After Anabelle

Well today we are 18 weeks and 2 days pregnant with Alexander. So far this pregnancy I've visited the hospital or midwife a total of  12 times.  6 of these visits have been routine or pre-booked; the other 6 visits have been extras and a result of bleeding scares. 

For the most part I cannot fault the hospital's care. They've had me in quickly when I've needed to be checked over. They keep scanning me, re-checking my cervix to ensure everything is ok and listening to Xander's heartbeat. 

Today was yet another of those days; which also included an insensitive and fumbling Doctor.  

My only complaints so far regarding my care is the Sunday episode and having to wait 2 days to be scanned because it was bank holiday, and this Doctor today who insensitively bowled in with the question "is this your first pregnancy" because he evidently had not bothered to look in my notes he was carrying under his arm.  Really; would reading my notes and handling me gently be too much to ask?  He has been my least favourite encounter so far and inspired the least confidence in me. 

Anyway, yet another bleed last night that felt like it filled the toilet bowl and spotting afterwards meant another phone call to the hospital to be told they wanted me in for first thing.  

This time I've been diagnosed with cervical erosion. A 'harmless' type of bleeding in pregnancy I'm told, often caused by hormonal changes affecting the neck of the womb; being sensitive and inflammed can lead to bleeds of various degrees, but totally unrelated to the safety of the pregnancy itself and well away from the womb and the baby. 

Well it may be harmless to Xander but it is pushing mine and Jon's stress and coping levels to new limits at the moment, an added worry that we just don't need. 

Who are these women who sail through pregnancy? Why can't I be one of those?  I thought I had sailed through more or less with Anabelle until our threatened prem-labour, but now in our subsequent pregnancy when I'm feeling increasingly fragile we could really do with the bleeding to go away and stay away more than ever. It doesn't look like that is going to happen and so this bleeding may well continue on and off throughout this pregnancy.  

The Doctor I saw today said there was no need to come in again for it unless I thought the episodes were substantially worse or accompanied by pain, but as I said, not bothering to check my history didn't inspire confidence in me and I just want to see my consultant now who knows the bigger picture and more ready to appreciate my crumbling emotional health.

Being this time of year and June is not helping at all. A week today until it is 12 months since Anabelle died. 

Another question I want to ask tonight is; why does it take our family history and Anabelle's death to give me this level of prompt care in pregnancy?   We had a few bleeds in early second trimester with Anabelle, nothing to the extent as its continuing with Xander but it happened; it happened three times before anyone wanted to see me at all, three times before they would scan to see if everything was ok.   The difference of care I'm receiving at the moment is quite astounding. 

I know the answer is cost. Caring for people costs money. Of course I'm currently costing the NHS thousands of pounds in Doctors time and equipment; I know that my son is worth it, but so was my daughter. 

Why does it take one baby to die before this level of care is put in the next pregnancy?  Will this level of care make a difference to the outcome of this pregnancy? Or is it to ease my anxiety a little?  I suppose the hope is if even the slightest of changes will be spotted instantly and acted upon, but surely all women and babies, regardless of obstetric history should receive close monitored care? 

So far in 18 weeks Alexander has been scanned by the NHS 5 times - we have another 2 pre-booked routine scans booked in next week which will take us to 7, and they'll continue at a maximum of 4 weeks apart until he is born unless it is deemed necessary to look in even more frequently than that. I think the final number of scans will be quite something. Apart from scans I'm booked into see consultants at a maximum of 4 weeks apart from Monday onwards for various other checks and  weekly midwife from 25 weeks pregnant onwards as well. 

Anabelle had extra scans too - we had 6 in total with her; her dating scan, an extra scan after the three bleeds, her anomaly scan, a random scan with a consultant to check her position which we weren't expecting, the scan I had before being discharged following threatened prem-labour and then that final sixth scan that confirmed she had died.  But no-one was "on top" of my care as they are now. No-one was going out of their way to reassure me. 

Monday I have an appointment with my consultant. I'm desperate to see her now for any level of reassurance and understanding. These last weeks have been increasingly tough - feeling fragile and vulnerable about sums it up, a single thread of coping left, no energy left to deal with anything else scary with Xander and still so much of June to get through. 

I miss Anabelle. This isn't supposed to be how my family is. 

