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This has been a long time coming. It’s Neave’s birth story, continued on from here.

My lovely midwife Beth practically promised me that my baby would have a nice long ‘after birth’ sleep of approximately five hours. I felt confident that it would be so – I’d really earned a rest, and the baby had spent at least an hour latched on to my breast, sucking away, so she ought to be content. This was my first ‘real’ baby (as in ‘full term’), and I was looking forward to having her room-in with me and not merely borrowing her for feeds. Don’t get me wrong – I knew I wouldn’t be getting much sleep, but I was very hopeful for a short reprieve after the birth, before we began the chaotic, sleep-deprived mess that is having a newborn.

I kissed my little baby, wrapped snuggly and tucked into the plastic hospital bassinet, climbed gingerly into my own bed and closed my eyes for what I hoped would be at least three hours. But I couldn’t sleep. My mind was still racing from the events of the day. My baby was, at last, safe and sound and sleeping right next to me. Tomorrow I’d be taking her home. I was nervous, excited, sore. More sore than I remembered being after Molly and Tiernan (although this time there was no tearing, or even grazing). I thought about what to call my little one. We had four possible names for boys, but only one for girls. Isla. But it didn’t seem like the name for her. Even though it was the only one on our list, neither of us wanted to commit. It bothered me that I couldn’t call her by name.

Eventually, despite my inner turmoil, I did manage to drift off to sleep… only to be woken what seemed like a millisecond later by her tiny wails. She’d slept about 90 minutes. That was all the time she needed to recover from birth, and now she was ready to get stuck into being a newborn baby and doing newborn baby things like feeding all through the night and then crying for much of the rest of it. That first night, like her birth, has become a bit of a blur. At one point, I had finally got her settled back into her bassinet after feeding her and was just drifting off again when a midwife came in to check on us. To my horror, she unwrapped my baby, took her temperature and then promptly told me she was too cold and I’d need to do some skin-to-skin contact with her. The midwife stripped her off and tucked her down my shirt, then left. Now, I do love me a bit of kangaroo care with my babies. I did it at various points with both Tiernan and Molly, and loved every minute of it. But I’d never tried to do it and sleep at the same time. And sleep was of major concern to me. Not that my baby’s wellbeing wasn’t important to me, but in my dazed and confused state, I really was having a hard time getting past my desperate need for sleep. The good news was that my baby slept much better curled up against me (co-sleepers the world over will attest to this). But I didn’t! I was trying to sleep sitting up and it really wasn’t working out for me. After what I felt was sufficient time to raise her temperature, I decided to dress and wrap her again so I could lie down and try to sleep properly. But my midwife friend caught me in the act and, after checking her temperature again, advised me to continue with the skin-to-skin contact. I think some small measure of disgust must have registered on my face, so this time the midwife actually helped me to get into a comfortable position to sleep with her, and then it wasn’t so bad.

Once I got it into my head that the ‘reprieve’ wasn’t going to happen and I was just going to be this exhausted for the next twelve months or so, then I was able to just go with it. It’s funny how you forget what beyond tired feels like. You forget that it just goes on and on and on, until your body eventually accepts that three hours sleep is the new eight hours, and somehow you become semi-functional again. But the weeks until that happens are the hardest.

Things looked slightly better in the morning. They always do. We were visited by the kids and Tom, and his mate Daniel (who he had enlisted to help him with the kids!) I was keen to come home, but we had to wait until Neave was 24 hours old to make sure she didn’t develop a GBS infection (hence the temperature-checking). The subject of names came up between Tom and I again, but since we were both busy (toddlers and hospitals do not mix), we really couldn’t discuss it properly. So, after they went home, my baby still had no name. I was pretty disappointed.

When my Mum arrived, she and I sat and tossed names around while we waited for it to be time to go. Initially I said I thought she would be Isla because that was what I had been calling her in my head all night, but she didn’t really like it. She said she needed something smaller and cuter, to suit her smallness and cuteness, I suppose. I do remember looking at my baby and thinking she had such a round, pixie-like face, and wanting to give her a name that suited her. Isla wasn’t really it. During our discussion, the name Niamh came up. It’s an Irish name, meaning “Bright” or “Radiant”. I liked it, but when I mentioned it to Tom months previously, he had dismissed it straight away. He didn’t like the spelling.

Meanwhile, my baby slept soundly for most of the day, feeding every two or three hours. She even had some awake time after each feed, when she would look around, taking in her surroundings and listening to our voices. She was a real baby! Eventually 5pm came around and Tom picked us up from the hospital. On the ride home we discussed names again and I mentioned Niamh to him, but suggested changing the spelling. He didn’t reject it straight away, and I took that as a good sign. But he also didn’t seem to be nearly so worried as I was that our baby was 24 hours old and still had no name. I know that in many cultures babies aren’t named for weeks or even months. But it was a real sticking point for me. It just didn’t feel right. I wanted to give her a name and use it to bond with her more. Feel closer to her. Really, we were bonding just fine, but it still felt incomplete. It’s hard to get to know someone when you don’t know their name.

On her way home from hospital

Waiting for us at home were Tom’s parents, his brother, James, my Mum, my sister, Kate and her partner, Mitch. We had dinner together, the baby was passed around, as babies always are, and I got to have big cuddles with Tiernan and Molly. They seemed pleased with the baby, but not terribly fussed either way. They gave her lots of cuddles and kisses, but were just as happy when she was put down to sleep and they were the centre of attention again.

Big brother Tiernan

Neave was a placid, content baby during the day. She slept for hours at a time, didn’t stir at noises, and had awake periods but was easy to settle back to sleep again afterwards. But at night, she just cried and cried, unless she was in contact with me. In hindsight, I think we should have just done away with the bassinet altogether, because she spent way more time in bed with me, feeding away, than in it. We dabbled with co-sleeping when the others were little, but the third time around we got much closer to the real deal. Partly because we were less worried – babies are pretty tough, after all – but mostly because it was just so much easier to let her feed while I slept. And to let her continue to sleep next to me rather than wake her up by moving her to the bassinet afterwards. I even started leaving nappies and wipes right next to the bed so I could change her without getting up. So, exhaustion and laziness were major factors in our slow slide into co-sleeping. The hardest part was actually getting Tiernan to stop coming to our bed during this time, though. While I felt fine about having the baby in with us, I didn’t want Tiernan in there too. It was too squashy and I was more worried about her falling out when he was there. It seems unfair, because we had been allowing to come in to us during the night for a few weeks before Neave was born, but after a few nights of telling him ‘No’ and putting him back to his bed, he got used to it. (Here is where I admit that, these days, all three of them have full access to the parental bed during the night. Most mornings we wake up with at least two out of three in with us. We should have upgraded to a King instead of a Queen when Neave was born. Sigh.)

Feeding Neave, while much smoother and easier than the first two times, became quite horrible on the third day. This is baby blues day for me. Neave’s latch wasn’t perfect and it was causing some damage to my nipples, and it soon became excruciating while she attached and munched away. I used plenty of Lanolin, and also resorted to a nipple shield on the left side to give the nipple time to heal. Coupled with that, my milk was coming in (a good thing, but rather painful and emotional) and I was getting awful contractions with every feed. These contractions are triggered by breastfeeding and they help the uterus return to its normal size. I barely felt them after Tiernan, definitely noticed them and even took Panadol for the ones I had after Molly, but this time around it was so much worse. The midwife who came to visit me each day after Neave’s birth, actually told me her theory that every third baby is worse. She had no idea why, but she advised me to take the strongest pain medication I could get over the counter for the next few days because it was going to hurt! It actually felt like being in labour again, and my body would tense up automatically every time my poor baby tried to latch on. With all the different pains coming at me from different directions, I started to get rather overwhelmed. And she still didn’t have a name!

Between all the visitors people usually get in the days after a baby is born, lack of sleep and just being busy, we still hadn’t decided on a name. I was getting quite stroppy about it because it seemed to me that Tom was avoiding the issue or that he didn’t realise how much it meant to me. We discussed it over and over, but I couldn’t tie him down. He kept bringing in more names that weren’t previously on the list, so I would counter with mine: Beth, Erin, Sarah, Evie, Emily, Billy, Bob, Gertrude… Finally, finally, he gave me a choice between Isla Rose or Neave Elizabeth. I really thought Neave was the name for her. Small and pixie-ish, like she is. We chose to Anglicise the spelling because we were worried about her being called ‘Nee-am’ all her life. We chose Elizabeth mostly because it sounded nice with Neave, but also because it’s my Mum’s middle name, and it’s also the middle name of Neave’s cousin, whose birthday she was born on. So it all fits. I like having slightly unusual (but not ‘out there’) names for my children, and meaningful middle names that match.

Once the decision was finally made, I was very happy. A weight lifted and I was finally able to call my baby girl by her name. A name that she’s had for two years now, and that she is certainly living up to. I couldn’t imagine her being anything other than my bright and shiny little Neave!

Bright, shiny girl

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Continued from here.

I slept as well as I could the night before Neave’s birth. I had the usual nervous, excited, anxious thoughts doing loops in my head all night, so it was hard. But, at least I was at home in my own bed, instead of sharing a room with another about-to-give-birth mother, and being woken and poked and prodded by nurses all night long. There were also no crying babies, blaring lights or beeping machines to keep me up. Just my unborn baby kicking merrily at my ribs. This was a new experience for me – I was in hospital days before each of my other births, so being home was nice for a change. When my alarm went off (just as I was drifting into the deepest sleep I had managed all night), I hopped out of bed, woke Tom, and set about getting breakfast. Tom, Tiernan, Molly and I ate together as a family of four for the last time. We told the kids that they would have a new brother or sister by the end of the day. They were excited. Tiernan wanted a brother. Molly wanted a puppy. We said we’d see what we could do.

