Postpartum and morphine

Gracious Mummy blog

The thing they don’t tell you about the postpartum hormones is this: They suck. Yes, you are overwhelmed with love for you baby but you also feel like absolute crap. So that is to be expected right? You have just had a major operation. You are not at home right away and you can’t even think about your body functioning normally! Your baby has to be lifted to you. You can’t shower on your own and you are desperately trying to work out the whole booby, milk, breastfeeding thing. (Or formula measurements.) But what I have never once heard anybody speak about is the morphine plus hormone cocktail that creates a six-day high before you crash into a big pile of poo! At the time I didn’t realise it, but looking back I was clearly high for six days straight after birth!

I was being wheeled across the ward to see my baby. I was given three ok-ish meals a day. I had my partner taking such good care of me. I was floating around. Oblivious to the fact that our first night on the ward I was the only mum who didn’t have her baby next to her. I heard one crying in the night and thought nothing of it. The next morning, I woke up and put on make-up! Then I took selfies. I sent one to my best friend. First full day of being a mum. I captioned it. I didn’t even have my baby with me. I was delirious and full of adrenaline probably. I had slept for about an hour. Between still having the catheter in and the pain when the medication wore off, I could not rest. That and there was also a man in a chair next to his partner, snoring his head off in the cubicle next to us. I mean, bless him he must have been so tired. But wow he was loud.

I was wheeled across to see Zach and for some reason, the situation had not sunk in. I was seeing the world in front of me, but I wasn’t seeing reality.

Then day six hit and a tsunami of emotions took me down. I was breastfeeding constantly and I mean constantly. I woke up at 7am and picked up my baby. I put him to the breast. He fed on and off until 10am! A minute on and a minute off. For three straight hours. I did not know this at the time (I was told afterwards by a midwife) but when you breastfeed your hormones surge. Prolactin is one, which releases the milk. But to do this, dopamine has to stop. Dopamine is the happy hormone. So momentarily you feel like crap. But if you are feeding constantly, you feel like crap constantly. Then on top of this, oxytocin goes crazy so that you bond. But that feeling can be a bit too much and well the result was a lot of tears. I cried over Zach so much in those first few days he must have thought it was raining. At 10am I managed to put him down in his cot for long enough to have a shower. When I came back a nurse was rocking his cot as he had woken up and “was a hungry chap.” I could have crumbled down into a heap on the ward floor there and then. How could he be hungry? He had just fed for three hours straight. I smiled at the nurse and thanked her. I lifted my screaming baby and held him in my arms trying to comfort him. The wires and infusion lines came too, of course. I put him to my breast. He latched and the after two minutes fell asleep. I put him back in his cot. He screamed, so I fed him. And so on for thirty minutes until I gave up and just let him sleep and feed on my boobs. I was exhausted. On top of all of this Emmanuel had to sort out some food for us and go about buying some nappies and a few other things we needed. He wasn’t there until later on day six. My mum came to help me. But there wasn’t much she could do other than hand me my water bottle and hold Zach whilst I went to the toilet.

Day six also happened to be the day I was told I had a UTI. I was given antibiotics. No wonder I had been feeling awful.

In the afternoon I was told that my beautiful son, who had been feeding all day, had low blood sugars. It didn’t make any sense! I must be doing something wrong? They came to take his blood every hour from around 2pm onwards. This involved pricking his heel and squeezing the blood out onto a thin strip that goes into a small handheld machine. The number pops up. 1.8. it’s too low. Keep feeding him they tell me. Like I am sat there twiddling my thumbs.

By the time Emmanuel got there around 4pm, I was a state. I was crying constantly. Telling anyone that would listen that I had a UTI and that my baby just wasn’t feeding properly. I had no idea what was going on but this felt like torture.

Did I also mention that I had stopped taking the morphine and the dihydrocodeine? That’s right I was going cold turkey. I had been on these meds for five days, every three to four hours. Then I stopped them just like that. On the same day that your hormones take a dip and you ride the lowest low possible. It was a dark day. The morphine and the codeine had been masking some of the hormonal and emotional surges. I am certain that I was feeling a slow build to this day and yet I was numb around it. The second I stopped the numbing agent everything hit me.

I stood by Zach’s cot with Emmanuel and my mum and cried as they told us they needed to take more bloods. I had no privacy to cry. No bed to go and lay down on for five minutes. I just had a noisy ward, an armchair and two very loving supporters who could do nothing for me. It was uncontrollable. Surprisingly, I felt no embarrassment. I didn’t care that everybody was seeing me at my worst.

I slept on the ward again that night. Or laid down and cried. One kind nurse suggested to me to express and she would give him a bottle so I could get a few hours’ sleep. I did. I expressed just enough for one full bottle of 41ml. He guzzled it down so fast it was like he hadn’t been feeding at all in the last 24 hours. I was so confused. He finally settled and slept. I slept and woke after two hours to see the nurse feeding him. I expressed again. We continued the cycle until the morning. I had managed a few hours’ sleep and felt a little better. Zach had a full tummy and his blood sugar was up slightly. He was clearly not getting enough from the breast.

All of this, the blood sugar, the pain meds, the breastfeeding, The damn hormones. They all came at once. They all hit me like a flood. I have never in my life felt so powerless to what was happening to me. Day six for me was just as the midwives later told me it would be. The worst day. The classic postpartum ‘everything goes wrong’ day. But for me, I did it whilst on display on a ward with nurses flittering around and doctors telling me different bits of information. I had support but all I wanted that day was to crawl into my own bed and sleep.