Ok so this is my first attempt at a blog hop! I've no idea if I'm even doing it right - someone guide me if I'm not! Celebrating Mums have started a new Mummy Moment blog hop - sharing photographs of special Mummy times. Well what could be a more special Mummy Moment this week than seeing my sons face for the first time! So I've added my Alexander Jon post to the first hop competition.

Yesterday we celebrated our little boy bump by Jon taking some more photographs of him! So here we are, Alexander and me 17+6 weeks grown, but feeling much bigger than that! Infact at the moment, based on weekly photographs taken of me this pregnancy and in Anabelle's pregnancy - we're currently matching my size last time at 22+ weeks! 

Wow! We have a little boy! I'm so excited to introduce you to our precious growing SON! 

Alexander Jon Morgan (or Xander, as he'll be known for short!)   

Today has been a really happy day - such a lovely warm fuzzy feeling since the sonographer announced our baby was team blue and we had a very clear view of his winky and a special little look at his face in 3D - even if he did refuse to move his arm out of the way for a full look! 

Today deserved celebration because there is much to fear. I can honestly say this is the first day so far this pregnancy that I've enjoyed whole-heartedly; dismissing how frightened I am and embraced the excitement surrounding seeing our beautiful boy. Today it was much more important to enjoy and celebrate than let the fear tarnish Alexander's special naming day.  

Our second child is named and I cannot wait to get to know him, watch him grow, pray hard he stays safe, meet him and bring him home.   So here I am, the extremely proud Mummy to both of my children; my beautiful babies, Anabelle and Alexander. 

A year ago tomorrow, on the 6th June, our nightmare was beginning.  We didn't know it yet; it still hadn't occurred to us our daughter would die, but the 6th marks the day it all started to go wrong for us and Anabelle.  

It was a Sunday and we were due to go to a 1st birthday party. Anabelle had been quiet, I wasn't sure I'd really felt her move much since Friday and I was starting to get a bit concerned. I didn't feel at all sure of myself; I'd been feeling what I thought was Braxton Hicks and had put the quietness down to the running out of room. Not being pregnant before I relied on the baby books for the information and 31 weeks meant running out of room for lots of movement and expecting to feel Braxton Hicks. But we were beginning to feel anxious we phoned the hospital for reassurance and asked to go in to be checked over.

We assumed we'd be up there an hour; the baby books say babies start moving around again as soon as the Dr's try to monitor them on a trace. So we let people know we'd be late for the party but expected to get there a bit later.  Only we never arrived and missed the party completely.

I was put on a trace and yes, Anabelle did the moving thing the baby books said she'd do, but almost immediately the trace identified the "Braxton Hicks" were actually more like early contractions/tightenings and worse that Belle's heart rate was dipping with each one and dipping spontaneously in between.

Never in a million years did we expect to go up to the hospital for monitoring to be told I was threatening premature labour and that Anabelle would be delivered by c-section if they couldn't stabilise her heart rate and stop the tightenings.

Everyone was springing into action. I was put on a permanent trace and a Doctor was checking my cervix was still closed and ordering drugs to stop the tightenings and steroid injections to help Anabelle's lungs and breathing if the other drugs didn't work, ordering catheters and other 'prepping me for theatre bits' incase the other drugs didn't work.

It was incredibly frightening and we were terrified our beautiful girl was going to be born too early, worried for her development and how it could affect her future if she was born 9 weeks early.  A neo-natal doctor was called down to delivery to talk us through what would happen to Anabelle if I was taken into theatre sometime that day or over the coming days.

Thankfully (I think? I'm tortured by the what ifs of the whole situation) the drugs worked and the tightenings started to settle down and space further out, Anabelle's heart rate stopped dipping. The fear of theatre was now on hold and after 8 hours on delivery thinking our daughter was going to born we were transferred to maternity ward for a nights rest; more monitoring and treatment, two days on maternity ward before being allowed home. Scanned and discharged they were confident Anabelle was absolutely ok.

We went home and rushed about preparing things for Anabelle, fully expecting that a 40 week delivery seemed unlikely now.  Every extra week was going to be a bonus. Little did we know we only had one week left with our daughter alive at all.    We made a cast of my bump, we had those precious bump photographs taken, Anabelle's room was painted, I washed all of her clothes ready for her, Jon started building her furniture.