We called the hospital at 7am, as instructed, to find out when we should head down. They were experiencing a bit of a rush and so asked us to call back in an hour. With some extra time to kill, I had a shower and made sure I had absolutely everything I needed in both mine and the baby’s bags. The baby’s bag was chock-full of white, yellow and green clothing. Having washed baby clothes to pack was also a new experience – we were completely unprepared for both Tiernan and Molly, so both had to wear hospital clothes for their first few days.

I don’t remember what time we ended up arriving at the hospital, but I think it was around 8:30am. We walked into delivery suite, were shown to a room, and met our midwife, Rachel, and her student (whose name I have forgotten). We showed Rachel our birth plan, which was quite specific. This being my third induction, I knew exactly what I was in for, but I also now knew, thanks to some research, that there were certain things I could have a say in. My assumption for my first two induced births had been that I had no control over the situation whatsoever, and no-one, at any point, gave me any indication that this was not the case. However, after extensive reading about what induced births look like in the UK, I suddenly realised that I should be the one calling the shots. It was my baby and my body, and the midwives and doctors were there to give me their advice, but not to order me around. So, after double-checking with my obstetrician that this was actually the case (he conceded, somewhat reluctantly), I wrote my birth plan.

In my plan, I stipulated that I wanted to be given the minimum dose of Syntocinon, the artificial hormone used to induce labour. I also stated that I wanted the dose to only be increased very, very slowly. The reason I was so specific about this is because of what happened in both of my previous births. The usual procedure for induction is to break the membranes so that the baby’s head puts pressure on the cervix and helps it to slowly open. Then the Syntocinon drip is started, with a low dose at first, and is increased every half hour until labour is established, which is defined as three strong contractions in every ten minute period. However, I read a paper on the OC Support UK website, which suggested that women with OC may sometimes overreact to Syntocinon, with far stronger contractions that what would normally be expected. Now, I don’t have any ‘non-OC’ contraction experiences to compare to, but I do believe that my body did overreact to the Syntocinon I was given to start both Tiernan and Molly’s births. Both times, everything went well – I started to have light cramps that gradually got stronger and stronger and became harder to cope with, as is to be expected. The reason they slowly turn the drip up is to try to simulate the progression of a natural birth, from light contractions in the beginning to strong, pushing contractions at the end. However, in both Tiernan and Molly’s births, there came a point when suddenly the contractions were completely, overwhelmingly strong, when I felt like I was being ripped in two and that the pain was going to kill me. It was unbearable. The first time, I responded by demanding an epidural, the second time my baby was so tiny that she was expelled from my body after only 4 minutes of pushing. The third time around, I wanted to avoid these crippling contractions altogether, if possible. I wanted to give my body the chance to do its job with only a little kick-start. My obstetrician agreed that this was fair enough, given that I had responded well to induction in both my previous births. For some women, induction doesn’t work at all. Since I had a good track record with it, he agreed that I could ask for the smallest dose possible, with the drip only being turned up every hour.

My birth plan also stated that I wanted to be able to try different positions throughout the birth, rather than being stuck on the bed or in a chair, as I had been with Tiernan and Molly. I knew this would be difficult, as I had to be attached to foetal monitors to make sure the induction wasn’t upsetting the baby and that she was safe. However, I knew from my reading, that it was possible – monitors can be repositioned periodically if they need to be, and turned off for short intervals for labouring women to go to the toilet or change positions. Despite this, Rachel seemed dubious on this point. She said she was happy to go along with my first request for as long as the labour was progressing satisfactorily. But as far as trying different birthing positions went, she really just wanted me to stay on the bed or in the chair. I was a little disappointed but had to concede the point. So, we got on with things.

We went through the usual procedure. I had a cannula inserted into my hand, through which I was given antibiotics for GBS. I then had my waters broken by an obstetrician, and the Syntocinon drip was started, on a low dose. Then the waiting began. As with both Tiernan and Molly’s births, I experienced period-like cramps to begin with. These showed up on the monitor, but barely registered. But they were there, and at least they proved that something was happening. This was enough to convince Rachel that we could indeed leave the drip at the lowest level for an hour before turning it up a notch. When going into a birth for the third time, most people would expect to be in and out of the delivery suite faster than ever before. However, since we were taking a new approach this time, I felt sure that this birth would actually take longer than Molly’s (about an hour and a half after labour was ‘established’), and possibly even longer than Tiernan’s (six and a half hours). I really thought Molly’s size was the biggest factor contributing to her fast birth, so I was quite dismissive of having this third baby quicker. The labour certainly took a lot longer to establish, which was to be expected, but  that didn’t concern me at all. I was happy to take my time. It was pretty boring though! At around lunch time, the delivery suite shift changed, and we were assigned a new midwife, Beth. I remembered seeing Beth around the hospital after both Tiernan and Molly’s births, so I felt very comfortable with her. It also helped that she was so lovely. I didn’t bother mentioning my birth plan to her, having already resigned myself to the task ahead, in my chair. However, Beth took the time to read it from my folder, and she came in to let me know that if I wanted to move around and try different things, she was all for it. I was so happy. By this stage, things were getting a little bit uncomfortable. The drip was still being turned up very gradually, and Beth was happy that we were making enough progress to continue taking it slow. After being unhooked to visit the toilet, I decided I wanted to stand up for a while, just because I could(!), so Beth set the monitors up with me standing. She also raised the bed right up so I could lean on it during contractions. I still wasn’t quite in established labour, but we were getting close.

This position worked for about an hour or so (I’m a bit hazy on the details), but I eventually got tired of standing / leaning up, so asked to try something different. We lowered the bed and I knelt on the floor with my arms on it, resting my head on my arms in between contractions. I’m not sure at which point I crossed over into ‘proper’ labour, but I think things started to feel a bit more serious at this stage, so maybe it was then. However, after a while on the floor, my knees started to hurt and I wanted to move again. I apologised to Beth for the inconvenience, but she laughed and said that this was exactly what she was here for, to make me comfortable. I felt really lucky to have her as my midwife this time around. We did more tricks with the bed, this time lowering the end so I could kneel on it, and raising the head to give me something to lean on. I found it hard to get comfortable there, probably because I had a baby coming out of me (slowly), so nothing was really going to be ‘comfy’. Beth brought me a ball to lean on instead of the bed head, but I just couldn’t relax between contractions in that way, so I asked to go back to the floor. Sorry Beth! Once back in my original leaning position, Beth brought a mat to put under my knees (covered in a sheet), and some extra pillows to make it easier for me to kneel. I decided I was much happier there. Beth also started getting various ‘baby’ things ready, which let me know that we weren’t too far away. She asked if there was anything else she could do for me at that point, but I said I was fine. It was getting to the point where I was finding communication a little tough. Tom was great throughout all of this, too. He was patient. He held my hand, rubbed my back, passed me water. Waited. There wasn’t really anything else for him to do.

As I’m writing this, I’m surprised at how ‘fuzzy’ Neave’s birth is in my memory. It is the most recent, but the hardest to recall. I think this is because it was the ‘nicest’ – I won’t say easiest because it wasn’t easy, but it was the one where everything went right and where I felt the most respected and in control. Tiernan and Molly’s births were both so jarring and, indeed, traumatic, that they have imprinted themselves so much more clearly in my mind.

So, some vague amount of time after returning to the floor, the contractions were stronger. I was getting through the pain by breathing slowly in through my nose, and out harder through my mouth. I found that when I concentrated on doing this, it was enough to distract me from the pain and it didn’t seem as acute. It was still there, and it hurt a lot, but I was coping. As the pain got worse, I think I moaned a little when I was breathing out. It seemed like the thing to do, and it helped a little. Maybe I was just trying to let Tom and Beth know that it was really hurting! Eventually, I started to consider pushing. I asked Beth whether I should and she said I should go with whatever my body wanted to do. So, next contraction I did push. I pushed out a poo. I can’t believe I’m actually including this detail, because it’s so embarrassing, but my aim in sharing my birth story is to tell the truth, and truthfully, this is what happened. Apparently it happens often. So there you go. After that I decided not to push any more for a while, and this worked fine. Until my body decided that it really was time to push and have this baby now. As with my previous births, when it was time to go, it was really time to go. Only, these pushing contractions were nowhere near as powerful or scary as the last two times. I attribute this to the Syntocinon drip being kept at the lowest dose necessary.

When I started really pushing, Beth knew because I also started yelling. A lot. She asked me to kneel on just one knee so that the baby would actually have room to come out. I somehow managed to do this, despite my legs feeling incredibly tired and weak – there is a down side to standing and kneeling during labour, you have to use muscles to support yourself! Through the next few contractions, Beth encouraged me by telling me my baby would be in my arms very soon. I concentrated on her words while I breathed and cried. I also squeezed the crap out of Tom’s hand. When my baby’s head was out, Beth told me to reach down and hold it so that I could be the one to catch her when she came out. This was another point on my birth plan, only, by this stage I had completely forgotten about it. But Beth remembered, and she made sure I did it. I will forever be grateful to her for that. With one last contraction, Neave’s body left mine, and I pulled her into my arms. She was slippery and warm, and quite heavy, I thought. Nice and pudgy, but just a little bit blue! And after a quick check, I also noticed she was a girl! She didn’t cry right away, which had me a little concerned, but Beth gave her a quick suction to unclog her nose, and she let out a quiet little wail.

Beth and another midwife (who joined us at some point in the proceedings without me really noticing), then helped me onto the bed so that I could hold my baby on my chest. They put a blanket over us, and got me ready to deliver the placenta. I was so distracted by my gorgeous, red-haired girl that I barely registered this going on. I held my baby in my arms, and drank her in. She had a cute little, round face, and dark blue eyes. I knew they were dark blue because they were wide open and staring back at me. After a little while, we had our first try at breastfeeding. To my amazement, Neave actually attached pretty well, and stayed attached for at least half an hour. It was slightly painful, so I did try taking her off and re-attaching her a couple of times, but this didn’t really seem to help much. In the end I decided that I wasn’t too bothered by the small amount of pain – it was worth it just to have her straight on the breast like a proper baby, instead of it taking months of hard work. Sitting there with my baby in my arms for such a long time after her birth, was like a dream come true to me. It was another ‘tick’ for the birth plan – I got to deliver Neave and was the only one who held her for the first hour of her life. Again, this was thanks to Beth, who did the usual measurements (length, head circumference) while Neave was feeding, and she waited until she was finished before weighing her (3065g, or about 6 pounds, 12 ounces).

