Planning for emergencies

Why it keeps happening is unexplained, but it does seem that we can expect it to keep happening.

After week of normality, I experienced another big bleed on Thursday night, in the middle of the night. I had been out for a lovely evening with friends and my husband had been in to London to see a band. He was home, I got up for a glass of water at about 01:30 am. We had a brief chat about what nice evenings we’d both had, and then, whoosh, I was covered in blood again.

We knew what we were supposed to do. I phoned the labour ward and explained the situation. They told us to come in. Since the bleed seemed to have stopped and there had been and was no pain whatsoever, I drove. Whilst my husband wasn’t drunk, he had had a couple of drinks during the evening, so driving would have been unwise. I specifically asked the duty midwife whether it would be OK for me to drive – had the advice been ‘no’, we would have taken a taxi.  I hasten to add that, at 28 weeks, I really don’t think its unreasonable to carry on with some kind of normality. However, under the circumstances of constant uncertainty, we have now reviewed this high risk ‘going out’ policy.

On the way to the hospital we saw an owl, which was pretty cool. But we were rather too preoccupied to really enjoy our Springwatch moment.

Upon arrival we were shown into the maternity triage area and I was treated to the usual procedures of monitoring, blood tests, cannulation, internal exam, showing people the contents of my underwear etc. This time we even got a scan. Was I in pain? No, except for the needles and intimate examinations. This, once again, didn’t seem to be the onset of early labour. Whilst we were being seen, another lady was brought in who was in labour. I think that this was the first time that my husband had ever heard someone in pain like that before (i.e. in real life, not how its portrayed on the telly). I think he found it really rather alarming.

By about 5, it had been agreed that rest and monitoring were the way to go, However, the labour ward was full, so we were put in a delivery suite for the remainder of the night. I had the bed, my husband had a beanbag on the floor. He commented that the beanbag was somewhat lacking in beans. We put this down to NHS cuts. (Bloody Tories!) I was also given an(other) anti-D injection due to my Rhesus -ive status. Apparently you can’t overdose someone on this, so I can expect another jab every time I’m in, as well as the routine one I’m getting next week from my midwife.

We got a couple of hours’ sleep and then were transferred to the Observation ward. This was a private room, which was nice. More monitoring, and baby continues to do well as far as heartbeat and movement are concerned. I was not being fed, which is of some concern, because that means that someone, somewhere thinks that surgery could still be on the table (so to speak). My husband went in search of food (he brought me back a croissant, but I had to wait to get permission to eat it). As we awaited the doctor’s rounds, we realised that we could overhear the phone calls being made at the desk just outside my room. The patient under discussion was me, and there seemed to be some degree of disbelief over the position of my placenta. The doctor doesn’t believe that my placenta praevia could have resolved so much between 20 and 27 weeks. This is consistent with what we were originally told; it might move, but it has a long way to go, so we shouldn’t hold out much hope of that happening. But, according to the scan last week, move it has. She’s not convinced and another scan is required. I am sent, by wheelchair, to radiography. It’s weird being wheeled around. i feel like a bit of a fraud, but I don’t have a choice.

The scan confirmed that the placenta has moved, and that everything is looking good. There was still no obvious bleed site, so, really we’re no further forward, except for confirming something that today’s consultant thought was unlikely, but which was, in fact, true.

After this, I was allowed to eat, and the staff on the observation ward arranged for me to be sent upstairs to the slightly less observationy communal ward. They just needed to check that the bleeding had stopped. I was happy to comply, and sat up, and Gush. The clock started again. I’m not going anywhere for 24 hours. On the plus side, I got to stay in the private room, which is good because I’ve just bled all over it.