I cannot help but think how things could've been different. We're promised the threatened premature labour is in no way related to her death seven days later, that it was just a horrible co-incidence in timing. Would she be here if she'd been born on the 6th June? Would she have been safer in a special baby care unit than she evidently was inside me?

How will we ever know... I have to trust that the hospital did what was best for us with the information they had at the time; they had no reason to think Belle would die and neither did we.

What decision do we make if we find ourselves in the threatened premature labour again? We thought we'd done our best by Anabelle but she died. I know, at 31 weeks she would've had a good chance of being strong and surviving. I know she equally could've died in a SBCU but would the doctors had more chance of saving her there? If Bow tries an early escape what do we do?  I'm not sure I could cope with even a sniff of history repeating itself in that way (or any way); even if I'm told the premature labour wasn't related to her death, I cannot help but think now it was a warning sign. Something was wrong, she wasn't happy, she was trying to let us know and maybe we made the wrong decision for her.

I don't trust myself in this pregnancy, not at all. I'm not sure I can make the right decision for my baby, or notice the things I'm supposed to be noticing. I'm doubting myself all of the time. There is such a long way to go.

Last year on the 6th our pregnancy was rocked with the unexpected. The start of our list of painful "this time last years" is marked with tomorrow being a special day - this year on the 6th June we're being introduced to Bow as a little boy or girl. By tomorrow evening I hope to be able to tell you all if we're having a blue or pink baby and introduce Anabelle's little brother or sister by name.

There are 18 days left until Anabelle's 1st birthday. 

How is it June again already? 12 months gone by, a whole year. It's too fast. I'm not ready for it to be a year. Life feels heavy at the moment; the weight of the world on my shoulders, juggling far too many balls. Of course I knew June was going to be difficult but here we are and I'm wondering if I've bitten off far more than I can chew. 

I'm beginning to re-live the "this time last years" when our nightmare began. The onset of a threatened premature labour, a hospital stay, a discharge and then after thinking we'd succeeded in keeping her safe for the time being and out of special baby care, she died a week later. 

Maybe the start of June is contributing to the pressure and fear of this pregnancy. This time last year I ended up on the sick and then on maternity leave far earlier than I ever imagined. After all it is this time last year it all ended for us with Anabelle. Or maybe it was this time last year that everything started for us with Anabelle; I suppose it depends which side of the coin you're looking at. 

I don't think I'm quite all there at the moment, I can't pull my head together properly. A big part of me would love to start curling up away from the world, see as few people as possible and hibernate until November. Not that it is possible; trying to meet my teaching responsibilities and the start of the second busiest half term in an academic year, my angel Mummy responsibilities and pulling off a successful fundraising day for Anabelle, my pregnant Mummy responsibilities and just somehow keeping Bow alive (although realising that this one is completely out of my control)... lots of hospital appointments and remembering everything else that has to happen this month too.

Maybe I should've just concentrated on getting through June instead of having all these plans to contend with on top of all the first anniversaries and Anabelle's 1st birthday. 

Be warned, this post is going to be a "too much information" blog.  Don't read if you don't talk about "women's things." 

The last few weeks have been tough. Emotionally I'm struggling to cope with this pregnancy. Every time I think I have a handle on it and my confidence improves; I then find myself terrified again and unraveling fast. Our anxiety levels are currently through the roof. 

In the last few weeks I've now had 3 episodes of spotting, the latest 'episode' turning into a week of stress- sometimes brown, sometimes red. These added 'complications' are putting an enormous strain on our emotional health during already one of the scariest times of our lives . Each time I've had a loss I've been scanned; and Bow has been fine. The build up each time to another scan is intense, fearing we're about to hear those words again replaced with an overwhelming relief that for now our second little one is still there and still growing. As lovely as it is to see Bow each time, I wish it wasn't because of something scary.

The spotting hasn't been anything that dramatic may I add, well not in the sense of actual loss, its not gushing out of me by any stretch of the imagination, but you can imagine that even the smallest evidence of blood on toilet paper is enough to send Jon and I into panic stations. Despite knowing that lots of women bleed in pregnancy and still bring home babies, knowing sometimes there is no explanation and despite knowing that blood doesn't equate to it all going wrong; knowing how pregnancy can be for other people doesn't make this any easier for us.  