It’s amazing how quickly after birth everything returns to normal. One minute, I’m in the ‘zone’, with almost no verbal skills beyond crying and yelling, unable to concentrate on anything other than giving birth. The minute the baby is out, all pain is forgotten, the fog lifts, and I’m able to carry out a conversation as if nothing happened. Only, something huge did happen – I gave birth to a baby! This is when the little details, that were totally ignored before, start to register. “What time was she born?” 4:58pm. “So that means the labour was how long?” 1 hour and 25 minutes. “What?” 1 hour and 25 minutes. “Are you kidding me?” No. You pushed for three minutes. “What?” And then, “Oh my God, did I really do a poo?” (For comparison, Molly’s birth was 1 hour and 15 minutes long, with a pushing stage of 4 minutes… so Neave’s birth was surprisingly quick, once we got going!)

Tom did eventually get to give Neave a cuddle, while I had a shower. Then we called his Mum and Dad, who had Tiernan and Molly, to come and see her. We had prepared some presents to give Tiernan and Molly, from the baby. They went down a treat. They were more interested in their new toys than they were in their new sibling, although Neave did get plenty of love, too. Tiernan didn’t seem to mind too much that he had another sister and not a brother. Nanny and Poppy were also quite chuffed with their second granddaughter. So everyone was happy.

The kids didn’t stay happy for very long, however, so Nanny and Poppy took them home after a quick visit. By this stage, it was time for the baby and I to move upstairs to the maternity ward. We were visited there by my sister, Kate and her partner, Mitch. Neave was sound asleep, and I really wanted to be, too. But I was happy to give Aunty Kate her first cuddle with her newest niece before turning in. As luck would have it, Neave and I were given a single room, yay us! After Kate, Mitch, and Tom all left, I eventually climbed into bed, exhausted, and tried to think of suitable names for our darling girl.

Okay, so here comes the next installment of my childbirth novel! For other installments, see here. I’ve also written a much more brief account of my pregnancy with Neave here.

You would think that after two rocky pregnancies and two premature births, I would have been done with the whole baby thing. Certainly, I was very put off ever having another baby in the first few days, weeks and months after Molly was born. It was all so scary and traumatic. I never wanted to go through it again. After two experiences with Obstetric Cholestasis (a condition caused by pregnancy hormones interfering with the liver’s ability to process bile acids, which can cause stillbirth, particular after 37 weeks gestation), I was sure there would be no avoiding it in future pregnancies. I was also very worried by the fact that I seemed to have a much more severe case of it the second time around, but with no warning symptoms until it was too late. If I were to do it again, surely it would be even worse?

Added to this, I also had a hard time getting over the guilt and grief that surrounded Molly’s birth. I felt I had let her down. Even after she came home, and I became super busy looking after a toddler and a premmie baby, I still had these nagging feelings of failure. So I started to do some research online, and I found this wonderful site, OC Support UK. The site includes a wealth of information, including forums, birth stories, and opportunities to become involved in research. I started to learn more about the disease, and I slowly began to come to terms with what had happened to me. More importantly, I also learnt that any future pregnancies were not necessarily doomed: some women with OC have gone on to have healthy pregnancies in future; and most of the women who have developed OC again have had healthy, almost-full-term-babies, through the help of their doctors and an appropriate management plan. I was stunned at how much more aware of this disease people seemed to be in the UK. Here in Australia, even my obstetricians had seemed fairly clueless about what I should be doing in my second pregnancy, when I told them of my history with OC. They definitely should not have told me to wait for the first sign of an itch before acting.

Anyway, armed with this new information, I started to consider the possibility of having another baby in the future. I had always wanted three children. For a while after Molly’s birth, I tried to reconcile myself with stopping at two. As I was told many, many times by others, I had my perfect, pigeon pair, who were both happy and healthy. What more could I want? However, maternal desire is a funny thing. I just didn’t feel done. Perhaps I could have felt complete with my perfect pair had I been the one controlling the decision not to have more. But as it was, it felt like my experience with OC was robbing me, not only of the last two, precious months of Molly’s pregnancy, but also of any future pregnancies. It sucked. Eventually, I resolved that, while I loved my two babies dearly, deep down I really wanted another one. But I was going to be smart about it.

So I immediately got pregnant again. Not smart. We weren’t ready. While we had recovered somewhat (but not completely) from Molly’s high-drama entrance to the world, we still had many, many things on our plate. Tom was studying at TAFE; life with two under two was tough enough – now we were expecting three under three; and not to mention the bills, bills bills! I’m sorry to say that the first few weeks of Neave’s existence were not exactly joyous. I think both of us felt trapped, scared, and pretty stupid for allowing ourselves to be in this situation. However, after a few weeks passed, and we had a little more time to get used to the idea, we both started to come around. It’s not that we didn’t want another baby, we just hadn’t planned on it being so soon. But, sometimes you just have to deal with what you’re given. So we sucked it up, and tried to stop feeling sorry for ourselves. We started to share our news with family and friends. Of course, we got a lot of What the????  responses, but mostly people were supportive and understanding.

I didn’t waste any time making an appointment with my GP: I had to get her onside to agree to let me have tests. Lots and lots of tests. This was the most important lesson I learnt from Jennifer and OC Support UK: I needed to get baseline Bile Acids Test (BAT) and Liver Function Tests (LFT) done at 12 weeks so that we would know what was ‘normal’ for me. Then I would need to get them done every four weeks, until I reached 26 weeks of pregnancy, when it would become fortnightly. If I made it to 36 weeks, I’d then be having the tests weekly. This was the ‘management plan’ that I should have followed when I was pregnant with Molly, but didn’t because I was told there was no need. How different things might have been. The horrible thing about the BAT is that it is a fasting test. So, on testing days, I would have to get the kids their breakfast and then take them with me to the pathologist. I’m not a good faster. I get all weak and wobbly and headachey, even when I’m not pregnant. So you can imagine how much fun it was to sit and wait for ages with two toddlers in the boring, boring pathology clinic while I was hungry and cranky. I had so many tests done that, by the time Neave was born, I had visible scars in the crease of each arm. They’ve faded now, though.

Two days after each blood sample was taken, I would ring my GP for the results. My poor GP must have been thoroughly sick of me by the end of it all. But she was very patient and obliging. She printed me multiple copies of the blood test referral she wrote so that I didn’t have to visit her every time I needed to get a test done. She also read out every number on the results so that I could write it down and then plot it on the table I was keeping. Yes, I was that anal. To me, those numbers were of vital importance. As long as they all stayed within normal range, I was happy. My baby had time. I was completely terrified that the bile acid levels in my blood would suddenly jump without me being any the wiser, as happened in my pregnancy with Molly. I was also convinced that this would happen earlier than last time, at around the 28 week mark, because it made sense to me that it would happen earlier each time (with Tiernan I had symptoms from about 33 weeks, and with Molly it was 31). I desperately wanted to avoid having another baby spend time in the NICU.

You can see how all of this would have made me feel like a bit of a nervous wreck throughout most of the pregnancy. I decided not to do any teaching from the beginning of 2010, when I was about four months pregnant, because I wanted to be as stress-free as possible. In between blood tests, I tried not to think too much about what my next results would be. I tried to think positive thoughts, and visualise a big, healthy baby at the end of it all. But it was hard.

In between my multiple blood donations, I started visiting the high-risk clinic at Nepean hospital every three weeks from about 18 weeks on. At each visit I would insist on seeing my actual obstetrician (and not the registrars), because I wanted to make a plan with him about what we would do if any of my blood test results started to climb. He didn’t take too kindly to my extensive research and lists of questions. He just wanted me to play dumb and let him make all of the decisions. To him, I was just another meddling, pregnant woman. How dare I try to have a say in what happened to my body, and what actions should be taken to try to prevent another premature baby? Sometimes I felt like I was talking to a robot. A baby-delivering robot who had no empathy or basic human feeling. He didn’t care how or when my baby was born, just as long as it was alive. Then we could be scratched off his list, and we would become someone else’s problem: either the NICU or the maternity ward midwives. Being in the public system, I really didn’t have much choice but to try to work with this guy. So I plied him with questions and tried to cobble together a basic ‘plan’, which went along the lines of: I could continue getting blood tests and collecting results and bringing them to him; if things started to change he would review the situation at my next appointment; I wasn’t to call the hospital with results but if I was worried I could go to delivery suite; as soon as my levels went above the normal range, I would be admitted to hospital and started on medication to try to reduce it; if I stabilised I would be sent home, on medication, and induction would be booked for 36 or 37 weeks; if I didn’t stabilise, my baby would be born by induction or caesarean. At the end of each appointment he would try to reassure me by smiling and saying, “You know, you may not get cholestasis this time around.” And I would think to myself, Don’t worry, I will.

28 weeks

And I did. At about 30 weeks, one of the enzymes tested by the BAT came back slightly (very slightly) high. The other important enzyme had also climbed, but was just within normal range. I booked an emergency appointment with my obstetrician, arranged childcare for the kids, packed a hospital bag, and went to the appointment, expecting to be admitted and started on medication post-haste. However, my obstetrician was decidedly underwhelmed. He asked me to get a repeat test and come back in two weeks. No way. In two weeks, the thing could have sky-rocketed and I could have been itching like a dog with fleas. In two weeks it would be too late. So I told him I wasn’t happy with that suggestion. I wanted medication. He said he couldn’t give me medication because he couldn’t give me a diagnosis based on one only slightly high enzyme and no symptoms. I explained to him (again) that I had no symptoms last time until it was too late. Couldn’t he give me medication prophylactically? He still wouldn’t budge. I was turning out to be a major thorn in his side. He deliberated for a few more minutes, and then suggested I see a gastroenterologist for a second opinion. I agreed. Driving home that afternoon, I felt so many different emotions. I was pretty upset and angry that I still wasn’t being taken seriously, although the appointment with the gastro gave me some hope; I was relieved to be going home to my family instead of being stuck in the hospital; but mostly, I felt drained. The anxiety and nervous tension of the last few months were starting to get to me. I just wanted it to be all over. I cried as I drove home.

