Pregnancy after preemie (part 2); that leap of faith.

Our daughter Edie was born in February 2017. She was born 17 weeks early, before viability, at 23 weeks’ gestation.  She weighed 580 grams.  Her arrival came out of nowhere; it was a complete shock.  She was born in very poor condition and wasn’t expected to survive.  She fought the most brutal of battles at NICU, suffering a long list of serious health issues and was so sick at one point that we were asked to consider the discontinuation of her care.  It was the worst time of our lives as a family.  It’s changed who we are as people and it’s something that we’ll never truly put behind us.  

At NICU we were asked to make impossible decisions.  We looked on helplessly as she clung on to life by a thread, struggling to breathe (even when in receipt of a ventilator’s full capability) and in a great deal of pain.  We were presented with daily issues that were a serious threat to her life, and this went on for months.  The fear and worry was all consuming.  It was a beating; it was brutal; it was relentless.  But with Edie’s unwavering strength and determination, along with the care of the best professionals, treatment, and what still seems to me like a little bit of magic, she came home to us after 109 days at NICU.   

Edie in ICU at 3 weeks old, with Eddie the octopus. She was ventilated and was in receipt of her 1st long course of steroids to mature her lungs. Here, she had just defeated sepsis, was still battling pneumonia and a bleed on her brain, amongst many other issues.

Edie’s about to turn four years old and has no ongoing health issues.  She’s a bright, highly spirited, headstrong little girl.  She’s just like any other healthy child her age, which at one point seemed impossible; like something that could happen only in our wildest dreams.  The blessing of today’s normality is not lost on us.  

Our beautiful Edie, today at 4 years old. Healthy, happy and bright.

You can probably imagine that it wasn’t an easy decision to have another baby.  Initially we said never again, but to my surprise the desire to have another came to me, and stayed.  We met with a consultant obstetrician in October 2017 who seemed confident that her department could assist me to a full term pregnancy (if necessary) and as a result we both felt more positive and confident about doing it again.

We didn’t start trying to conceive immediately.  Edie was only 7 months old at the time of our meeting with the consultant and had only been home with us for three months.  Lookingback, I’m surprised that we could think about another baby so quickly after such trauma.  I’m even more surprised by how I was so motivated to arrange a meeting.  It was partly because it felt like Edie had been home with us forever.  She had consumed every inch of our being since the day she was born, so at this point in time it was difficult to remember life before her.  She fitted in with us perfectly and we slipped into our new way of life with relative ease, considering.  But the main factor in our desire to get on with baby number 2 was our age.  We were in our late thirties and felt we didn’t have a great deal of time to waste.  If we were in a position to have another baby, we needed to know in order to plan.  If it wasn’t in the cards for us we needed to know that too.  We were more than happy with our miracle girl; we felt blessed, but we needed to know whether my being pregnant again would be a sensible option for us because if not, we wanted to think about adoption.  

We touched on the topic of adoption a number of times beforeour meeting with the obstetrician, and afterwards.  The conversation was mainly driven by my husband, Dave.  He was happy to bypass the potential drama and heartache that could come with another pregnancy and jump straight into the adoption process.  He worried a great deal about the possibility of another preterm birth and about the possible risks to me (my life being at risk was discussed at one point during my labour with Edie).  I was also concerned of course,and adoption was something I was absolutely willing to consider but before I did, I wanted to know for sure that doctors would advise against my getting pregnant again.  My desire for Edie to have a sibling was very strong but my desire to carry another baby was strong too.  I missed out on so much that pregnancy has to offer.  I never made it to the third trimester, experiencing all the miracles it brings; I never packed a hospital bag and Dave never got to cut the baby’s cord.  It took us a long time to conceive Edie.  She was a much wanted baby, so missing out felt particularly bitter.  The length of time it had taken us to conceive was another reason we felt we had no time to waste in trying for another baby.

After our meeting with the consultant there was no immediate “right, ok, we’re doing this”, but we both knew it wouldn’t be long before we did.  We carried on enjoying our life as a new three.  We wanted to make memories and to enjoy Edie; finally.  We celebrated her first Christmas in 2017 with Dave’s family and for her first birthday we threw a huge party.  I think of that party now with such emotion.  Friends and family travelled far and wide to make it.  It was a coming together of people who had worried a great deal for us, who care for us and who were at that point truly happy to celebrate the birthday of a little girl, who everyone, in no uncertain terms knew to be a warrior.  We holidayed domestically in Pembrokeshire, we cruised around the Mediterranean, and again around the Caribbean, and we enjoyed being with friends and family and making our own little traditions. 

Through our conception journey my health has always been a significant factor.  I have a number of autoimmune diseases,and after Edie’s NICU discharge, my doctor thought I should be re administered a drug called methotrexate.  I had taken methotrexate before to treat rheumatoid and psoriatic arthritis.  When pregnant with Edie I hoped my disease would go into remission as it often does during pregnancy but the remission never came.  If anything the disease was highly active.  I was in a lot of pain.  Methotrexate is not safe to take in pregnancy.  It can cause birth defects in the foetus and miscarriage.  It’s a heavy duty drug that requires close monitoring and in addition to treating various autoimmune diseases, it’s used to treat some cancers.  It’s a slow release drug that stays in your system for a substantial amount of time, therefore men and women who take it are advised to stop doing so at least 6 months before trying to conceive, as I did when trying to conceive Edie.  It took us three and a half years to get pregnant with Edie and so for that time I lived without the drug best suited to keep me well; plus the additional sixmonths before trying to get pregnant.  By the time I got pregnant, I was ok but I wasn’t in the best of health.  I had been administered a substitute drug that was safe to take in pregnancy but it was less effective than methotrexate and thathad begun to tell on me.  I’ve put my body through a lot to have my children.  It’s been a sacrifice.  

After being re-administered methotrexate in July 2018, the skin on my face became very sore.  It looked burned in parts,so my monitoring nurse decided to discontinue the drug.  That’s the thing with methotrexate; it works wonders for many people but it’s a toxic drug that can cause a number of nasty side effects.  There have been times when I have been floored by the side effects and have wondered whether taking the drug is worth it.  I always conclude that it is.  It was at this point that Dave and I said, “Ok, this is the time to do it.”  It was that open window.  We don’t have the luxury of trying for a baby whenever we please; not with my being dependent on medication that’s not recommended for pregnancy; especially when the medication comes with lengthy treatment plans.  We knew we had to control our path before the consultant chose a different one for us.  If I got used to another treatment plan she’d put together, I might have gotten used to feeling better and it’d be hard to stop it.  

I was six months methotrexate free at the end of January 2019, a few days before Edie’s second birthday and I was eager to make a start; but another hurdle was placed in front of us.  After speaking with a doctor, she advised that we should hold off trying for a baby for four more months because we had recently visited the Caribbean, leaving our pregnancy at risk of the Zika virus.  The Zika virus is a cause of microcephaly, a birth defect where the baby’s head is smaller than expected.  Babies with microcephaly often have smaller brains that might not have developed properly.  We were aware of the connection between the Zika virus and the Caribbean but it had slipped our minds, so it was a surprise when she brought it up.  I wouldn’t have ignored the medical advice but I must admit I was bitterly disappointed having to delay things even further.  A ten month delay had occurred before we were able to start trying to conceive again and I was frustrated and concerned because of our previous conception problems.    

