Pre Eclampsia and an Emergency Epidural

9.36pm. Waters broke 5 minutes after my head hit the pillow. I sat up uncertainly as a small trickle escaped. A wave of energy ran through my uterus. It was a strange and unfamiliar feeling but I knew what it was. Waddling out to the living room where Jeremy sat trying to fix my computer, I wondered what to do next. “My waters just broke,” I said. Jeremy stood up to hug me and I started to cry as the reality sunk in.

The hospital wanted me to come in right away, but told me not to rush. I was prepared for this news. Both Mum and Nan started their labours with their waters breaking first so I knew it would happen that way and had long since given up the dream of labouring slowly in the peace and solitude of my home.

In the last weeks of my pregnancy I’d developed pre eclampsia. After several days of hospital visits and constant monitoring, the doctors told me that baby needed to come out. I was just waiting for my obstetrician, Dr Cary, to return from school holidays the next day. Facing a medical induction, we raced the clock using every trick in the book (sex, spicy food, acupressure and caster oil) and won. I was feeling very pleased with myself as we drove to hospital, but a bit of a surprise lay waiting for me.

Dr Cary came to see me right away. He gently informed me that I was going to need an epidural. Somewhere in the bottom of my labour bag sat several copies of a birth plan that would never be used. The birth plan had specifically requested no epidural unless needed in an emergency. High blood pressure, it turned out, was such an emergency. The epidural would lower my blood pressure and ensure that the pain of contractions didn’t tip me over the edge of safety. It also meant Dr Cary could pump me full of Syntocin to get the contractions hurtling along like a bullet train and baby could be delivered as quickly as possible.

As it turned out this was the best-case scenario. I had an appointment to see Dr Cary the next day but he told me in hospital that I was in line for a serious chat. If I hadn’t gone into labour on my own and my cervix wasn’t ripe I would have been facing a caesarian. I guess I hadn’t realised the seriousness of my situation.

The anaesthetist arrived and I was systematically attached to a drip, CTG, blood pressure monitor and finally the big needle was stuck in my spine. “Let’s have a dawn baby,” Dr Cary said when he left me after midnight to go home and get some shut eye.

During the night I couldn’t sleep. There was no pain or discomfort, just a steady boredom and a nagging interest in what was happening inside me. Next door I heard blood-curdling screams of another woman in labour. I could feel the baby moving and as the night dragged and my legs became heavier and more numb, I could steadily feel my contractions as short, sharp pains growing closer together.

Two midwives attended to me through the night. I chatted with them and discovered the primary attendant was a trainee. It was apparent by the fact that she failed to find my urethra 5 times while trying to insert the catheter. I quickly gave up any pretense of dignity. After all, I had already soaked my pants through with amniotic fluid when I arrived, but it would have been nice to have a competent midwife by my side through the long night.

As dawn came creeping over the horizon the midwives starting fussing about my contractions which they insisted were getting weaker. During the night they’d upped the Syntocin according to Dr Cary’s schedule so they failed to understand what was happening to my labour. I was frustrated and worried. This was the reason I’d wanted to avoid an epidural. I’d heard the horror stories of 40-hour labours resulting in c-sections and I started to see it happening to me. I wanted to sit up and give gravity a chance. So the midwife raised my bed for me and I was suddenly overcome by nausea. The midwives handed me a sick bag and a wet cloth.

Soon after 6am Dr Cary arrived back on the scene and asked me how I was feeling. “Nauseous,” I said, holding back tears of frustration. “Let’s take a look.” Dr Cary took one look and saw a head. “Well the reason you’re feeling nauseous is because you’re about to have a baby, so let’s get those legs up and push!”

The midwives were shocked. I guess if either one of them had bothered to actually examine me internally, instead of trying to rely entirely on the CTG, they might have known what was happening. They were so useless and were completely unprepared for delivery. They flew into action as Dr Cary gently coaxed them. I shudder to think what would have happened if Dr Cary hadn’t shown up when he did, but he did so I won’t waste time worrying about that.

Three contractions and some well-visualised pushes later, our darling Jude was born. As his head emerged I stopped pushing and sat back to watch in quiet contemplation as his body was delivered on October 7th, 2008 at 6.39am. My little posterior baby had turned himself around. What an angel!

The midwives were pretty astonished by how quickly it happened. Jeremy and I were blissfully happy, we both cried as Jude was placed immediately on my tummy. He was all slippery and floppy and fragile. “Is it a boy?” I asked through tears of joy, but they hadn’t looked between his legs yet. It was soon confirmed what the 19-week ultrasound had shown … the dream that had been Jude Hugo Thomas was now a beautiful, perfect reality.

