To tell you truth right from the very beginning there was something about this pregnancy that just felt...well too good to be true.
Spotting in early pregnancy is not uncommon I know and is most likely entirely unrelated but I can't deny that for me, it set the tone for the months to follow.
Needless to say it bought a small amount of relief seeing that little cashew nut floating around the screen at the much anticipated twelve week scan. I left the hospital with that glowing new- mum -to- be feeling,entirely oblivious of the scenes yet to follow. Scenes that were reminiscent of a nightmare on elm street (part two I believe).
Six weeks later,post school run, the whole situation came toa bit a head. At the time I was browsing in one of the local shops for a spice rack. Chatting to the shop keeper, he was signposting me to the next town along when suddenly I felt a gush. Making my excuses I quickly left the shop.
Outside I discreetly tried to investigate.
Hmmm.. notepad and magnifying glass seemingly unnecessary as the red blood in all its abundance was running down my legs.Feeling shocked and more than a little panicked, at this point there was just one thing on my mind, pre-term labour.
My rational side made some feeble attempts to assess the situation. Blood? this much blood? (about a pint) why not water? Frightened and confused I decided to head to the near by pharmacy who swiftly called an ambulance.
I think it was the shock combined with low blood pressure that caused the world to go a bit topsy turvy and I came very close to passing out.
After causing a scene worthy of a rapidly growing audience I was carted in to the ambulance waiting in the middle of the high street. * embarrassing*
On the dual carriage way I could hear the paramedic casually mentioning to the ambualance driver that he might want to pull over. I think my blood pressure was dropping and the blood flow continued relentlesly.
Wait a minute, whats that hes taking out of the cupboard, heart monitor leads? Oh no..
'Am I going to die?'
'No you're not going to die'
Pheww...that wouldnt be good.
Being wheeled through the long hospital corridors on a portable bed I felt a mixture of thoughts and feelings. There was a sense of temporary security combined with rising levels of anxiety as I fretted over the impending prognosis.
Getting pushed past the ladies sitting in the day assessment unit was something of a poigniant moment, I recall feeling quite sorry for them as I thought to myself.. 'Yes, this is what your worst nightmare looks like'
Thankfully Stephen arrived before the doctor and never was I more pleased to see him than at this exact moment in time.
The midwifes were keen to offer some reassurance, doppler at the ready they ask 'Shall we listen for babies heartbeat?' and like some sort of preschooler with stage fright I reply 'No.. I don't want to, I'm scared'
Little did I know the doppler and I were going to become quite familiar over the coming weeks, each encounter offering snippets of reassurance amidst the worry and concern.
On this day a whole new world opened up to me. Medical terms and abbreviations intended only for professionals became regular features in my google search box.
On reflection i think this highlights a real lack of communication on the part of the midwives at the time who were so quick to dismiss my questions as 'anxiety'.
In view of the circumstances I considered this to be a highly dated and cretinous approach that was at best an insult to my intelligence and at worst quite damaging. (rant rant)
Once a scan had ruled out all the known causes for haemorrhaging, they had no real explanation for the sudden loss off so much blood and after an overnight stay they packed me on my merry way.
Sadly this was not the end of these sorts of episodes, no less than 24 hours later I was back in hospital with more of the same. This time they identified the source of the bleeding as coming from the cervix. 'This is good news' they tell me as they are prepping me for theatre.
'An artery in the cervix has ruptured and we just want to pop a little stitch in. This means the blood isnt coming from the uterus so the baby is safe.'
Coming around from the surgery I look anxiously up at the one familiar registrar and I say in a croaky voice 'Hi Tom.. is everything ok?'
'Yes I think they had a listen in and everything was okay'
'We'll have another listen in shortly'
Out comes the preschooler
'Can we listen in now?'
'In a while we just need to wait for a few minutes'
Hearing baby roo's little heart beat is enough to keep me quiet for say.. half an hour.
'So..can you tell me then what is the relationship between cervical bleeding and pre-term labour?' I ask
'Well the thing is my dear,we dont really know'
'In your experience though?'
'My experience tells me that at the moment you are not in pre-term labour'
Okay I know I am probobly not the easiest patient in the world. Far from an optimist, Stephen once joked that with me not only is the glass half empty but someone stole it too.
With little else to go on I revert back to trying to disentangle the medical jargon from the pregnancy notes.. Page 14, November 19th, 'Anxiety +++'
I think there were at least two more incidents of major bleeds after the stitch each resulting in trips back to hospital but the condition was one they had never come across.