By the end of August 2019 I was pregnant and very happy.  We told our immediate families at the earliest opportunity and asked them to keep it a secret.  Some people’s reactions surprised me.  My father’s did the most.  My father’s never found it easy to express his emotions.  We have a great dad whose love for us we’ve never questioned.  It’s clear.  But verbalising his emotions is difficult for him.  I’m the same.  I remember the journey to my parents’ house; I couldn’t get there quickly enough.  I was practically jerking the car forward with my body to hurry it along.  I couldn’t wait to see the looks on their faces.  We walked into the house and I gave Edie the pregnancy test to hand to my mother.  The look on my mother’s face was priceless.  She stood there wide eyed and open mouthed.  She was smiling.  Dave and I were stood at the kitchen door and my father had his back to us, preparing food.  He turned around quickly to say hello, then carried on.  My mother, who hadn’t yet said anything, winked at us, tapped him on the shoulder and handed him the pregnancy test.  I waited with baited breath for his reaction but it was not at all what I expected.  He looked at it; registered what it was;and in an unenthusiastic manner, said, “Again?” He turned back around to the food and said no more.  I laughed in an attempt to convince everyone he was joking but I was surprised and embarrassed.  Realising that more would have been expected of him, he managed to muster an “Aah”.  He wasn’t trying to hurt our feelings.  His reaction was involuntary.  He was surprised.    

I’d only told my mother and sister we were trying again. Most people we knew would have probably concluded we’d drawn the line at Edie, given what had happened before.  I never told anyone else because I didn’t want to be put off, see surprised looks or hear as much as a negative tone in anyone’s voice.  We had made our decision but it didn’t mean that making it was easy or that we were sure we were doing the right thing.  So to protect our confidence I chose to keep most people in the dark until a pregnancy occurred.  The truth was I was worried what other people may have thought of me, choosing to do it again.  I worried that they’d think I was selfish.  Worse: that I was a selfish mother: someone who was willing to put her future child’s life at risk just to be able to experience the things she missed out on the first time around.  There was far more too it of course.  I don’t usually care what people think of me; I’ve always been the same; but if I feel there may be an element of truth to it, then the thoughts of others affect me.  And I did battle with the belief that part of me was being selfish.  

In order to establish whether I was mentally ready to be pregnant again, a doctor arranged for me to receive counselling.  She recognised I had gone through a trauma and felt it would be a sensible thing to do before travelling a path that had previously caused me a lot of fear and heartache.  I had one session.  I found it helpful but I’m in tune with my thoughts and feelings and knew I was doing well mentally and would probably stay that way.  However, I agreed to go because I wanted to ensure I had covered all bases before getting pregnant again.  We had spoken to a consultant regarding the physical aspect of a future pregnancy and I wanted to ensure that the mental aspect had been assessed too.  (I mentioned in my previous blog that our decision to have another child was an informed one and that making it wasn’t done lightly.)  

I expressed my concern to the counsellor, that people would think I was selfish.  She explained that I could do little to change what other people thought of me, that their views didn’t matter and that it should have no bearing on what I chose to do with my life.  I already knew this of course, but hearing her say it was a bit of ‘eureka’ moment.  It’s interesting though; almost everyone we told about the pregnancy seemed thrilled for us but the only reaction I remember (in addition to my father’s) was someone’s response of “Are you mental?”  The person who said it was joking, but it bothered me because part of me wondered the same thing.  

Going back to my father’s reaction that day … when my mother realised I was disappointed, she brought the topic up to me privately.  She said, “He’s just worried about you, that’sall.”  She said, “When I asked him what was wrong, he said, I just hope she’s going to be alright this time.”  I understoodand knew he acted that way because he was worried.  I understand a person can be so concerned that they can’t hide it; but it shocked me that my father couldn’t on this occasion,because it’s what my dad does.  I didn’t hold his reaction to our happy news against him.  Our family went through hell when Edie was born.  He was right to be scared.  He had the worry of a grandchild being born prematurely and the added worry of his daughter becoming ill too or possibly broken hearted. It didn’t take him long to shake it off and be happy to get on board.

I was surprisingly calm throughout my second pregnancy, for the most part.  It was as if I knew deep down that everything was going to be ok this time.  It was like a sixth sense; a feeling I had.  But when you’ve been as traumatised by pregnancy and childbirth as I have, the ‘Ghost of NICU Past’ will always live quite comfortably underneath the surface of your skin, choosing to pay you a visit from time to time. When you’ve gone through NICU, it’s impossible not to have a ghost; even if it doesn’t show up often.  I felt physically differently during my second pregnancy.  I felt well.  It was as though this baby was perhaps more compatible with me; with my makeup.  My disease was practically in remission.  It was probably the best I’d felt in years.

We’ve always been cautious in pregnancy; even before heart ache struck.  We didn’t tell many people I was pregnant with Edie until the 20 week anomaly ultrasound.  Once we knew Edie was well at the 20th week, we finally allowed ourselves to become excited.  All seemed perfect at the 20 week scan, yet she was born two and a half weeks later.  It came out of nowhere, so you can imagine the shock at that time and how guarded we became throughout the second pregnancy.  It was strange; we were guarded the second time around but still calm (mostly) and able to feel happiness within the pregnancy.  We, on some level, had accepted the possibility of turmoilbecause it had been our norm.  It was such a shame our past had made us this way.      

Before my second pregnancy, a letter had been written by a consultant obstetrician, and kept on file, stating that if I became pregnant again, I should be seen by a consultant and be in receipt of a care plan as close to 12 weeks of pregnancyas possible.  I almost memorised the content of the letter word for word.  As requested I contacted my GP surgery at 8 weeks pregnant, to set up my booking in appointment with the community midwife.  I reached 9 weeks of pregnancy and I hadn’t heard from her.  With the obstetrician’s letter in my head and my 12th week getting closer, I became concerned andcontacted the surgery again to prompt the midwife to call me back.  She was very nice when we spoke but she seemed casual about it all and this made me anxious.  I wouldn’t normally feel anxious as I’m very laid back, but the demons of my past were lurking.  I explained my past situation to her and we booked an appointment for the following week (10 weeks pregnant).  I wasn’t happy about it but I accepted it.  Then I received a text message informing me that the appointment had been rearranged to the following week.  The new date was provided without any discussion about whether I could attend and my stress levels started to build.  I’m aware nothing can be done to save a pregnancy prior to 12 weeks but that wasn’t why I was eager to see the midwife.

I was eager because at the rate things were going I wasn’t going to be seen by a consultant within the timeframe set out in the letter.  If I was still pregnant at 12 weeks, I would be carrying a viable embryo that I could go on to lose, not necessarily because there was anything wrong with the embryo but because there could be something wrong with me as its host.  There was a chance my cervix would “malfunction”, so I needed the care plan in place as early aspossible to increase the chances of maintaining a safe environment for my baby.  I wasn’t able to speak directly with the community midwife over the phone.  I was only able to reach receptionists who told me they knew little about her schedule or how I could get hold of her because she operated independently of the surgery and only used a room there.  The new appointment would take me to 11 weeks of pregnancy; so it was unlikely I’d have my booking-in appointment at the hospital by 12 weeks.  I certainly wouldn’t be handed over to a consultant to start any necessary treatment and monitoringby that time.  I was trying not to get stressed because stress can be harmful in pregnancy, but when you’re vulnerable in pregnancy like I am, without knowing why, being stressed is a particular worry.  I was persistent in trying to get hold of the midwife, though, and this eventually got me an earlierappointment with the community midwife and at 13 weeks pregnant I had my booking-in appointment at the hospital.  

