A date forever etched in my brain, the day when my pregnancy naiveté dissolved in a puddle of bloody amniotic fluid as my waters broke at just over 18 ˝ weeks gestation.
Like most women, I was well aware of the pre 12week miscarriage risk and assumed once you safely passed that first 12week scan, you went on to term and had a live baby. It wasn 't like I was new to all this after all - my first pregnancy 7 years earlier had ended with the safe arrival of David. How little did I know! Even with my scientific background I never knew the amniotic sac could rupture before you were in active labour. I was ignorant of the crucial role the amniotic fluid plays in lung development between weeks 18 - 26 and that the baby couldn't survive in utero for many weeks without fluid. The doctors ' prognosis was very poor - our chances of a live take home baby had all but gone with the amniotic fluid.
The bleeding that preceded the rupture had never been that heavy, at its worst heavy spotting, and for two days this had disappeared after the large cervical polyp causing it had been removed. However, early that morning I had passed a large clot as it restarted with a vengeance. Each morning as part of my daily checks the midwives would listen for the baby 's heartbeat with the Doppler and each morning they would find it chugging away as part of me prayed for them to find it, another hoped they wouldn 't as that would mean the ultimate decision had been taken from my hands.
There are several major problems facing a pPROM mum as she seeks to continue the pregnancy - the main one being the ever present threat from infection. Once the sac ruptures the baby and the uterus are no longer in a sterile environment and bacteria can ascend from the vagina. Without the cushioning effect of the fluid the umbilical cord, the baby 's lifeline supplying oxygen and nutrients, becomes vulnerable to the twin dangers of cord prolapse and cord compression. In the end I succumbed to both an infection and cord prolapse and was advised to induce at 19 weeks 2 days. After an hour of short intense contractions the baby was born 22cm long weighing 170g.
At first we were informed the baby was a boy, but 4 days later the midwife called to let us know that Jonathan, the baby boy we were grieving was in fact a little girl. A feeling of panic ensued as I was desperate to ensure the baby went to the funeral service with her name on her coffin, it was so important to me, almost a compulsion, that the name plate on the coffin had a name and didn 't simply say 'Baby Currie '. In the end we chose Lesley, a name that Iain 's mother had chosen when she was carrying him as she was convinced she was having a girl. In many ways this seemed appropriate as she 'd died the year after we married and was now looking after our little girl for us. Her middle name of Kathryn, a version of my own, we gave to her as a gift on her due date. In the end she was perfect and no cause for the pPROM was ever ascertained.
The following 7 months passed in a blur with the gradual erosion of hope that we 'd ever be able to give David a sibling. In the end a referral to the infertility clinic, another 9 months and several tests later our worst fears were confirmed - as we suspected we did have fertility problems. Somewhat surprisingly it was sperm problems and not me - the last diagnosis we were expecting. The loss of hope that ensued saw us both hit rock bottom. That loss of hope after all we 'd been through was particularly hard for me to live with - it made so many things seem so pointless.
I was just learning to live with it and giving thanks for my good fortune in having had David so easily without any problems when I was surprisingly pregnant again. In late 2004, after a carefully monitored pregnancy Alasdair was born screaming - to the eternal thanks and relief of his parents we had our miracle, our third child was here safely and we were content.
We will always feel a gap where Lesley should be in our family. I will always wonder what sort of difference having a female child would have made on our family dynamics and what sort of mother-daughter relationship we might have had. Our life had settled into a comfortable pattern caring for my boys when shockingly after 13 months I was unexpectedly pregnant for the fourth time.
Despite the shock, surprise and initial worry over money we were starting to think in terms of a third living child, daring to hope that perhaps this time we would have a daughter to raise, when our hopes were once more cruelly dashed. Five days earlier we 'd clearly heard the baby 's heartbeat at a routine antenatal appointment, when the consultant had decided that she would like a baseline measurement of cervix length before deciding how to proceed. Sadly, at that ultrasound check our baby was found to have no heartbeat and had probably died a day or so earlier. We were in the 17th week of gestation.
