And I just started to prepare myself for being in for a long, long time. But obviously as the hours went on and I kept having these really serious spikes of blood high blood pressure, and there started to become more talk of, you know, every day that you can go, before you have to deliver is, is good, and I started to kind of have the realisation that, you know, it was, we were going to have the baby sooner rather than later. I suppose I started to, I think I was in denial for a while, because they said to us on the Saturday, Would you like to see a paediatrician to come and explain to you about what will happen if your baby’s born at 29 weeks and I said, Oh, no, no, no. Because I just, I think I just assumed that I would, my blood pressure would go down, they’sd be quite happy for me to go up onto the ward and it would still be a few weeks until I had the baby. And then when I had the second major spike in blood pressure and they asked again and I thought, actually, yes, I suppose we’sd better speak to someone to because I’sd rather know than be caught unawares. But again, you know, even when they, even at the point where my consultant decided it was time to deliver, even sort of fifteen minutes before then, and all the talk was that I was going to go up onto the ward and so when she sort of said to me, You know, we’sre going to have to deliver the baby. It still felt like quite a shock. Because I thought, you know, I just had it in my head that everything would be fine. But actually when I saw, when I saw the monitor and it said 205/110, I thought, yes, this isn’st good. This is really bad. So yes, it was really kind of mixed, mixed emotions, because you know, I was trying to get myself mentally prepared for a long stay in hospital. And then I was sort of thinking well what will happen if the baby’s born early and what will that be like and I just never entertained the idea that I wouldn’st have just a normal pregnancy and that I wouldn’st, I didn’st even know anything about premature babies.

How did they make the decisions?

Well I don’st think there were any options. It was get baby out as soon as possible. They were trying to gauge the approach to take to get baby out. We weren’st given the option not to do it, only forms to consent to doing what needed to be done.

So I didn’st think there were any options but I can’t imagine myself ever saying, “No, don’st do that,” because obviously the risk is that the baby’s going to die.

And what was the role of your husband in all this? So, it must be a very challenging situation?

Yes, yes. He did ask about the blood pressure; what should it be. He kept a very close eye on it. He would answer a lot of the questions on my behalf and I’d correct him [laughs]. He didn’st actually look at the consent papers I don’st think, that was given to me which is right but equally I don’st think I was really in the right position to sort of digest it properly, but at the same time what options what are there? They can’t my husband shouldn’st be reading and signing on my behalf, and unless I didn’st want to go ahead with it there was little option other than to sign it.

Doctors and midwives make decisions every day to try and help women to choose when to have a baby but sometimes medical problems can make these decisions difficult. Often, women will fall pregnant and will try to construct a written or verbal birth plan. This will give ideas about the timing and setting of birth. But pre-eclampsia is a condition where usually the treatment is to give birth and, therefore, there are some circumstances under which a midwife or a doctor might recommend a baby to come out relatively early. Now, for the vast majority of patients, these decisions are taken when the baby is ready for the outside world and midwives and doctors use the phrase term to denote a gestation of 37 weeks and beyond. Now, at this time, the baby is not regarded as premature but if pre-eclampsia ensues at or after that time, it is often the recommendation to bring the birth forward and the commonest way to do this is to give medicines to start the labour, also known as induction of labour. However, in early onset cases, which are severe of pre-eclampsia or HELLP syndrome, the midwives or the doctors will sometimes give a different recommendation and they may recommend that the baby be born before 37 weeks. So this is a conscious decision for the baby to be born prematurely but the decision is taken on balance because the doctors and midwives are feeling for that individual scenario that, if the pregnancy were to continue, the mother’s wellbeing and the baby’s wellbeing would be put at risk. Such decisions can be difficult and the midwives and doctors always try their best to allow the parents to fully understand the decision and to participate in the decision.

But and then was an issue of the fact that there was no there were no operating theatres available you know, so I was kind I felt that it really did feel that night that we were up against it. And I a Doppler scan and there was a real clear sound of the dip in the heartbeat going much, much slower, and so I’d also only just, a few hours beforehand, had the injection for thinning my blood, so they said, “Well we can’t do anything until, you know until you get over that anyway; until your blood starts to thicken up again.” So, anyway this all went on for, you know most of the night until about four in the morning where they rushed me, or I rushed, I ran, to a into an operating theatre and he was yeah he was delivered in about four minutes.

I think that again, you know I just wonder about those decisions that were made at the time about [son’s name] welfare and my welfare, and whether they were having to having to balance somehow the fact that I was needing this blood clotting thing to work. Had they given me blood clotting probably I can’t remember, I don’st know. That they were, you know just waiting for my blood count to rise was it? My blood count to rise, something, I can’t again I can’t remember the technical aspects of it. And that was what was actually holding it up in the end. So, I was having, you know consent forms put at me; I had something in my arm here and something in my arm you know it was literally it was so much happening and I was on my own it was you know I’d had a lot of friends and family visiting all the time but here I was just on my own surrounded by a lot of doctors, a lot of nurses, a lot of midwives.