Jude opened his left eye, then his right eye and started searching my chest for the nearest nipple.

Pre-Eclampsia or Hypertension

On Thursday I went for my routine 38-week check up. I mentioned to the midwife that I thought baby's movements had been a bit less pronounced. She asked me if I felt it was a significant reduction in movement and I didn't really know how to answer that question (based on what knowledge would I be able to judge what "significant" means in this case?) The midwife suggested a cardiotocograph (CTG) which is just a simple heat-beat monitoring test for the baby.

After that, she measured my blood pressure. This is the only measurement I've had throughout my entire pregnancy. It has always measured around 120/70, but when the midwife checked it had risen to 130/90. She was a bit concerned about it, but I thought it was probably just related to the stress of wondering if my baby needed the CTG or not.

During the CTG that same day, my blood pressure raced up to 160/120. Now I happen to know from previous experience that I am susceptible to stress. My blood pressure has been this high before. I didn't think there was anything to worry about, but they ordered some blood tests.

That afternoon I had a call from the midwife who said my blood tests were ok but I should go to the hospital on Saturday for a follow up. That evening, however, I had another call from the attending obstetrician's office who said there were some concerns about my blood test and asked me to come back the next day (Friday).

Friday (yesterday) I went back for more monitoring. Apparently there was something about uric acid in my blood results. I had my blood pressure re-checked (the midwife said it was high, but I don't know what the measurement was) and then I had another blood test plus a urine test. The results didn't come back that same day, so I had to wait and see what happened at the hospital.

Today is Saturday. I went in to the hospital this morning with my husband by my side really not knowing what was going on. We had another CTG and my blood pressure was checked again. Today it measured 139/94, which is considered pretty high.

I asked some appropriate questions and I now know that I am being monitored for pre-eclampsia. A condition specific to pregnancy where a woman's blood pressure rises for no known reason. It starts in the placenta and can cause oxygen deprivation for the baby. It can be quite serious. At my stage in pregnancy the treatment is to deliver the baby as quickly as possible.

My obstetrician is away on school holidays, but he'll return this week. At the moment I'm not particularly under any specific obstetrician's care (just whoever is on duty). The doctor on duty this weekend didn't want to make a call today, given that he's just been introduced to my paper work (although I haven't met him because he was in theatre when I was there).

This means I have to go back again tomorrow (Sunday) for more blood/urine/blood pressure tests and a CTG and if my blood pressure has gone up or my tests come back any worse I will be induced almost immediately.

This comes as quite a shock. I'm a little bit thrown that I could suddenly be facing the imminent arrival of my baby. It's been 9 months and in just one more week I will reach my due date. My baby has already been considered full-term for 2 weeks, so having my baby now is completely acceptable it's just that I hadn't expected it to be this way.

I had assumed I would go into labour at a time that the baby would choose and it would all be a big surprise and at first I wouldn't even realise I was in labour, or I wouldn't be certain, and it would probably be in the middle of the night ... but now I'm facing a very real chance it could be tomorrow.

I sort of hope I go into labour naturally in the middle of the night and skip all this rigmarole.

Braxton Hicks Contractions

At some point during pregnancy a woman's body produces hormones that tell the uterus to get into shape and start practising for labour. The resulting contractions are called Braxton Hicks. They're (usually) painless and are felt as a tightening of the entire uterus, so they may be uncomfortable.

I didn't notice them at all until the last 2 weeks or so. My obstetrician asked me if I'd felt them around 30 weeks, I said I hadn't had any. He said I probably had, I just hadn't noticed. As far as practice contractions go, I think my uterus has been a bit laid back.

Until a couple of nights ago. I woke up with a strong, sharp, tight pain in a band across my abdomen. I eased myself out of bed and felt an ache in my lower back. I thought it might be the real deal, I hadn't experienced this before. After emptying my bladder I returned to bed, feeling a bit shaken and sore. Was this it?

The thought occurred to me that once labour begins it won't stop until the baby is born. I'll have no control over it. The pain will come and go and become more intense, and I won't be able to do anything.

As I lay in bed wondering if another contraction would follow I somehow knew that it wasn't actual labour. I took a few deep breaths and reminded myself it was just a strong Braxton Hicks and I then I went back to sleep. They say I'll know when I'm in labour and I believe that's true, but now I'm feeling constantly on edge wondering when it's going to happen ... could be any time.