By all accounts a cone biopsy I'd had taken from the cervics at age 22 had left the cervix so scarred that it was finding it difficult to accommodate the increasing volumes of blood as the pregnancy progressed.
Despite the bleeds, the medical professionals did all they could to reassure me that the baby was safe.
The thing was, during this very difficult time as I was approaching the stages of viability it was difficult to know how to look after myself and my unborn.
'Don't bed rest' say the doctors.
'Bed resting causes blood clots,and theres no evidence that it prevents pre-term labour'
Not knowing how to protect her and keep her safe, in what to me, was an obviously dangerous situation bought an overwhelming sense of helplessness and responsibility.
I cant say I ever got used to the bleeds, after all such episodes are unnatural and symbolise all that shouldn't be when one is in the womanly way. Not to mention the impact it was having on my eleven year old who was all to often being packed into the back of the car as we anxiously set off for yet another hospital visit.
On the last episide however it was just Stephen and I. As you can imagine by this stage we were quite familiar with the routine. The making our way to the car as quickly and calmly as possible. The desperately hoping the traffic wasnt heavy. The call to the hospital to let them know we were on our way were all becoming an all- too- regular part of life. However this time as Stephen gets out of the car to grab a wheelchair from the hospital lobby I call him back..
We were 24 weeks gestation.. just.
Premature rupture of the membranes (or PROM as it is clinically known) was actually a surprise to me when it happened.
I mean contrary to the professional view that the pregnancy was safe I had fearfully predicted an early delivery. However I think I envisaged something far more dramatic and involved than what actually happened on that december night.
Bizzarely, once I realised that my waters had gone I felt a strange sense of calm and I hate to admit this because it really is very wrong to gloat in situations such as these but if I'm telling the absolute truth it was sort of good to know that actually I wasn't a hormonal fruitcake with an over active imagination - that my intuition hadn't failed me.
Yes if all else fails,so help me, I still had my sanity and frankly I was relieved.
With the surreal and heavy atmosphere permeating the hospital side room. Gone was the urge to demand immediate medical attention, to insist on a consultant and not registrar, to fiddle over my rubbish notes app and bombard the nearest medical random with my latest cascade of questions. I was at this time feeling very calm and saddened and ready to surrender my care to the only people who could help me now.
We wait some more...
'Is Tom here?' I ask the midwife.
'Yes..he's just making some calls, he'll be in to see you shortly'
Well that's something I thought, a doctor with a sympathetic bedside manner goes a long way in these situations.
The door swings open, it's not Tom but two female SHO doctors. Oh no..whats that shes holding? eeekk...its metal mikey.
Ohhh.. do we have to?
'It wont take long, we have to confirm the situation'
Fortunately I had one of the best midwives sitting with me that evening. Young,friendly and sincere she helped me through what was going to be a very long night.
It felt like an eternity later when Tom finally came in to let me know what was going on.
Looking more than a little unsatisfied with the sitation he told us that he had been on the phone trying to organise a bed and cot space for myself and the baby but as yet had been unsuccessful
'I have to tell you that 90% of women whose waters break go on to deliver their babies with in 24 hours.
'The difficulty is there are hospitals with cot spaces but no bed space and visa versa. However as yet we have found no hospital within our network with both bed and cot space available'
Oh no.. Mary and Joseph..
OMG! We're like Mary and Joseph...
'Im just going to make some more calls, so far I've tried Exeter,Plymouth and Bristol'
Gosh.. Bristol was at least an hour and a half from where we were at. Thankfully our eleven year old George was at my mums house, most likely engrossed in some on line adventure game happily oblivious to the situation.
It was a further three hours before Tom came in looking slightly deflated he announced that the ambulance would soon be on its way to take us to Portsmouth.
'That's 150 miles away!'
'I know.. I know it's far, far from ideal.. I'm afraid it happens all too often these days..
Firstly we will give you a shot of steroids then Katy will take you to the ambulance and accompany you on the journey. Your partner will follow in a car?
Katy, in fairness did turn out to be the very best of accomplices for the three hour journey through the ice and snow. We talked about families, life and love. She listened to me rant about the ordering of lives through work and welfare systems, the highs and lows of drug services, what they do well, what they do badly and what they dont do at all...
In short I think we talked about just about everything except what was actually happening right there and then and what could happen in the hours to come.
I recall being immediatly impressed by the appearance of the Queen Alexandra hospital.