Fortunately, the rest of that evening and night passed without further incident, although I did manage to get a couple of hours ‘off cannula’ in the evening. I got a new one before going to sleep, though. No-one wants to have to put in a new one in a midnight emergency. I was told by the evening doctor that no-one knows what keeps causing the bleeding, but that they’re going to treat it as if it is the placenta. Better safe than sorry. It’s a balancing act; as long as the baby is fine, they’ll leave it in as its far better off where it is. However, if the baby starts to become distressed, or growth doesn’t carry on as normal, it could mean that the placenta is failing, and then they’d take the baby out as, at that point, it would be better off in an incubator. Hopefully those things won’t happen, though.

Another morning, another doctor. The same ‘we don’t know so we’re going to be cautious’ message. It was the same doctor that we saw on Tuesday. No, it looks like I can’t keep away, lol. Actually, I do keep running into medical staff when I’m out and about (by which I mean walking between my bed and the toilet), and they greet me like old friends. I’ve been here too long.

So, my current instructions are to take it very seriously, keep as active as I can but don’t go too far from the hospital. I can go back to work (assuming that work will have me) as long as I come straight back to hospital if there is any further pain or blood or anything else that might cause concern. As long as my and the baby’s obs are good on the evening rounds, I will be free.

I spent the rest of the afternoon upstairs on the regular ward. The food, which has been good up until now, was rather hit and miss on Saturday and I got an egg salad sandwich in place of the ordered macaroni cheese, but I was hungry, so I ate it. Dinner took its sweet time, too, and by the time it arrived, I was laying flat so that they could listen to the baby’s heartbeat on the monitor. My husband had to spoon feed it to me in bit size chunks. As if this wasn’t a strange enough experience, at the same time the lady in the next bay, separated from me by a curtain went in to labour very quickly after her baby kicked her hard enough in the cervix to break her waters (she was overdue, so they were probably ready to go). Less than metre away, my husband was leaning over all the machines trying not to get ketchup on everything whilst this poor woman was begging for an epidural. It wasn’t funny really, but it was such an odd situation, that, whilst we and I were trying to be quiet and discrete, we were failing because we kept getting the giggles. You couldn’t make it up, but there is a comedy sketch in there somewhere.

I’m back home now, enjoying the comforts that that entails, hoping we don’t have to return to hospital anytime soon.

I need instructions for normal

We had our consultant appointment yesterday, and we have the all clear to carry on as normal. No bed rest or even house arrest, because apparently all this lying around might lead to blood clots in my legs and the risk of that is now greater than the risk of bringing on any further bleeds or, indeed, labour. On the subject of labour, given the shortened cervix, at 28 weeks we have been advised that the baby is pretty much ‘done’, if small, and, because it’s had the course of steroids, it would have a very good chance if it were to arrive early. It would have to go in an incubator, but it would be considered a better option to let nature take its course rather than try to delay things. The only reason that they would give treatment to delay things is if they needed to move me to a different hospital where there were available incubators.

BUT, all of this is ‘worst case scenario’, because there is every chance that I will carry this baby to term and have a totally normal, emergency free delivery at some point in June. This really is something to get my head around as we had had it in mind for the last 2 months that we would have a planned C-section at the end of May. I have not done any of the mental preparations that the books have been going on about, because I didn’t think it would apply to me. Being something of a control freak, I was quite comforted by the idea that we would go in to hospital at 36 weeks and come out a few days later with a bundle of joy. Job done. Not so straight forward anymore, but normal is good.

The consultant encourages me to take gentle exercise and go swimming, and to take regular stops to stretch my legs in long car journeys. My waking life is now to be treated as if I am on board a long-haul flight; support stockings are on my mind, if not yet on my legs.

My blood pressure was taken (still fine, at the low end), the bump was measured (ahead a little, but I expect that’s down to the growth promoting steroids), and the baby’s heart beat was listened to. We’re keeping the appointments at the end of April ‘just to be extra sure that things are still looking normal’, and we remain on the kind of alert that is normal for women in their third trimester (amazing to think we’ve made it this far!).

