“Sorry what was that? I’m 2cm dilated?! But how?! Why has? How?!” “Yes” the doctor said; “you’re 2cm dilated and I can see the membranes bulging”. “Sorry, what are the membranes? I don’t understand what that means.” She said; “it’s the amniotic sac; your waters, they are visible.” Me: “uh right ok ….”
I looked at Dave for answers and for him to tell me that all was going to be ok. He obviously couldn’t do that. He’s standing to my left looking extremely stressed and confused. At this point there are a thousand thoughts and questions running around in my head. Just like me, Dave seemed incredibly worried and just so shocked; not fully able to comprehend what we were being told. I mean we got the gist of it, and without having asked any questions we knew that the answers were probably not going to be good; but like me he couldn’t rationalise what was being said. I mean how did we get here?! How were we in this position?! I had done everything right! How was this our reality now?! Why was this happening to us when just 30 minutes ago life was normal; great in fact!
The weekend had only just gone by; Dave was in North Wales spending time with family and I had spent the Saturday with my mother, eagerly having a good old sort out at the house in preparation to decorate the baby’s room. Two very excited women; one most definitely nesting and the other more than happy to help her. On the Sunday, Dave and I had walked into town and back and enjoyed a casual Sunday lunch, talking about work and family and what was going on with friends, but for the most part we spoke about the baby and how different things were going to be but how we were so ready for the change.
At the assessment unit, I don’t really remember who asked what; but I know that mine and Dave’s queries and concerns were the same. We asked; “what does it mean being 2cm dilated now?” “Does that mean the baby is coming now and if he/she is coming now, what does that mean for the baby?” “At this point how early am I exactly? I can’t think!”
At some point Amy introduced herself to us. A really friendly personality from Brentwood, she was going to be the midwife looking after me for the shift. She wasn’t new to midwifery; but having moved from Brentwood to Cardiff a couple of months before, she was new to the University Hospital Wales (UHW). She seemed like the type of person that if you were on a night out with her she’d be a lot of fun; a bubbly and happy soul. She was just genuinely nice. She asked me whether I had felt any tightening in my stomach and whether there had been any pain etc. I explained that there had been tightening but that I had been having them for weeks. I told her that I’d wake in the morning and one side of my stomach would almost be flat and on the other side there would be a big, rock hard lump and I could pin point exactly where the baby’s head was. I could cup it with my hand. I explained that soon after waking though, my stomach would quickly go back to normal and that would be that. She asked me how often that happened and I said a few times in the last couple of months. She asked if the tightening had become more frequent lately and I explained that they had today. “Ok my love”, she said.
As a patient you know that there has to be a reason why specific questions are being asked and you always know which answer stands you in good stead and which doesn’t. The fact that I answered yes to this particular set of questions made me feel very uneasy indeed, though I said nothing about it at this point.
When we were told that I was two cm dilated the doctor that examined me explained that it was hard to say whether the baby was coming now or not. She said; “your being dilated could mean that the baby is coming now or he/she could stay in there for a number of weeks. Dilation is the sign that the baby is coming we just don’t know how soon.” I just couldn’t believe what she was saying to me or why she didn’t have more information. She said, “ok Nicola, we’ll be transferring you to a different room soon, one where you can have more privacy”. It was now time to place me where I needed to be, with the team of obstetricians and whoever else that would be caring for me going forward.
She left; health care professionals came in and out; but Amy continued to be there, chatting to us and doing her bits and bobs. Taking my blood pressure, she was just so caring and, frankly, at this point, the closest thing (after Dave) that I had to a friend. She was an almost permanent fixture in the room and was able to answer many of my questions. So I ran over everything with her again. Looking up at her like a desperate, terrified little animal, willing her with my eyes to tell me something different to what the doctor had previously said or to even say something like, “oh you know, these doctors exaggerate!”; but she didn’t say anything like that all. Instead she reiterated all that had been said previously. I tried hard not to put words into her mouth. I failed; “but Ame, this doesn’t necessarily mean that the baby’s coming now though does it?” “No not necessarily lovely”, she said, “sometimes women dilate for whatever reason and stay like that for weeks.”