I felt calmer in the days before my booking in appointment at the hospital because I was getting closer to those doors; but whilst at the appointment I found myself in another frustrating situation.  I remember sitting on the seats outside the sonographer’s door, watching all the midwives rushing by, carrying folders and calling out names.  I looked at the parents waiting as we were and I wondered about them.  I wondered what sex their babies would be; I wondered if they had other children and if all would continue to go well with their pregnancies.  I hated that my past had programmed me into being aware that things may not develop smoothly.  They had all reached 12 weeks of pregnancy, where the chance of miscarriage drops, and yet I was still so distrusting of the whole process.  The truth is, when you’ve been exposed to a NICU you’ll never escape what you’ve learned there, and you learn a lot.  

I lay down on the sonographer’s bed and the common apprehensions came to me.  I asked myself, “Will there be a heartbeat?  Will everything look ok?”  Dave did what he didwhen attending Edie’s scans; he sat there with saucers for eyes, looking petrified, while pinching the skin on his neck.  He does that when he’s nervous.  He does not enjoy ultrasounds one bit.  For Dave, they are not the exciting, romantic occasions they are for many men.  They are a formality; a way of clarifying all is well so we can move on. He’s the same with labour too.  The sonographer was a very nice young man called Lewis, but unbeknown to me, seeing Lewis was a major trigger; a big shock; and this did not help remedy the common anxieties that occur when laying down for the 12 week scan.  You see, Lewis was the sonographer who conducted the scan when I was pregnant with Edie, seemingly losing her at 23 plus weeks plus 2 days’ gestation.  He had confirmed that my amniotic sac was a mere 0.5 centimetres away from the opening of my cervix and that an emergency cervical stitch to try and keep the baby in couldn’t be inserted.  Our one shot was a no go and this news literally killed our dreams.  The concern on his face while seeing what he saw that day will both haunt and move me forever.  It’s sometimes surprising to see a complete stranger genuinely upset for you, even when you know you’d feel the same for them.  Lewis wouldn’t have remembered us but I’ll never forget his face, and the second he called, “Nicola, please” this time around, my heart stood still.

Our second baby made Lewis work hard for his money, and it took him two days to complete the 12 week scan.  Edie was the same and Dave whispered to me “why are our children such a pain in the arse?” It made me laugh.  Lewis was pushing extremely hard on my stomach with the ultrasound probe: not harder than he was meant to, but after two hours with a lot of pressure on my abdomen, I felt bruised.  I was nervous about going again the next day because I knew it would feel worse.  I hinted about my stomach being sore, hoping that he hadn’t realised how hard he was pushing but he was well aware and said, “I know, I’m sorry.  I just really need to get this.”  It made me realise, though, that I didn’t need to be as concerned as I had been about Edie’s little elbows and knees poking me in my pregnant stomach.  I used to worry that they were causing the baby harm but there was little I could do about it.  I could hardly stay away from my two year old daughter for 9 months.  “Ok Nicola, I’m really sorry about this but I just can’t get what I need today, so I’m afraid you’ll have to come back tomorrow.”  I was happy to do two trips but it did make me feel uneasy that I had to wait another day to be told all was ok … or not.  Lewis told me he thought everything looked good but he needed a little more information before being able to give me that completeassurance.  

“My cervix looks ok though does it?  It looks closed?” I asked.  He looked confused.  I expected him to know what I was talking about but he didn’t.  I continued, saying, “There’s a letter that’s been added to my file advising that I should receive cervical length scans from as early as 12 weeks”. I expected this information to have been passed to him and I wondered what the point of the letter was if it wasn’t somehow put into the hands of those dealing with me at my booking-in appointment.  So I did what I did many times that afternoon and what I have done on countless occasions throughout my ongoing hospital life … I filled in the blanks; became the link between departments; became responsible for my own wellbeing; and on this occasion, for my baby’s too.  “Oh I don’t know,” he said.  “’I’ve only been told I’m doing a routine dating scan.”  I went into the whole thing.  I explained about the letter, what had happened with Edie, and why it was incredibly important to check my cervical length from 12 weeks.  During my last pregnancy I had unknowingly beenwalking around with an open cervix.  I didn’t know until it was too late and the consequences were a devastating threat to my daughter’s life.  My cervix could have already been openat this scan with Lewis and I couldn’t have rested for the weeks that’d follow until somebody told me it wasn’t.  I appreciated that staff were rushed off their feet but that wouldhave been no consolation to me if something bad but preventable had happened to my pregnancy.  This was my life and I found myself angry that Lewis hadn’t been informed about my needing a cervical length scan.  

He carried out the cervical length scan but he did it out of the kindness of his heart.  He explained that my cervix looked closed and I was relieved and explained what it meant to us to receive that information.  I was glad to have him deal with me.

After the scan with Lewis, I sat and waited for my routinebooking-in appointment with a hospital midwife.  “Right, so let’s see if you will be consultant or midwife led,” she said.  “I’ll be consultant led,” I said, “because my daughter was born at 23 weeks, we don’t know why and I was consultant led last time because I have autoimmune diseases.  It’s been instructed that I’ll be seen regularly by a consultant this time,” I said. “Ok,” she said, looking confused.  “Well let’s go through everything and have a look.”  She started doing her bits and pieces and eventually she confirmed I’d be consultant led.  She said, “So … you won’t necessarily be seen regularly; you’ll be seen by a consultant at …” and I thought, “Oh hell no!”  She was very nice but she wasn’t getting it; the seriousness of it all; and once again she knew nothing about what had been previously advised, so I interrupted.  I was polite but I wasn’t having any of it.  If memory serves, I think she said I wouldn’t ordinarily see a consultant until 27 weeks’gestation, but I’m not certain.  With or without the letter/plan, I wasn’t going to accept seeing a consultant occasionally when I had given birth at 23 weeks in my previous pregnancy.  “There’s a letter written by a consultant.  Isn’t it in the file you have there?” I said.  “No this is a new file that I’ll be making up today,” she said.  “Ok, well what about the file from my last pregnancy?  Isn’t that here?  Won’t you need to look at that for information?”  I asked.  “In case there’s anything I’ve forgotten to mention or may not even know about?” “No,” she said. “We don’t refer to files from past pregnancies.  This is a separate pregnancy with a separate file.”  Frankly; I thought that was ludicrous.  “Right,” I said.  “So you need to find this letter because it’s got a lot of information in it.”  I started to wonder if I had imagined a phantom letter and began to question myself.  When we were alone Dave reminded me that I should never question myself when it comes to situations like this.  “You’re always spot on”, he said.  “Your little database doesn’t falter.”  It made me laugh.  “So you’ll need to find that letter,” I said to the midwife.  “But I don’t know where I’d find it,” she said.  A little narked, I said, “Well, type my name into the system and see what happens … or my hospital number.”  It really wasn’t rocket science, I felt.  It seemed so obvious to me that I wondered whether she wanted to find it; but in her defence I was frustrated.  I was tired of having to keep going through the whole thing over and over again. I was getting stressed about being stressed, and that made me angry. I understand that sometimes stress is unavoidable but I felt this was an avoidable case.  How did no-one know what I was talking about? I didn’t walk through the hospital expecting everyone to know who I was; I’m aware I’m not a celebrity; but what was the point in a care plan being put together if no one was going to know where to find it; or more importantly; knowthat they should be looking for it?  I got to thinking about those patients who are not as persistent as me; who are not as confident to speak up; or who do not have the capacity to remember, relay and fill in the gaps as I did that day, and I wondered what happens to them.  