Back at home, and in the absence of anything proper to worry about, I decided to read my notes for the day. I was alarmed to see that, under the heading of ‘Hb’ the number 106 had been written. Heart beat of 106? Whose? Not mine! Mine is closer to 80bpm. The baby’s? Should be 140. It was 140 last week! What’s going on?! To add to the confusion, the 106 was written in a different hand writing and a different pen to the rest of the notes from yesterday. Underneath this, in yet more different handwriting, it says ‘x low hb’. This is even more alarming. My husband, upon studying the notes more carefully, notices that the box for ‘fetal heart’ is ticked, indicating that it was heard but not measured today. Looking back, it is this box, not ‘Hb’ where the numbers are usually written. I am reassured that we would still be in hospital if there were any real concerns. After all, they were very cautious with us last week, why suddenly become reckless now? It’s much more likely that I simply don’t understand the notes, he advises. I agree, and bow to my husband’s logic in this matter. Then I secretly google ‘decoding antenatal notes’ and discover that the code ‘Hb’ stands for IRON!!! Not heart beat. What an idiot! (To be fair, heart beat does seem reasonable… maybe I’m not supposed to understand the code?). I have low iron. I mentally note to eat some leafy dark green vegetables tomorrow.

With that panic firmly put to rest, I relax into my new status of ‘normal’ and look forward to remaining ‘normal’ for the next couple of months, at least. Then I awake at 4 am and, realising that I am now 28 weeks and am supposed to no ‘count the kicks’. Unable to get back to sleep, I start counting. I get 10 in 20 mins (apparently you should worry if you don’t feel 10 within 2 hours). More normal, more reassurance. I go back to sleep and have a very vivid dream about blood transfusions…. I think this might be my normal life, now… :)

48 hours on the labour ward

I am a walking life support machine. For the moment, this is my only and most important function. It’s a really big responsibility, and, on Tuesday of last week, it looked like I might be breaking down. The diagnosis at 22 weeks of placenta praevia (PP) meant that any spotting whatsoever had to be taken very, very seriously indeed. The issue with PP is that, if you get a bleed, it is usually a precursor to future, more significant and serious bleeds. These are caused by weakening or tears in the placenta, which, if they become worse, can cause it to stop functioning. To manage the risk to both mother and baby in the case of increasingly catastrophic bleed scenarios a decision is usually made, once a bleed gets to about a pints’ worth of loss, to perform an emergency c-section and put the baby in an incubator. The very grave warning to take my diagnosis of PP very seriously indeed was written all over my notes, but no spotting had manifested, and things seemed to be going very ‘normally’.

Until Tuesday of last week, when at 26.6 weeks, with a lack of pain that would almost have convinced me that I had experienced a failure of bladder, I found myself soaked in blood. I was asked for descriptions of how much several times on Tuesday evening, and the best I can do is to say that my underwear was soaked, but it didn’t hit the floor. This equates to about 30ml, apparently. Enough to raise all kinds of alarms.

I was at work, fortunately not teaching (it was the end of lunchtime), and I had gone out of my office to find a student from my tutor group whose birthday it was as I had bought a cupcake for him (a little tradition we have in our class), but had forgotten to give to him in tutor time. Not an especially strenuous activity. Having delivered the cake and birthday greetings, I felt that something was ‘not right’ and went to the toilet next to the school matron’s office. There, I found that I was soaked in blood. I had already given matron the number of the labour ward so that it would be on hand should anything happen such as this, given the PP diagnosis, and I asked her to call it, and an ambulance. I felt surreally calm; I had been warned that this might happen, and now it was happening, and so I had to deal with it. I phoned my husband. There is no way of not sounding alarmist when you tell your husband that, at just under 27 weeks pregnant, you have experienced a significant bleed and are awaiting ambulance transportation to hospital. The same can be said for telling your mother, too.

By the time I had spoken to the midwife at the 999 call centre about the details, the ambulance had arrived and the bleeding had subsided. It was a paramedic and car, rather than a full-blown ambulance, and my blood pressure etc. was taken. Having decided that I could be taken in the car, and after the laying down of an absorbent sheet on the passenger side, I was transferred to Stoke Mandeville labour ward. I was feeling, as usual, some discomfort under my ribs (totally unrelated muscular issue which I have been experiencing for a few weeks), and I kept reassuring the driver that the associated wincing and facial contortions were down to that, and that I was not going into labour in the car.