I remember one of the male doctors walking past and my nurse quickly asked him what to do for Zach. “She is feeding him too much. It should be every three hours.” He barked at her over his shoulder as he disappeared into his office. The nurse came over to tell me what he had said. So, we tried that and Zach’s blood sugars dropped again. It was the worst advice I was ever given.

It turned out Zach had a tongue tie that nobody did anything about. Because Zach could latch, they all assumed he was fine. This was why he couldn’t get enough milk. His tongue tie wasn’t sorted out until months later. He was too old by then. I expressed and bottle-fed him. Sadly, my breastfeeding journey was a tough one. Maybe I should have just carried on with the morphine for a little longer. 😊

The Savannah

When Zach was born, we were in the neonatal intensive care unit and then the HDU neonatal unit at St Thomas’ Hospital. We then moved over to the HDU on the Savannah ward at the Evelina Children’s Hospital. Its very confusing, but the first HDU is next to the labour wards so parents are next to their babies. Savannah is a part of the Evelina hospital – in a whole other building!

We were moved to the Savannah ward late one evening in the first week of being at the hospital. Myself and Emmanuel call the Savannah ward, The Jungle. It is pretty wild. Imagine a large room with six cots all containing tiny babies. Next to the cots are the worried parents and walking back and forth between them are the nurses and doctors. Each bay has a blue curtain that pulls around your allotted little space. Inside that space, that is perhaps the size of a small shed, are two chairs a storage cabinet, a table and a mountain of medical infusions and monitors. Plus, two suitcases, three bags, breast pump equipment, shoes and a coat. Then imagine living in that space whilst trying to breastfeed your brand-new baby. The nurses have their desk area right next to the first cubicles. There is also the doctor’s office, scanning room, toilets and shower. It was as Emmanuel called it ‘The wild, wild west.’

When it was time to move across, we were walked from St Thomas’ to the Evelina with our two nurses and a student nurse. It was the first time Zach had seen the outside world. He looked around from his cot as we passed through glass corridors, taking in the blue sky, before falling asleep. He then slept for the rest of the walk. We were taken through the old part of the hospital where they have the teaching areas. There is a display case of old medical equipment. ‘The iron lung’ and other old ventilators. They looked like torture devices and sent a shiver down my spine. It made me think that medicine had a pretty brutal history. Street doctors that hacked off limbs and dentists that pulled out teeth with big metal plyers. What about the people that had been hooked up to those old machines, had they lived? Had any of this horror movie looking stuff worked? A movie scene popped into my head; the man had been strung out by his organs but he was being kept alive by machines. His intestines hanging on hooks. His heart beating out in front of him. I physically shook my head and tried to concentrate on Zach. He looked peaceful in his cot. Like an emperor on a travelling throne being brought across his land. All these people here for him and he was blissfully sleeping.

We arrived at the Savannah. As Emma and Emily dropped us off, I hugged them both. I had grown very attached to them in my days in the HDU. Our Savannah nurse came over to introduce herself. The HDU nurses were explaining to her about Zach’s medication and infusions. My heart quickened. Why didn’t she know this stuff? Were we safe here? Was Zach’s careful care going to be messed up? I started asking questions. My anxiety started to rise. In HDU you have two babies per one nurse. Here the nurses can have three babies at a time and there are six bays. I was so scared that something was going to go wrong. I was becoming prickly; I didn’t know how things worked here. A heath care assistant came over to help us ‘move in’ and when she started to move the breast pump machine out of the way to get to the plugs behind it I started almost yelling at her.

“I NEED THAT, you can’t take it!” So, I wasn’t quite yelling, but I certainly wasn’t nice to her. She explained that she was just moving it. I thought she meant moving it away from my area so I continued to tell her that she can’t. Emmanuel stepped in to explain what the lady meant. I stood back and let her finish. I felt awful. She was only trying to help me. The next day when I saw her again I apologised for how I had spoken to her. I explained that I was really unsettled being moved across and I was just feeling really anxious. She was lovely and thanked me for apologising. We actually got on quite well and started joking with each other about miscommunications. I didn’t see her much after this, but I would smile at her when she was around and she to me. “Well done.” My mum said to me after I apologised to the woman. It doesn’t matter how old you are but hearing well done from your parents always means something. “Thanks mum, she really didn’t deserve how I spoke to her. It was only fair.” Yes mum, I am a grown up after all!

Each bay has a pull-down bed next to the patient’s bed for a parent to sleep on. It is tucked into the wall. It is a few wooden slats with a thin foam mattress on top. It reminded me of the mats that you get in sports halls for PE. Where you line them up and do forward rolls and cartwheels across them. They are great, but not for sleeping on.

When the nurses switched over and our night time nurse came over she offered me a proper hospital bed in the bay next to Zach’s. There was nobody in there and she knew I was just a few days post-surgery myself. I could have kissed her. She pulled the curtains around us to make one big giant bay. For the first time I got to sleep next to my baby boy. The hospital beds elevate at the head end so that I could sleep sitting up. After a C-section it is extremely difficult to sleep laying down. It’s difficult to do anything to be honest, but laying fully flat is agony. So, there I was a new mum sleeping next to my baby for the first time surrounded by four other mums and babies all cocooned in blue curtains. The thing about the blue curtains is that they don’t block out any noise. So, all night long you can hear the nurses, the other babies and parents shuffling around. Of course, when one baby cries in the night so do all the other babies. It’s like they play tag with each other. ‘You start crying first this time and I will for the next round. Then we can take it turns like a dawn chorus so that nobody gets any sleep.’ I imagine this is what the babies were up to. So that first night I managed about an hour. 

