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Samantha

Age at interview: 32
Age at diagnosis: 31
Brief Outline: All went well during Samantha's pregnancy, until a check at 24 weeks showed her blood pressure was very high. At 28 weeks she was admitted to hospital for checks. Samantha's blood pressure continued to rise. Doctors decided to perform an emergency caesarean. Her daughter was born at 29 weeks and spent 7 weeks in hospital.
Background: Samantha is a pensions consultant. She is married with one daughter. White British.

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This was Samantha’s first pregnancy, and everything had gone very smoothly, until she reached 24 weeks, when a routine check discovered she had high blood pressure. She spent a night in hospital and was put on medication to reduce her blood pressure. She had another check at 28 weeks, and again her blood pressure was high, so she was admitted to hospital for checks. At 29 weeks she was diagnosed with pre-eclampsia and told that she would have to stay in hospital until the baby was born. 
 
Samantha was admitted on a Friday and started to prepare herself for a long stay in hospital but after two spikes of very high blood pressure over the weekend, the doctors decided they needed to deliver the baby early. Samantha was visited by an anaesthetist over the weekend, and also a pediatrician who came to explain to her and her husband what would happen to their baby after she was born and taken to the special baby unit. They found this very reassuring. 
 
Samantha had an emergency caesarean on the Monday morning and was only briefly able to see her daughter before she was taken off to neo-natal intensive care (NICU). She did not get to go and see her again until 5 hours later, this time for only 10 minutes. She describes feeling “cheated” by not having that special time with her baby just after her birth. She was also sad that she was unable at any stage to establish breastfeeding, although she tried hard for a month. Samantha spent a further couple of days having 1-1 care in the delivery suite, as doctors struggled to get her blood pressure down. But she was then discharged to the maternity ward from where she was able to visit her daughter regularly. She was discharged home after 9 days and her daughter spent another 40 days in hospital. The travel during those weeks was hard as she was not allowed to drive and her husband was back at work. But they soon established a good routine of visiting their daughter. Their daughter had no major complications from her early birth. Samantha felt very well supported in the neo-natal unit by the staff and also a parent run charity.
 
Samantha felt that communication with the doctors was good. She felt confident during the crisis that they had a plan, which they had told her about, and that they knew what they were doing. Although she has not had a formal follow up with the consultant, they did have a very helpful chat while she was still in the hospital about subsequent pregnancies. The consultant also emphasised that she should ask to be referred back to her if she had any concerns. That offer of an open door has given her a lot of confidence. Samantha has had routine GP 6 week check and midwife checks but described the care as mostly focused on her daughter. Her daughter was 8 ½ months at the time of the interview and doing well. Samantha was shortly due to go back to work. 

 

 
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Samantha was being monitored for high blood pressure, but also developed headaches and...

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I went to the Day Assessment Unit at our local hospital, for a check-up so that was at 28 weeks. My blood pressure was still high, even though I was on the medication, they checked protein in my urine was fine at the time but obviously I was having headaches and pain, so they asked me to come back later on in that week. At which point I was just 29 weeks. 
 
And when I went back into the Day Assessment Unit at that point the, there was a lot of protein in my urine, and the headaches were worse, my blood pressure was higher, and the pain I had was worse and at that point they decided to admit me. For what they hoped would be a fairly lengthy stay in hospital controlling my blood pressure and you know, until the baby was born. I spent… They also gave me steroids at that point in case the baby was delivered early to help the lungs develop. 
 
They kept me on a one to one, I was on the delivery suite at that stage because I needed the one to one care. So they were treating the, the high blood pressure basically and the hope was that that would reduce to a relatively normal level and I could just be put onto a ward for observation for a few weeks. 
 
But unfortunately I had quite a few spikes in blood pressure, so I was admitted on a Friday, the Friday night, Saturday morning; I had quite a major spike in my blood pressure which they had to treat quite aggressively. It then sort of settled down a bit. I then had another major spike on the Sunday morning at which point my consultant said that if it happened again, they would probably have to deliver the baby.
 