My husband arrived about 10 minutes after I did, and, from the look of him, was in a much worse state of shock than I was. I was seen and assessed quickly by a midwife who kept calling my husband ‘Dad’ which I could see he found confusing as its not yet a term of address that he has associated with himself. Having been poked and prodded by doctors, we were visited by a team of consultants, the most senior of whom informed me that ‘my maternity leave had just started’ and that I could ‘expect more and heavier bleeds’. I wasn’t going anywhere tonight.

I was installed on the labour ward and my husband dispatched to fetch the overnight bag which we really should have packed when we were given the original PP diagnosis. I was cannulated, given a fish and chip supper, a raspberry pudding and an incredibly painful steroid injection in the backside. My assessment of these developments; if you are in hospital and they cannulate you, you are not going anywhere. If they feed you, they are not anticipating operating on you immanently. If they give you a massive injection, it still has the potential to all get a bit serious. Steroid injections are given when there is a chance that a baby might need to be delivered early. These injections are given, 2, 24 hours apart, to assist with the development of the baby’s lungs in order that respiratory complications after birth are minimised. Better to have them and not need them than need them and not have them. They chuffin’ hurt, though.

Throughout these proceedings the baby was monitored and was active, healthy and apparently completely unbothered by the medical emergency in which is was involved. This was obviously very reassuring.

That night on the ward, I hardly slept and kept imagining that I would find myself covered in blood at any moment. That didn’t happen, though, and I was relieved to be fed again in the morning (so surgery still not immanent). I was told I would be scanned at lunchtime and my husband was going to return in time to accompany me to that. However, a slot became available at about 11am, so I went on my own. The news was good. The PP has resolved, the placenta iss now a good 2cm away from the cervix; a ‘safe’ distance. Even better, it showed no signs of damage or bleeding. In fact, where the bleed had come from was a mystery, with no obvious bleed site anywhere to be seen. The baby, meanwhile, continues to grow well, and seems active and healthy. In the absence of evidence of anything more sinister, the bleed has been attributed to a burst varicose vein. However, the sonographer noted that my cervix has become shortened (thankfully still closed), but this gives us something new to worry about. It seems that we have exchanged the PP diagnosis for the possibility of early labour. It’s less dramatic, but not the ‘normal’ prognosis that I was hoping for.

Back on the ward for a second night, I was fed again (yay!) and the cannula was removed. Red alert had officially been stood down. I still had to endure round two of the pain-tastic butt jabs, but, better done than not done. The consultant has said that the shortened cervix presents ‘no significant clinical concerns at this time’, and I have been released to laze about in my own bed. We have to go in and see another consultant on Tuesday afternoon to find out what the plan will be for the rest of this pregnancy – house rest, bed rest, carry on as normal etc. and I am, of course, on constant vigil for anything else untoward, which would require immediate return to hospital.

The only one who has been seemingly unaffected by all of this has been the baby, which, on Thursday morning gave myself and the duty midwife the proper run around (at 27 weeks, it still has plenty of room to change position) when they were trying to do its obs. It was being very uncooperative; it wouldn’t stay still and kept kicking the doppler probe. I had to literally chase it round my tummy with the machine for an hour and still we couldn’t get a good reading, although it was obvious to all that baby was alive and well in there. I guess that’s the price you pay for giving your baby steroids!

So now its just a case of waiting to see what happens next and hoping that its all normal and non-emergency in nature. Stay in there, baby, not too much longer to go!

