This section of our story, which is both final and introductory, begins with a visit to the GP. Actually, I’d better backtrack a day or so.
On Tuesday (06/03/2007) we had an appointment at the antenatal clinic with the consultant obstetrician. We also had an appointment for a detailed scan of the placenta booked for Thursday (08/03/2007). The consultant decided that given the size of the baby, they would book an induction for around 40 weeks. I mentioned Hannah’s fairly severe pitting oedema, but didn’t seem to think too much of it and her blood pressure was pretty normal. Hannah was not feeling very well, with a sore throat and a headache but the midwife thought she probably just had a bug of some kind and recommended rest, paracetamol and plenty of fluids.
The sore throat and headache persisted through the paracetamol and the night so I decided to get to see the GP. We didn’t think they’d be able to do much, but it was worth a shot. I am so glad we bothered.
Amazingly, I got an appointment with ease. Normally, our doctor’s line is engaged at 8.30 and many redials are necessary just to get on hold. On this occasion, it rang once, prompted me to press 1 for appointments, rang once more and was answered!
So, at 9.30 we rolled into the doctor’s room and explained the symptoms. To her great credit, she did the routine stuff including taking blood pressure. This seemed to cause her some concern and she mentioned pre-eclampsia. She called the Day Assessment Unit at the Royal Berks “for advice” with the result that we got back in the car and drove down there. The car can pretty much drive itself there these days. I was supposed to be covering support at work in the afternoon and we assumed that they’d probably just stick Hannah on the CTG for a while and tell her to go home and rest so I dropped her off to be collected later. Hannah’s never had high blood pressure in her life and it seemed so unlikely that she could have any problems now. Paula (Hannah’s mum) was already at the hospital for an appointment of her own so she met Hannah there so that she wouldn’t be on her own.
I went home and got on with work. Some time later, I got a call from Hannah to tell me something both scary and exciting.
They had waited around 45 minutes before being seen (it was pretty busy) and Hannah had her blood pressure taken again. The results were pretty impressive. At one point she had 7 health care professionals of various grades in the room simultaneously, including two consultants (one obstetrician and one anaesthetist). Upon examination, her cervix was 1cm dilated. Not a lot in the scheme of things, perhaps, but compared to the previous occasion a bit step forward. It meant, basically that they had room to break her waters so that an induction could happen.
Hannah decided that I should carry on working until they had broken her waters as it would be some time before anything really happened. Paula would stay with her until then, and I would replace her.
I managed an hour or two of this arrangement before finally cracking and insisting that I was coming down now. I had to phone the delivery suite to find out what was going on and let them know that I was coming in.
In the meantime, Hannah and Paula were having fun and games with various sharp implements. The swelling she was exhibiting was making her veins even harder to find than “normal”. An anaesthetist had 5 attempts at getting a canular in and in the end the consultant anaesthetist had to do it. Hannah needed 2 canulars, so she ended up with one in the underside of her wrist. She also had an epidural put in at around this time.
At 14.50, I arrive at the hospital. I had a surprisingly calm drive over to the hospital with no real traffic problems. That lasted until I got to the car park. I have never had any real problems with finding a parking space at Royal Berks before (in all my numerous visits to the hospital for various reasons). This day, I had to go up to the top level and come back down, eventually finding a space after having driven around several times. My blood pressure and temper suffered somewhat, I’m afraid.
15.00 I arrive on the delivery suite and take over from Paula. Hannah is spouting tubes from everywhere, it seems.
15.15 A catheter is put in and anti-emetic administered. Hannah is feeling very sick, which is relieved quite quickly by the drugs.
15.30 IV antibiotics administered because of Hannah’s GBS (Group B Strep) history.
15.50 Hartman’s solution drip attached.
15.55 Magnesium Sulphate drip attached to prevent fitting.
It is incredibly hot in the room. I whack the fan up for Hannah, but it doesn’t help me much.
16.05 Syntocin drip started at 1ml/hour. Hannah now has 3 separate drips going into her simultaneously. They’ve had to find extra pumps to fit to the drip stand. It all seems very medicalised (understandably, though) but Hannah is taking it surprisingly well.
16.20 Syntocin drip increased to 2ml/hour
16.35 I go out to sort out my parking permit, grab a coffee and call Paula to ask her to bring in Hannah’s inhalers.
16.50 While I’m out, contractions start, Hannah can only just feel them because of the epidural.
17.30 The epidural is topped up. Hannah is only aware of the contractions from what the CTG is showing.
18.20 Various bloods are taken.
19.10 Epidural is topped up again because Hannah was feeling the contractions. Apparently this is not desirable at this stage.
19.25 Hannah is moved onto her side to prevent pressure sores. She’s rather sleepy.
19.30 I prompt the midwife to give Hannah another anti-emetic because she’s feeling very sick again. Also ask about the next dose of antibiotics, which had been crossed off her chart, so they are administered, too.
19.35 I eat a sandwich, which annoys Hannah because she’s virtually nil by mouth. I tell her it is a doughnut sandwich and she falls asleep with a grimace on her face.
19.55 Foetal heart-rate monitor becomes detached. I am a little disturbed to discover that this is attached directly into the baby’s scalp by a small metal spike. The midwife has to take it out and put a new one in. Lots of aseptic kerfuffle involved in this. Hannah’s cervix is examined at the same time and is 2cm dilated, posterior and slippery from a show and her waters.
Hannah: Go away cervix
Midwife: Yes, bugger off cervix
There are problems getting a good connection, the wrong leads were provided. Syntocin drip is now at 16ml/hour.