She typed in my hospital number and said, “Ah, there it is!  Got it;” and the relief oozed from my pores.  She began reading the letter and it was almost word for word what I had said.  “I’d like to see Nicola from week 12 of her pregnancy.  I’d like her to take aspirin from the 12th week and progesterone at week 16.” “Well we’re too late for that now, we’re already at week 13,” she said to herself.  And I wanted to scream “Oh my God! I know!  This is what I’ve been trying to say.”  The tone of the letter was serious, as I remembered,and I hadn’t been able to make people see that and that vexed me terribly.  I wasn’t satisfied that my first consultant appointment was at 16 weeks of pregnancy when it should have been at week 12 but I had to accept it. 

Once I managed to break through the bureaucracy barrier, I was very happy with my care.  Everyone who dealt with mewas fantastic but I feel there’s a definite disconnect in communication between departments within the NHS, which often requires the patient to play too significant a part in their own care.  It’s been the same in other areas of my health caretoo.  My memory and persistence on many an occasion has been essential, and I can’t help but feel there’s a simple solution.  At the very beginning, the letter that had been written by my consultant, (even though there was no pregnancy and no file at that point) was rightly placed under my hospital number.  It should have been made available to all departments (perhaps it was) to enable anyone dealing with any aspect of my healthcare to decide whether the content of the letter would affect their potential treatment plans.  An unmissable ‘IMPORTANT’ marker should appear whenever my hospital number or name is typed into the system, indicating there’s something on file that should be read before any actions are taken by any healthcare professionals, anywhere.  That way, when the community midwife booked me in at doctor’s surgery level and when Lewis and the hospital midwife dealt with me, they would have been informed and prepared and I wouldn’t have had to relay my pregnancy history over and over again, or to point out where the letter could be found.  I wouldn’t have been stressed, the chances of anything important being missed would have decreased and those who are less likely or unable to advocate for themselves are less likely to suffer as a result.  

At week 16 of my pregnancy, Dave and I waited attended the hospital for my first appointment with my consultant.  I sat down in the busy waiting room, looked around, took in all the faces and then I heard my name; “Nicola, please”.  My consultant stood there; tall and slender, with brown bobbed hair and rosy cheeks.  “Hi, it’s nice to meet you”, she said.  She had a soft, silky voice that relaxed me.  It was a bit like a voice you hear on TV that advertises relaxation.  She was clearly very bright, was down to earth and I was a little in awe of her.  She had the career, was doing the whole family thing and I thought “God, she’s like superwoman.”  She was impressive.  

We sat down and she went straight in with “oh you poor things.  You have really been through it haven’t you?” and we laughed because it was so true.  She asked questions about Edie’s journey and we spoke frankly about it all.  “So how is Edith now?  Is everything ok with her?” She asked. When we explained that it was, she shook her head and said, “Just amazing.”  “Right; now let’s go through everything together, from the beginning.” I liked that.  I like a methodical approach.  It’s what I expect.  As the doctor began goingthrough my previous file, she read while thinking out loud.  Listing all my health issues she said, “Oh you’re a tricky one aren’t you?” and again, we laughed.  Her journeying through my medical file was an education for Dave and me.  She talked about things we had no knowledge of and hearing how it all went down last time made me feel nervous again.  She was making it real again; taking us there again.  She had to of course but it made my stomach flip.  It was a reminder of all that could go wrong: of all that was at stake.  It made me feel like I was standing on a crumbling cliff edge again, only this time I had chosen to stand on it and that was a particularly uncomfortable feeling.

Skimming through the file, she said, “Ok there were no signs of infection, (we knew that) there were no issues with the cord, (we knew that too) oh ok so that’s interesting; your placenta was bleeding (we knew that, also).  Why was it bleeding? Hmm … hang on; why was your kidney function abnormal?  What was wrong with your kidneys?” She said to herself.  At this point Dave and I looked at each other in surprise.  We had no idea anything had been wrong with my kidneys but it did take me back to my original belief that I’dhad an infection.  “Did you say my kidney function was abnormal?”  I asked.  “Yes,” she replied. “Do you think I had an infection after all?”  I was constantly on a quest to find out the reason I gave birth prematurely and here I was hoping she would give me a definite answer.  “Look, who knows?” She said.  “I mean maybe you did.  It’s possible but the tests came back negative.”  She left the room.  I don’t recall why but as soon as she shut the door Dave said, “Oh my God, you are the worry of my life.”  With half a laugh he said, “You are going to be the death of me.”  She returned, continued to look through the file, and just as I was about to conclude in my mind that I’d given birth prematurely because I’d had an infection, she said, “ah there it is!  See?  Your cervix was funnelling.”  Pointing at a sonogram of my cervix, she showed us what was supposed to be a straight, horizontal line but what actually looked like a butternut squash side on, and said, “You have an incompetent cervix.” Bam!  Just like that.  

Shocked; I said, “I have an incompetent cervix?  You think I do?”  Still studying the image, fascinated, she said, “yeah.  Yeah I do.  See?  This is supposed to be a straight line (pointing to my cervix); not round like that.”  I couldn’t believe it.  I was shocked because I finally had a diagnosisafter all this time and because I had resigned myself to thinking that the best we’d ever get is a ‘most likely’ situation.  The consultant we met with in January 2017 was confident I didn’t have an incompetent cervix and that was why we decided to go ahead and have another baby.  I mean maybe we would have done it again knowing I had an incompetent cervix, I guess I’ll never be able to say for sure but if there was one reason for my preterm birth that would have stopped us from taking that leap of faith; it would have been an incompetent cervix.  My mind was swirling.  All I could think was, “My cervix is incompetent; it’s unsafe and now there’s a baby growing in there.”  Dave and I had spent all this time managing to maintain level heads and to keep calm but now we were both scared.  Our baby was unsafe and our happiness and peace of mind was fragile again.  We were in danger again: the baby and our family unit.  

It hurt seeing that scan.  I had never seen it before and suddenly it was in front of our eyes.  It was startling.  It painted a clear picture of how much danger Edie had been inand the image broke my heart.  She was obliviously happy and content in there and the unfairness of it all made me feel sick as it had done before.  She was healthy and thriving in the womb but she was coming out and about to be dealt a very different hand as a result.  She lay cosy in her sac but her sac was almost bulging out of a big, gaping gap.  A gap that should have been closed shut.  She had been in this predicament before the scan had been taken and I’d had no knowledge of it whatsoever.  I was blissfully daydreaming about our future.  It haunts me to think about it.  