…and a little bit of emotion came out

I’ve been thinking about things. The real-life reality is finally beginning to dawn on me that in about 11 or so week, a baby is coming to live in the house with us. I know, I catch on quick. Being pregnant, it seems, is one thing; I’m enjoying the lovely kicks and rolls (even in the middle of the night), I feel like my lungs are the size of a postage stamp, I no longer bend in the middle, I get a back ache whenever I try to do any work (apparently not sufficiently an excuse to actually not do any work), and, thanks to the placenta praevia, I’m not allowed to lift or shift anything except my own body, which is becoming increasingly difficult. Yesterday, it took me two attempts to stand up from a sofa. Yes, I had an audience. This is the day to day grind, and it’s fine, albeit uncomfortable.

I was reading a pregnancy book today and the chapter on week 25 provided a helpful list of baby clothes to buy (the essential ones, not the cute ones that make you make a high pitched noise when you see them). I suppose it is something to think about. I need to clear out a drawer for them, first. Perhaps I’ll leave it a bit longer. 10 more weeks, perhaps…? At the start of this pregnancy (actually since the first loss), I have been quite wary of reading ahead to the next developmental section of the book. I felt that, it was a bit fraudulent to think about what was happening whilst waiting for the next scan which may well confirm the worst. I used to read them retrospectively to find out what had happened, once we knew what was what on the inside. The kicks have eased this anxiety, and now I sometimes read a week ahead. But today’s ‘buy the baby some clothes’ shocker in the cheeky sneak peek at week 25 has accelerated my mind much farther into the future than I was anticipating.

Then, later, something even weirder happened. A very brave lady I know has just had her baby today (she has a similar story of recurrent miscarriage to me), and I have just seen a picture of her, and her new baby boy, on facebook. Amazing, gorgeous boy and proud, exhausted Mum. I’ve usually avoided this kind of thing because it was just too painful to see what I was missing out on (I never promised to have rational emotions), but I was very pleased to see this new arrival. And, something else, new, too. A strange realisation that, soon, that will be us. My nose has gone a bit tingly just thinking about it. My eyes might follow. What is this feeling? Emotional ice, melting. Barriers, softening.

Guess what… I’ve just realised… a baby is coming to live at our house… really soon… our baby.

If necessary use the emergency exit

I am happy to report that baby’s re-scan went well today. Spine and kidneys all present and correct. Baby was asleep when the scan started, but awake by the time it was over (well, so would you be if you were being prodded and poked and blasted with sound waves). Growth is on track, and he or she (we haven’t found out) seems perfect – and looks like a real baby (there is no reason for me to be surprised by this, but somehow I still am).

The less good news is that the placenta is really very low, and, although many low placentas do move up in later pregnancy, it seems that mine has quite a long way to go – 7 centimeters. We saw the consultant and he has officially given me the diagnosis of placenta praevia (http://www.nhs.uk/ipgmedia/National/Royal%20College%20of%20Obstetricians%20and%20Gynaecologists/assets/Alow-lyingplacentaafter20weeksknwonasplacentapraevia.pdf). He is already talking about a planned c-section at 36 weeks or so, which brings the EDD forward to the week of the 27th May. That’s almost a whole month! (!!!!!) I’m not too worried about that, per se, because it’s pretty much term, and they can give me injections to help accelerate the development of the lungs etc., so the baby will be able to manage. To be honest, I just want it to be OK, so I’ll take whatever advice I need to take to achieve that. I don’t think I’ll feel any ‘less of a woman’ if it ends up coming out through the sun roof. It’s not about me, it’s about getting this baby healthily into the world, whatever it takes. I’d rather avoid hospital scares along the way, but I’ll do what I need to do to achieve that objective.

We’ll be scanned again at 32 weeks to see what’s happening and I expect the final decision will be made then. Assuming, that is, that nothing untoward happens in the mean time; we are on alert to go straight to the Labour Ward if there is any spotting of any kind, where I’ll me monitored for 48 hours to check it isn’t a more serious bleed. But hopefully nothing like that will happen. (Please don’t let anything like that happen!).