20.07 Anti-emetic topped up
20.15 Hannah’s blood pressure has dropped a bit and she goes a bit woozy so has a lie down on her side again. Another dose of IV antibiotics administered.
20.22 Hannah is asleep.
20.55 Epidural topped up.
21.35 Staff changeover. The new doctor gives Hannah another VE and the cervix is at 5cm. Everybody is very pleased as things seem to be progressing very well. The doctor says “That’s amazing, you’re doing really well.”
It may be apparent that this is sourced from notes that I was taking at the time. I had little else to usefully do up until now, as the epidural was preventing me from even being shouted at. It was at this point that things went a bit awry. I only really have one more note made at the time which was a very hastily scribbled:
Only minutes ago, the doctor was being very pleased with progress. Almost immediately, the Foetal Heartrate started to drop. Hannah was given oxygen to see if that helped. It didn’t. We are told that it’s time to get the baby out, they need to do a c-section right now and it will have to be under General Anaesthetic. Also, because it’s a GA, I won’t be allowed into theatre. It may sound stupid, but neither of us were really prepared for this.
Of course, we always knew that there was a chance that a c-section might be necessary. It was absolutely the last thing Hannah wanted, but she accepted that she would have to have one if either life was endangered. She had also had problems after an appendicectomy under GA two years ago. She had around 10 fits in recovery, took 3 hours to come round and had a series of fits (or fit-like episodes) for some months afterwards. That being so, we had seen a consultant anaesthetist well in advance for advice about pain relief in labour etc. The options boiled down to: IV paracetamol (surprisingly effective) or an epidural. A GA was to be avoided if at all possible.
Naturally, Hannah raised this with the doctor but we were told there wasn’t enough time to top up the epidural and they understood the concerns but both lives were at risk. During this exchange, what seemed to be dozens of staff were turning the delivery room upside down and were ready to take Hannah and her bed down to theatre. I had a set of scrubs thrust into my hands and I was told to put them on in case things changed. I tried to put them on over my clothes and was told I had to take my clothes off. I realised at this point that I hadn’t said “good luck” or similar fatuous comment to Hannah and she was rapidly disappearing down the corridor. I throw the scrubs into the sink and charge down the corridor after her. She passes her rings and necklace to me and I try to reach far enough over the threshold off theatre to get her earrings, too.
I can go no further and go back to the delivery room. It seems strangely empty and I put on the scrubs, which are enormous. I find myself standing alone in the room, in scrubs and hairnet feeling decidedly forlorn. Fairly quickly, though, a midwife arrives to tell me that things have stabilised enough for them to top up the epidural, thereby avoiding the GA. They find me some shoes and ask me if I have my camera ready. Despite the fact that we bought the camera so that we would be able to get decent baby photos, somehow it seems an odd question at the time. I grab the camera and we go to theatre.
Hannah is surrounded by medical staff, and they are all busily preparing things. The anaesthetist is spraying very cold liquid on various parts of Hannah’s body to see how far up the epidural is affecting and adjusting it accordingly. I am put on a stool by Hannah’s head, behind the low screen. I decide I have no wish to see what will be on the other side. I feel sick and shaky but try to keep it together for Hannah.
They start the operation with a speed I’m not prepared for. A disturbing feature of the epidural is explained to us. It stops pain, but not all sensation. Hannah, therefore, is able to feel tugging and prodding “down there” so I have to try to keep her mind occupied for the next few minutes. All of a sudden, the baby is out! He appears above the screen, covered in vernix and pretty quickly starts to cry. Hannah does too. He is quickly swaddled and dried off and placed on Hannah’s chest for her to hold. He’s beautiful and I take some photos. The surgeons are sewing Hannah back up and I can smell cauterising flesh. The staff are all lovely. Hannah gets the shakes, which is put down to the epidural. One of the nurses takes pictures of all three of us.
Oscar is given to me to hold while they finish sorting Hannah out. I try to stay close, but not under foot.
Details from now on get a bit hazy. We go back to the delivery room and take more photos. Oscar is weighed, but has had a bowel movement into the towel and his lower body is covered in meconium so has to be bathed first. He weighs 8lb 9ozs.
I leave the pair of them alone while I go to make the necessary phone calls. After weeks of being on standby, with my phone battery carefully check, I have managed to let it get perilously low. I managed to phone both sets of parents and then compose a text message to be sent to about 20-30 people. The sending of all these texts is taking an age, so I leave the phone under my car seat and hope the battery holds out long enough for them all to send.
I return to the room and they find me a Z-bed to sleep on. Scrubs (that fit this time) are provided for me to sleep in. The midwife gets me a mug of tea and some toast. Hannah is still not allowed to eat and is restricted to 100ml of water per hour. Lots more photos are taken.
02.00 Amazingly, up until now, Oscar has been very quiet and well-behaved. About now, he starts to cry. Hannah manages to get him to suck, despite feeling a bit out of it. We put him back to bed after he spits the nipple out, but he cries again. He feeds from the other breast.
We alternately cuddle Oscar and give him feeds for most of the night. The midwives are in and out, looking after us all.
Oscar is quiet/sleeping from 6-7am and we both sleep for that hour. At 7am I wake up and feel strangely alert and fresh.
The consultant does a ward round and Hannah is allowed to eat and drink again. Subject to stable blood pressure, they will be moved up to the ward around lunchtime.
I stay around all morning and go home to get some extra things, shower and make sure photos are safe.
To be continued…