Where's Baby?

I had a bit of fun this morning with my camera. This silly series was taken at 37 weeks and 4 days.

Where's my Bump?

Ah, There it is!

Monitoring Fetal Movements

I am 37 weeks and 1 day pregnant. There isn't long to go now. Officially, my baby is now fully developed and could be born without complication (and quite probably a full head of thick hair). It's a wonderful, beautiful feeling to know that we made it to the end ... but the baby isn't on the verge of falling out just yet, there's quite likely a few weeks to go.

I've been advised by my obstetrician and various books that I should be counting my baby's movements. If I register a decline in activity inside my uterus, I should contact the hospital. My doctor told me there should be 10 movements before morning tea.

This frantic counting from the moment I wake up has me a little bit worried during those times when the baby is asleep. Sometimes I realise I've been a bit preoccupied with other things and I haven't noticed for hours whether the baby has moved or not, and so pass a few tense moments until I feel a telltale wriggle from inside me telling me everything is OK.

I'd really like to be able to relax. Didn't we make it? Haven't we reached our final goal? Why now, in these last few weeks, can't I take it easy? I don't want to be counting movements, it's tedious and stressful and I haven't actually once counted to 10 because I always lose interest around 5. This simply isn't how I want to spend my day or even the first few hours before morning tea.

And yet I'll just take a moment to pause now, pat my belly and check to see what's going on. Baby's sleeping ... should I call the hospital or wait, worried and anxious, until baby moves again?

Vitamin Supplements in Pregnancy

I have just been taught me a very important lesson. Do not take your health for granted in pregnancy. When a woman grows a baby inside her womb all the mother's nutrition goes to the baby. If there's nothing left for mum at the end of the day then mum misses out. Even someone like me, someone who has always eaten a well-balanced diet and is always in the best of health, can end up basically malnourished after the baby gets all the good stuff.

Last week I started to experience debilitating fatigue. It was a lot more than just feeling tired or not getting enough sleep. I was completely run down. My eyes burned with exhaustion all day and I struggled to function. I became incredibly clumsy and lost awareness of my own space so I was always bumping into things. At first it was just physical, but it rapidly became quite mental as well and I was overwhelmed by stress and emotion.

Just before my last obstetrics appointment I was trying to fill out some paperwork that needed to be signed and was quite straight forward, but it was too much for me and I completely broke down. I was crying uncontrollably into my pillow with my poor husband trying to console me, but not really knowing how to help or why I was so distressed.

He's a wonderful friend, that husband of mine, so he gave me an expanding file folder on which he wrote "Too Overwhelming Folder (even a little bit)" and he said "put anything that you can't cope with in there every day and I'll take of care of it when I get home from work." This cheered me up enough so I could wash my face and go see my doctor.

I told the doctor about the fatigue, and he said it was completely normal in the last stage of pregnancy. What I neglected to tell him was that I never followed his advice and I hadn't been taking the supplements that he recommended about 3 months ago. Back then, I decided not to buy expensive supplements because my blood tests came back perfect and so I arrogantly thought "clearly my diet is good enough and I don't need extra vitamins."

It turns out I was wrong. After seeing my doctor I headed over to the hospital pharmacy to buy the elevit supplements, just in case they would help. I was going to get just 1-month's supply to see me to the end of my pregnancy, but Jeremy reminded me that a breastfeeding woman needs even better nutrition than a pregnant woman, so we spent a bit extra for the 100-day box.

I started taking the supplements that evening and they had the most miraculous impact on my mental and physical health. I went from falling apart one day, to washing the bathroom and vacuuming the house the next.

We're having some friends come and stay on Saturday night, and we're entertaining some more friends on Sunday night and without the proper nutrition in my system I can assure you that I never would have coped with visitors, especially 2 nights in a row, so I am very glad that I (finally) made the right decision and invested ... yes, it was an investment ... in my health.

Pregnancy Pains

Oh, how I bragged through the first and second trimesters when my pregnancy was going so swimmingly. Then along came the third trimester and the pain.

The pain was concentrated in my hips and pelvis. It became quite unbearable at night when I was trying to sleep. I was advised not to sleep on my back any more, because the weight of a baby on vital arteries is detrimental to a pregnant woman's health, but the agony of lying on my side was too much to handle. I was at my wits end so I went to see the physiotherapist who lives a floor down from my obstetrician.

