this means in effect is that in some areas you are taken into hospital for proper monitoring at 41 weeks, regardless of induction method or duration, while in others you have to wait another seven days with only the bare minimum of monitoring. For my baby an extra day would have literally been the difference between life and death.
Should I fall pregnant again, I'm assured, I will be more closely monitored throughout as I'm now categorised as at risk. But if just a little more monitoring had been carried out in the final stages of this pregnancy it could well have been avoided...
If health boards want to err towards the latter induction range, in my opinion the onus should be on them to produce evidence that it is safe to do so, not to simply argue that the existing research is outdated and so shouldn't be relied upon.
Also,
check out my c-section recovery story.