No, sorry, I might have misled you, it was only at about 28 weeks that I developed the pain and because I had had a stay in hospital previously and I was given a number of warning signs to look out for and because I had started to develop that pain and the headaches was when I went back into the Day Assessment Unit for a check-up. And as I say, they, asked me to come back later in the week, which is when things started to really go pear shaped [laughs].
 
And how did you feel in between those two day. Did you, can you remember much about them?
 
Yes, I can. I had a couple of days where I felt fine, and I had a couple of days where I felt awful. But again I tried to, I think I tried to sort of put it down to, oh you know, millions of women have babies, you know, and everyone gets indigestion and, and heartburn and I’m sure it’s just that, and you know, I think I tried to convince myself that it was just a normal stage of pregnancy, and I just needed to get on with it, and actually on the day that I went into hospital I felt pretty, I felt pretty good. I did go downhill pretty quickly after that, but it was really swings and roundabouts. I had some, sometimes I felt absolutely fine and at other times I felt absolutely awful.
 
So going into hospital, did you have any expectations when you went in on that Friday I think you said it was.
 
Yes, it was. I thought I was going in for a check-up and actually I was all dressed to go to work and I, I kind of knew the routine by then, because I’d been in there a few times for check-ups so I knew they were going to check my blood pressure, I knew they were going to take blood. I knew they were going to ask for a urine sample. So we did all that and I sort of sat there, and I had my book, because I know that it takes a little while, and when the midwife checked my, my urine sample, and there was a, I think she said it was a plus 3 reading of protein which is like, I think is like the highest they check. I thought to myself then, okay this is bad. And she said to me, you know, “We’ll get the doctor to come and see you.&rdq
 
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Samantha had an emergency caesarean because she had developed pre-eclampsia and very high blood...

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So we had an emergency caesarean. From, I think from the time of the really high blood pressure reading until my daughter being delivered was probably about two hours. But that was only because they very kindly waited for my husband. It was getting to a stage where they were, unfortunately he got stuck in traffic, but it was getting to a stage where they were going to have to just go ahead and do it. But luckily he arrived just in time, and he arrived, they threw some scrubs at him, and we literally went straight into theatre, with all the usual sort of paraphernalia that happens with a Caesarean. In the time that we were waiting for my husband to arrive we obviously had a, the anaesthetist come and talk to me. 
 
And what about you and your health over that weekend. Did you feel, I mean you described sort of being in denial almost, but were you frightened? Were you concerned?
 
No, I, even when I had these, the really bad spikes in blood pressure, you know, because, because the, any time it happened my consultant was here straight away, saying, this is, blah, blah, blah, blah. “This is what we’re going to do.” I don’t, I never felt scared at all. The only time I felt really scared was when sorry, even at the stage, sorry I’m rambling a bit. Even at the stage where my consultant said to me, “We’re going to have to deliver the baby.” I didn’t feel scared then. I felt really scared when the anaesthetist came to speak to me. Because obviously they have to say everything like, you know, “We’re going to be putting this in your back and blah, blah, blah, blah. And there’s a one in five thousand chance that this could happen, and that could happen and that sort of thing.” And all of a sudden you’re having lots of forms shoved at you to sign, and you know, because it was an emergency situation it was all happening quite quickly, and that’s when I got quite scared and actually when they wheeled me down to theatre and I was sitting on the edge of the bed when they were getting ready to put all the things into my back, I was, I was physically shaking, and I’ve never felt like that before. I was physically shaking. I was crying. And I think I was scared, but then I thought to myself, well if I don’t calm down, they’re not going to be able to put in the epidural and spinal block and all those sorts of things, and that actually made me worse. But then even in theatre when I don’t think I felt it at the time, but when I look back on it now, everything was such a well-oiled machine. You know, no one was in there that didn’t need to be in there. Everyone that needed to be in there, came in there at the time they needed to be there, they weren’t just hanging around and they obviously do so many of them, but it was, when I look back on it, it was, yes, it was so well organised. But it was just incredibly scary, because I’ve, I’ve never spent any time in hospital, never had an operation, and I remember saying to my husband, “Am I going to be okay?” And he bless him was trying to, at his best to just be sort of jolly and make it feel a lot less scary than it was actually was.
 