So, a few days later I saw the gastro. I paid him $200, and I got my own way. He agreed with me that I would probably end up with OC again. He agreed with me that I would probably end up on medication for it at some point. He agreed with my obstetrician that there was no evidence that taking medication prophylactically would help at all. But he agreed to let me just go ahead and take the damn medication, anyway. At last.

Ursodeoxycholic Acid is not cheap. I think I paid about $100 for only a month’s worth of tablets. But the price was worth the peace of mind it gave me, let alone anything it may or may not have been doing for my stressed-out liver. Starting the medication marked a turning point in the pregnancy, I believe. Finally, something productive was being done, other than my ‘torture by needles’. Finally, someone had listened to me and acknowledged my feelings and my input into the decisions that were made about my body. I felt warm, fuzzy feelings towards my gastro guy for quite a while. I started to relax a little and enjoy being pregnant for the first time in the entire pregnancy. The whole thing had been one emotional rollercoaster ride up until that point. But now I knew that I was doing everything possible, and that I would just have to wait and see what happened. It was very freeing. Tom and I started to get a bit more serious about the ‘name game’. We had a few boy’s names to choose from that we both liked, but we were struggling with girl’s. I figured that meant the baby was probably a boy. It had worked that way with both Tiernan and Molly.

Things continued to go well until 34 weeks, when I was surprised to discover another sharp climb in my blood results. This time, my obstetrician wanted to admit me and monitor the situation for a few days. I knew this meant that I would probably be having my baby within days. I had already packed a bag for myself and a bag for the baby. Optimistically, I left the baby bag at home. I figured Tom could bring it to me when the time came anyway. Once in hospital, my obstetrician and gastro decided to increase my medication to the maximum dose, and take daily blood tests to monitor my bile acids. I also had twice-daily foetal monitoring, where I was strapped up to the trace machine and told to press the button whenever I felt my baby move. Each session lasted about half an hour, and it was pretty uncomfortable. However, it was nice being able to just sit and listen to my baby’s strong heartbeat and know that, despite everything I was going through, so far everything was great with her (I didn’t know it was a her, but it’s easier to just say ‘her’). It was bonding time. All around me, in the antenatal ward, woman were wandering around in various stages of pregnancy, and even labour. I felt almost certain that I would be one of them very soon. I resigned myself to having a 34-weeker. Not full term, but much, much better than a 31-weeker. I felt no guilt this time – I knew I had fought and fought the hardest I could, and now I just had to let things be. At least a 34-weeker should, theoretically, have a much shorter stay in the NICU, and have a much easier time of feeding. So, all going well, with no complications or infections, perhaps we could have our little one home in two weeks? Not great, but not as bad as last time. I was nervous, but at peace with the situation.

So imagine my delight when, after two days in hospital, both my doctors came to tell me that while my bile acids were high, they were fairly stable, and that I could go home tomorrow after one more test. I couldn’t believe it. This had never happened before – I had never left hospital still pregnant. I am going to throw caution to the wind and attribute this marvelous fact to the medication I had already been taking for some weeks. Of course, in the science world, this can’t be proven because 999 other pregnant women with OC didn’t also take part in a trial with placebos vs medication vs no intervention at all. But, when you compare my three experiences with OC, the best outcome I got was when I started taking ursodeoxycholic acid before I was officially diagnosed, with the dose increased once my diagnosis was confirmed. There is no doubt in my mind. I will forever be grateful to my gastroenterologist for taking this chance with me. And I’m thankful to my obstetrician for at least referring me to my gastro when he didn’t know what else to do with me. I feel a little sorry for him, even though his attitude sucked. I wasa pain in the arse. But I was right. At this point I should mention that I would never have had the courage to do all of this wheeling and dealing with so many doctors and midwives if it weren’t for the support of Tom, my Mum, Jennifer from OC Support UK, and also the benefit of my previous pregnancy and birth experiences. This time around I knew what I wanted, I knew what I was entitled to, and I knew how to get it.

I went home the next day, with a tentative induction booking for one week later, at 35 weeks. In the meantime, I was to start weekly bile acid tests, and return to the hospital for foetal monitoring every two- to three-days. This was a serious inconvenience – poor Tiernan and Molly, who had been dragged from one waiting room to another for months now, were starting to get pretty fed up with it. Me too. But, it was necessary, and so much better than having to drag them to the NICU every day. So we did it, with lots of help from family and friends. Sometimes one or both of them would be minded, sometimes I would be met at the hospital and they would be taken for a walk while I was busy. And sometimes I had to do it alone. Despite being so happy to be still pregnant, this phase of the pregnancy was very, very exhausting. I was getting big and cumbersome, and I was spending lots of time running around after toddlers, wrestling toddlers into the car, entertaining toddlers in waiting rooms, as well as the usual tasks of feeding, cleaning, dressing and, you know, nurturing them. A hospital bed and a few days respite was starting to look rather inviting!

Things still looked good at 35 weeks, so my induction was postponed for another week. By now, I was starting to get a bit excited. 36 weeks was still a little too early for my liking, but it was a huge improvement on 31 weeks. It was exciting, but stressful too; every week, I would mentally prepare myself for having a baby on Friday, but then, after my Thursday appointment, I would have to mentally prepare myself for another week of being pregnant instead. It was pretty exhausting.

During the next week, three days before my induction was booked, I started to itch a little at night. Very, very mildly, but enough to make me a little concerned. I also felt a bit ‘icky’. A bit light-headed, vaguely nauseous. Nothing I could put my finger on, but just generally ‘off’. I decided to go down to the delivery suite to have my baby monitored again, and another blood test, for peace of mind. I waited until Tom was home from work, and then went down. Once there, the midwives were very kind and reassuring, and they hooked me up to the monitor, took my blood, and called an obstetrician for me. My baby was still there, as happy as ever, kicking away. It took a while for the on-call obstetrician to arrive, but eventually she did review me and my situation. She said everything seemed fine with the baby, but we wouldn’t really know more until we got the blood test results back the next day. She gave me a choice of being admitted, just in case, or I could go home if I wanted to. I felt reassured that my baby was okay for now, so I went home. That night I slept well, and there was no sign of any itching. The next day, I went to my usual Thursday appointment. My obstetrician was away for the Easter long weekend, so I was reviewed by a registrar. She told me that my results were actually slightly lower than they had been the week before. I was pretty surprised, but pleased. I tentatively asked whether that meant my induction could be put off for another week? She thought about it for a minute and then said she would have to check with another obstetrician since my one wasn’t available. I waited for about half an hour. When she returned, she said the doctor she had consulted had seen no reason not to wait another week. Wow! Once again, my baby was going to get another week. 37 weeks. I had never been that pregnant before. Technically, that’s full term.

This was fantastic news, but I felt quite ambivalent about it. One of the little ‘hang ups’ I had over both Tiernan and Molly’s births was that neither of them were spontaneous or even the slightest bit natural. During this pregnancy, even through all of the complications, I think I still held a vague hope that I would somehow, miraculously get to experience this. However, driving home from the hospital again, still pregnant again, I finally was honest enough with myself to admit that I was so damn sick of being pregnant that I really didn’t mind being induced early. Not just physically, but mentally too. I was really, really ready to have this baby now. So I couldn’t help being a little disappointed that it wasn’t going to be over tomorrow. That I would have to wait another week. It may seem odd that I felt this way, since I was the one who asked to wait another week. But I did it for my baby, not for me. I knew that one more week would make a huge difference to her. Once again, we called everyone and told them no baby for another week. Once again, I played the role of exhausted-pregnant-Mum. But at least it was Easter, so there were more people around to help.

At my next antenatal appointment, my obstetrician asked my why on earth I was still here? So I told him. He didn’t seem too happy. He told me that this was it – Friday 16th April was the day. No more delays. In all of the papers I had read about OC, there was some debate about whether 37 or 38 weeks should be considered the maximum ‘safe’ gestation before induction. As mentioned above, OC is associated with a higher risk of stillbirth after 37 weeks, and no amount of foetal monitoring or ultrasounds can predict which babies will live, and which won’t. That is why doctors prefer to induce early. Despite the evidence that the risk doesn’t seem to increase until after 37 weeks, my obstetrician was of the opinion that inducing at 36 weeks was better. I can see that he wanted to be safe rather than sorry, but I was worried about the risk of inducing a little bit too early. While Tiernan, who was born at 36 weeks, was fine in the end, it was pretty obvious that he really wasn’t ready to be born. For this reason, a 37-week induction sat much better with me. So I guess we were lucky that my obstetrician went away for Easter, because I’m sure he would have insisted on 36 weeks had he been there.

Anyway, a slight rise in my bile acids that week only cemented the deal. I knew not to argue for more time. I didn’t want to anyway, I was done. It was time to have this baby!

This post is a monster! It has taken such a long time to write. Partly because I was a little sketchy on some of the details, and partly because it was such a difficult time for us. I also had trouble rendering the whole ordeal into words that made any kind of sense. It was hard, but here it is at last. I hope it’s not too wordy for you. Skip this one if you like! This story continues on from Parts 1, 2 and 3.

Nepean NICU had a completely different ‘feel’ to it than Westmead. It always seemed busy and bustling, rather than quiet and insulated, the way Westmead seemed. The NICU at Nepean was arranged into four bays, with the smallest, sickest babies in Bay 4. Babies in Bay 1 were nearly ready to go home. Molly went into Bay 3, so we knew we would be having quite a long stay. Molly’s first nurse at Nepean was called Stephanie. She explained to us how the NICU was organised, and let us know ways that we could be involved in looking after Molly. I was determined to visit Molly twice a day and do her ‘cares’, which is what they called changing her nappy, and giving her a sponge bath occasionally. I wanted to be as involved as I possibly could, so I booked myself in to do her mid-morning and late-afternoon cares. At that point she was on a two-hourly feeding cycle, so my visits were at roughly 10am and 4pm, from memory. These changed as her routine changed, however.