Apparently, the risk factors (that could possibly affect me – given that I am not a smoker or a cocaine user, I can rule those out as possible causes!) are age (a factor at 38) and previous c-sections (no) and ERPCs (4 + 2 hysteroscopies, including the surgical removal of a septum). Has my surgical history caused this placenta to mis-grow? Even if it has, there’s nothing I can do about it now.

Wish us luck for an incident free path through the next 3-4 months, and getting baby safely into the world in either June or May. Whatever it takes.

A look inside

This week has been a week of scans.The letter that invites us to the routine 20 week anomaly scan is really quite a scary read. It lists a range of unpleasant things that could be missing or damaged with your baby, and the percentage chance of them being detected. (If they are present is what the letter doesn’t say). The wording is alarmingly ambiguous, making you wonder, on first reading, what the chances are that your baby might have all of the unfortunate conditions listed. An addition of the sentence ‘These conditions are rare, however, if present, these are the percentage chances of your sonographer being able to visually detect them’ would make it read slightly better.

My nerves for this scan had been building for some days, but the reassuring kicks helped me to think that things would probably be OK; nothing that wriggles about this much could be poorly. If this optimism sounds like the prelude to the revelation of some terribly sad news, don’t worry. It turns out there’s a little person in there, with two arms and two legs (with reassuringly average length thigh bones). Parts of the developing brain are picked out and measured; all present and correct, head looks normal, as does the face, and it all seems to be proportional, size wise. Abdomen, also fine, with stomach and bladder clearly visible. All four chambers of the heart are busily pumping away and eventually a good enough still image is taken for our records. But, for all it’s wiggling and kicking, this baby doesn’t want to turn around. I am sent to go for a wee in the hope that my moving will encourage baby to move, but it doesn’t. So, whilst we’ve seen the spine, the image wasn’t sufficiently clear to complete the scan report, and the kidneys also need a closer look, so we’re back in 2 weeks for another scan. The placenta also seems to be lying a little low, and although it will probably correct itself, we are also going to need to be re-scanned at 32 weeks just to make sure it’s moved. If it hasn’t we’ll be looking at a sun roof delivery. But that’s ages away.

The extra scan isn’t a problem; I’ll be on half term so no need to ask for more time off work (which isn’t a problem in itself; work are being great), and we were due back in to see the consultant on that day, anyway. The administrative dis-communication with appointments this week and last has been quite special. Last week I was offered an appointment at High Wycombe hospital to see the obstetrics consultant. This would have been the day before the scan, which was going to be at Stoke Mandeville. I was able to make the swap between hospitals to see a different obstetrics consultant, but for 2 weeks time, and now we have been able to organise the repeat scan for the same day as the consultant appointment, too, so it all seems to have worked out.

The other bit of me that’s needed to be scanned this week is my armpit. One of my boobs (which which are going for some sort of world record) has grown into my left armpit, and is a bit lumpy and sore. It’s been like it for years, but it’s got worse since I’ve been pregnant, so I’ve been sent along to the Wycombe breast clinic to get it checked out. The appointment I was allocated? Within 10 minutes of the scan appointment at Stoke Madeville on the same day. They were happy to change it, but I do think that some kind of patient records information system would have been useful here. The breast clinic is excellent, and I was scanned, seen and reassured in one afternoon. They were running late, and I was there for a few hours, but it was OK. Better that than some other kind of bad news.

So, happy mummy, happy (stubborn) baby. And we get two bonus sneak peeks. Meanwhile, I’m still getting kicked, and, since most of the kicks are on the left hand side, I’m guessing baby is still pretty comfortable where he or she is.

When getting a good kicking feels like a good thing

It’s funny, I never thought I’d get this far; 18 weeks. Having been obliged to ditch my regular wardrobe a week after returning to work after the Christmas holidays, I’ve had to start making maternity style choices. This is exciting (I’ve been a bit of a wardrobe raider, which is great fun. Since almost all of my friends have already had their children, they’re very happy to have someone take those bulky bags of pre-loved clothes away!). It has also been somewhat frustrating (I want to exercise outdoors but all the maternity joggers that I can find are jersey style cloth meaning I’ll get cold and wet if I try it).

