The Arrival of Francis James - Part One - The Problems Start

As promised, here is the first installment of Francis's birth story. In the interest of confidentiality, with the exception of Fran, my midwife, and James, the theatre assistant, the names of all health professionals and fellow patients have been changed. I wouldn't want to see myself being accused of bringing nursing into disrepute!

Thursday 1st March 2007

At 30+4 weeks pregnant I went to see my Midwife, Fran, for my routine 30-week check-up. I was feeling well, apart from being signed off sick with exhaustion, and was looking forward to hearing the baby's heartbeat again. As usual, Fran took my blood pressure and tested my urine for protein. Worryingly, my BP was slightly raised and I had +1 of protein in my urine. As Fran toyed with the idea of sending me to hospital, I made the decision for her after telling her about my swollen ankles and flashing spots in front of my eyes, all signs of pre-eclampsia. While Fran said it was highly unlikely that there was anything wrong, she felt it best that I be checked out at the hospital just in case and rang the assessment unit to let them know I was on my way.

I trundled off to the bus stop feeling a little perplexed and slightly concerned. I made a quick call to Graeme to tell him what had happened and he agreed to meet me at the hospital. Once there we made our way to the Day Assessment Unit where I was strapped to a BP monitor for an hour (an experience I would later become accustomed to) and had to provide another urine sample for a more in-depth analysis. I also had to give what was to become the first of many many blood samples. Before getting the test results I was seen by a specialist midwife who performed another scan of the baby to check that all was well; unfortunately, according to her at least, all was not well. She informed us that the baby was small for my dates and I had very little amniotic fluid. Naturally this sent my mind into overdrive and did nothing for my nerves.

Eventually we got the news we did not want to hear - I was to be admitted for further tests and observation. At about 5pm we were led up to the antenatal ward where I sat on the bed feeling thoroughly fed up and more than a little frightened at the prospect of being on my own. I was well and truly out of my comfort zone. I was told I'd have to do a 24-hour urine collection and my blood pressure was to be very closely observed, as was the baby. So I was given a jug to pee in and a container in which to store it and was left to wonder what the hell had happened. Why is nothing ever straightforward for me?

Friday 2nd March 2007

At this point I really didn't believe that anything would go horribly wrong. I was certain that I'd be going home in a couple of days despite being monitored closely and clung to the hope that I could still have the water birth I so desperately wanted. A visit from the Consultant, Mr Williams, shattered my hopes. As Sod's Law would have it, he arrived just after Graeme had popped out for some lunch. Mr Williams explained that I did indeed have pre-eclampsia. I'd read enough about PE to know that it could turn very nasty and for the first time since my admission I was glad I was in hospital.

However, I was totally unprepared for what Mr Williams said next. I was told that my pregnancy would not go to term and that, because of the PE, the baby would be delivered at some point in the next few weeks by caesarean section and would then have to spend a couple of weeks in the Special Care Baby Unit. I was crushed and in complete shock. My dream of a water birth and bringing the baby home the same day lay in tatters. The only positive news Mr Williams had for me was that I'd be able to go home on Saturday provided my urine had less than 0.5g of protein in it, otherwise I'd be staying in hospital until they felt the time was right to deliver the baby. Mr Williams was hopeful that I would get to 34 weeks provided my condition remained stable, but told me I should prepare myself for the possibility of an even earlier arrival. Needless to say, Graeme was not very pleased to hear all of this when he got back from lunch.

Saturday 3rd March 2007

My urine test results came back and it was not good news. There was 0.55g of protein in my urine meaning that I was unable to go home. I was pretty annoyed, but did take some solace from the fact that I was in the best possible place.

That evening I got some horrendous pains just below my ribcage. I'd never known pain like it and was struggling to cope. Debbie, the less-than-sympathetic midwife, took little notice of me, even when Graeme asked her for help, and the next thing I knew I was in the grip of a panic attack. Debbie's solution to this was to open a window and tell me that if I didn't calm down I'd distress the baby. Very helpful. She also ordered Graeme off the ward because visiting was over! I was distraught and Graeme was clearly horrified at having to leave me. Fortunately the attack passed, as did the pain, and I was able to call Graeme on the sly to let him know that all was well. I have since learned that the pain could have been a sign of problems with my liver, so Debbie really should have shown a bit more concern.

Sunday 4th March

Today was the day things started to go downhill. As usual I'd been feeling well. In the early evening, just after tea, I was sat in the chair with my feet up, half-reading a magazine and chatting to Jane, the lady in the next bed. Jane was in for an elective c-section as her baby was transverse and we were joking that maybe I'd nick her theatre slot. Graeme had gone home for his tea. A student came along to do my latest BP check. I was well used to this by now and carried on chatting to Jane. I stopped chatting when the obs machine started beeping quite angrily so I glanced up at it and saw that my BP was 195/100! I was shocked and knew instantly that things were taking a turn for the worse. The poor student obviously thought she'd done something wrong so re-did my BP using my other arm, with pretty much the same result. She went for help as I sat there in shock, but putting on a brave face. A midwife came and checked my BP manually and then went to find a doctor.

A registrar turned up and told me that they were very worried about my BP (no shit!) and as a result were moving me to the delivery suite! They wasted no time either - I was instantly whisked away on my bed to a High Dependency room on the delivery suite. I knew Graeme was due to come back to the hospital soon and didn't want him arriving at the ward only to be told I'd been taken to delivery! A student went to phone him while I was told that, because of my escalating blood pressure, they were going to have to deliver the baby!

Graeme arrived and was as white as a sheet. The midwife started preparing to catheterise me for theatre when a doctor came into the room and told her to stop! Mr Williams had been consulted and he felt that the best course of action was to put me on some antihypertensives to manage my BP and review my situation the following day. Talk about feeling relieved! So I was started on a course of Nifedipine, which gave me horrendous headaches, and attached to an obs machine, which went off every 20 minutes thus ensuring I would get little or no sleep for the remainder of my pregnancy.

Part 2 coming soon...