It became suddenly apparent that Relaxin, a hormone produced during pregnancy to help relax both mind and body in preparation for birth, had caused my hips to slip out of alignment. The physio did a great job of realigning my hips. The pain didn't vanish, but it became tolerable.

Soon afterwards, however, I started experiencing shooting pains in my left buttocks. It would stop me in my tracks for a moment, but the pain would subside and I was able to go about my business in manageable discomfort. I mentioned the pain to my obstetrician and he diagnosed sciatica, a common-enough complaint in pregnancy caused by the baby's weight on the sciatic nerve which runs from the lower back down the bum and right down the back of the leg. He told me to see the physio, but I thought I could tough it out.

Then one Tuesday I was in agony. The literal pain in the bum spread down my thigh and into my calf muscle. I couldn't walk, stand, sit, lie ... hop, skip or jump. Fighting back tears I made another appointment to see the physio and they slipped me in on Thursday. Of course (as always happens when I go to see a doctor) that Thursday I felt tip-top with no pain at all, but I explained what I'd been experiencing.

The physio saw that my hips were out of alignment again so she pummeled me some more and sent me on my way. It didn't really help the sciatica so I figured I'd just have to wait until baby is born to be pain free again.

However, the sciatica remains and I'm sick of the discomfort. I know it's all related to the fact that my baby is sitting on my left-side with its back pressed against my back (which is known as posterior positioning and is "not optimal" according to my obstetrician). I heard that acupuncture could help reposition a baby, as well as fix sciatica, so I went along this morning with my husband to his medical acupuncturist to ask if there was anything that could be done.

To my disappointment, I wasn't given acupuncture, just some more pummeling. The Doctor also recognised my lack of proper alignment and he spent some time pushing my lower back and hips into shape. Then the remedial massage woman came in and gave me a deep-tissue massage in my butt cheek to try and sort out that sciatica.

I'm feeling fine as I write this, but I'll have to wait and see what the long-term benefits of this third round of pain management are for me. There are only 4 more weeks until baby is due, but I would very much enjoy 4 pain-free weeks so I can rest and relax before the baby turns my life upside down.

Pregnancy and Insomnia

There are a million reasons why I'm not sleeping so well lately. Number 1 contender is probably the mug of raspberry leaf tea I keep drinking right before bed. That's got to account for at least 3 trips to the toilet in the early part of the night.

Then there's the misaligned pelvis and associated hip pain that makes sleeping quite uncomfortable, despite the Snoogle body pillow having helped somewhat in that respect.

On top of physical causes, such as a full bladder and pain, there's the mental aspect as well. I close my eyes and start thinking about everything: baby, pregnancy, labour, husband, house, money, jobs, family ... you name it, it's floating up there in the dark recesses of my mind, emerging when I want to sleep.

Jeremy has been trying to go to bed earlier than adults usually go to bed because he's always tired and he has to work at either 8am or 8:30am. Sometimes he likes to walk to work, so he sets off earlier than he really needs to. This means I'm waking up at the crack of dawn with him. I try to sleep in after he leaves but I get hungry for breakfast and I have to get up, and so begins another day with heavy eyelids and a constant desire to sleep.

I have finished work, but I have a lot of personal projects I want to be working on. I sit down to my computer and my head screams at me "please don't make me think, I'm too tired." My body wants to nap, but I've never been good at taking naps during the day. The only time I can nap is when I'm exhausted to the point of passing out, which often happens when I'm travelling around the world on a limited time frame, but not when I'm sitting around the house doing very little (because I'm too tired to do anything, damn this catch-22).

Everywhere I turn people keep telling me to get lots of rest before the baby comes because after that I'll never sleep again, but in what universe are they living that getting lots of rest at this late stage in pregnancy is actually possible?

Buying a Stroller

Quite frankly there are too many options available when it comes to buying a stroller. This baby industry thing is out of control. What has 4 wheels, a baby sits in it and you can push it around? Nothing, because nothing in the world of strollers is that simple.

I don't remember the exact date I started researching strollers, but they became something of an obsession. I started not seeing strangers in the street, but I was captivated by what they were pushing their children around in. I did ask a few people what they thought of their strollers, but I soon realised people are too proud to admit any fault in their belongings.

What I wanted was a one-hand-fold, 4-wheel, umbrella-style stroller with a big generous basket underneath, full lay-back ability for a newborn and ideally a means of turning the seat. I dragged Jeremy out one day to look at a bunch of stores to see what was out there, and came home with my tail between my legs. At this point I realised that umbrella strollers were not as big on features (such as generous baskets) as I had hoped.