Only twelve months old, the interior paint was calming shades of pale blue and lavender. I was happy to see that someone had the good design sense to colour the skirting boards and lower door panels in black, after all there's nothing worse than seeing the reminants of the hospital mop water sloshed up the walls or the imprint of black trainer sole marked on the door. No, this hospital made the previous one look third world standard by comparison.
Stephen and I had arrived at the hospital within an hour of each other. The doctors scanned the baby and found no immediate cause for concern. I was not in any pain and despite it being 6am and not having slept at all I didn't feel in the least bit sleepy.
The afternoon bought no signs of movement and as the prospect of imminent delivery was looking less likely the questions started to sneak in.. Why wasn't I contracting? How long can a baby last without water? What are the chances of survival? So as you can imagine I was mightily relieved when a consultant paediatrician appeared in the doorway, ready to give us 'The talk'
His speil included multiple aspects of the delivery and management of a 24 weeker. At about three minutes in I was thinking.. this guys a mind reader. His explanation of the forseeable events was so thorough he literally left me stuck for words. Every time I thought of a question he answered it in his next paragraph. Ingenious, a medical professional who can make me questionless. Well virtually.
By this point I had of course had the second set of steroids and was having the odd scan here and there to check babies progress.However the most important scan was to be carried out by the lead consultant, a specialist in fetal medicine, Mr David Davies.
Yes David Davies.
Don't ask. I never did.
Many of the staff pointed out what a great honour it was to have the hospitals very best ob-gyn consultant in charge of my care, and as if to echo the great sense of morale Mr Davies followed suit praising the neonatal team and their outcomes to no end.
'It was your good luck that there was no room at the other hospitals, my colleagues in the neonatal unit are in the top five percent nationally and are amongst the very best in the country.'
Lying back in the patient chair in Mr Davies' plush new office, I wait anxiously for the screen to show an image of my much wanted, much cherished and much loved little bubba .Clearly he is a man at one with his machine as the intricacies of his state of the art equipment do nothing to intercept his casual and confident demeanour.
This scan was about to reveal how much, if any water was left in my totally stupid and pathetically incompetent water bag.
'Hmmm..' says Davies, 'just two tiny pockets of water left'
Looking at the screen I saw two lime green splodges which is what I assumed Davies was referring to. The outline of the baby was somewhat distorted and appeared to merge seamlessly with other unidentifiable components of the female anatomy. Feelings of guilt and pity overcame me as I empathized with my soon- to- be offspring who was apparantly engulfed by a giant burst hubba bubba bubble or similar.
Mr Davies explained how sometimes the water bag can reseal itself, depending on the severity and location of the hole or tear.
Amniotic fluid, he explained is generated by the baby as she breathes in the fluid and urinates it out.
Suddenly something captured Mr Davies' attention.'Look!' he exclaimed 'There! she's practicing breathing motions'
Although he didn't go on to explain the significance of this observation, such enthusiastic intonation was not what I perceived as typical of his calm yet confident manner. When we returned to our side room that evening I held on to that moment as I played it over and over in my head.
Mr Davies liked my babies breathing! Mr super duper top of the range very succesful and highly regarded consultant actually liked my babies movements..
Ahhh sleep beckons..
The fact that baby was staying put was a positive sign but we had been warned of the risks.
'Im afraid it's a race against the infection' We were told.
'Essentually it's a balancing act, we are balancing babies' gestational age against the risk of infection and at 24 weeks, the best place for baby is in the womb.'
'Should you become unwell or display signs of infection, we will have to act quickly which is why you will remain in hospital where you can be monitored.'
The next few days brought with them an immense sense of responsibilty. I was told to bed rest but to use the bathroom as was necessary.
Frightened to do so much as flinch I tried my best to stay as still as is humanly possible.
On day four a paediatric nurse took Stephen and I on a guided tour of the neonatal intensive care (NICU), presumably so that we could prepare for the inevitable.
Our tour guide had over 30 years experience of working with neonates. Sensitive but direct she wasted no time putting us in the picture about neonatal etiquette.
'Once the baby is born he or she will be bought to this room here' She said pointing to the intensive care unit.
'After a period of stability you can 'containment hold' your baby. Containment holding is when you firmly place your hands at either end of their body, it will let them know that you are there.'
'Some parents want to touch or stroke their babies, but the babies dont like to be stroked and touched. It can sometimes have an adverse effect.'