Molly in her new Nepean NICU humidicrib

She pulled her tube out, so this was a rare pic of her whole face

Because Molly was still under phototherapy lights (for jaundice) when we first arrived at Nepean, I wasn’t allowed to hold her again just yet. But the nurses assured me that I would have lots of opportunities for ‘kangaroo care’ (skin-to-skin contact), as soon as possible. Kangaroo care was actively encouraged as it has been shown to improve premature babies’ growth and development significantly. However, it was also important that she be given lots of time to rest, so that she could use every last calorie to grow. Nepean also had a slightly different visitor’s policy: they allowed three people to visit at a time, but restricted visitors to parents, siblings and grandparents only. It was very lucky that Molly’s Aunts and Uncles saw her while she was at Westmead, because they didn’t get to again until she was discharged six weeks later. They also didn’t allow visitors who were sick, for obvious reasons. I absolutely dreaded coming down with a cold during Molly’s stay because I couldn’t bear the thought of not being there to see her every day. It was bad enough not having her at home, but to have no contact at all would have been devastating. Luckily, even though Tiernan had at least two or three viruses during Molly’s stay, I managed to avoid them all.

I went home to my baby boy and my husband the night Molly was transferred, if not happy, then at least happier. And so began a weird time where my life basically revolved around the hospital. Tom was at home to help for the first week, but we decided that he should go back to work and then take more time off when Molly came home, so that we could all bond and get readjusted together. It was quite a juggling act, trying to find care for Tiernan while I visited the hospital. He divided his time between daycare, grandparents, family and friends, all of whom Tom and I were extremely grateful for. When other arrangements couldn’t be made, I took Tiernan to the hospital with me to visit his sister. He was so little (still a baby, really), that none of it made any sense to him. But he went along with it and coped beautifully. I also made sure we had some quality time together, just Tiernan and I. I couldn’t help thinking that, if things had gone to plan, we would have been spending lots of time, just the two of us, right then, as my teaching prac would have been over, my assignments would have been completed, and Molly would not have been with us, yet. Oh, the guilt. The crushing guilt that I was failing my children because I couldn’t be with both of them at the same time. I really think that if Molly had been my first baby, then I probably wouldn’t have left the hospital much at all until she was out. This wouldn’t have been at all good for my wellbeing, I’m sure. I’m also sure that the nurses would have encouraged me to take some time to myself. During our stay, I noticed that some other mothers of premature babies had made the decision to return to work until their baby was home, and start their maternity leave again then. Heartbreaking.

Every day I was reminded of how lucky we were that Molly was so strong and healthy, despite her diminutive size. I overheard a conversation between some nurses about a baby in the next bay who was now both deaf and blind due to a botched birth. Another family, with their baby only about half Molly’s size, had already been at the hospital for two months, and still had several to go before discharge. Two parents I said hello to and inquired about their baby in the parent’s room told me their baby was doing well, but his twin brother had died. The only thing I could think of to say was, “Oh my gosh, I don’t know what to say. How awful.” Molly’s start in life was tough, but it could have been a lot worse.

That’s not to say that it wasn’t the most difficult experience I’ve ever been through. I remember that nights at home without her were the worst. I often cried in Tom’s arms. Tom was brilliant. He didn’t try to make it better. Just listened and made allowances for my crabby moods. About a week after Molly was transferred to Nepean, we received some frightening news. A paediatrician came and saw me while I was sitting with Molly. He explained that they had done a routine brain scan, which they do on all premature babies in the NICU. They found that Molly had a grade I brain haemorrhage, which she probably sustained during birth. He quickly told me that it was basically a bruise, and that it would probably heal on its own. He said they never even used to tell parents about grade I’s because they aren’t really of concern, but do need to be monitored in case they progress to grade II, or worse. There are four grades of brain bleeding, with grade III and IV being very serious and likely to result in permanent brain damage. The paediatrician tried his best to reassure me that there really wasn’t anything to worry about at this stage, but of course I was terrified. I had been confidently picking her up and holding for a few days now (Molly was out of her humidicrib by then, and I was allowed to hold her and do kangaroo care as much as I wanted). But this news made me nervous again. When the doctor left and I had finished cuddling Molly, I wrapped her and put her back in her bassinette. It was a plastic hospital bassinette, and the nurses often tilted them so that the baby’s heads were higher than their toes, to help with reflux and respiration. I was so shaky that, when I tried to tilt Molly in her bassinette, it slipped out of my hands and dropped into the horizontal position with a loud clunk. Nobody in the room batted an eyelid, and neither did Molly, who was sound asleep. But I was mortified. I thought this little jolt might cause Molly’s grade I haemorrhage to become a grade II. I fought back tears, and urgently asked the nurse if Molly would be okay. She was very kind and reassured me that she would be fine. Molly had follow-up scans every few weeks to monitor her haemorrhage. There was no change at first, but the second follow-up revealed that it was healing, so she was given the all clear. We were so relieved. It was only a small worry, but one that we carried with us for many weeks. Thankfully, all was well in the end.

Out of her humidicrib and into a bassinette

Another quite awful thing happened when Molly was about two and a half weeks old. She had been moved to Bay 2 when she came out of her humidicrib, and had been making good progress. Meanwhile, at home, Tiernan had an awful cold. We became very concerned with his breathing during the night and eventually decided to take him to emergency. He wasn’t exactly struggling to breathe, but his respiratory rate was very high, and I could see that he was working hard. After spending most of the night in emergency, we eventually saw a paediatrician, who suggested trying Ventolin and steroids to see if that made a difference. It did, so he was admitted into the children’s ward for treatment and monitoring. And with that, we now had two sick babies in hospital. To make matters worse, Tom was due to leave for Black Springs (out west, near Oberon), for his brother’s wedding. We had already decided, weeks earlier, that I was going to stay home. I was sad to be missing the wedding, but it didn’t feel right to leave Molly in hospital and travel all that way. But now Tom had to go, and leave us all at the hospital. Poor thing. He tried to enjoy the wedding, but was worried about all of us. The only good thing was that we had already asked my mum to come and stay for the weekend to help me juggle Tiernan and hospital visits. Instead of helping me at home, she helped me at the hospital. Luckily, Tiernan responded well to the treatment and was home within 48 hours. It was his first of many asthmatic episodes, brought on by colds. The whole experience was very weird and upsetting, but we got through it. Thank goodness for Mum!

Our last piece of bad news came soon afterwards. We were living in a rental property, and the real estate agent informed me over the phone that
the owner had decided to put the house on the market, so could I please have the house ready for inspection? I was flustered, to say the least, but I let her know of our situation and she was very kind. She managed to postpone the proceedings for a few weeks, but we still ended up having our lives ‘on display’ at literally the worst time! I did my best to keep the place clean and tidy, but there was only so much I could do, in between hospital visits, expressing milk six times a day, trying to care for myself and Tiernan, as well as several other things that new mothers are usually excused from, such as grocery shopping and running errands. It was just another thing we really didn’t need, as was the worry that we would have to pack up and move soon. Fortunately, the house was slow to sell, and the people who eventually bought it were friends of ours and were happy for us to continue renting from them.

Got milk?

In amongst all of this bad news, we also had good news. Molly made good progress, and was out of her humidicrib much sooner than I had expected. Her feeds were slowly increased. She was gradually weaned off her supplements. I remember looking forward to Molly’s regular ‘weigh-ins’, which occurred on night shift, every three nights. Each time Molly gained weight, I felt that she was closer to coming home. She gained weight quite steadily, with only one or two little plateaus along the way. As Molly grew, her OGT (orogastric tube) was swapped for an NGT (nasogastric tube), which was slightly more comfortable for her, and meant less tape on her poor little mouth. After a few weeks, they started to allow her one ‘sucking feed’ per day. They had to be very careful with introducing this, as sucking a bottle, or breast, requires a lot of energy, and premmie babies just don’t have much to spare. So, at first it was only one per day. Sometimes they gave her expressed breast milk (EBM) in a bottle, and sometimes I was allowed to put her to my breast. This was encouraging, but also frustrating because she was still too little to attach properly, so she never really got much of a feed this way. But it was another small sign that we were moving up in the world.

My regular routine when arriving at the NICU was to spend absolutely ages looking for somewhere to park; end up walking nearly a kilometre; buzz myself in; scrub my hands at the sink and then use the special anti-bacterial gel (years later the smell of it still takes me right back to the NICU); take my expressed milk to Molly’s box in the freezer; say hello to Molly; have a stickybeak at her notes. See, the thing about hospitals is that no-one is very forthcoming with information. I’m not sure whether the notes were purposely left there for parents to peruse, but was pretty sure that, legally, no-one could withhold medical information about my daughter from me. So I always read the notes. Then I would do Molly’s ‘cares’, and hold her while she was tube-fed, or I would bottle feed or (attempt to) breastfeed her. Sometimes I found out interesting things from the notes that I may not have found out otherwise. Such as the time “Test for TF? negative” was written in there. When I inquired about it, the nurses weren’t sure what it meant and so paged a doctor for me to ask. They had tested her thyroid function because of her protruding tongue, which can be a symptom of hypothyroidism. In this case it wasn’t, hence the ‘negative’. She still has a protruding tongue.

Molly in a size 000000 suit

My favourite memories from the NICU were the times I spent doing kangaroo care with Molly. Just sitting and bonding with my tiny baby hidden down my shirt – as close as possible to where she should have been, right under my heart. I sometimes wonder whether Molly has any subconscious ‘memories’ of the time we spent together like that. She has always been a Mummy’s girl. As Molly’s routine changed and she started having three-hourly feeds, due to the increasing volume of milk she was able to take as she grew, it became easier for me to visit mid morning and then in the evening, after dinner. I would sit with her until about 10pm, and listen to the nurses doing handover, which was another great way of getting more information about Molly’s progress and their plans for her care.