We now found ourselves once more discussing medical management of the end instead of discussing a plan of care for the next 20 odd weeks of pregnancy - a case of seen it done it. 48 hours after taking the tablets to start the cervix ripening process we wee again attending the labour suite to give birth to a baby far too soon. Within 90 minutes the baby was born, still enclosed in the sac with the placenta attached. Now we were on familiar ground. Once baby had been cleaned up photos were taken, though he was so delicate and fragile we decided not to handle him too much. This time the baby would go to his funeral wrapped in a muslin square that had belonged to Alasdair and accompanied by a teddy that had originally been bought for Lesley 's first Christmas. The little touches that we 'd regretted not doing for Lesley simply because we 'd not known we could or how important these little things were, we made sure were done for this baby. Because I was kept in longer than expected waiting for the bleeding to subside as well as the anti-D shot to arrive Iain had gone home to pick up the boys and bring them to the hospital.
As we were leaving I asked to see the baby again to say a last goodbye and David asked if he could see the baby too. So we got to spend a few minutes with our youngest child and two of his three siblings. The long walk out of the labour suite with empty arms and shattered dreams was this time made bearable by the sight of David holding Alasdair 's hand as he gently guided him along the long corridors. This time we made no guesses as to sex and patiently waited for the midwife to call once the baby 's sex had been determined to see if we were grieving for Jon Alexander or Jessica Rose. After a week the call came that the baby was a boy. Now our grief had a name - Jon (a consistent favourite with his dad) and Alexander (after his dad).
Once more Iain had the task of carrying the coffin of his child into the crematorium. David carried the flowers - once again a simple bouquet of white roses to symbolise the purity of the baby we were honouring as I carried a guardian teddy bear and guided Alasdair in the short walk to the front. Two candles were lit for Lesley and Jon to symbolise the flame of life that had flickered so briefly in this world, but still shone brightly in our hearts and minds. The teddy that had kept Jon company whilst he was apart from us sat forlornly atop the coffin, arms open wide as if awaiting a cuddle. It had been replaced the day before with a teddy sent by dear friends to accompany Jon on his final journey and its twin now sat guarding the foot of the coffin. At the end of the service Jon 's brothers each carried a teddy away - they now grace the shelves in the living room, important reminders of lives barely begun before they were ended. We 're still waiting for the results of the post mortem. After much thought we opted for a full post mortem examination - whilst there will probably be no more pregnancies (surprise or otherwise) the need to know what had happened was overwhelming. Though from experience we are also aware that one more we may get the non- answer of 'no known cause '.
If someone had told me at 18 I would find myself pregnant 4 times I would have laughed in their face. At that age motherhood was the last thing I wanted. Thanks to Lesley and Jon I now have a much greater capacity for compassion and patience. These days with the sensitivity of modern home pregnancy tests women are rejoicing in their happy news and making plans for the new life they 're carrying at ever earlier days after conception. Never thinking that for one moment they will never see the child drawn breath or take its first step. Late miscarriage can be particularly difficult to deal with - family and friends focus on the word 'miscarriage ' and form the idea that this baby is somehow 'damaged ' and as we have found this is not always the case. The word miscarriage conjures up something that is like a heavy period and is therefore relatively painless. What they don 't realise is that you have to go through labour and give birth - not to an amorphous mass of cells but to a recognisable, fully formed baby. Albeit a small and delicate baby, but still a baby that can be held and marvelled at - very often with recognisable features inherited from mum and dad.
Babies born still before 24 weeks gestation receive no legal acknowledgement and they are not registered. Though now many hospitals will give the parents a certificate to acknowledge the baby 's birth. No matter the gestational age of your baby when it dies, from the moment of that positive pregnancy test you harbour hopes and dreams for this new little life. When these are suddenly cut short, your feelings of grief can often be very surprising in their intensity and friends and family often fail to appreciate just how life changing these experiences can be. At Sands I 've found the support I need to help me appreciate that my feelings of grief are not abnormal, they 've allowed me to find my way through the difficult emotional maze of others ' expectations of my experience and what I felt in reality.
Sands - Stillbirth and Neonatal Death Society
The Miscarriage Association |