The doctor recommended regular cervical length scans, and administered aspirin and progesterone as there’s some evidence they help to stop preterm birth, and as we were about to leave I asked, “Should I be worried?” She said calmly, “Let us do the worrying for you.”  That wasn’t the answer I wanted to hear.  She could tell and said, “Listen, at least we know now.  We didn’t know last time.  You were walking around before with no clue your cervix was opening.  It wouldn’t have opened overnight.  It would have been a gradual thing but unfortunately you didn’t know until it was too late.  We’ll monitor you and act if necessary.  It’s good we know now; you could have ended up here at 22 weeks’ gestation with something wrong and it being too late to do anything.”  “Well that’s what happened last time,” I said.  “But no”, she interrupted, “we’ve started monitoring you now at 16 weeks. We’ll be watching you carefully.”  This bombshell saw me a little narked again that I had to fight so hard to see her early.  It convinced me all the more that I was right to be persistent, so I started to explain about the rigmarole I had gone through to see her early(ish), despite her having set out clear instructions in the letter.  However, I don’t think she quite knew what I was getting at.  “Well good for you”, she said.  “Because of you, you got to see me early.  Women should be persistent in getting the right care for their babies.”  I appreciated the praise but thought, “no they shouldn’t.  It should already be there.”   

Dave and I left the consultation a little shaken.  We were ok but we had to do the thing we do when we try to gather ourselves …  “Right, let’s think straight … you’ve got aspirin and progesterone,” said Dave.  “You’re being monitored this time; you know all of the signs to look out for; we have her number if we need to call her and you feel much better than you did last time.  Ok?  Let’s focus on that.” After the shock and fear of finding out I had an incompetent cervix, we managed to reel ourselves back in and carry on being cautiously optimistic.  

We felt safe with this doctor.  She was kind of kick-ass and we liked her a lot.  That’s important.  She was quite direct: I like that.  She used plain English and explained things very clearly and while all that would have been enough, she had a great sense of humour too.  She could be very funny and being in her company was an all round pleasant experience.  

The pregnancy progressed and I continued to feel physically well.  I was tired at times but that was to be expected when having a toddler to run around after. I did become anaemic half way through the third trimester but whilst that was a little tricky to deal with, I felt in tip top shape compared to my first pregnancy. When considering I had endured the shock of an unexpected extreme preterm delivery, the sad scenes of my labour, and the months of trauma at NICU where Edie wasn’t expected to survive, I was doing very well mentally too.  However, a pregnancy that follows a preterm one is odd in so many ways.  I found myself celebrating peculiar milestones that at times made me laugh because they brought home to me just how unbelievably terrifying a journey we had been on and yet we were still here not having lost our minds.  We were relieved to have successfully passed the 12 week scan and of course the 20 week anomaly scan too, but where a person who hadn’tbeen scathed by a negative experience of pregnancy before, may have fully relaxed at 20 weeks, that wasn’t an option for us.  We counted down and waited to tick off each and every milestone that was poignant to us and our journey.  

At 23 weeks and 4 days pregnant (the gestation that Edie was born) I announced ‘to the world’ that we were expecting another baby.  I waited until that day to announce it because it was a significant day for us but also because I was superstitious (a sign that I was not as ok as I often believed I was).  During my last pregnancy I had done everything right.  I had really looked after my body and every move I made was with the baby in mind; yet things still went horribly wrong for us.  At that time I thought the universe and some kind of bad karma was against us.  I thought I was paying the price for being a bad person in some way and so this time, I felt that if I announced the pregnancy on social media to as many people as I could then the Gods of fate wouldn’t do anything to harm us because they wouldn’t want all these people to think badly of them.  23 weeks plus 4 days was an incredibly bittersweet day in my second pregnancy.  I was elated to get there knowing this baby was still benefitting from all the goodness the womb has to offer, but it reminded me that my first baby, on this day, was already out in the open air, fighting for her life and suffering.  On that day my heart both sang and cried and I hugged Edie for as long as she’d let me.  At 23 plus 4 I was acutely aware that anything I experienced after this point would be for the first time and that was exciting.  Having 17 weeks of firsts in my second pregnancy made me wonder how on earth Edie was here with us and it was yet another reminder of how amazing she is.  

At 24 weeks’ gestation I celebrated again.  We had reached viability.  Our baby was viable.  This was huge.  Viability was such an enormous part of our journey with Edie because she was born before it.  Technically she was considered a miscarriage; she was only offered medical assistance at birth because of the hospital we were in.  There’s a whole ethical argument about saving babies born at 23 weeks and if I’m honest, after seeing the way Edie suffered, I can understand why.  I’ll write more about this in the future.  Before Edie was born doctors spoke to us about viability and the particular problems Edie would likely encounter being born at 23 weeks.  At 24 weeks the chances of survival more than double.  This was a huge shock to us.  We’d had no idea how important a day in the womb could be for growth and development.  Why would we?  The subject was explained to us so clearly and in such depth that at times it felt like a science lesson.  It was given to us bluntly and as such the topic of viability has scarred me.  How we waited every day, willing the hours to go by just so we could reach viability and having it slip out of our grip, is something that made me feel powerless, and that’ssomething that’s affected me quite a bit.  So when we reached viability in my second pregnancy, I was overjoyed.  Having the topic of viability in my life again was odd though.  I’d announce milestones and say things like, “my baby is developing surfactant today.”  Edie’s lungs never developed surfactant; she was born too early.  People would politely smile with a glazed look in their eyes and I could tell they had no idea what I was talking about, but that’s the reality of being a preemie parent; you’re aware of things you should never have to be.  

Getting to the third trimester was a huge thing for me.  It was brand new territory.  Edie was born when I was still in the second trimester.  I was bigger than I’d ever been when I carried Edie and the movements I felt were different now that the baby was growing and maturing.  It was amazing.  I had started buying things for the baby in a calm thought out fashion, not like when Edie was at hospital and we were running around as panic stricken parents, having unexpectedly found out she was coming home from SCBU (Special Care Baby Unit), not having bought a single thing for her.  I was able to enjoy everything about the third trimester; the anticipation, packing the hospital bag and buying the coming home outfit.

Despite these happy milestones, I couldn’t quite shake off the negative memories of my previous pregnancy. Not when I had spent four months at NICU, thrown in amongst an endless list of women, all with very different reasons for being there.  The further into the second pregnancy I got, and in the knowledge that prematurity was becoming less of an issue as each week passed, I concerned myself with all the other scenarios that could await us; including the scenarios that I had come to know of regarding the full term babies that were at NICU.  I had listened to stories about healthy pregnancies and safe deliveries that suddenly went wrong immediately after the baby was born.  I listened to stories of babies being placedromantically into their mother’s arms only to suffer frombreathing difficulties and serious infections.  I also worried about the rare diseases that went undetected in utero.  While I was enjoying the pregnancy, I wouldn’t be entirely settled until our baby was born, in my arms and feeding successfully.    