I think Molly was about four weeks old when she finally made it to Bay 4. It was so exciting to think that this would be the last step before she came home. By now, she was having two to three sucking feeds per day, and was almost ready to start a new feeding pattern, which would be tube, tube, suck, or TTS (ie, her 9am feed might be a tube, then 12pm would be tube, and 3pm would be suck, then back to tube at 6pm and 9pm, then suck at 12am, and so on around the clock). Babies would stay on this pattern for between four to seven days, to make sure they were still gaining adequate weight, before being moved up to the next pattern, TSTS. Then came SST. Then full sucking. Then home! As Molly went on to TTS, I made sure I was there for her sucking feeds so that we could practice breastfeeding as much as possible. This helped my morale and my milk supply. She still wasn’t really getting much this way, so I would give her a bottle feed afterwards as well, just to make sure. Things were going very well, until Molly came down with a cold, which set her back. Her nose was so congested that she was having trouble breathing while bottle feeding, so they had to swap her NGT back to an OGT. I found this really difficult to cope with, as it made it impossible for her to breastfeed, and because the nurses were seriously considering dropping her back a stage so that she wouldn’t expend too much energy on feeding. Sensing my frustration (so close to home, yet so far!), a wonderful male nurse called Morgan explained to me that these tiny babies just don’t have the energy stores that full term babies do, so if you push them too far, they can just collapse. Big time: back on respirators, full tube feeds, the works. He helped me to put this small set back into perspective. Much better to just give Molly time to get over this bug slowly, than make her work too hard and end up back at square one, which would be devastating. So, I had no choice but to just go with it. Strong little Molly recovered from her cold and was back on TTS in about a week. And then she was ready for the next step, TSTS. I think it was about then that we started trying a nipple shield for her breastfeeds. It made a huge difference, as she was able to latch on much more easily, and suck and swallow actual milk, straight from me. It was very exciting. We were getting closer and closer. During this time, Molly was also taken off her monitors. I was surprised to discover that she had no leads attached when I went to change her nappy one morning. Confused, I asked a nurse why she wasn’t plugged in, and was told, “Oh, she doesn’t need that any more!” I was happy, but couldn’t help wondering how I was supposed to know if she was breathing or not! (Look at your baby, not the monitors, the nurses were always telling us).

Molly and her 'plugs' before they abruptly disappeared

We finally made it to full sucking feeds. The last step. Soon we would be going home. Then we received the news that Molly was being moved to the children’s ward, because they needed the NICU beds for sicker babies than Molly. I had mixed feelings. On the one hand, it would mean I could stay the night with Molly and feed her myself around the clock. On the other hand, I knew and trusted the NICU nurses so well that I wasn’t sure about taking her up to the big, busy children’s ward. Surely she was too little for that. I especially didn’t like that Molly was put in the furthest room from the nurse’s station, right next to the gate at the entrance to the ward. Anyone could come in and take my baby, and nobody would notice. (I should say that the entrance to the children’s ward has since been changed: it now has a glass security door and visitors must be buzzed in). But as it was, there was no way I was going to leave my baby’s side while she was in there. In a way, it was nice because it finally felt like I was really her Mum, and not just borrowing her occasionally. But it also meant I was stuck there at the hospital, and wouldn’t be able to see Tiernan unless Tom brought him to the hospital, or did a swap with me. So, after two days on full sucking feeds, I started to push to bring Molly home. Our new paediatrician resisted at first. She wanted Molly to be weighed at least twice before we left. But I was adamant. I explained that I had another young child at home who needed me there, too. She finally agreed that we could leave a couple of days later, as long as we promised to come back for another weigh-in after two days at home. Deal.

So, on Friday 31st October, 2008, we finally, finally left the hospital!! It wasn’t quite what I imagined. In the NICU, I had watched many families take their first steps off the ward together. There were many congratulations from nurses and fellow NICU parents. There were cards and gifts exchanged. There were tears, and promises of return visits. Up on the children’s ward, it was just Molly and I, as Tom was working. I had to leave Molly with the nurse while I ran outside and installed her car seat into the car that Tom had dropped off for me that morning. It took ages. It was very warm outside, so I was hot and bothered by the time I got back inside to pick up Molly. I put my tiny baby in her oversized pram, and wheeled her outside, for the first time ever. Nobody wished us well, or waved us off. Nobody hugged us and said they’d miss us. It was all a bit deflating, really. But never mind, we were OUT!

Not too happy about her first pram ride

Too tired to care by the time we got to the car

I put Molly into her seat. She looked like a doll. Still way too small. I drove so very carefully all the way home, because I was worried she would slip out of her seat if I made any sudden movements. I arrived home for the first time in days. Tom’s Dad was with Tiernan. He said a quick hello to Molly, and then had to leave for work. He left me with them both. I wanted to beg him to stay – this was all a bit too quick. Suddenly I had these two children and I had to look after both of them at the same time. That was a big reality check. I had been so focussed on getting us out of that hospital, that I hadn’t been thinking too much about what I would do once we were all home. I sat in the lounge room, feeding Molly and playing with Tiernan, and let it all slowly sink in. Together at last. Help! But at least we could finally celebrate Molly’s birth properly. One thing that really struck me during Molly’s hospital stay – so many people congratulated us on her birth, but I just couldn’t see what was so good about it. Sure, we had a beautiful girl and we were quite sure that she would be fine, but she wasn’t supposed to be here yet. It was too early. I also found it difficult to relax and have fun while Molly was in hospital. It’s almost like I would catch myself laughing or having fun, and subconsciously remind myself that I was supposed to be sad. I was sad, but I didn’t have to be every single second of the day. Once Molly came home, it felt like I was free to be a whole person again – happy, sad, excited, nervous, joyful, fearful… all of it. There wasn’t anything holding me back anymore. I could be happy that we had our Molly, and that she was here with us.

Molly's first sleep in her bassinette at home

And just like that, it was all over! Our NICU experience was the most difficult time of our lives so far, but it wasn’t anywhere near as bad as it could have been. We were so lucky to have such supportive friends and family surrounding us. Molly had follow-up visits with the paediatrician for the next year, until her growth had well and truly caught up. She also had some sessions with a physiotherapist to help her gross motor development; some visits from a lactation consultant to help wean her off the nipple shield after several months; and she is still seeing an ophthalmologist annually to monitor her vision. But she has had no negative outcomes from her prematurity. I feel so incredibly lucky that we live in a time and place where we have the medical resources that not only saved Molly’s life, but ensured that she has thrived and will experience life to its fullest. Very, very lucky.

Happy family

 

This is the story of Molly’s birth, continued on from here.

Thinking back, I am realising that some of the details of Molly’s early days are pretty sketchy. I wish I had kept a journal of our experiences. For a great account of what life on the NICU is like, visit ‘Mike and Ollie’. Little Isaac and Molly were born at 25 weeks’ gestation, in 1992, and, against the odds, they are happy, healthy 19-year-olds today. Their Mum kept a journal of their time in hospital, and beyond, and reading it has brought back a flood of memories – the sights and smells of the NICU, the anguish of being separated from a newborn, the constant fear and worry. However, I have to stress that, since these two little ones were born much more prematurely than my little Molly, they were much sicker than she ever was. Even though our NICU journey was a traumatic and very challenging period of our lives, our Molly’s life was never in danger, the way their’s was. Our journey was pretty much smooth sailing, over in six-and-a-half weeks.

Being buzzed into the NICU (Neonatal Intensive Care Unit) for the first time felt like being admitted into some sort of top-secret club for guilty parents. Maybe not everyone felt this way, but for the first few days (weeks, even) of Molly’s life, all I felt was sad and guilty. It was not a welcoming atmosphere, which was not the staff’s fault – everyone we met in our short time at Westmead NICU was warm and lovely – but the sterility and the silence of the place were quite unnerving. 

We were led into a semi-lit room, occupied by two humidicribs, several nurses and lots of equipment. Equipment that beeped and flashed different hues, monitors that showed squiggly lines and colour-coded numbers, and tanks and tubes that hissed and gurgled. We were instructed to wash our hands and arms (with both soap and anti-bacterial gel), and then we got to see her.

I was actually quite surprised at how perfect she was. I knew she would be small, but to me she was beautiful and quite ‘normal’ looking. Now I recognise the look of a premature baby – their eyes tend to be a bit bulgey for several months (depending on how early they are), and their faces are a bit more angular, until they build up more fat reserves. But I didn’t see any of this – all I saw was my beautiful daughter. She looked a lot like Tiernan as a newborn, only smaller and more delicate. It was a little bit of a guess, though, with all of the tubes and lines coming from her body and getting in the way. It was all very overwhelming. We were only allowed to touch her through the hand-holes in the sides of the humidicrib. I cried as I stroked her hair and her delicate skin. I remember marvelling at her golden hair, with the same metallic sheen that most newborns seem to have. Her head could have fit neatly in the palm of my hand, like a grapefruit. It was tiny.

When we were ready, the NICU nurses explained what each bit of equipment was for. Although Molly was breathing (and crying, even) when she was born, and did not require resuscitation, the paediatric team put her on CPAP (Continuous Positive Airway Pressure), which helped to deliver extra oxygen to her lungs without actually breathing for her. At the same time, she was given artificial surfactant, which is a substance that helps the lungs to stay inflated, and which premature babies do not make on their own. Hopefully, the doses of steroids I had been given days earlier would be enough to help Molly’s lungs mature that little bit faster, and she would not require help with her breathing for long. CPAP was the least-invasive method of helping Molly to breathe, and the doctors were just waiting to see whether it would be enough – the next step was full intubation and ventilation, which does have some risks. At the moment, Molly was comfortable enough.