But I think, yes, I think it was when things started to happen very quickly. While things were sort of, you know, going along quite slowly, I was quite happy, but when it all started happening very quickly. Lots of people coming in and talking to me, lots of things to be signed. That’s when I really got scared.
 
And you were awake during the delivery were you?
 
Yes.
 
 
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Samantha and her husband appreciated meeting with paediatricians who explained what would happen...

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And what did the paediatrician tell you? What sort of information did they give you when they came to talk to you?
 
They were very good actually. They told us about, you know, obviously they can’t speak in specifics until a baby’s born, but they, they gave us information about a baby born at 29 weeks gestation, you know, the main concern that we have is for the lungs. I’d had steroids already to already to address, you know, to certainly try and address that issue. They explained to us about some of the likely medication and machinery that, that you’d probably have to go on and you know, how they would sort of deal, deal with the baby in theatre and then take her away and that sort of thing. So, and actually that was really good, because when, I didn’t see her for quite a while, because they wouldn’t let me off of the delivery suite. But when my husband went upstairs and they were using terms like, ‘oh this is the CPAP machine’, he knew what that was and why they were using it. He already knew that and although it was still a big shock for him to see, you know, our daughter in that sort of situation, he did understand what everything was, and why it was there. So I’m really glad that we had someone come and speak to us actually, because, I would, I think otherwise I would have just been completely freaked out and you know, what’s going on, sort of thing. But because they’d talked to us about what you know, a baby at 29 weeks gestations is generally what their condition generally is, it wasn’t such a shock.
 
And actually the way they talked to us as well was, it was quite matter of, not matter of fact, but because they were able to say, “Okay, in the, if, for a baby at 29 gestation this is generally, these are generally what the problems were, are.” It felt like, oh well they obviously know what they’re doing, so it didn’t feel so scary I think. And luckily she was quite a text book case as well. She didn’t have any very major issues other than her prematurity and yes, I just, it just felt really comfortable that everything was going to be okay [laughs].
 
 
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Samantha was keen to see her daughter as soon as possible, but had to wait several hours because...

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She was born at quarter past eleven and I wasn’t able to go and see her until half past four. They wouldn’t let me off the ward because my blood pressure was still bad. When they eventually did let me off the ward, I had to go with a nurse, and my husband obviously, and I was only there for ten minutes. So that was a very, it was really difficult actually because I was still on quite a lot of medication. I was, my hormones were all over the place and I was very emotional. And then obviously, they sort of wheel you into special care which is, you know, quite a scary place the first time you go in there, when you don’t know what all the beeps are and what all the machines do and that sort of thing. 
 
And, you know, they sort of said, you know, “This is your daughter.” And it was really difficult to see her actually, because you know, she had lots of things going into her, she had a mask on her face. So I couldn’t really see what she looked like. She her skin was very translucent so you could see, you know, the veins and that sort of thing, and obviously with the lungs being a problem area, it was obvious that it was really difficult for her breathing. And I think that, yes, that quite upset me at the time, and the fact that I could only stay for ten minutes as well, upset me quite a lot as well. And one of the other things that I sort of feel a bit cheated by is, because I was on a lot of medication I have very hazy recollection of that day. And I have to ask my husband. 
 
Every so often something will occur to me, and I will speak to another friend whose got a baby and I’ll sort of say to him, you know, “When you first went up there, what happened here? And when did they come and talk to you, and that sort of thing? Because I can’t remember a lot of things and again, you know, I’d always just had in my head that we would have a baby, you know, and she’d be given to us or he would be given to us and we’d kind of have to get on with it, and I just, I wasn’t prepared emotionally at all for, for what was going to happen.
 