Even though Amy knew that what she was telling me was a possibility; it wasn’t untrue necessarily, she still couldn’t guarantee that I wouldn’t go into immediate labour either. She had to feel a little uncomfortable by my questioning and approach, but a desperate mum will unintentionally back you into a corner for the answer that will help them get through to the next hour.
Health care professionals continued to come and go and they’d ask for details of the situation in hushed tones. The almost whispered questions and answers seemed to bellow through the place though. Chatting between themselves they’d ask “what is the gestation?” Someone would answer; “23 weeks plus 1.” To hear it said would be just gut wrenching! I then heard the words, “tightening” together with “contractions” and in my mind I screamed; “Oh my God those tightening are contractions! How could I be so stupid and not realise that?!” And so I calmly said to Amy; “Amy, do you think that the tightening are contractions then?” She said, “Well that is what contractions usually are but you said that there is no pain with them, so I’m wondering whether it’s Braxton Hicks.” And that was enough for me! It was convenient for me to go with that. “Yeah that’s what they are then; they must be; otherwise there’d be pain. Oh that’s alright then it’s just Braxton Hicks!” I thought. I don’t know if I really believed that but I was sinking and for the time being Braxton Hicks was my life preserver.
Being in the same room as the people who are discussing your case is on odd thing. It can at best be very awkward for all parties involved and at worst extremely upsetting. Medical terminology is often very scary and sinister sounding (even when they are only talking about possibilities) and hearing it can often do you no favours. You can find yourself having an anxiety attack when later down the line you find out there was really no need.
Amy asked us if we wanted a cup of tea and said she was going to find us some sandwiches. Dave and I were left alone for the first time and I really can’t remember what exactly was said. We were in such shock and so confused.
I remember that throughout our hospital stay we took turns to plunge into the depths of despair. One of us would nose dive leading the other to adopt a more positive approach in an attempt to bring the sinking head back up above water. Then we’d switch positions.
At some point Dave contacted home to tell them what was happening. A conversation that I dreaded. My heart pounded in anticipation as I could hear the phone ringing. They were going to be so shocked. As I keep saying, all had been wonderful. I worried about how upset they would be. Calling home at that point was something that Dave wanted to do. His Dad answered and Dave began to tell him about the hell we had suddenly found ourselves in. About to tell him what had happened, he suddenly just couldn’t do it. He made three or four attempts and just couldn’t finish the sentence. I was conscious that his Dad must have been getting increasingly worried (not that hearing the news would have made him feel any better but I just wanted to put him out of his misery) and I asked Dave to pass me the phone. It was Dave’s turn to be in the depths of despair and therefore I’m in automatic optimist mode. I guess that’s what happens when you’re the type of team that we are. Even though you are going through your own personal hell, without even thinking about it you want to make the other person feel better.
I remember speaking to his Dad, telling him about the situation and coming across not at all in the way that you would expect of a woman who was probably going to lose her baby. I was most definitely in shock. Dave’s father listened, as he always does, and behaved in the way you could only hope somebody would. He was calm and supportive and was kind enough and brave enough to give me a little droplet of hope. Not too much but just the right amount. He said; “you know Nicola, I have known of babies to survive at this gestation”. I so needed to hear that! He could have been talking about only one or two babies, but we said no more. Dave’s father was a medic; admittedly not in the field of obstetrics; but being a doctor he would have been more tuned into these situations than most.
If I’d had it my way I wouldn’t have told my own family that night. If this was all going to go terribly wrong, I wanted them to have one last peaceful night’s sleep before we all become completely consumed by this awful situation. However, that was not to be. I had phoned my mother earlier that evening to tell her about the blood. To this day I don’t know why I did that but I guess it was because of my assumption that all would be well. So she rang me to find out the outcome of our hospital visit; but as we were in the midst of it all, I didn’t pick up. As the night progressed and me knowing that by now she would be worried sick, I asked Dave to phone her. It was about 11pm. I have no recollection of their conversation; I must have blocked it out.