Speaking of exercise, the pregnancy recommendations are a mine field of don’t get too hot, don’t get too cold, don’t get thirsty, don’t exercise ‘on empty’, don’t lie on your back, don’t lie on your front, don’t do anything you can fall off, or over, or up. All very sensible. Believe me when I say that I don’t want to take any risks; I’m not complaining about the advice to keep safe, but the fact is that all of these safety instructions seem to add up to don’t exercise, and the advice (and I do want to take it) is definitely do exercise. As it is, I can no longer put my outdoor exercise trousers on, so it’s a moot point. I’ve been going swimming instead.

There is one thing that I am really enjoying, and that’s feeling the baby move. Its, quite simply, magical. I am not writing this to be smug (although I’m aware that I probably am being a little bit smug). I’m writing it for the record so that when I’m being woken up because I’m being kicked in the ribs or the bladder I can read this and remember how I feel about it now.

So, I’m doing well and getting my head round the idea that this might actually happen this time. I’m the subject of school gossip, in the nicest possible way. My class gave me a round of applause! People are congratulating me without being told I’m pregnant by me.

20 week scan next week – the anxiety is beginning to creep in… have I relaxed too much, got too confident? Fingers and toes crossed for the next milestone, and in the meantime, I’m enjoying getting a good kicking.

Telling people

Written 20th December, 2014.

We’ve finally reached the part of this journey where society says we can let people know what’s going on. Thanks for the green light, world! On Tuesday we had our 12 week scan, and baby is literally alive and kicking (fidgeting, he says). It’s growing fast, too, and we’re now 12.6 when we thought we were 12.4 (which was advanced from being 11.4 when we thought we were 11.1). The NT measurement is 1.4 and, whilst we still await the blood test results, we are beginning to consider starting to think about possibly relaxing. A little bit. Maybe. PHEW! I have a photo, but I won’t post it here. I’m still in such a state that I find it hard to see other people’s photos, and given my ‘readership’, I just don’t think it’s appropriate to post such an image here. We’ve even booked a 20 week scan, which seems extraordinarily confident. I’ve been asked what we call it. No pet names just yet. We call it “assuming all is…”, “if everything…”. We’ll have to do better than that, but not until we’re ready.

There are lots of reasons why I really disagree with this socially mandated tradition of waiting to 12 weeks before telling people you’re pregnant. It’s a way avoiding embarrassing conversations in which you have to ‘un-tell’ people you’re pregnant because your baby has died (miscarriage makes people so uncomfortable – poor them), but I do understand that these are horrible conversations, and women may genuinely want to grieve in private. But, and this is my main objection, the people who are affected my miscarriage are grieving. This is a legitimate human emotional process and it does people damage to bury it. Grieving means that sometimes people experiencing it get emotional angry and withdrawn (and a whole range of other perfectly normal grief responses), and they need support and understanding They don’t need socially imposed secrecy and shame. This, if they’re keeping the pregnancy and then miscarriage a secret, is support they don’t always get. I think this a cruel and wrong. I’ve been lucky to have so many wonderful friends and family around me to give support, but I know lots of women who have kept everything secret and suffered alone. And this says nothing of the partners who’s emotional needs are often even more neglected. Still, at least no-one’s made a social faux pas.

That said, people do say some really weird things to women who have miscarried and some of those are down right offensive (it wasn’t really a baby yet etc.). On balance, however, I think that this is a consequence of people not really knowing what to say. Maybe if everyone was more open, people would get better at not putting their foot in it. So I stand by my original point.

I want to write, however, about another delicate problem, the weight of which I feel very acutely, and to which I don’t really have a solution. This is the problem of telling people who will be upset by the news. Having been on this road for over 3 years, I know lots of people who are in similar situations. I know (because I’ve been there – and if you follow my blog, you’ll have seen the messy outpourings of grief that follow other people’s pregnancy announcements) how devastating Other People’s News can be. It’s not selfishness, it’s self preservation mixed with varying degrees of Post Traumatic Shock and (guess what?!) stifled grief (from all of that not-telling you did to stop people from being uncomfortable when you had your miscarriage). That’s really damaging, and it makes me feel really sad that friends of mine are going though it. It makes me even sadder that, now, I am the cause of this kind of upset to these friends. I’m sorry.