There were other lines coming from Molly’s body that were monitoring her heart rate and her blood-oxygen level (saturation). She had a cannula in her little arm, with a drip supplying nutrients, and I think a prophylactic dose of antibiotics, as infections picked up in the hospital environment are the biggest risk to otherwise ‘healthy’ premature babies. At the moment, the team were mostly interested in getting Molly stable and comfortable. She had no clothes on, and the temperature in the humidicrib was turned right up because, with no stores of fat to provide insulation, Molly had no ability to maintain her core temperature.

I don’t remember meeting any doctors straight away, but Molly’s nurses were lovely, reassuring, confident and sensitive at this scary and emotionally draining time for us. They made us feel welcome, encouraged us to ask millions of questions (which we did), supplied additional information when we didn’t know what to ask, and let us know that we could come and visit our baby any time, night or day. Visitors were limited to only immediate family members, and only two at a time. Molly’s Grandparents, Aunts, Uncles and cousin came to visit her often in those first few days, and their support meant so much to us, particularly those who shared care of Tiernan for us.

I was encouraged to express breast milk for Molly. I was given a Polaroid photo that showed all of her face, without all of the tubes and tape. It was to help me ‘think baby thoughts’ when it was time to express colostrum (and later, milk) for her. At first, I was bringing tiny amounts of colostrum (like, 1-2 ml at a time) down to the nurses and bashfully handing it over, saying, “Sorry it’s not much.” They chuckled and let me know that she wouldn’t be taking anything for the first 24 hours, and even then they would have to be very careful – only giving her about 1ml every second hour, and seeing how she tolerated it.

After a few hours on CPAP, it became clear that Molly needed a little more help, so they intubated her. We were told there would be some risk to Molly’s eyesight and brain function as a result, but hopefully she would not need to be ventilated for long, which would minimise the risk. As it turns out, she was only ventilated for 12 hours before being weaned onto CPAP once again, and after only another day, she was breathing with no assistance at all. It is utterly amazing to me what such a tiny, tiny human body is capable of.

On day three, I got to hold her. Mum was with me, and she cried with me as I held Molly against my skin for the first time. I longed so much to absorb Molly back into my body, where she still belonged. I never wanted to let her go again. It was exquisitely painful. Yet, I was so relieved that she was healthy and safe. Molly knew it was me, too. While I was holding her, she nuzzled into my skin, and then practically lunged at where she knew my breast was waiting. My 31-weeker had a rooting reflex so strong she almost crawled in my arms. Absolute amazement. Unfortunately, I was not allowed to satisfy her wishes, as it would have been too physically draining for her to attempt to feed – she needed to reserve all of her strength for the simple act of growing and gaining weight. Instead, I held my little Molly for hours, until my arm went numb, my stomach complained of hunger, and my back ached from sitting so still. Sadly, I handed her back over to the nurse.

By this stage, Molly had an OGT (Oro-Gastric Tube – a tube going through her mouth and down into her stomach), through which she was being fed tiny amounts of my colostrum/milk. Molly was tolerating the feedings well, and so the amounts she was being fed were slowly increasing. She had also been started on various other medications and nutrients via a drip, to make sure she stayed hydrated and to give her additional ‘growing power’, I guess. My first cuddle with her would be my only one for days, as she was placed under phototherapy lights to treat her worsening jaundice, so I was very lucky to get one when I did. We also received the news that Molly was stable enough to be transferred back to our closest hospital, and that, as soon as an appropriate bed was available, she would be moved.

This was very welcome news, as day three also happened to be the day that I was abruptly discharged from the maternity ward upstairs. To put it mildly, I was a mess. I am so grateful that my Mum was with me that day (Tom was at home with Tiernan for most of it), because she helped me through one of the toughest days of my life. I couldn’t bring myself to leave my baby at the hospital. The thought of it made me feel lost inside… almost destitute. However, at the same time, I desperately missed Tiernan and wanted to be home with him, too. I was stuck, without a clue of what to do. I think the strength of my emotions on that day may be attributed, in some part, to ‘baby blues.’ I experienced it on day three with Tiernan, when my milk came in, and it was the same again with Molly. While I recognised it for what it was, it didn’t really help me to see through the fog to a solution I could live with. The attitude of the staff on the maternity ward did not help, either. They showed no regard for the trauma I was experiencing. I constantly missed meals (I was downstairs visiting my baby), and no-one bothered to hold them for me; I was treated with exasperation when I asked for more supplies of syringes, sterilising solutions and other equipment I needed to express breast milk; and when being discharged, I was rudely asked what time I would be gone by. I couldn’t believe it. Thank goodness for Mum – she got me in touch with the hospital social worker, who arranged for me to stay the night in the accommodation reserved for cancer patients who are undergoing long-term treatment. I just needed one night to clear my head and get used to the idea of leaving Molly behind.

As it turned out, that one extra night also helped me to gain a little perspective on the situation. Tom, who stayed the night with me, met another mother who had a baby in the NICU. Her baby was a couple of months old, and she had been alternating fortnights spent at home in Dubbo, with her other children, and there at the hospital with her tiny baby. Talk about heart breaking. It made me realise that leaving Molly at Westmead was not the worst thing in the world – it would take an hour, at most, to travel to see her every day. It would be easy to divide my time between home and Westmead. Easy peasey, compared with a drive to Dubbo and back.

By morning, I had made up my mind to go home and see Tiernan, and sleep in my own bed for the first time in almost a week. We went to visit Molly, and received the news that she was booked in for transfer to Nepean that day. It was such a relief. It seemed to make all the difference – we would be only twenty minutes away from her, we wouldn’t have to battle traffic or parking issues, and I would be able to spend time with both of my children much more easily, which was so important to me. We said goodbye to the NICU at Westmead on Molly’s fourth day, and we will be forever grateful to the wonderful doctors and nurses who saved our precious girl’s life.

The NICU at Nepean Hospital was Molly’s new home for the next six weeks of her life, and it was there that we would learn more about becoming involved in her care, the many, many tests she would need to give a picture of her physical health, and more about the ups and downs of daily NICU life. Stay tuned for more!

This is Molly’s birth story, continued on from here.

I didn’t sleep much on the night before Molly’s birth. I was feeling too miserable. I made up my mind not to go through with things in the morning until I had spoken to an obstetrician and confirmed that this was definitely the right thing to do. It sure didn’t feel like the right thing to do. It felt like I was about to allow my perfectly healthy baby to be taken from my body way before she was ready. I could have justified it more easily had I felt that I was so unwell I couldn’t continue the pregnancy. But I didn’t feel unwell at all. Looking back, I think this has been the hardest thing to accept: that my body was failing Molly, and she was the one who was going to suffer most for it, not me.

In the morning, a nurse came to take us down to the delivery suite. She looked at my belly and asked, very concerned, how far along I was. When my reply was 31 weeks she said, “Oh, that’s okay then, I thought your notes said 37 weeks.” When we looked doubtfully at her for calling this a good thing, she explained that my baby, being perfectly healthy and a good size for her gestation, was in a much better position than would a 37-weeker of the same size, because a 37-weeker that small would probably have something seriously wrong with it. Hopefully, our baby would only need to grow and learn to feed. This gave us a bit of perspective, but it wasn’t enough to make us feel better.

When we met our midwife, I immediately told her that I wanted to talk to the doctors again before going ahead. She replied that we had to wait anyway, as there were still some blood test results pending, which would confirm our course of action. She set about getting the preparation underway, all the same. I was cannulated, given IV antibiotics (for GBS), and hooked up to foetal monitors. When the doctor finally came, my last hopes were dashed. She came to confirm that my platelet count was normal, and we could continue with the induction instead of a caesarian. What??? Nobody had bothered to mention that I was under consideration for a caesar. I had assumed they were checking to see whether the medication I was on was working, which I hoped might mean we could delay the induction and wait and see how things went for at least a few more days. However, they were doing nothing of the sort – the blood test they were referring to was to rule out a much more serious problem, called HELLP syndrome, which is potentially life-threatening. The reason they were checking for this was that my liver enzymes were much higher than what would normally be seen with OC. Sadly, even though HELLP syndrome was ruled out, there was still no going back for me or my poor bub, it just meant that we could try for a vaginal birth rather than a caesarian.

 Once underway, Molly’s induction was much the same as Tiernan’s, only much, much quicker. The midwife attempted to break my waters, but couldn’t. She tried for at least ten minutes before having to find an obstetrician to come and have a go. It’s really not the most pleasant procedure at the best of times, and it was terrible to have it dragged out this way. Molly really, really wasn’t ready to come out!

Finally, the membranes burst and the Syntocinon drip was started at about 9:30am. We waited, terrified, for the contractions to start. We weren’t terrified of the labour, as we had a fairly good idea of how that would go, but we had no idea what our baby was going to look like at the end of it, or whether she would be okay (we didn’t actually know the sex but it’s easier to just say ‘she’!) Natalie, our midwife, made us feel a little better by saying that she had delivered a 31-weeker only a few days earlier, and this baby was doing well. It had even come out crying, which was a great sign.I tried to relax, but I just felt sick to my stomach about what we were doing. Forcing my baby out like this was all wrong.

Meanwhile, the Syntocinon was doing its job and I was starting to feel period-like cramps. These became stronger and more regular as the labour progressed. I started to think about pain relief (not because I needed it yet, but because I thought I’d better at least have a plan in my head!), and realised I was very much against having an epidural this time. I knew that our baby would be taken away from us to be stabilised in the NICU (Neonatal Intensive Care Unit) as soon as she was born, and I wanted to be able to follow as quickly as possible, without having to wait to be able to use my legs again.