I always say I’ve come away from NICU about as unscathed as any NICU mother can.  I’ve escaped PTSD and I’ve managed to go on with my life with my nerves intact.  I’m able to not mollycoddle Edie which is quite something considering the world was trying to take her from us at one point.  I often remember what happened and think about our journey; I feel it’s important to do so, but my revisiting these memories happens in a way that’s healthy: most of the time.  Sometimes I find it a little strange, thinking how well I’ve come away from all of it, and I don’t know what it says about me.  I’ve wondered if I have some sort of chip missing in my brain.  Shouldn’t I be a nervous wreck now?  When she was sick my heart ached so badly that my body physically hurt.  I was living in the darkest part of my mind.  I didn’t want to live without her.  I became physically unwell; I lost weight and spent all day, every day by her side, consumed by her. But I left NICU with her and closed a door in my brain to the worst parts of it all. I remember every detail of it; even how it felt but I’ve put it in a box and I live on a day to day basis, almost as if it never happened.  However, the ghost of NICU past is a cunning beast and pays us all an occasional visit; even a NICU parent like me, who’s outcome was a positive one.  It lives just beneath the surface of the skin and appears when you least expect it.  I’ve had a couple of moments where my behaviour or reaction to an event has been different to how it would have been pre-NICU, and I’ve found myself affected emotionally by unexpected triggers.  

One Saturday, a trip to the park with Edie took a dramatic turn when I fell over trying to prevent Edie falling off playground ride.  I was concerned but I kept calm despite remembering some horror stories I’d heard.  I made my way to the assessment unit alone (Dave had to stay behind to look after Edie) but I was so caught up thinking about the baby that it hadn’t occurred to me how I’d feel when I got there.  This is what happens when you go through everyday life after NICU as well as I do.  You rest on your laurels; you subconsciously assume there’s nothing to recognise; nothing to bother you;and then when these surprises occur, they smash you in the face.  As I started making my way there, parts of the route started to become familiar to me and I began feeling uneasy.  Unease quickly turned to dread.  I had gone back to the place that held such bad memories.  It all came rushing back.  I remembered the smell; the lighting; the reception desk; the dreaded waiting area; and I started to panic on the inside.  Visiting the assessment unit the first time saw our lives turn upside down.  Those walls were the walls that encapsulated the worst words ever spoken to us and details I had forgotten came back to me; like the pink and blue elasticated bands they place on your stomach to monitor the baby, and suddenly I was reliving that night.  A lovely midwife called Emma talked me through what would happen.  She took my blood pressure reading and asked me if it was usually high.  I explained it never was.  It was quite high on this occasion because I was so het up.  She wanted me to relax a little but I couldn’t until I heard our baby’s healthy heart rate on the monitor.  In those moments when she placed the jelly onto my stomach and picked up the probe my heart beat vigorously inside my chest.  I told myself I was there because I’d been too calm throughout this pregnancy and therefore I was being taught a lesson because I’d been complacent.  I found myself feeling superstitious again; but there it was; a beautiful and strong little heartbeat; and my own heartbeat slowed down as I relaxed a little.  I left the hospital that evening exhausted because my rapidly beating heart and adrenaline saturated brain had left me feeling as though I’d run a marathon and I felt startled by the reminder that sometimes life can change in an instant.  It’s almost as though I’d forgotten.  One trip to the park could have changed our lives.  Then I brought myself back to the good place, having told myself that while it’s scary not knowing what’s around the corner, we can’t live in fear of the unknown and that all I needed to focus on was that everything ended up being ok.  I’m very lucky that I have the ability to do that.  I think it’s this ability that has allowed me to live a content life after NICU.         

I also made a second trip to the assessment unit during this pregnancy, because I was concerned that the baby was moving less.  I don’t know whether these thoughts were accurate or whether I had worked myself up over nothing.  I gave it a little while but knowing how long to wait before you contact the hospital is a particular area of confusion and worry.  There is a 27 weeker we’ve grown close to whose mother went to the hospital a number of times with concerns about his movements.  Her persistence saw the midwives scan her and within a couple of hours he was delivered by Cesarian section.  I couldn’t get his story out of my mind.  Fortunately, it turned out that all was well with our baby.  We went back home, never to return to the assessment unit.    

To our surprise my cervix stayed closed and at every visit my consultant would say with a bemused but happy look on her face, “well it’s still closed”.  I was always elated to hear this but also bemused.  I’d been diagnosed with an incompetent cervix after all.  Eventually she said to me, “You know, I don’t think you have an incompetent cervix.”  I was thrilled.  I said, “yeah … I mean, surely progesterone is not that much of a wonder drug that it’s enough to keep an incompetent cervix closed all on its own, right?”  She didn’t verbally confirm or deny but she nodded and shrugged her shoulders as if to confirm it was a little bit surprising.  I mean, if my cervix had been incompetent, it’d have to be pretty incompetent to have completely let go of my baby at 23 weeks. “It seems to me there was some kind of inflammatory response in your last pregnancy that made you go into early labour”, she said.  We had previously discussed that I wasn’t well when pregnant with Edie. “When I looked at your results from last time it’s clear that something was wrong; that you were unwell.  This time, with you feeling well your cervix has stayed closed.  I think your condition was poorly managed last time and that caused you to go into early labour”, she said.  I asked, “So rheumatoid can cause early labour?”  I had had no idea.  When you have an auto immune disease you don’t sit there researching all the things that can go wrong in life because there are so many that you’d spend your entire life worrying.

No one had ever mentioned to me there’s an increased chance of early delivery when you have an inflammatory auto immune disease: not the GP or any of the numerous doctors I spoke with on our very long conception journey.  So I had never felt the need to research how my disease could affect my pregnancy.  I’m not blaming anyone; it was just never a thing.   “Studies have shown,” she said, “that women with conditions like yours can have negative pregnancy outcomes when their conditions are not well managed but if they are well managed then there’s often not a problem.  Therefore, I don’t think there’s anything wrong with your cervix but last time, your condition being highly active, and your being unwell, is what ultimately caused Edie to come early.”  

We went the long way round but ultimately, what we had been told by the original consultant in October 2017 had been right all along and was now being confirmed by the consultant before me.  It was such a relief to have her confidently agree with what had been said by someone else and to finally have my answer, though it came with some pain.  She said, “You see; your body is constantly fighting to keep you well, and growing Edie was too much of a job on top of all that. Growing a baby is hard work without having to fight chronic conditions and the task was making you ill.  You don’t have a great deal of resources behind you either; you’re quite slim, sowhen it came down to it, your body couldn’t cope with it.  It recognised she was causing you a problem, and it decided to let go of the pregnancy in order to heal.”  

It’s a common thing for NICU mothers to blame themselves, whether their babies were born early or full term.  It’s par for the course.  However, most of the time, these mothers have played absolutely no part in their children’s tragic start to life.  It doesn’t matter how much they are told otherwise, though, they’ll continue to blame themselves.  But there I was, being told that my body literally evicted Edie.  It threw her out because she was causing it problems, and hearing this was tough to take.  Even for someone like me who usually has such a logical way of thinking.  It’s ironic because I’d give up my life for Edie but when it came down to it, biology and my body on a primal level let her go in order to stay well.  I’ve found peace with that now.  I choose to consider that what my brain and heart would do means more.  