I had to rethink things a bit, and I was still set on the idea of being able to have baby face me. I became addicted to Product Review Australia (which is the best site in the whole world, as far as I'm concerned) and that turned me off a few strollers I thought looked great in the store but sounded terrible in reality.

I was able to quickly cancel out the need for bits and pieces like cup holders, especially those strollers that included 2 cup holders for the baby. As if one cup (let alone two) is going to sit in a holder in front of a baby for more than 1 second before it's on the ground. There are certainly some extras on strollers that I had no interest in, which should have made things easier but it really didn't.

Finally we found a local store where the shop assistant was keen to give us some advice and show us the ropes. Jeremy and I quickly settled on the Bebe Care Caprice pram /stroller, which looked great and the seat could turn around. It seemed a bit fiddly to take it all apart in order to get it in the boot, and it was pretty heavy, but it came with a free nappy bag so that was a bonus.

Mum and Dad came up from Sydney with the intention of buying us a stroller as a wonderful gift. We took them to the store to show them the Caprice and mum had instant concerns about it. Firstly, she didn't think it was wide enough to accommodate a growing child and secondly it was too thickly padded for the QLD summer that our baby will soon be enduring. Her concerns were valid and I was glad she was there to give me that advice. Being a first time mum I never thought of those things.

But mum and dad were here with a purpose, and we were all keen to get this stroller business over and done with. There was one other stroller in the store that looked good. The Valco Latitude. The only problem was, it was a 3-wheeler and I had been adamant all along about getting one with 4 wheels, because they're generally narrower and I do not want to be one of those pavement-hogging women who thinks they own the streets with those giant tanks they push around.

Also, the seat didn't turn around, but the basket was generous and the stroller folds easily. Also, the wheel base is very narrow and it's incredibly small, light and compact for a 3-wheel stroller. I hadn't ever seen or heard of this stroller before, it was all very sudden so I wanted to give it some thought. We went out for lunch and I looked online to see if there were any reviews, but this stroller is so new there's hardly anything written about it. It's just been released!

It felt like a stab in the dark with my eyes glued closed and my hands tied behind my back, but before the day was out we decided to go ahead and buy the brand new Valco Latitude, which I obviously haven't been able to test with a real baby but Augustus, my teddy bear, went for a ride and seemed to enjoy it (when I was looking down on him through the window in the stroller hood).

I think it was the closest I could get to matching my requirements, because apparently the perfect stroller doesn't exist despite how many choices are available.

Spending the Baby Budget

After months of planning, scrimping and saving we've just started blowing it all away, finally spending the money we've put aside for baby on the very items we intended to spend it on. With just 6 weeks to spare.

In the past 2 weeks we've bought flat cotton fleece nappies, snappies, pins, newborn clothes, a stroller and 6 of those Bum Genius nappies I mentioned a few months back. We also bought a few items for my hospital bag including maternity pads (boy am I looking forward to using those, not), cheap knickers (which can be thrown away in a fit of disgruntled dismay, if needed), and a post-pregnancy nightie for hospital nights.

I really should write a separate article about the ordeal of buying a stroller, because it was such a convoluted process.

There's still plenty to buy, but anything else would be luxury items rather than essentials, or should I say essential items rather than bare essentials. We didn't want to buy absolutely everything on the off chance that family (particularly those due to visit from the USA) might want to give us a thoughtful gift, and not just some left-over rubbish that we don't really need or want, but something that will be a lovely addition to our baby collection. However, we do want to be ready for when baby comes.

We're not making the assumption that anyone will give us gifts, so we've still budgeted for everything. It's hard though, because you have to think about these things and consider family. Some people like giving stuff, especially grandparents when it comes to newborn babies, so it helps to consider what they may or may not enjoy giving without trying to imply that it's required.

We didn't have a baby shower, partly because I'm just not comfortable asking people for gifts and partly because we live far, far away from family and friends. People kept telling us "don't buy too much, because you'll be given it all as gifts in your baby shower" but we already knew that wasn't going to happen, so we really did have to budget for everything.

Luckily my sister came through with a treasure trove of baby clothes, accessories and a cradle from her 2 little ones, all of which were still quite new and in wonderful condition. That saved us a hell of a lot of money and we couldn't be more grateful.

Living in a small apartment, we don't have a lot of extra space for stuff so we're quite happy keeping it simple. All we really want now is the timely arrival of our healthy, beautiful baby.