I want to show these friends of mine that I have enough respect for them that I don’t announce in public places where they can’t get away from a social situation, but it also feels like such a breach of trust to call or email someone and bring such upset and anguish into their home, their safe space. It’s such an intrusion. Even writing these blogs caused me to really think about who might see and be upset by them. All I can really say is that I am sorry, and I do get it. I used to feel the same. I hope it will happen for them soon, too.

Risk

Written 13th December, 2014.

Last Tuesday we had what Professor Brosens described as a ‘highly reassuring’ scan. We are now over 11.4 weeks and the baby was leaping and dancing about, kicking and hiccoughing. As I commented to the consultant who scanned me, we’ve never seen one that big before. Every good scan means that it is just a little bit more likely to happen this time. The odds are, as you might say, increasingly are in our favour. But can we relax? Of course not.

Next Tuesday afternoon is The Scan. The Big One. 12 weeks. And we’ve been there before, and it was not a happy experience. Although we’re beginning to turn our minds to the possibility of there being a chicken, we’re still not quite ready to actually count it.

The 12 week scan comes with tests (http://www.nhs.uk/conditions/pregnancy-and-baby/pages/screening-amniocentesis-downs-syndrome.aspx#close) which we both (think we) want (great if the results are good) and don’t want (what if they’re bad?). The consultant gave us a bit of a talking to to ensure the implications of getting those test results. We have been through so much already. Have we considered what the possibility of high risk results might mean for us? She hastily assured us that she had not noticed anything on the scan that made her mention it, in particular, but that she felt that too many people have the standard tests without really thinking carefully about the implications of the results. The first thing to do is to realise that risk is not diagnosis. Lots of people, apparently, don’t understand the difference. So a risk of 1:150 is considered ‘high’, but, of that, it means that 1 baby in 150 with those results would have a condition such as Down’s Syndrome. 149 babies would be fine. It’s still pretty scary, though. We’ve been through so much to get to this point. Would we make a choice to end it? No. I don’t believe that I would even consent to further invasive tests like amniocentesis because of the 1% risk of miscarriage. But I think that knowledge is better than no knowledge, so we plan to go ahead with the screenig next week.

The odds are in our favour (mostly – they were more in our favour three years ago when we set out on this journey, but what can you do about time?). How much more can we take? Could we ever do it again, even if it works out? We always thought we’d have more than one child, but it’s been such a a struggle to get to this point, and I’m not getting any younger, and the risks will only increase.

And I know too many stories. My own sad ones, and the sad heartbreak of other women whom have been kind enough to support me on this journey. You think what I’ve been through is bad? I know stories of recurrent miscarriage that break my heart and chill my blood. No-one can keep their innocence about pregnancy after this.

At the end of The Lord of the Rings: Return of the King (the film, sorry, not got my literary hat on this morning!), Frodo says: “How do you pick up the threads of an old life? How do you go on, when in your heart you begin to understand there is no going back? There are some things time cannot mend. Some hurts that go too deep that have taken hold.” We did go back and are in the midst of having another go, but how many times can anyone do this? What has happened to us will stay with us forever. It has made us, in a really fundamental way, different than we would otherwise have been. What’s the cost? ££££ on counselling and cognitive hypnotherapy to try to repair the damage done by post traumatic medical shock. I still can’t look at other people’s 12 week scans on facebook. I think I could be The Old Woman Who Lived In A Shoe, with so many children I didn’t know what to do, and a babybomb scan photo would still turn my blood to ice. This is a terrible learned behavour. I feel sad that I seem to be stuck with it.

What else can I say? Wish us all luck for Tuesday.