Because of my medical history, I am under what they call [name of specialist maternity care] Care. So [name of specialist maternity care] is, encompasses all the problems that you would have with diabetes, with placental problems like placenta abruptions and pre-eclampsia and various things like that, HELLP syndrome, all sorts of weird and bizarre things. I think they also deal with things like obstetric cholestasis, if I’sve got that right, various things like that. So they are my main point of call and in normal appointments, so you have a certain number of normal appointments in your pregnancy that you’sd have with your midwife or with your GP. And they sort of outrank those so I tend to have more hospital appointments than I would have seeing my midwife or my GP. I still see my midwife and GP but they’sre they, they always say have those on top and it’s almost like a paper filling exercise seeing my GP. So, for example, I went to see my GP at twenty five weeks for the twenty five week meeting but that was purely to get my MAT1 form signed because the hospital don’st do it. But all the other care is done in the hospital. So I have routine appointments ever three weeks but, depending on what’s happening with the diabetes or my blood pressure, it can be sooner or later. And then, in between that, I’m also having, now having scans every four weeks and it goes down I think at 32 weeks, I then I start having them every two weeks.

This is the trouble, because I was classed as high risk but there was actually nothing wrong, I again fell in this kind of in between zone where I didn’st really get extra care and I didn’st see, I didn’st have any rapport with the consultant or with the registrar. I just saw a different one each time. Whenever I saw a registrar, they’sd hadn’st even bothered to read my notes so I was going in every time completely fresh, having to explain everything. In fact, the first time I saw the, the first registrar that I saw I walked in and she said, Oh, I take it I’m seeing you because you’sre obese. [Laughs]. I said, Well, actually, I think you’sll find it’s because, yes, my BMI is high but also my age and the other reason I’m seeing a consultant is because I have a bad back and I have sleep apnoea. So again, more boxes ticked for being a high risk pregnancy. So she hadn’st even bothered to look at the notes to see why I had been referred as a high risk [laughs].

And you reached the hospital what sort of tests and investigations happened at that point?

So, I got there and I remember quite a sort of assertive nurse told me to take a urine sample, and then she came back and went, “No, no you’sve got to take another one; you’sve not done it properly.” And then I came back and did another one and she went, “Ah,” because I’d had obviously a high protein read and she wanted to check it was right.

And then she took my blood pressure and she just sort of said, “Yeah you’re not going home,” and tagged me and put me in a bed so [laughs].

So it was very quick, it was, you know it was no hanging around.

We were probably down there for quite a few hours. She’sd had another set of blood tests taken off and they were being sent to a lab to determine her platelet levels. That was something again I’sd never heard of what a platelet was, and I didn’st understand what it did, but the doctors explained that. Also my partner who sort of works in the health industry herself. So part of me felt a bit more reassured that because there were lots of all these things which I’sd never heard of. Part of me was sort of thinking, well I’m sure my partner has probably heard of a lot of these anyway. So if I’m not following everything exactly well that’s fine, I’sll ask her as soon as the doctors leave the room, so I wouldn’st feel like a real dummy for asking silly questions. So they were getting on to it. So the blood tests were sent off and we were waiting for those results and there was a slight mix up at the hospital, where I think some, well they were lost or they were misplaced. So getting the results back from those, sort of took an extra hour or two than what everyone had hoped.

Over the course of a pregnancy, blood pressure does not typically stay absolutely steady. It usually starts at a certain level. During the middle of the pregnancy, it would usually slightly and gently fall. And towards the end of the pregnancy, the blood pressure will slightly and gently rise roughly back to the level where it was at the start. However, we have to track these blood pressure changes by checking blood pressure at each routine check because this is the method by which we work out if, instead of these normal changes, a woman is starting to develop hypertension in pregnancy or pre-eclampsia.

When we measure blood pressure, there are two separate numbers. The first is called systolic blood pressure and the second is call diastolic blood pressure. The reason you have to take two separate measurements is because, over the course of one heartbeat, how high or low the pressure is inside a blood vessel changes. When the blood has been forced out from the chambers of the heart into the large blood vessels of the body, the blood pressure initially is relatively high. When the heart muscle subsequently relaxes, so that the chamber can fill up with more blood to be pushed out over the next cycle, the pressure is relatively low. So we look at both numbers because both are important and sometimes we look at the difference between the two.

I was under the consultant care again and the midwifery care because of my history. And they obviously are monitoring me, and I think I went for my 30 week check-up and that’s when they detected again that my blood pressure was high actually not 30, because he was born 30 weeks 28 weeks.

Twenty eight yeah.

And they detected protein in my urine, and then they just basically the same thing as last time, that we have to keep you in.