The best thing about Savannah ward is the breakfast. When hand over is just finishing and all the curtains are being opened, the breakfast lady comes around and she says these magical words “Toast or cereal?” I always had toast and a cup of tea. The toast was cold and the little pots of butter and jam were those plastic kinds that taste more like sugar, but it was delicious! After hardly any sleep and facing a day of uncertainty on the ward, tea and toast just made the world better for a brief moment. In fact, tea and toast become something that I relied on. When Zach was awake at 3am and not settling. Or they came at midnight or 5am to take yet more bloods from his poor feet. I knew in a few hours that I was going to have five minutes where I could eat some jammy toast and drink some very strong milky tea. I often ate it one handed whilst holding Zach. Or Emmanuel would feed it to me if I had no hands free and he had arrived early. It’s the small things that become crutches. It’s the small details that make the long days and weeks bearable. They also fed the breastfeeding mum’s lunch and dinner. I didn’t always eat it but it was a small comfort to know that I would have hot food there at 8am, 12 noon and 5pm.

The only other thing that’s better than the tea and toast in the morning is when you have had a particularly bad night or early morning and one of the nurses brings you tea and toast accompanied by a listening ear.

The first day on the ward my mum was still in London so she stayed with me all day. She was there as I fed Zach constantly. She helped me as I cried because he just wasn’t getting enough. She listened to me moan all day long. There really wasn’t much she could do but at least she was there. Emmanuel had to go and sort out a big food shop for us and take It back to our accommodation. He also had to unpack all of our suitcases and organise our room where we were staying. I am so glad I had my mums’ company that day. But at the same time, I felt so bad for just being this big mess. This definitely wasn’t the happy day with their grandchild that most grandparents dream off. It was so handy having her there though. When I needed to go to my own appointment the day after. Mum and dad sat with Zach whilst Emmanuel took me across to St Thomas’ hospital so that I could see the midwifes. They sent a picture in the family WhatsApp group of Zach in his cot. ‘First babysitting duties’ was the caption. Mum and Dad stayed for a week in total. It was perfect, they were there when we couldn’t be. They sat with Zach we had to do other things. My mum was a friendly face in the sea of nurses when I was trying to feed and change him. Sometimes you do just need your parents. Myself and Emmanuel soon felt ready to do this with just the three of us, as a family. When Mum and Dad went back home we were ready to try to handle this all ourselves. I will always be grateful that my parents got to see Zach when he was so little. Soon his other grandparents would meet him as well. It really meant so much to me for them all to come to the hospital to be with us.

HDU and Breastfeeding

This was it, the moment I was waiting for. Zach was three days old and my milk was starting to appear. A small screen was placed around a chair area next to Zach’s cot. With the help of nurse Emma, Zach was lifted out of his cot and placed on me and a giant pillow. I put him to my breast and he started to latch and suck quite easily. This is it! I thought we are doing it! Then He pulled away and started to scream. I mean really scream like there was poison coming out or something. I rocked him and soothed him and tried again. The same thing happened. He started ok and then he pulled away and screamed. The nurse came back over to see how it was going. She could clearly hear him screaming. I showed her what he was doing and she sat down beside me to help.

“Let’s calm him down and get him nice and relaxed. An angry baby won’t latch.” She informed me.

So I rocked him and patted him until he was calm again. We tried again, but he just yelled at me. He got so upset that red patches appeared across his whole body.

“Maybe he can’t get any out. Let’s express a little first and see if that helps.” Emma suggested. She disappeared off and came back with the hospital breast pump machine and the attachments. The machine was on wheels and reached around a meter tall. She opened two packets of sterile equipment and handed them to me.

She explained how the plastic tube section can’t get wet. If it does the suction would stop working, but the rest can be sterilised. She showed me the suction part of the equipment and gave me a sterilising bag that goes into the microwave with some water in it to be able to steam sterilise it. I had no idea how any of this worked! It was staring at some very strange objects. She sat with me and explained how to connect it all and how to use the machine. I didn’t get much out at first but it was a start. The start of a very long expressing relationship.

I tried Zach on my breast again and he latched for a short period but still wasn’t happy. Emma said she would arrange for a lactation consultant to come over and help me later. I was so thankful that I had all of these professionals around me to help me. I let Zach rest. We would try again later that day.

In the early evening, myself and my mum went over to see Zach and to try breastfeeding again. This was the experience I will never forget. I had the small screen offered to me again, but I wasn’t fussed and it took a while to set it up. We didn’t bother in the end. My mum sat with me, the lactation consultant appeared, Emma was there and so was another nurse. I had an army and we were ready to do this.

Zach was placed on me and our giant cushion. I unhooked my bra and placed him on me just as I had done before. His suck reflex kicked in and he started to suck, but not for long. He started to cry just as he had before. The lactation consultant stepped in to assess his suck. She put a glove on her hand and her finger in his mouth. Zach sucked on her finger reflexively.

“He has a slight tongue tie but he should be ok.” She informed me. I took her word on it and didn’t think much of it.

“Let’s try this” and she gave me lots of things to try. A sandwich hold for my breast. A ‘rugby hold’ for Zach. Expressing a bit of milk first. Many, many things, but Zach just screamed. We had to stop after a while as he was so worked up. I felt deflated. I so badly wanted him to be able to feed that I felt I was failing him already.

We tried one last time before the lactation consultant left. We got everything in position and then she very quickly grabbed me and Zach and pushed his head onto me so fast Zach had no option but to latch and suck and he did. He was finally feeding. I was so happy. What I didn’t know at the time was that forceful action that she had just performed would only have very short-lived success. Zach was feeding, for now. Every time I fed him, I now copied what she had done, as soon as his mouth was open, I quickly shoved his head on my breast. I would later learn that this just isn’t best practise.