As with Tiernan’s birth, the Syntocinon drip was turned up every half-hour, until the labour was established (three strong contractions in every ten minutes). And, as with Tiernan’s birth, I was coping fine, until I suddenly wasn’t! Natalie had told me to let her know when I felt the urge to push, as this would be her cue to call in the paediatric team, who would take care of the baby once she was born. Having not felt the urge to push with Tiernan (I was under an epidural before I got that far), I wasn’t sure, but tentatively announced that I thought I would need to push soon. Ish. By the next contraction I was quite sure. Natalie did an internal (flat on my back again – agony!) and said that I was only 6cm dilated, so it wasn’t time yet, but she thought it wouldn’t be long. She suggested I try the gas and air to get me through the next few contractions. After setting me up with the gas, Natalie turned to fill out some paperwork, but before she had gone two steps I was screaming and writhing in pain. The baby was coming, right now! The pain was so sudden and so intense that I started to panic, hyperventilating and bellowing the house down. I think I scared Natalie, too. She called the paeds, and then had to work hard to try and calm me down, repeating my name, over and over, until I listened to her and started to breath properly with the gas. It didn’t do much for the pain, but it did give me something to focus on. Once again, due to the Syntocinon, the contractions I experienced were so intense that I had no control over my body. Rather than pushing Molly out, I felt that she was forcibly expelled by the drug. I later found out that the whole birth lasted an hour and twenty minutes, with a ‘pushing stage’ of only four minutes!

Our beautiful, tiny, baby was born at 12:50pm, weighing only 1700g (or a little over three pounds). Natalie held her up to me, very briefly, so I could give her a kiss and see that she was, in fact, a girl. I had only a moment to take in her tiny form. I remember thinking that she actually looked quite good – like a ‘real’ baby, but much smaller. She had good colour (well, a bit blue, but her skin was pinkish and not translucent as I had been half expecting). And, she was crying! My brave little girl was crying as loud as she could (which wasn’t very loud at all), letting us know that she was okay, but rather cranky at being out here so soon. I breathed a huge sigh of relief.

All too soon, Molly was whisked away, and I had to get down to the business of birthing the placenta. Without a baby in my arms to distract me, this seemed to take much longer than it had the first time around. I didn’t need any stitches this time. I was so pleased to be able to jump (well, maybe not jump, but hobble), into the shower straight away to get cleaned up. We were then taken to my room on the maternity ward, where we nervously waited to be allowed to see our little girl in the NICU…

I have decided to write about each of my children’s births while I still remember all of the gory details! Don’t read this if it isn’t your thing. Personally, I love birth stories.

I have written about my pregnancy with Molly before, but skipped a lot of the detail. This is a more thorough version.

Okay, so you would think that after Tiernan’s shaky start I would have been at least a little bit nervous about having another baby. I wasn’t. In fact, I was so not-nervous that I became pregnant again when Tiernan was only eight months old. Then, suddenly, I was nervous! But not about the actual pregnancy part, really. After talking to the doctors when Tiernan was born, I came away believing that of the two conditions I ended up being diagnosed with, pre-eclampsia was the more serious, which was also the one I was least-likely to get again. I now believe that this isn’t quite true, although we never really got to the bottom of what happened with Tiernan’s pregnancy. Perhaps the undiagnosed obstetric cholestasis meant that I was more prone to pre-eclampsia, but who really knows? In any case, I was lead to believe that I shouldn’t have any issues with further pregnancies – if I developed OC again, it would be caught earlier (because I would know what to look out for), and managed effectively.

I was more nervous about how I was going to finish uni whilst also pregnant and trying to look after a one-year-old. My final subject of uni, which involved eight weeks of teaching and a million assignments, was my biggest hurdle (or so I thought). We upped Tiernan’s daycare to three days per week (he had been going once a week while I was working casually), and he spent the remaining two days with either his grandparents or with Tom.

It was extremely stressful. I was, in essence, working full-time, with the added bonus of then having to work from home of an evening, too. Because prac sucks – there is all that teaching, planning, preparing, evaluating, researching, reading, assignments, etc. etc. etc. I was also largely responsible for making sure Tiernan had food to eat and clothes to wear at daycare each day. I missed my baby boy terribly. I felt incredibly guilty that I had so little time for him all of a sudden. He coped pretty well, though. He loved his carer, Jillian (who is amazing!), and it also meant that he got some bonding time with Tom. I consoled myself with the knowledge that it was good for him to strengthen his relationships with some of the other, wonderful people in his life. Plus, the situation was also temporary. Prac would be over in a couple of months, and then, once my assignments were done, I would be able to have some quality time with him before the baby came. Or so I thought.

Throughout the pregnancy, I had been visiting the clinic at Nepean public hospital. Shared care was no longer an option for me, because of Tiernan’s complicated birth, so I was visiting the obstetric registrars (and if I was lucky, an actual obstetrician) each time. I asked, several times, whether I should be having any blood tests along the way to check that my liver was behaving, but was told that nothing needed to be done until I started to itch (the first, and often only, symptom of OC). So I waited to itch. I had a pretty good idea that I was going to eventually, but assumed that the worse thing that would happen would be another induction and another slightly early baby.

Everything went well until about week 30. I started to feel a bit run-down. I put this down to stress and exhaustion. My prac was nearly over, but I was starting to wonder how on earth I was going to get through the sheer workload. I didn’t want to do it any more. I must have known something was up, on a sub-conscious level. I started making noises to my prac supervisor about whether it would be possible to finish my prac a week early, due to being too tired and pregnant to continue. This lecturer had been extremely supportive throughout the semester, as had my prac teacher and the school principal, but she wasn’t sure whether there was anything she could do to ‘let me off.’

And then, at 31 weeks, the itching started. I woke up with itchy palms and feet. It wasn’t too bad and I was able to go back to sleep. So I let it go for one more night. When it came back again, I knew I would have to go to the hospital and get checked out. I was a bit disappointed, because I had hoped maybe I would get away without any OC this time. I had a brief moment of panic that if I went to the hospital they wouldn’t let me out again, like last time (with Tiernan), but I dismissed it: I imagined I would have a blood test, be diagnosed, and then be sent home on medication, an order to take it easy, and to come in for monitoring more frequently. I was fairly sure that I would be allowed to finish prac early, now that there was a medical reason, so I could use my ‘resting’ time to complete my assignments, and then spend time with Tiernan and prepare for the baby. Maybe it wasn’t going to be so bad, after all.

Well, of course, that wasn’t how it went at all. I did go to the hospital, on my way home from school that day. I did have a blood test. I waited hours for the results. And then I got bad news. My blood results were through the roof: two enzymes that are normally at levels of less than 40, were now above 600! I wasn’t going anywhere.

Once again, I found myself calling everyone from the hospital to tell them that I wasn’t allowed to leave. Tom came with clothes and moral support. Before being sent upstairs to the antenatal ward, I was given a shot of steroids that would help mature the baby’s lungs in case she had to be born early. Even though I was assured this was just a precaution, it totally freaked me out.

That was a horrible night. I was terrified about what might be about to happen, and I really missed Tiernan. I hadn’t been able to see him because he was already in bed when Tom came with my clothes. While I lay in my bed, not sleeping, I managed to convince myself that all this talk of the baby being born soon was just ridiculous (why induce a baby at 31 weeks? Pretty drastic, thought I). They were more likely to try to keep me in the hospital until the baby could be induced more safely, at 35 or 36 weeks. Well, I decided that I wasn’t going to be kept away from Tiernan for that long, so I would try and negotiate to be let out until then, even if it meant daily visits. With this plan firmly settled in my mind, I eventually drifted off to sleep. (Yes, I slept – the medication they gave me, ursodeoxycholic acid, stopped the itch completely this time around).

My blood levels were monitored over the next couple of days. I had been admitted on Friday with levels of 600+. On Sunday, my actual obstetrican came and told me that my levels were now over 1200, which was getting dangerous, for me. At this point, I don’t think they were too worried about the baby. I don’t know what exactly I was in danger of (liver failure?), not having the presence of mind to ask at the time. I was in shock. You know that funny ringing sound you get in your ears when you’ve been at a concert and then go somewhere quiet? I was listening to the obstetrician rattle off the options: caesar now, or induction tonight or tomorrow, through that ringing sound. In the end, she decided it was safer to try an induction, as this was my second baby (so labour would be quicker), the head was well down, and my cervix was 1cm dilated already. Also, she told me, a ‘natural’ birth can be better for premmie babies (as well as full-term ones), because it helps squeeze some of the gunk from their lungs. She then left to make arrangements.

Tom and I were left reeling from this devastating news. If I was worried about having Tiernan ‘prematurely’ at 36 weeks, imagine how I felt now that I would be having a 31-weeker. A timely visit from some paediatricians answered some of our questions: they told us that babies born at 31 weeks have a 98-99% chance of survival; some babies born this early have learning difficulties, and/or hearing and vision impairments, but not many; that the biggest risk after the birth is infection; that our baby may or may not be able to breathe independently; and that the baby would need to stay in the Neonatal Intensive Care Unit until some time around the due-date. It made us feel a little better, but it was a lot to take in.

Then we got another visit from the obstetrician, who told us that, as the NICU at our hospital was currently full, I would have to be transferred to Westmead that night, where my case would be reviewed by whichever doctor took me on. I hoped against hope that they would decide not to go ahead.

Then ensued the ridiculousness that is being transferred! I had to pack up my things, and then be wheeled out to an ambulance on a stretcher. It was so humiliating. The worst part was that I didn’t even feel the slightest bit unwell! I could have driven myself to Westmead with no problems, and here I was, being treated like an invalid. Actually, that was the part that stung the most about my baby being born so early – I couldn’t get over how well I felt. Run-down, yes. Stressed, yes. Tired, yes. But seriously ill? No way. I just wanted to go home, rest up, and have this baby in a few more weeks.

We finally got to Westmead at around 9pm (Tom drove and met me there). We were seen by my new doctor. She decided to do more bloods, but also booked me in for induction first thing in the morning. I held on to a glimmer of hope that the medication I was on may have kicked in by now, and they would call the whole thing off in the morning.

I was taken to the antenatal ward. Tom stayed with me for a while. We didn’t bother writing a birth plan, this time. We knew how it would go. There were no words to say. Eventually, he went home to get a few hours sleep before returning in the morning, and I went to bed feeling like a big failure.