I was so thankful to this consultant for keeping me well and for advising me so well too.  I followed every bit of medical advice she gave me. I took my daily dose of aspirin, never missing a tablet and I inserted the messy, uncomfortable, dreaded progesterone pessaries twice a day every day, too. They were at times a complete chore that sometimes dragged me down physically and mentally. Only slightly of course but the heartburn from the aspirin was a real pain, and the itching and occasional soreness from the progesterone was a drag. I didn’t enjoy walking around with what seemed like gritty candle wax seeping out onto my groin and inner thigh area. I also didn’t enjoy that the aspirin caused unusually heavy and persistent bleeding from the tiniest nick of the skin but all this was a small price to pay if it meant keeping my baby safe inside. I was grateful to be administered it; to even have it invented. My consultant’s input in this pregnancy was invaluable but I don’t think she was the only reason I didn’t give birth early.  This pregnancy was just so different from the start.  And I think that’s just down to nature.   “It makes my week seeing you guys,” she said.  “I’ve never had a surviving 23 weeker come into my clinic, ever … and I’ve been doing this for 20 years.”  That fact blew me away and made me so proud of my little girl.  I thought to myself, “It makes my week seeing you too.”

As I reached the end of my pregnancy and we prepared for a new life to come in, I felt melancholy about our family dynamic changing and our life as we knew it changing.  I hear this feeling is completely normal when expecting a new arrival but our threesome had been through the trenches together and it felt particularly bittersweet for me.  Our dream team; our incredibly tight knit little circle was going to change forever.  I loved this baby; he or she was incredibly wanted; we’d gone through such lengths to have him or her but there was this feeling that we’d reached the end of an era, especially because Edie was so unhappy about the prospect of becoming a big sister.  I tried to prepare her the best I could by talking to her about it a lot; I even bought her a book about becoming a big sister but she was deeply unhappy about the whole thing.  It was hardly surprising; she’d been the centre of our universe for three years.  I made the most of our days together with her as my only child.  


At 37 weeks plus 1 day into my pregnancy I felt very uncomfortable.  My stomach was very hard and my back hurt but I carried on about my day.  I was in early labour, though I didn’t realise it.  I probably had been for a day or two before this.  I was able to sleep well that night but I woke up the next morning having lost my mucus plug, a clearer indication that I was in labour.  At 37 plus 2 I woke with period pain type contractions that were irregular and didn’t last very long.  Again, I went about my day.  My mother was staying with us to look after Edie in preparation for my hospital admission.  I’m used to being in pain so I have a high pain threshold and a very calm approach when dealing with it. I said goodnight to my mother on the landing that night but the pain had heightened and I wasn’t able to sleep.  About an hour after saying goodnight, I woke her up again, leaning over the bed in discomfort and shortly after Dave and I made our way to the hospital.  It was happening.  

I had made it to full term.  It was as if the little one had thought, “Ok Mam, I did what you asked.  We’ve reached full term, now I’m outta here!”  Our goal had been achieved: what a feeling.  However, while a preterm birth wasn’t a problem for us; a global pandemic was.  You couldn’t make it up.  Dave dropped me off at the hospital entrance at around 12.30 am because he wasn’t allowed in until I was in full labourbecause of COVID-19.  He was only allowed to be with me for full labour, so he had to go home.

After full labour and birth, he’d have to leave the hospital, and once he left he wouldn’t be allowed to re-enter the hospital; not even to help me out to get us home.  I found myself bitterly disappointed that once again we wouldn’t get a normal birthing experience.  I wasn’t afraid to deliver my baby alone.  At one point I suggested it.  My mother is a carer who works in the community and with all the doom and gloom in the media regarding COVID – 19, I became paranoid and found myself considering birthing alone, rather than having my mother (who I was concerned about) come in to our home to look after Edie, where I’d also be bringing a new baby.  Dave, being the voice of reason, as always, was not willing to let me do it alone.  He reminded me that we knew very well how things can change when giving birth.  He said, “I’m not willing to leave you alone.  What if you are not fully with it and have to make some sort of decision or have to sign something?  It’s about balancing risk, Nic.  And when considering the survival statistics and the risk of being seriously unwell from the virus, our family unit is more at risk if something goes wrong in labour than with COVID.”  And just like that I got out of my head.  I know many mothers who were terrified about the possibility of birthing alone; I understood why but I’m just not like that.  I would have done it alone if I’d had to; without fear; but I just wanted Dave with me so that he could experience all of it.  It had been hell for him the first time around.  He sat there with a front row seat as our 580 gram, black and blue child flopped out, while gas and air saw me slightly detached from reality.  I desperately didn’t want him to have to come in late and leave early and be kept away from his new born baby after meeting him or her. It seemed unfair to me and it didn’t make much sense.  If he was allowed into the hospital for some of the time then why couldn’t he stay for all of it?  But the rules were the rules and we had to accept it.  Again, as the voice of reason, he said … “Nic; all that matters is a safe delivery.  Everything else is secondary.  The other stuff doesn’t matter.”    He was right.    

Before I left the house that night, I took one last look at Edie while she was still my only baby.  She lay there in her cot bedsound asleep.  She looked so small and peaceful.  She wascompletely oblivious to what was going on.  I stared at her, taking everything in, trying to capture and lock in my mindwhat she sounded like at that very point and what it felt like to only have her.  I tried to capture the size of her; to rememberher interests at that point in time; our routines and traditions, when knowing that I’d never truly be able to retain it all.  

At the hospital Dave waited in the car park while I was assessed.  I was admitted because I was three centimetres dilated.  I wasn’t in full labour (4 centimetres) so I was taken to the antenatal ward.  I let Amy, one of the wonderful midwives who looked after me while I was admitted at the hospital in those awful days before Edie’s birth, know I was there and was disappointed to find out she wasn’t at work.  I thought it would have been quite special to have her be a part of our second journey, as she was there through our storm but it wasn’t to be.  We were in contact though and that was lovely.  I was left to it in the bed in the dimly lit ward with my gas and air.  There were other women in cubicles, walking through pain, inhaling gas and air and some just lying there on their phones and I must admit I was in my element.  For me, it felt like I had finally joined the club.  I missed this part last time.  It felt like I was part of the gang; the birthing gang; and I was as happy as Larry to be there; even when knowing agony awaited me. 

It amuses me how laid back I am in situations like this.  I’m so used to pain and to complain about it is just not in my DNA.  In fact, I’d go as far as to say I don’t recognise how much pain I’m in at times.  I sucked on the gas and air pipe, laying in my bed, clenching my teeth while occasionally scrunching over and when the contractions went away, I sent funny picture messages to my sister.  That was my way of telling her I was in labour and that I was a little off my head on gas and air.  About an hour and a half after being admitted to the antenatal ward, I rang for the midwife.  The gas and air was having less of an effect and so I thought it best to mention it.  Oh so casually I said, “oh sorry to bother you but I’m sucking on this pipe and it’s not really doing anything and I’m finding it harder to keep comfortable.”  “Let me check if you’ve used all the gas and air,” she said.  “I can’t see it because you haven’t been here long … oh no; there’s lots more left.  Let me check you.”  She examined me.  “Oh wow, you’re 6 centimetres!”  She chuckled to herself at my “oh it’s nothing” approach to informing her and said, “Right, phone your husband, we’re off to the delivery suite.”  I phoned Davewho would have only reached home an hour or so before to tell him to meet me at the delivery suite.  The midwife explained that they were going to take me straight up because things progressed quickly with Edie, and not only because she was born prematurely but because my cervix responded quickly (as the consultant I spoke with in 2017 had previously said) and they were expecting the same to happen this time, especially because this was my second child.  