High Dependency Unit

HDU – 20th February 2020 – Zach is two days old

I remember the phone call so clearly. I was sat up in bed on the post-natal ward. Downing my morphine tablets and eating my cold toast and tea when they rang.

“Hi its Emma from HDU, EVERYTHING IS FINE.” She said this first, right out of the gate. I was holding my breath until she had finished that sentence.

“Zach has been moved to HDU” She continued. I stopped breathing again. What on earth was HDU?

“He is doing really well and he didn’t need the support in NICU.” She added.

“Oh really.” Was all I could come up with

“HDU is lower support than NICU” She explained realising my confusion.

“Ohhhhh” I said, “that’s brilliant. I am just eating my toast and tea. I will be over as soon as I can.” I told her with excitement and relief.

We said goodbye and hung up the phone. I turned to Emmanuel and retold the conversation to him. He had heard it, but I think I needed to say it out loud once more. He was doing so well after just two nights that he had been moved to High Dependency Unit (HDU) and out of Intensive care.

I gulped down my tea and ran to the shower doing ten-star jumps and some night fever arms for good measure. I put on a beautiful gown and danced my way to my son. NO. What actually happened was I had to ask Emmanuel to come and help me out of bed. So lucky he has strong arms. Then I waddled to the bathroom and prayed that I would be able to erm…..use the facilities. No such luck. But I powered on and stood in the grotty shower and washed the best that I could without being able to stand up fully.  I was relatively clean. Drying was another mission, but all I wanted to know was where my son had been moved to. What number was his bed? Did he have a good night? Had I missed anything at all. I had to get dressed with Emmanuel’s help. Yes, he had to help me put my underwear and trousers on! I guess at home you would just stay in you pjs but I had to put something clothe worthy on before leaving the room. I managed to tie my hair up and put some moisturiser on my face whilst Emmanuel showered as well. Despite our best efforts, it was still an hour before we made it across the hallway to his ward. We found his bed number and parked my wheelchair beside it. I could stand and walk but walking across the wards would have taken me forever and I would have been in agony. It was far quicker to just chair it across. We stood by his bedside staring at his sleeping form. The same wires, the same bed. They move the babies in their beds. So, for the majority of their stay, they are in their own cot. It’s the easiest way. We had an addition to the cot; we had a poster of his name that somebody had made and coloured in. It was the picture of a parrot. A squawking parrot, because our son squawked when they came to do any procedure on him. He had been given the symbol of the parrot. We loved it. It was laminated and stuck to the end of his cot across the top where the heat lamp lay above his head parallel to Zach.

Zach lay sleeping soundly in his bed oblivious to any fuss around him. He was two days old and he was blissfully, thankfully for him and us, unaware. Or at least at that moment, he was. His nurse came over and introduced herself to us. Emma. She explained that during the night Zach was doing so well that he didn’t need the one on one care that they have in NICU. So, they moved him over here. We immediately liked Emma. She had a warmth about her but also a very professional manner. You could just tell she was experienced and knew what she was doing, but that she cared and understood. Because of her, and perhaps the Morphine I was on, the next two days in HDU were actually pretty good.

Zach had no horrible procedures, caused no trouble and slept a lot. We almost had the experience that most parents get. We got to know our new tiny human. We laughed as he wiggled in his sleep and made cute faces. We handed each other baby wipes as we changed his nappy. And by we, I mean his daddy. What! It was hard for me to move around still. I don’t think I changed a nappy until Zach was four days old. Whoops. I missed all of the meconium fun! My parents came to visit us. We had to swap out a person each time as we were only allowed two people by his bed at any one time. I think we cheated once or twice and had both my parents there with me for a period, but we were well behaved. My mum held Zach in her arms with a beaming smile on her face. My dad told me about their visit to the National Portrait Gallery they had gone to visit that morning. It could have almost been my living room. Except for those beeping machines and wires attached to Zach.

Then it was time to start breastfeeding. Emma informed us that the doctors had instructed: “to get him feeding.” I was up, my role was here and I was ready. Or was I?

NICU – Part two

Leaving him that first night was horrible. Leaving him at all was horrendous. I knew that he needed me to be there, but I wanted to run with him into the night and never let anybody else near him. I wanted to hold my arms around his tiny body and hiss at people that came near our nest. I had to watch as a nurse would rock his cot, say sweet words to him or pat his blanket nest to calm him down. I seethed inside that somebody else had to show me how to calm my baby because I couldn’t simply hold him and rock him. To move him at all was an involved endeavour. First, we had to make sure it was a good time, that no doctor was coming or that he wasn’t due some sort of check. Then we had to make sure that all of his lines were in place and he was ready to be moved. One person would scoop him up and the other would lift his accessories with him. I was lucky I got to hold him at all. But it ached my heart to see him like this. To watch Emmanuel’s happy face as he held him when all I felt was wretched because this was not how it was meant to be. We were meant to be at home with visitors milling in and out. People bringing food and gifts. Not being sent pictures over WhatsApp along with medical updates. This hurt. I had no comparison to an elder child as he is my first, but I knew this was painful even though I didn’t know how blissful it could be. I hated some aspects more than others. The biggest for me was letting other people have control over him. I had to ask to hold my own child. I had to be told what was happening. I wanted to scream at them that they should ask me what was happening to him not the other way around. Yet I knew he needed to be there and I knew he was actually being cared for so well.

I was constantly being pulled back to my own ward. I needed pain meds, I had to eat. I had to have my blood pressure checked. I needed it but I wanted all of them to bugger off as well. Except for the pain meds. They could stay.