Yeh

Well actually before that theyyeah theyI had to have a 24 hour blood pressure monitoring.

Mm OK

So they sent me home with the cuff that I had to keep on all the time, and then I had to bring it back the next day, and then they saw that the blood pressure was quite high all the time, and they decided to keep me at 28 weeks.

But at 27 weeks I saw my blood pressure and I thought, ‘Mm it’s not good, it’s not good, that’s high for me. It was 15 point it was, what was I a 125 at that point I think over some number, and I thought that’s not good, that’s high for me.

So then again at 30 weeks I had a midwife appointment blood pressure had gone up again. I think it was about a 133 at that point, still climbing and I thought, ‘Mm yeh still climbing, not good, that’s not good. So, yeah it was the second hospital visit I left my desk; I’d left everything logged in, I was like because the day before I’d had a midwife appointment and my blood pressure had been high there but she said, “Oh it’s still a few points below what we admit,” and I was like, “Right I’ll just go home then,” you know like. I’m seeing sparkles; I feel weird; I had pain all round here; I had pain here and I was like, ‘It’s not good, it’s not good. So I thought, ‘You know what, I’m going to be back here tomorrow,’ and I thought, ‘I don’st want to risk my health,’

So yeah the midwife appointment at 37 weeks when I toddled off from my desk and I never went back. I’d borrowed a phone charger off a friend at work, and I’ve still not given it back to her because she left the office when I was on maternity leave. But I I got she took my blood pressure, it was the magic number it was over the magic number, I think it was like 160 or something over 90, some ridiculous number which for me was like I mean I was just I was swollen so badly everything was swollen. Like, my friends had been saying like my feet were just sticking out my shoes you know. I was like Michelin man, and my friends were like, “You should really see somebody.” I’m like, “I’m seeing people, you know I’m having regular visits for goodness sake.” This is you know it wasn’st being monitored. I felt I had to do more to look after myself. So, I had to do more really to look after myself than I was getting from the community team. I had one really good midwife and I made sure I always went back to her. She was the one who said, “Right, your blood pressure is too high,” that day, at 37 weeks.

And I went for a routine 32 week GP appointment one morning, 8.30 in the morning and said, Your blood pressure’s too high. And I said, Oh well, whatever. Because I’sve had, I’sve never been regular at having my blood pressure taken because of something that happened back when I was at uni and so I always hate having my blood pressure taken. And so, I sort of brushed it off a bit, and said, to him, You know, I’m sure it’s okay. Or whatever. He was like, I really want you to go into hospital. And I was kind of like, Oh that’s a bit extreme. And he said, Look, we’sll agree because you’sre a physio, and I trust you. You can go to work, but I want you to take your blood pressure once an hour for the next three hours. I’m calling you at 12. If it’s still too high, we’sre having this discussion again. And I said, Okay, that’s fine. Fair enough. So I went off to work and I took it for the next three hours and it was still very, very high, so we agreed that I’sd go to the hospital. Which I did, and went to just the day assessment unit, where they did more monitoring of it. It was basically, it was still high, but borderline as to whether they’sd medicate or not. So I think they said, if it was over a 150 on a 100 they’sd definitely put me on medication. If it was well below that they wouldn’st bother. Mine was sitting pretty well bang on that. So they didn’st know quite what to do. So they took some bloods as well and basically said to me, Look, we don’st know quite what to do with you. Come back on Monday, and we’sll see how things are then. Unless we call you and tell you that your bloods are off, and then we might ask you to come back in. So that was fine.

So he was delivered at 38 weeks, he was big enough, no no problems there. I came home a couple of days later, everything seemed to be fine and then I think it was on day five, he had actually developed a little rash and I think, you know, first time mum, really quite worried about it, thought we will pop down to, our midwives do a drop in clinic. So I popped down there and I had a splitting headache, which I’sd had for two days but, as I mentioned, you know, as a migraine sufferer, that’s quite normal for me and I thought it was the stress of having a new baby, trying to breastfeed, everything like that and that’s what I put the headache down to. And, while I was sitting in the waiting room, I had to rush off and be sick and that’s when I thought, you know, oh dear, this is this is quite normal with a migraine as well, to be sick.

And then I went and saw the midwife and she said, Are you okay? And I said, No, I haven’st been feeling well. And when she took my blood pressure, it was the highest that she’sd ever taken and I think it was up in the 210s, 150, or 130 or something like that. And so she was, you know, instantly, You need to lie down. You need to get on your left side. We need to call an ambulance. And I was rushed back into the [hospital] again. So yeah, and then, you know, they just monitored me. They put me on labetalol and more blood pressure medication, that kind of thing.