One of our babies are already dead - it isn't unreasonable to 'expect' it to happen to our other baby. 

My first extra scan suggested the very edge of the placenta had had a small bleed, but there was nothing to worry about - Bow was as happy and active as he/she had been in my dating scan. My second extra scan showed nothing of concern but a water infection was detected; I was treated with a course of antibiotics. Both of these bleeds were just over one day before they stopped again. 

Since Friday night I've spotted on and off each day. Again, sometimes red, sometimes brown. It isn't constant, but it is sometimes there at some point each day when I go to the toilet. Today is Thursday and there is still evidence of red. It is this particular bleed that has highlighted a monumental NHS failing in my particular hospital.  Obviously I cannot speak for every hospital in the UK. 

It wasn't until Sunday that I decided to ring in to Obs&Gynae ward. The ward I'm attached to is only open Monday - Friday for day cases and I didn't want to contact the other ward, who didn't automatically know me or our history, unnecessarily. I reasoned that we'd had two episodes of spotting before and all was fine; and as Friday and Saturday were 'only' brown I tried not to panic and would see how it went. Sunday brown turned to red and I knew it was time to phone the hospital and went in to be checked over. No water infection this time and cervix was closed tight - these were good signs that all was well with Bow.  But what I needed was another scan; and this is where the NHS failed us. 

Being Sunday meant that no one qualified was available to scan me; no sonographers on duty, no consultant available, the registrar currently on duty not qualified to scan.   Instead, despite our history of baby death we had to wait until Tuesday for a much needed scan while the spotting continued and anxiety levels increased.  My fragile state was evident to the Doctor on Sunday, even more so by Tuesday.  

The Doctor I saw was very apologetic. Agreed whole-heartedly with us that just because it was Sunday, the weekend, bank-holiday didn't change my medical need. He agreed I was getting half a service as a result of the staffing situation. Medical need is not dictated by day of the week after all.  It is incredible really that an obstetric and gynaecology department doesn't have somebody qualified to scan 24 hours a day, 7 days a week, 365 days a year.

Thankfully Tuesday's scan revealed a happy baby but no explanation for the spotting. The Doctor doesn't know what to suggest other than rest as much as possible and possibly put me on absolute rest if the spotting carries on now or keeps reappearing weekly as it has done. All he could offer us was to keep ringing whenever we are anxious. 

It isn't really much reassurance for us right now but I accept there is little else they can do but wait and see. They can't stop a bleed if they can't identify the source; I suppose even if they could identify there is still little that can be done unless there are specific circumstances. 

This weekend just made me think again on how our pregnancy care could be improved in an attempt to bring down baby death rates. Following on from my post last week (The UK verses Finland) - surely this is one of them - providing a 24 hour care service nationwide, giving scans when needed without delay. Scans are a basic obstetric requirement. 

It frightens me that for all they knew Bow was dead but were in no position to ascertain his/her health until Tuesday. Wasting this precious time could be costing babies' lives. I could not help but think of all the "What ifs" during those two days waiting for the scan. What if something could be done, but by Tuesday the 'could be' might've been too late? A multitude of horror stories ran through my mind. 

I worried for women even further along in their pregnancies than I am. Anabelle died on a Wednesday; we found out on the Wednesday. What if she had died on a Sunday - would I have had to wait until a working week day to have that urgent emergency scan to determine if she was dead? Are women living in torment over a weekend not knowing if their precious babies are alive?  Or was the wait I had to endure simply because I'm in the middle of second trimester no mans land?  Where on earth was a qualified consultant on Sunday? 

A multitude of horror stories are continuing to run through my mind. I know 'some women bleed all the way through pregnancy with no explanation' - I just wish that woman wasn't me for the last week. This is one of the things we could do without. Would it be too much to ask for a smooth ride and successful pregnancy? As if we didn't have enough to worry about and fear without this on top. I cannot cope with this; the signs of blood are increasing the fear that something terrible is going to happen in this pregnancy too. 

Currently we're frightened and frantic and I know this feeling is only going to get worse until by some miracle Bow survives this pregnancy journey and we get to bring him/her home.