The second day in NICU; Zach’s only full day in there. On Tuesday the 18th February 2020 he was born at 1.18pm and went straight to NICU. Wednesday the 19th he was there all day. We had a visitor that day. Emmanuel’s sister came to see us. It was so nice to have somebody visit. Along with my parents. The rest of Emmanuel’s family had been ill so they were keeping away for good measure. NICU babies and Zach were very vulnerable babies. It was a hard decision to make, but we knew they would all see him very soon. Zach’s Aunty Uzo came and gazed upon him as I held him in my arms. But soon, too soon we were all ushered out and away from him. They had to put in a “Long line” as his cannulas were failing, i.e. no drugs or fluid were flowing through them. I didn’t know what a long line was then but I do now. A long line is similar to a cannular but longer. It is a thin ‘line’ that can administer drugs. It is placed in the arm using a needle and a thin wire to go all the up the vein in the arm, across the shoulder and to rest just outside of the heart. I have no idea if when putting in this long line they gave him any painkillers. I just remember green sheets being put up around his cot to make it a mini sterile theatre environment as we were being asked to leave. Me, Emmanuel, Aunty Uzo and my parents all sat in the reception area making conversation as my poor baby boy was having a wire shoved through his arm. Celia bought us chocolate that had ‘Mummy’ and ‘Daddy’ written on the wrapper. I cried of course. I cried at everything in those first few days, but it was the first time I had seen the word mummy and it was meant for me. I was a mummy. I struggled to focus on the conversation that was happening. I think we spoke about my parents aiming for a theatre visit and their pending museum trips. Well, when in London.

We went back in after what felt like forever. Zach was not happy. I could tell. He just seemed upset. His arm was covered in blood, all trapped under a sticky plaster that held down the external part of the ‘line.’ It was coiled around and stuck down in the crease of his elbow. The line was now successfully giving him his prostaglandin drug, which was keeping him alive. But your brain can’t comprehend that. All I could see was my baby with blood on him. I had to leave him alone and just stroke his little head. I wanted to hold him so badly, but he was sleeping after the procedure and he was best left to rest.

We went back over to my ward and I forced down some food. They moved us to a private room. My Dad and Uzo helped move our stuff and chatted away as they did so. I was being wheeled as walking was still excruciating. I had a new room, with a shower and toilet en-suite. This was a luxury compared to last night’s situation on the ward. But all I wanted to do was be with Zach. Everything seemed foggy in comparison. My parents left to go and find somewhere to have dinner. We said our goodbyes. Uzo stayed and chatted with us for a while before she too headed home. Alone we sat in our new room the weight of what was happening sat between us. We started to talk about Zach’s little features. The way he moves, the pout of his lips. We forgot for just a few moments the danger he was in and focused only on him. It didn’t last long but it was just what we needed, for us and for each other.

At around 10pm I wanted to see him again and say goodnight. So Emmanuel pulled on his trainers and diligently wheeled me back across the ward. It was becoming a familiar route. He parked me by his cot and immediately I started crying.

“He’s sad,” I told Emmanuel before I knew the words were out of my mouth. “I can just tell. He is sad.”

“He’s sleeping baby.” He kindly said back.

I cried and cried as I stroked his hand and talked to him. I felt like he thought we had abandoned him. I did not want to leave but it was getting late and I needed to go. NICU is 24 hours for parents but at night the babies need their sleep. There were four other beds in the room also and we needed to let them all get some rest. Before I left, I had told Zach I loved him and that we would be back soon about a million times. I felt like he had lifted slightly. That he knew we were there somehow. So I fought the urge to sleep on the floor next to him and allowed Emmanuel to wheel me back across. He had to help me get into bed. We sat and watched something on the tablet for a bit before falling asleep. I think it was the last episode of Love Island. I had been watching it all and we had missed the last few by coming into hospital. I gazed at the screen but I wasn’t really taking it in.

NICU – Meeting my Son

Holding my baby boy for the first time felt surreal and the most natural thing in the world all at once. He was in an open cot on the Neonatal Intensive Care Unit (NICU) ward. It is a clear sided rectangle with a soft gel mattress that was covered with a soft cotton sheet.  On top of the sheet is a rolled-up blanket that looped round him in a ‘u’ shape to form a ‘nest.’ It makes them feel snug and supported in this strange world they have found themselves in. He was wearing his hat and a nappy and nothing else. He was covered in blankets but the room itself was warm as well. He had the three stickers on his chest and stomach that measure his heart. ECG (electrocardiogram) dots that track the beats and rhythm. He also had a cannular in his arm. This was connected to a line that connected to a pump. Inside the pump was a giant syringe that slowly presses and pushes through the drugs. In this case the Prostaglandin E1, Prostin. (Prostin is a hormone that was keeping open the ‘duct’ in his heart to allow oxygenated blood to flow through and avoid the narrowing in the Aorta.) He had another cannula in his foot that was giving him fluids and glucose. He had a red light glowing through a band on his hand and another on his foot. This was to measure his oxygen saturation levels pre and post. Pre – meaning before the blood went via the ‘duct’ into the heart and post meaning after. A significant difference between these two would mean that the duct may have started to close and more Prostin would be needed to keep it open until his operation.

All of this information is new and overwhelming when all you want to do is cuddle your new baby. I had to take in what I was being told and what I was seeing whilst desperately wanting to just stroke his cheeks and rock him in my arms. The machines above his head were all keeping track of everything. We could see the green line creating the rhythmical heartbeat pattern. Another blue one beneath it that showed his oxygen saturation levels. It was like being inside a space ship. We had landed on an alien planet and had no idea what this new language was. Despite having looked around beforehand we still were not prepared for the depth of machinery and wires that would be involved. These were here to keep him alive. That thought does not sit easily on a new mother and father’s minds. What if they stop. What if someone doesn’t notice a change on one of these lines. “What if?” became a huge part of everything. Nothing was certain anymore. All we had was each moment. For me that was difficult. I like to plan things and organize them. Not knowing was horrible.