We were moved to a “more suitable room” and it was all still busy busy busy with people coming in and out; but now our emotions had calmed a little. We were both exhausted by this point; quiet and defeated. I remember feeling really down trodden by the frustration of not having any definite answers and things being all so up in the air. The situation regarding our baby’s future; our future, was just up on the air! All of a sudden Dave turned to me and said; “Nic, you do know we’re in the delivery suite, don’t you?” This was something that just hadn’t occurred to me in the midst of it all; but the instant he pointed it out, the realisation of it cut through me like a knife! It’s a real possibility that this baby could be arriving now! Even though this had been discussed as a possibility, being moved to a delivery room made it so very real. It was a terrifying prospect.
During our stay at UHW prior to Edie’s birth, we were to be seen by endless groups of doctors and nurses of all ranks and everyone in-between. Obstetricians, Neonatologists, Paediatricians, Midwives and NICU nurses. A little while after being moved to the delivery room the first wave came in. Dr Ali came to see us. She was a mild mannered, softly spoken lady who’s headscarf accentuated her kind face. I don’t think she was alone, although it’s only her I remember. As nice a person as she was, she might as well have been called ‘Doctor Doom’. Now don’t get me wrong, when I say this (and I probably will in future blogs about other doctors) it’s said with the utmost of respect; she would have been completely wrong to have given us any false hope. What she did give us, were the facts and the statistics. And the truth is, that for 23 weekers the outcome is often bleak! Fact. End of. She didn’t put it that way of course, but it’s the truth as I see it.
Our conversation with her was the first time that the full situation and all its probabilities had been put to us. A clear picture laid out on the table by a professional in the field of obstetrics. Again, they didn’t know if the baby was coming now or not; she explained that it was possible but it could also be possible that I would remain 2cm dilated for weeks; and perhaps bed rest would remedy the problem for a while. I asked her why this had happened and she explained at this stage they didn’t really know. She said; “it could be an incompetent cervix but I doubt it because this happens in only a very small percentage of women and those women have usually had other children, pre-cancerous cells or a procedure has previously been carried out on their cervix, and none of this applies to you.” She said, “we think you may have an infection; perhaps we’ll know more when the results from your blood and urine tests come back tomorrow.”
In desperation I asked; “could you put a stitch into my cervix to keep the baby in?” She explained that it wasn’t an option for me. She said; “at this late stage it isn’t guaranteed to work.” I remember thinking; “So what?! It’s got to be worth a try surely?!” I didn’t care about a guarantee. If there was only a one percent chance of success then I wanted to take it. This was my child after all. But she went on to say; “also, we can’t put a foreign body into the cervix of someone that has an infection as this could potentially be life threatening to you. At this point Dave had turned a funny grey colour. I mean what the hell was happening?!?! She continued, “and an infection would mean that labour will follow; and we can’t put a stitch into a cervix that will start contracting for obvious reasons.”
My heart dropped! “So you really think the baby is on its way then?” “I don’t know”, she said. I wanted to go to sleep and not wake up. As well as the words that had just come out of her mouth, her sadness was hard to witness because it was another marker of how dire our situation was. With every word and sigh and frown, hope left me, bit by bit.
Dr Ali couldn’t say that the baby was coming now, although to me it seemed that she presumed so. We were definitely dealing with a premature birth but how premature was the question. An early baby was one thing; a 23 weeker was another. “Do you have any other questions?” Dr Ali asked. We were out of them. She said, “if you’d like, you can speak to our neo natal team.” In my head I was like, “Uh, YEAH! Send them to us! I haven’t got a clue who they are and what the hell they do but if we need to be speaking to them then send them our way!!” So we smiled and said, “Yes please, we’d like to speak with them. Thank you Dr Ali.”
She left and Dave instantly broke down. The reality and possibilities hit him instantly and hard. With me, it was more about shock and confusion. I still had the “well what about this” and “I’ll ask the neonatal team that” mind set going on. Amy, (who had this miraculous ability to create these very short moments where you were able to forget about what was happening) who was naturally upbeat, was clearly deflated after Dr Ali’s visit. To see someone so naturally chirpy now so genuinely low was very sad to see and, again, led me to the realisation that our situation was miserable.
Going to sleep that night still with no clear answers and so much uncertainty and no plan of action on how to keep this baby safe was just torture. “We’ll just have to wait and see what happens.” they said.
And so we started counting. Every second, minute and hour willing our child to stay in. Plain torture.