Dave got to the delivery suite in record time, at around 3am,and it all began.  Two wonderful midwives called Hannah and Sharon looked after me and we chatted and laughed in between pushes.  Things perhaps progressed a little too quickly for me to get used to the pain, so I accepted pethidine.  I’m not sure it helped with the pain; more that it made me quite sleepy.  I was exhausted.  Granted I hadn’t been in full labour for very long but I had been in slow labour for around 2 days and at that point I hadn’t slept for around 28 – 30 hours.  In between pushes I’d fall asleep.  I can hear Hannah’s voice now; “Nicola!  Nic!  Wake up Nic!”  I’d wake upstartled, I’d push and as soon as the contractions stopped, I’d fall asleep again.  I also remember her saying, “Nic, don’t push, you’re not 10 centimetres yet.  You’ll damage your cervix.  Don’t push yet Nic.”  And I remember thinking, “Iknow but I can’t stop.”  Eventually my waters broke and out with it came a lot of muck.  It was like muddy water.  The baby had pooped in utero.  I know that this can be dangerous because it happened to a relative of mine where the baby ended up in special care.  You’d think I would have panicked and that this would have set off some kind of a trigger but it didn’t. It may have been because I was using gas and air and pethidine or maybe it was because my first labour was so horrendous that we were desensitised and hardened and to us this was a small issue.  It also didn’t hurt that everyone in the room was perfectly calm and so we followed their lead.

At 5:35am, at 37 weeks plus 3 days’ gestation, Harris Oliver Madoc-Jones was born.  He was black haired, he weighed 6lb 11oz and was one of the two most perfect babies I had ever seen.  He scored 9 on the Apgar score to Edie’s 0 and then 10.  Ever so quietly and smoothly a NICU doctor walked into the room.  She did so inconspicuously and the only reason we knew she was a NICU doctor was because we had spent 4 months with her previously.  If we hadn’t we would have assumed she was an obstetrician and that she was there to check on the baby as part of some kind of routine obstetric check. She didn’t introduce herself, Hannah or Sharon didn’t announce that anyone from NICU would be coming and we didn’t see them call for anyone.  I admired it; no fuss; not to alarm parents.  The doctor walked in wearing a mask and I immediately recognised those big brown eyes. She looked at me, did a double take and looked at Dave to make sure she was seeing correctly.  “Oh hi!” I said to her and at the same time, she said, “I remember you.  You’re Edie’s parents!” My heart burst with pride.  Edie’s memorable at the hospital and everywhere she goes and so she should be.  It was funny because this wasn’t a doctor we had much to do with at the time, for whatever reason. It was all so strange (in a good way); she had been on maternity leave and the day Harris was born was her first day back.  We were her first patient/parents.  She asked how Edie was doing and she was so happy andinspired to hear.  She said, “She’s amazing.”  She then started talking about Edie, telling Sharon and Hannah all about her/us and I was touched to hear how much she remembered.  I don’t recall ever speaking to her at NICU or seeing her treat Edie.  Perhaps she did when we weren’t there or maybe our traumatised brains didn’t take her in but Edie made an impression on her.  She then said something I’ll never forget because it took me completely by surprise.  She said, “You are the bravest NICU parents I have ever seen.”  I write this, overcome with emotion and with a lump in my throat.  I can’t put into words how it feels to have made such an impression on her, just by the way we were there for our daughter.  I’m not sure it’s true, however, but to hear it was wonderful. It was confirmation that we did right by Edie.  

She informed us that Harris was fine and said, “I am so happy that you’ve had the experience you deserve.” We thanked her and she went back to NICU.  We wouldn’t choose to have a NICU doctor attend the birth of our child but we knew Harris was fine and as a result it almost felt that her being there was meant to be; that our past was giving our present a pat on the back, a tip of the hat, the thumbs up to say, “congratulations guys, you did it.”  It was the perfect way to end one of the most magical moments in our lives.

As I looked over at Dave holding our son, I took it all in; a loving father looking at his healthy new born child.  There’s nothing better than that. I remember that man; shocked, shaken and traumatised at Edie’s birth; seeing things that no one should ever see.  And now, he was calm, holding and gazing at Harris, and that was the moment that told me we were right to do it again.  About an hour or so later, after a couple of pieces of toast and a bunch of stitches, it was time to head to the postnatal ward.  Dave carried my bags and we said our goodbyes at the lift.  It worked out fine to be honest.  My labour progressed quickly; it went smoothly; he was there for all of it; he had a couple of hours to cuddle Harris and by the time we had to part ways at around 8am, we were both exhausted and happy to sleep.  I only needed to stay at the hospital with Harris for one night, so with Dave being busy with Edie at home, it was a perfect amount of time before collecting us the next day.

I was so exhausted that I slept for a number of hours back at the post-natal ward and once I woke-up I found myself sharing a room with some lovely ladies.  I had that “happy to be here” feeling again.  It kind of felt like being in a dorm with a bunch of girls and even though I had just carried out the mammoth task of bringing a child into the world, I must say it was nice to have an excuse to lie in a comfy bed all day.  I felt relaxed.  Out of nowhere a doctor approached my bed and again two lovely, familiar eyes peered at me.  This time they were blue.  Two more NICU doctors paid us a visit.  It was a complete surprise.  They told me that the doctor who had checked Harris in the delivery room, had gone back to the unit, and at hand over she had announced that Edie had become a big sister.  I can’t describe how that feels; that even though three years had passed, the staff still thought about our daughter and still cared enough to announce and celebrate one of her major life milestones.  That’s the thing with the staff at the University Hospital Wales’ NICU, they don’t just do their jobs very well; they care a great deal, so when situations like this occur, they leave a lasting impression on your heart.  After finding out we were at the hospital, these two doctors paid us a visit.  One of them, a lady from Belgium, worked very hard with Edie in those early days, keeping her alive.  Edie certainly kept her on her toes.  It was very strange to find myself happy and calm in front of these two inspirational women who I had once faced in completely differentcircumstances.  I loved seeing them and was touched they cared enough to visit and meet Edie’s little brother.  It was like catching up with old friends and it was a beautiful, poignant reminder that life sometimes goes around full circle. 

Dave came to take us home the next day.  Going to meet him at the entrance was exciting.  The day before, we’d had a son;we spent the night apart after that and I couldn’t wait to see the two of them together and to be a family.  I could hardly contain my excitement of getting home to squeeze my little girl, who I hadn’t seen for almost 48 hours, and to have my two babies meet.

I had carried our second child to full term and had given birth at the height of a global pandemic.  I felt like superwoman.  And so I wanted to be the one to carry him out of the hospital.  

I loved every aspect of giving birth this time around.  I have never felt so empowered in my life.  I loved delivering him and in some weird way I even loved the pain.  I felt at one with nature and when Harris arrived into the open air, he was accompanied by the voice in my head that said, “This can’t be the last time I do this.”