But back to the room and the cot and looking past all the machines and wires, laying calmly was my baby boy. His dad stood over him, looking proudly into his face. We asked a nurse to help us with the wires so that I could hold him. I had a pillow on my lap to cover my stitches and to help me support him. He was lifted from his cot and placed gently in my arms. I cradled his head in my elbow crease. His tiny body curved against mine. He was warm. He was soft. He nuzzled his head backwards and relaxed into me. He was home. He recognized me. We were one again. I would have stayed there for eternity if they would have let me. But I only had half an hour with him before I started feeling dizzy and needed to go back to my own recovery bed for my blood pressure checks. In those thirty or so minutes we became a family. He relied on us and we fell in love with him. Emmanuel stood next to me, hand on my back. We were all connected. My baby had that soft puffy newborn look to his face. His eyebrows were defiantly Emmanuel’s. His chin was from me. The lips could be either of us and the nose was one thousand per cent my Emmanuel’s side of the gene pool. I loved every tiny section. I stared at him and drank it all in. I cried over his body for the first of many times. The lines and wires attached to him were heavy. We had to hold them to keep them from pulling on his skin. Or worse coming off. It was always a two-person operation. I wouldn’t for a long time be able to hold my son by myself. I would always need someone or something helping me. That stung. I wasn’t going home with my baby to snuggle him in bed and lay him on my chest. I had to look at him lying in his plastic cot being kept here by things that I had no control over. It was going to be the start of a long journey and battle between my instinct to want to take him and hide him and to let the doctors and nurses care for him.

I looked at my Emmanuel and he looked back at me. We were a unit. Our son wrapped in his white dumbo the elephant blanket. His tiny mouth sucking on his dummy. We had a long road ahead of us. The fight harder than we thought and we were only just starting it.

Emmanuel lifted him from my arms and lay him back in his cot. The nurse came and helped him to place the lines and wires back correctly. He settled back down and quickly fell asleep. I left a square of fabric that I had kept with me and had worn in my bra. The fabric was placed next to our son’s head so he knew I was there even when I wasn’t. I cried so hard when I placed that little square next to his head. I felt like all the other mothers in the world have their babies next to them in a bassinet. I had to leave my baby with strangers in a sci-fi world of beeping machines. I could not take in what was happening. All I could see was his beautiful face. By now the Morphine had fully kicked in and I was floating on a drug high. I am glad that during the first week I had the painkillers to numb out reality. I don’t think I would have managed quite so well without them. Mentally and physically.

Alone To Recover

The nurses checked on me every half an hour after my C-section surgery. I was in a private room with a view across London. Emmanuel was with our baby. I was so alone at that moment. Yet I still felt full and happy, not sad. I felt like I had accomplished something. Something with a nine-month build up.

Emmanuel came to my room and gave me my phone. He had kept hold of it for me after Bethany (the Anaesthetist) had taken our wonderful birth photos for us. I had been alone with no phone for almost thirty minutes. I think that feeling was more bizarre than the numb legs were. He bowled into the room with the biggest grin on his face. He was a father. No matter what, from this point onwards he was a Daddy. I had had nine months to get used to the idea of having a baby every time I felt him kick. Emmanuel had this moment. It was written all over his face and his navy-blue scrubs. I am a Daddy. He looked like he might burst.

“How is he?” I asked.

“He’s good. The doctors are just sorting him out now.” He beamed at me with such joy, I couldn’t help but feel the same way.

“Go. Go be with him.” I would have pushed him out of the door if I could have.

“Are you ok?” he asked.

“I’m fine. Just go.” I was again left alone.

I looked through the pictures on my phone. Seeing it all captured made me so happy. I zoomed in on Zach’s face, his wide-open screaming mouth. That beautiful squashy nose. In one picture his face was next to mine and his hand was reaching for me. I couldn’t stop staring at it. Then my phone pinged and Emmanuel sent through pictures of him now. His bottom half was tightly wrapped up in a hospital blanket. He was wearing a hat with a white and grey star print on it that I had picked out as his first outfit, He didn’t need the baby-grow that matched as he was on a heated bed. His chest had three little wires attached to it with different coloured sticky pads, a red, a green and a yellow. These were to measure his heart. But I didn’t know that at the time. I barely saw them. I just saw his face. His beautiful fluffy new-born face. My son.

My parents had booked a hotel room in London near to the hospital. As soon as we gave the go-ahead for them to visit, they appeared in my room in a nanosecond. Armed with a gorgeous teddy and a card. It was so surreal to see them there. I had just briefly met my son and now my parents were about to as well. They came to me at my bedside, because of course I couldn’t move, and gave me hugs. I told them right away to go and meet their grandson. It didn’t take much convincing before they left to go and find him.

Again, I was alone. A nurse came in and took my blood pressure and observed my bleeding. Which involves lifting the sheet to peek at you and see if you are bleeding on to the giant pad sheets.  At the time I did not care a dot. Looking back, it was really humiliating. I asked when I could go and see my baby. As soon as you can get into a wheelchair was the answer. Over the next hour and a half, I sat there trying to wiggle my toes and get my legs to move enough to be able to get into a wheelchair. They offered me morphine and I accepted. Anything to make it easier to get off this bed and into that chair. By 3.30pm just over two hours after I had been stitched up, I was calling the nurse.