'Ahh.' Stephen and I chorused. Glad to recieve the pearls of her wisdom.
'With the permission of the parents I will introduce you to some of the babies, however once your baby has been admitted we ask that parents don't wonder around looking at other peoples babies, after all it wouldn't be appropriate to do it on any other ward would it?'
Good point I thought.
Inside the intensive care unit the atmosphere was surprisingly tranquil despite the beeps coming from the many many monitors. The colour scheme and lay out of the setting struck me as not at all dissimilar to star trek. In particular the windows looking out on to the night sky offered a spaceship type effect adding to its surreality.
As hard as i tried i found it difficult to envisage myself as some sort of cyber mummy, at one with the NICU paraphernalia, manoeuvring tubes, sensors and wiring in order to carry out the otherwise simple task of changing a nappy.
Strangely enough, the babies I saw that day didn't seem all that small to me. Back in safety of our side room I say to Stephen 'Did you think those babies were small Steve?'
'They weren't that small though were they? Not as small as I expected.'
'They looked alright' Steve comments nonchalantly.
Looking back, it is interesting how efficiently my mind denied the possibility that these 1lb babies were incredibly small and vulnerable. Such thoughts must have been rapidly deposited into the 'we wont think about that box.' A storage facility in my psyche that I seldom utilised until this incredibly challanging time.
I had been an inpatient at portsmouth for one week exactly when I started to feel, lets say a little achey. The rising infection markers were a sign that the delivery couldn't be put off much longer, and later on that day I started to develop flu like symptoms which were causing me to feel worried and concerned.
Eventually I was wheeled around to a different ward to be assessed. Having read the charts the doctor decided IV antibiotics and fluids may hold off the delivery so he set to work on fitting a cannula. However his rather clumsy injecting technique meant he was poking and prodding for quite sometime, not a good look in the face of a crisis.
The midwife who was tracing the babies heartbeat was also struggling. After a double take she could see it was high at 200 beats per minute. The faint frown lines that appeared etched on her face suddenly became more profound as the heart beat began plumiting down to 170 and she looked at the doctor shiftily.
They left the room.
I knew they were outside the door having a private clinical discussion because of the way they scuffled off together. Besides, I could see the doctors dodgy barnett through the little square window in the door.
After that everything happened quite quickly. The anaesthetist came in and started talking at about 100 miles an hour. I was then promptly taken down to theatre where Stephen popped up dressed in scrubs. His eyes peaking out over a mask. He appeared to me like a fretful clone of the surgeon.
The theatre was full. With the paediatrics team also present there were over 20 people there. I took a good look at the people who would be caring for my baby. I could see the nurse who had shown us around the unit. She smiled and nodded. I was glad she was there.
When I awoke from the anaesthetic Stephen was with me. He was holding out a very blurry picture of a tiny little baby.
'She's here and she's okay' he says.
And then.. (by his account) I look up and in a croaky voice I say 'more drugs.. get me more drugs...' Hardly the maternal statement of the year, I know.
So weighing a teeny 1lb 7oz my little Roo had made her way into this world and for the moment she was stable. I was taken to a single room where a nurse watched over me until sunrise. Desperate to see my little Roo I begged and pleaded but the nurse in charge was extremely bossy
'Do not try moving' She chastised, wagging her finger.
Some hours passed.
'Do you think shes still okay?'
'Will they call us if shes not?'
'Do they phone or come in person if theres a problem?'
The questions came like bullets until the nurse finally surrendered and agreed to put me in a wheelchair and take me to my baby.
Despite the anaesthetist having done an excellent job on the morphine front. The pain caused by the number of incisions necessary to deliver the baby safely had left me feeling more than a bit like humpty dumpty. (After the fall)
En-route to the NICU unit, this time as a mummy I didn't know what to expect. Would I be overwhelmed with love, pity or fear? Would I know how to respond to this tiny creature?
I glanced in through the glass like pains and there, in her make shift house lay my tiny Smidge. Curled up like a kitten she was holding on for dear life. At that time and still to this day the feeling that I felt for her was one of complete and total admiration and respect. What a strong soul you have I thought, to have come so far for all she has endured.
Soon after I made a promise. It was a silent promise but none the less a promise. I promised my Smidge that should she feel able to fight this battle that I would be behind her 100 percent, that she would walk no road alone, that I would make sure she never has anything less than the best possible care and that we, her family would take her in to our hearts and love her forever and ever, for better and for worse so long as we both shall live.