Age at interview: 34
Age at diagnosis: 32
Brief Outline: Julie was expecting her first daughter and felt well through most of the pregnancy. But once she had passed her due date she started to feel unwell ' had headaches, distorted vision and high blood pressure. She developed pre-eclampsia and doctors performed an emergency caesarean.
Background: Julie is a research and performance manager for a local authority. She is married with one daughter. White British.

More about me...

Julie was interviewed when her daughter was almost two years old. She enjoyed the pregnancy, which went well. However after she passed her due date she started to feel unwell. At 40 weeks, 5 days she started to develop high blood pressure and swelling. She saw lines across her eyes, had severe headaches and felt dizzy. Over a period of 2-3 days she described being monitored, and finally admitted to hospital, and feeling increasingly unwell and ‘out of it’. 
After two days her blood pressure was very high and doctors were concerned. They started induction, but labour did not progress fast, and once the baby started to go into distress she was rushed through for an emergency caesarean. There was meconium in the waters and her baby needed to be resuscitated at birth, but she was then fine. Mother and baby were able to be together soon, and they stayed in hospital for six days as doctors monitored her blood pressure.
On discharge she was well supported by her community midwife, and close family. Her recovery was however complicated by a burst appendix when her baby was seven weeks old. At this point she stopped breast-feeding. 
She was told what had happened to her in a brief chat with the consultant in the hospital. But she had not been offered any follow up since, which she would have appreciated, to try and make sense of her experience. She had done a lot of online research herself into pre-eclampsia, but was not given any by the hospital. She would also have liked some more formal support, or opportunity to talk to others, after such a traumatic event. She was very upset by how medicalised her birth experience had to become, and suffered flashbacks for a while. She and her partner have not thought about other children until now but are just starting to consider trying for another although they are concerned over whether the pre-eclampsia would happen again.

Julie's baby was overdue. She had high blood pressure which was being monitored by the midwives....

Yes, and obviously with me being with me being overdue the midwives came quite frequently just to see if anything was happening. And they booked me in for a standard induction on a certain date, saying, “Right if you’ve not had your baby by then, we’ll book you in, and you’ll go in on that day and, and things’ll proceed. 
I think they must have come in about day five and they did the manual sweep to see if they could start things off, and they did all the routine tests of my blood pressure which had started to go up, just ever so slightly, but nothing significant. And at that point, I just felt heavily pregnant, didn’t feel anything wrong. 
And then, one afternoon I was sat on a birthing ball in the living room and I just got all these horrendous lights coming in front of me and my head and I thought someone had hit me over the head, this severe pain, so I thought ooh I don’t feel very well and felt very sick. And I thought ooh I’ve gone into labour, because obviously I’ve never had a baby before. I had no idea other than physical pain. I didn’t know if these were just quite normal.
So I got my books out and rang the hospital and spoke to the midwives and they asked me to ring my community midwife and I rang her and she came out, took some bloods, did a urine test and just examined me and everything and took the bloods, ranging me later with the bloods from the hospital saying I was borderline having the starts of pre eclampsia. So she said, “You rest. And when I say rest, you rest. You know, you’ve got to be really careful.” And came in every day. 
Then so, that started on the Thursday. On the Saturday I started with really severe headaches again and the, the visual disturbances were there pretty much all the time. So I felt very, very unwell. By then I couldn’t put shoes on my feet, because my feet were so swollen and I started to get pitting oedema on the legs. I mean I didn’t think my face looked swollen, but when they saw me, they were like, “Yes, you are, you are very swollen.” But I think that was then I felt that poorly I didn’t really, I wasn’t bothered by then.
So we got the pleasure of going to [hospital] Maternity Unit for the day where they could monitor [daughter] and make sure she was okay, monitor my blood pressure. They did, I had to do a twenty four hour urine collection over the weekend, for looking at the protein and my blood pressure all the time and it was just going up and up and up and they were like, “For now, you’re okay. You can go home.”
So we went home on the Saturday after being there for about nine hours, since my (or I) came home with the 24 hour collection and I was told to ring if I felt anything had changed overnight, and I had to go back in at 4 o’clock on the Sunday just for them just to see how I was again.
Sunday morning I got up, well I mean I can barely remember sort of the Sunday, Monday because it all just… I felt that ill. So I got up on the Sunday morning and I had to take all my jewellery off because my hands had really swollen. I mean I could see it at that point. And every time I moved I felt very dizzy and very, very unwell. 
And I got a little bit of tummy ache. Not like labour pains, because we never got to that point. But I just felt, I didn’t feel right. So I rang the ward and they said, “You need to come in.” 
So we got there, they did my blood pressure and I think it was something like 220/130 something. So they said at that point I was definitely not going to be going home [laughs].

Doctors were monitoring Julie’s blood pressure and tried to induce her labour. She describes...