“I can do it. I can get in the chair.” I was so determined that I didn’t care if I actually felt ready or not. She wheeled in a chair with a humiliation pad on it. And a big sheet to wrap around me so that I wasn’t flashing my butt to everybody through the back of the chair.

I used every piece of strength I had to heave myself into that seat. I could move my legs but not properly. I was using my arms to get off the bed and closer to the wheel chair, closer to him. I stood one foot on the ground and lifted, exposing my naked back to the nurses. I did not care. I swung around and placed my butt down into the seat.  Leaving my remaining leg to drag behind me, with some effort I managed to pull it across and into the footrest. The nurses wrapped the sheet around the chair. I was so happy with myself that I ignored the pain in my abdominal region. I pushed it away like a leaf down a sticky stream of mud. It was not going to stop me seeing my son.

My dad came to wheel me over to the Neo-Natal Intensive Care Unit (NICU). I gleefully joked with him about Mario Kart driving as we whizzed past the rooms and receptions of each ward. We passed the lifts that separated the mothers from their babies. A wall between us. Soon, so soon, I was outside the room where he was. Emmanuel came out to meet me and to wheel me in. My wound was throbbing now. The morphine hardly touching the edges of the pain, but it was certainly making me high. I didn’t realise at the time but the morphine and the dihydrocodeine were making me feel giddy. I was a little bit ‘away with the fairies.’

I was ready. A nurse held the door open for us and I was pushed inside a softly lit room filled with four baby beds. I was about to meet my son, properly. To hold him in my arms for the first time. To look into his face, to hold his hand and whisper his name.

The Birth

As we drew closer to my induction date on the 16th February it was becoming apparent that Zach would not be turning on his own. Despite my attempts to get him to flip around, he remained in a head upwards position. I had a phone consultation with the doctor at St Thomas’ Hospital where I would be for the birth. She talked through the risks of attempting a breech birth. It did not look good. So reluctantly I agreed that if a 3rd ECV attempt didn’t work that I would have a planned C-section. The ECV and was booked for Monday the 17th of February. I was 39 weeks pregnant.

We arrived in hospital on Monday morning, I was so hopeful that he would turn but deep down I think I knew that he wouldn’t. I knew either way that very soon my son would be born. Either we would start an induction today if he turned. Or I would be going to theatre for a C-section if he didn’t.

We tried the last two ECV’s to turn our baby boy around but he wouldn’t budge. As it turned out Little Zach was stuck in position because I have a heart shaped Uterus instead of the regular oval shape. Or at least That is possibly why, He could just have been really comfortable there.

“You tried baby,” Emmanuel said to me as he held my hand. I was sat perched on the edge of the bed still waiting for the salbutamol to go away so that I could stop feeling jittery. We were left alone whilst the midwife arranged a room for us. We would be staying in until the C-section was booked.

We were checked in and given a private room. Then we waited. And waited and waited. It turns out that we would not be having our baby that day. The hospital informed us that they just couldn’t fit us in. So, we went for dinner and came back to the hospital later. The night was an odd one. We both knew what was coming but we were in limbo. Emmanuel had to sleep in the reclining chair next to my hospital bed for the night. We watched Love island and fell asleep early.

The next day I was woken up by the nurses at 7 am and given omeprazole to prevent acid reflux during the C-section. My blood pressure and oxygen saturation levels were taken and we were again left alone to wait. At 8 am the nurses changed shifts and we were visited once more. This time we were told we would be going to theatre today at some point. Today would be my baby’s birthday. I liked the date that it had fallen on which is a weird thing to focus on. But somehow the 19th Feb just wouldn’t have suited him and likewise the 17th. The 18th was a good day for Zach to be born. I liked it. So today was the day, then we waited. And waited and waited. We messaged family and friends and let them know what was going on but truthfully, we were just kind of floating around with no idea.

At around lunchtime, I was given some compression socks to put on and antibacterial wipes to ‘wash; with’. Along with a gown. I got washed up, dressed down and sat on the bed so that Emmanuel could help me with my compression socks. Trust me when I say there is no easy way to put on a pair of compression socks. It took about half an hour to get on just one sock. My feet were so swollen and the socks, of course, were so tight that the task became a hilarious event of pushing and pulling. It didn’t help matters that I hadn’t shaved my legs for months. Added friction.

Finally, with the socks on, we were called to theatre. It was literately a knock on the door and let’s go. We were taken to another room in another ward. This would be the room that I would come to afterwards for recovery. We lugged all of our bags and bits and pieces across. I set up my bottle of water and tablet ready on the table for afterwards. Then we sat taking in the view overlooking the London eye. We took some last photos of the two of us dressed in our gown and Emmanuel in his ‘scrubs’. The knock on the door came and off we went. We walked down the corridor to the theatre. I was holding my gown closed so I didn’t flash anybody my bum.

The theatre was not what I expected. We walked in through two sets of doors to a green coloured room and that was it. There it was right off the main corridor. You could almost stumble into it.

I was sat on a bed and given a chair to rest my feet on. My blood pressure etc. were all checked before we started and then the procedure was explained to me. I had a cannula inserted into my hand for drugs to be administered. Then a fluid drip was set up. I was given a pillow to lean over and hug onto. The anaesthetist then cleaned and numbed the skin on my back. She pushed between two of my vertebrae with her fingers for a while before finding the correct spot. She then inserted the needle and administered the spinal block. I could feel it, I won’t lie. But it’s not painful it’s more like pressure. Almost straight away my legs went tingly and I felt sick. I was helped to lay down before I lost anymore feeling. Emmanuel was given a chair so that he could sit by my head the whole time. The anaesthetist, Bethany, stood the other side of me. She was amazing. From start to finish I couldn’t have asked for somebody more kind or professional to take care of me. My gown was lifted to be used as a screen and a blanket placed over my lower half – then the part I had been truly dreading and I mean that. The catheter. My legs were moved by the nurses and the catheter inserted. I had no idea about any of it of course but I knew what they were doing as they were talking and telling me as they went. And honestly, that was probably the worst part. It still makes my tummy feel funny just thinking about it.