And I was adamant she well I didn’st know what I was having, but I was adamant she wasn’st coming out because I knew they weren’t good risks. When I was taken back to the ward when I was still in the room of four, the hospital in [City], the paediatrician comes to see you and they take you into intensive care and they show you the room.

And Imogen’s little incubator was sitting it was a giraffe, it was empty and it was sitting, just waiting on her, and I think that’s when it really hit me, I’m really ill. ThisI’m not going full term with this baby.

I’m kidding myself that I am because I was in denial you know, I feel fine. But then I was like, ‘This baby’s coming early and this baby’s going to be tiny,’ and I’d seen the size of the incubator and I thought, ‘Oh, oh my goodness she’s she is going to be tiny,’ you know and it was quite frightening.

But they show you, and there was no tiny babies in the ward at the time, but they have different stages you know they’sve got an intensive care and then a high dependency and a family kind environment, the room that’s next down, and then they’sve got individual rooms and then they’sve got they have got a family room where you can go and see where baby in preparation for coming home. And they went through it all with me and a lot of it I didn’st take in because I was I was very much in shock. And I was under the impression that babies born at 24 over 24 weeks they can live can’t they, and they’re like, “Yeah, but there is a lot of complications and a lot of them don’st.” And I think the media, because you see so many success stories, you think everyone’s a success and actually, no they’re not.

And I didn’st know that, I was kind of kidding myself that she was going to be just fine.

That was awful. You’re just lying there; you’re just in their hands; you just hope and pray that, you know they know what they’re doing and you have no say in it; you sign the form saying that you, you know you want your organs to be donated and it’s just it’s a real smack in the face as to, you know how serious it is and poorly you are. So yeah I was just surrounded by the SCBU (Special Care Baby Unit) team and the anaesthetists and this was, you know three o’clock in the morning, so everyone just appeared in a whole rush and panics on their faces I could see which then panicked me. And no-one was really explaining what was going to happen. No-one was holding my hand to say, you know XYZ and before I knew it I was counting back from ten and I was gone, and I just remember sort of I counted at least 20 people around me and I was just wired up, and it was the most scariest thing I’ve ever done, and never want to do.

Horrific.

So, on the Friday morning I’d spent Thursday night there. The Friday morning they did a ward round, so my consultant came in especially and the consultant that was on, and they decided that they were going to section me on Friday morning.

That I was the top priority and I was going to be the first on the section list. And they were kind of talking about it amongst themselves, and they said, “How do you feel about that?” and I said, “I don’st want to have a section.” For me it was because I lived too far away.

And I knew that he was going to be in special care and I knew I wouldn’st be able to drive for six weeks, so how was that was all going through my mind how was I going to get in and out from hospital to see him. So, I begged and they agreed to induce me. So, the hospital that I work at we use a drug that you it stays in the cervix for 24 hours and after 24 hours they take it out and then they kind of reassess. So, I was given four hours with this drug on the Friday morning. So, they put it in for four hours, and then they had obviously gone out of the room and had a discussion, and they decided that at that point my blood pressure was under control, and that they would see what the 24 hours would do. So, I was really pleased about that.

And I’m really pleased with my decision because then on the Saturday they took it out, they managed to break my waters and within about four hours I’d had him.

So, I do believe that if I wasn’st a midwife and I didn’st know what I was talking about, that I would have had a section regardless, which I think is major surgery for, you know someone of my age that isn’st wasn’st it wasn’st necessary. I mean, if my blood pressure was amazingly dangerous at that point, and they were really worried about him, I would have done; I would have done anything. But in my mind, and through discussion with the midwife I felt like I was that was the right path to go down. But I had not been a midwife things could have been very different yeah.

So that was on the 16th of February, when I went in to have my normal check. By the 26th, we’sre talking about having, delivering the baby early because they didn’st like what was happening to my body. And then, the worst thing was, I was hearing from the young doctors and I didn’st see that female consultant ever again. That annoyed me a little bit because I felt I wasn’st I wasn’st important enough for her to come round again ever since that first visitation, that was it and I felt very annoyed. So on the 26th, I remember a young female doctor that came in to see me. I was not particularly nice to her. I said, I want to see that consultant. Why is she not here, especially when she told me that we needed to deliver the baby early? So I demanded to see the consultant and it wasn’st it wasn’st until the 27th, morning of the 27th, she came to see me and I said to her, I want to hear it from you, what do you, is the best option? And she said, The way you are, yes, we need to have this baby delivered and options are either caesarean or we’sll induce you but we prefer the caesarean. And I said, because of the hidden, I’sve heard about people having caesarean and always people that I know of, like relatives and they’sve never had a good experience with it.

So, when I told my mum, she advised me against it and she said, Go for natural birth. They’sre there, the medical experts to help you and you, they wouldn’st give you those two options if they weren’st safe for the baby to be delivered naturally. So I said, I’sd rather to have a natural birth. So they said, Okay. We’sll wait until the 35th week.