Yes, on the Sunday night. So I still felt exceptionally unwell with this severe headache and visual disturbances. And of course my blood pressure just kept going up and up and up. They put me on fluid restriction and obviously every time I went to the loo I had do it in a pot so they could monitor what was coming in and out. I was strapped to the bed strapped to the bed with the monitoring equipment on. So I couldn’t really, it was quite how I thought it never would, because I was hoping for a natural water birth. I thought, I thought it was just going to all beautiful and lovely.
So I had all the monitoring on. Wasn’t allowed to go anywhere unless it was to the toilet so I really, you see I wasn’t allowed to eat or anything, just 100 mls of water an hour that was it, that was all I was allowed.
So I got induced probably about 9 o’clockish - 10. Between 9-10. And then probably at about half past eleven at night I just thought phew I have a really bad back ache. Really horrendous back ache. So I thought, I got out of bed, I’ve got to get out of bed, because it was… I felt like someone had just kicked my spine round the back. It was horrendous. So I sort of got up and sat on the birthing ball that they’d eh, left for me. 
I sat on that and then all I could feel, it was just contraction after contraction after contraction. They were literally there. I’d gone from absolutely nothing to full on contractions within probably an hour and a half.
So they came and examined me again and gave me some gas and air because it was just, well the pain, well I’ve never felt anything like that before. Obviously I was still monitoring and everything, but I hadn’t progressed. I think I’d gone like 1 cm and nothing was happening. So they were like, “Right, well we’ve got a long way to go. But obviously see how you go. Just try and relax. Try and have some sleep.” But it was getting, the contractions were coming faster and faster and faster. And obviously as that was building up, so was my blood pressure. It was getting higher and higher and higher. And I just felt like I were on a different planet.
I’m still getting little sketches bits of information coming back to me, because I was just so out of it and they gave me some Labetalol I think it was called to bring my blood pressure down. Which, it did work, it brought it down, but by then, I think I’d sort of gone to a different level. I mean all I kept saying is, “I want to go to sleep.” Because I felt that poorly I just wanted to go to sleep. And they were all like, “No come on, you’re all right. You know, we want to get this baby out.” And then they tried to come and cannulate because they obviously knew something was, something was kicking off but they didn’t say anything to me, they were just very calm, and very relaxed, saying, “You know, we’re monitoring you.” Because I knew my blood pressure wasn’t right. But at that point everything else. Yes, we weren’t progressing ready to deliver, but we were, knew everything was, you know, baby was okay.
They tried to come and cannulate me but at that point I started to shut down, so they couldn’t get anything in me. So I ended up with probably, well my arms were black and blue, because they really tried bless them. I felt quite guilty because there was just nothing, they couldn’t go anywhere.
Then they still kept monitoring my blood pressure and baby. But my blood pressure started to come back up again even though I’d had Labetalol it was still, it was, you know, obviously I just needed to have the baby there and then. 

Two years after her first child was born early, when she had pre-eclampsia, Julie now feels ready...

And have you thought more about other children? I mean she’s still quite little, but have you…?
Yes, yes, we are talking about it now. Which is something that’s, again it’s took me two years, because I mean, I always wanted children close together. I always wanted two close together, but after the first episode, I was just like never, ever again, because of what had happened to me, and all the midwives kept saying to me, “Don’t let it put you off.” And I was like, “How can this not put you off?” How can it not? You know, but now I just think they would just monitor me like a hawk and I know they would. Not that I particularly want that, because it sort of takes a lot of the, the naturalness and the sort of letting your body do what it needs to do. But at the same time I know that they would totally monitor me this time. Not that didn’t before. Because they did. But I mean me and my husband one of our main things, is why did they not induce us earlier? And why did we have to wait until we got to the critical point, rather than if it started on the Thursday why couldn’t I have been induced on the Friday? Rather than having to go, for things to escalate to the point where it was horrendous, when if I had it done on the Thursday I was still, oh I was still at point where I was okay. I wasn’t well, but I was all right, and things might have been very different. They might not have been. But they might have been. 
So I think it impacted on us for a long time, the thought, I mean I think if I’d found out I was pregnant I think that would have been the end of me. I think it would have just destroyed me, because I was so frightened, whereas now, I just think, yes, I would be quite happy now. I’d be more than happy.
Because I think in my mind I’ve put things to bed so to speak. I think, yes, because I talk about it, and like getting involved in this and the pre eclampsia thing. I think that really works for me.
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Julie trusted the midwife who looked after her overnight before her daughter was born. She felt...

I mean I think it is reassuring knowing I’ve got a very, very good community midwife. I mean she was an older midwife. I mean I’m not saying she was old, but I knew she’d got that experience and that skill and you know, you’ve all got to learn haven’t you, I’m an ex nurse myself, so I know you’ve got to learn on the job, but I felt very safe with her. And I had a midwife that we were with overnight, and I felt completely safe with her. Even though things were going wrong, I felt safe and I trusted her, I completely trusted her. And that made it a lot better because I knew she knew what she was doing. I just got that sense from her, you know, and she was just so… She’d just got time for us, she barely left us. For probably twelve hours she was there with us the whole time. And that made a real difference to us. A real difference. Because we felt, not valued, not valued, that’s the wrong kind of phrase, but we felt that she cared, and I think that really made a difference.
Whereas when you go up to the post natal ward, different ball game completely. I got shouted at for not breast feeding properly and I am thinking you’ve got no idea what I’ve just been through. You’ve got no idea. And then the fact that the midwife was probably about nineteen didn’t help and I just thought, you know, use your skills. I’ve just gone through something really horrible. Don’t shout at me. I don’t want to be shouted at, and especially not by somebody that’s half my age. I mean it really upset me and made me cry. Because I just thought, “don’t, you’ve not done this, I have, you know.” They’re all different aren’t they.


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