 

Samantha felt her 6-week check with the GP was a bit brief given what she had been through, but...

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Oh I’m trying to think. I think it was about three months. It, I was for the first week that I was discharged, I had to see a midwife every day, and to have my blood pressure checked after a week the midwife discharged me and I had to go to my GP four weeks after that to check, to have a check and then I was going every four weeks, and at about three months they were happy, you know, that my blood pressure was pretty stable. And took me off medication. I have had it checked a couple of times since, and its, its generally, generally fine. It’s slightly on the high side but it doesn’t need medicating.
 
Okay and have you had any follow ups at the hospital?
 
No I haven’t. What, when I was discharged my consultant said to me, that were we, would we consider having any other children, which at the time I had no idea really and she said to me, “You know, before you even consider having another child, have your GP refer you back to me and we can, you know, monitor you, from the very, you know, from the very early stages of conception and so as to try and…” I suppose if I have a problem with the blood pressure to, to try and tackle that at earlier stage. So that if I did develop pre eclampsia again, you know, hopefully it would be at a much later stage. Because I think, from my understanding is that I, that its usually something that about quite later on in pregnancy and I was only 29 weeks gestation.  
 
I had my six week post natal check. Which was fairly kind of, I guess perfunctory, you know, she sort of said, “Are you okay?” And I said, “Yes, I’m fine,” [laughs]. So there wasn’t a lot of sort of delving into what had happened and why and that sort of thing. Yes, there hasn’t, there hasn’t really been a lot of follow up for me, at all, but you know, like I said, I do feel that if I wanted to, you know, I can go back, I can go back to the, to the consultant and discuss. 
 
 
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Samantha had pre-eclampsia and her daughter was delivered early and in neo-natal intensive care...

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I think in hindsight I wish that I’d gone back to talk to someone about what had happened. Not necessarily the issues of our daughter being in special care, but what happened to me. And I think it would have been good if there’d been some sort of group that I could have gone to of other mothers that had been through something similar. There seems to be lots of help for sort of parents who have got children who are poorly. But there doesn’t seem to be that much discussion about if you’ve been through a difficult birth experience, and whilst I had my NCT post natal group that I spoke with, that was just one, one week out of sort of eight, and then we sort of went on and we were talking about parenting stuff and things like that. And I think yes, in hindsight I would have liked to have been able to talk more about what had happened. Not necessarily to get any real resolution on it, because I understood exactly what had happened, but just to talk about it. And to know that there were other people out there who’d been through difficult experiences.

 
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Samantha was reassured that her consultant asked her to come back if she was thinking about a...

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Okay and have you had any follow ups at the hospital?
 
No I haven’t. What, when I was discharged my consultant said to me, that were we, would we consider having any other children, which at the time I had no idea really and she said to me, “You know, before you even consider having another child, have your GP refer you back to me and we can, you know, monitor you, from the very, you know, from the very early stages of conception and so as to try and…” I suppose if I have a problem with the blood pressure to, to try and tackle that at earlier stage. So that if I did develop pre eclampsia again, you know, hopefully it would be at a much later stage. Because I think, from my understanding is that I, that it’s usually something that about quite later on in pregnancy and I was only 29 weeks gestation. 
 
So, yes, I think, she also gave me some tips, sort of lifestyle factors that I could help myself with losing weight and just generally being, you know, a bit healthier, that those are things that I can do to help myself if we’re considering having another child at a later stage.
 
Yes, I mean she was very, very good. I saw her in the ante natal clinic she was there on the day that I was admitted. She was there all during my stay in hospital, and she actually delivered the baby as well. And as I said, she cared for me afterwards as well and you know, she, sort of, you know, said to me, you know, “Feel free to ask for me next time, and you know, if you’re considering having another child.” But I definitely found it very helpful that she sort of gave me those steps, and I think otherwise, I would have gone away and thought, oh well what do I do now, you know, but because she had a chat with me, I felt, I felt better about it, and yes, I know that I can sort of get referred back to her if, if we want to at a later stage.
 
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