The anaesthetist used a cold spray to check I was numb all over before anything began. Once she was happy that I couldn’t feel anything anywhere we were ready. I was giving her detailed feedback. “well I know you are there, but it doesn’t feel cold.” I am sure she was used this. I was concentrating so hard in case I could feel anything, but I couldn’t at all. They do explain to you that they take away the pain but not the sensations. So, you will feel the movement. They said it would be like rummaging in a handbag! Nice analogy! There I was, Emmanuel holding my hand, everything numb and ready to go, but the surgeon was nowhere to be found. Bethany stepped up and called to someone to sort this out. She was efficient and assertive. It was just what was needed at the time. Then he entered, in a room full of women a man walked in. He took a moment to introduce himself to me before a proper screen was put up and I could no longer see anything except the blue fabric, Emmanuel and Bethany. The surgeon was concerned by the size of the bed and wanted the side extender removed as he couldn’t reach across. It was what felt like a power play but must have been a genuine concern. The side of the bed was quickly removed. It was time.

My blood pressure started to drop at this point and I began feeling sick so Bethany gave me some drugs to counteract this. I felt better almost right away. I was a bit shaky but this was just the adrenaline in my body, like when you go to the dentist for a filling and afterwards your legs are wobbly. Then it started. Within minutes we heard them saying, we can see the baby’s feet and bum. They all laughed as he pooed on his way out. Then we heard the most beautiful sound I have ever heard in my life. My baby boy cried as he was lifted out of me. Bethany took my phone and snapped loads of pictures for us. Thanks to her I have a picture sequence of the most amazing moment; the birth of my son. His bum being lifted out. His face appearing. His cord being cut. His screaming face and long body stretched out as they lay him across my legs. He was taken aside for a few moments to be checked and wrapped in a blanket before being brought over to me. Because of the poo, he had to go straight to NICU (Neonatal Intensive Care Unit) but I had a few brief moments of him placed next to my face. He reached out and grabbed at my face as if he knew who I was and was asking to stay with me. But soon, too soon, he was gone. Emmanuel kissed and hugged me and told me well done before he left with our baby. I was so adamant that he stayed with our son that I am sure I was practically shouting it.  I was alone in a room full of strangers. But the most wonderful strangers. The nurses chatted to me and kept me calm as they started to stitch me back up. I thought I would feel sad because my baby and my partner had both just left, but I felt pretty good. As if I had just done a workout.

As they stitched me back up, the student nurse and Bethany kept up the conversation. “is this your first baby?” “Did you know you were having a boy?” Questions that I would soon get very used to hearing and answering. Safe questions. Normal.

I asked how the stitching up was going. Bethany told me they were nearly done. I asked again “no I mean what layer are they on?” She paused before answering and telling me there were three to go. Fat and two skin. I told her I had watched a YouTube video on how it was done. She laughed and nodded.

The surgeon leaned over the screen and informed me that he had knotted the stitches on the outside and they will likely need cutting off later. The midwives would do this. This is not a normal procedure; stitches are normally all tucked in and would dissolve apparently. I still have no idea why he did this. Perhaps he was trying to start a trend. He said goodbye and disappeared off. The nurses cleaned me up and gave me a painkiller in the form of a suppository. I had no idea and wished they hadn’t have told me. I was leaned onto my side so they could clean the blood off me fully and then move me onto a travelling bed. I joked about being heavy. The five nurses chuckled politely as I am sure they had heard that joke a million times whilst lifting a 5’9 – just given birth so carrying some extra weight – woman across to another bed!

That was it. I thanked everybody as I was wheeled out of the theatre and down the corridor into my room. It was over. I had ‘given birth’ to our son. He was beautiful. That feeling is something I cannot explain. Hearing him cry and seeing his face for the first time. Something inside my heart moved for him.

Four ECV’S and a Breech Baby

The weeks progressed and the news sank in a little. Some days I would feel hopeful and happy. Others I would be full of fear for what was to come. I soon found that working nights in the private members’ club that I managed was getting too much. The loud music, the drunk people and the 4 am finishes left me exhausted. I spoke to HR and started maternity leave early. I was going to miss my job and my friends there but my body couldn’t do the late nights and my mind was elsewhere. So, in late November 2019 I finished work.

I started nesting at home and getting things ready for Zach’s arrival. I wanted to be prepared as well in case Zach was going to come early. So, by Christmas time I had our hospital suitcase packed, the nursery ready and the car seat installed. I had pretty much everything we would need all sorted. I loved standing in his nursery and looking around. I would sit in his nursing chair and imagine what it would be like to be sat there feeding him. I started to find that I needed something to do. To take my mind off things a little bit. So, I got my sewing machine out and made gift bags for my family’s Christmas presents! After Christmas I got into the routine of seeing the midwifes on a bi-weekly basis for regular measuring check-ups.

The local midwifes would measure my bump each week and check Zach’s position. He was in the ‘Breech’ position for the entire pregnancy. Which isn’t a problem, until you get towards the end. At this stage its ideal to have a baby positioned facing down, with their head in the pelvis.

Zach decided that he wanted to stay where he was, with his head sitting under my right rib-cage and his bum sat above my left hip. He was laying diagonally across in utero. This is fine for the pregnancy bit, but not so great for the birth bit. So, I was given the option to have an ECV to try and turn him around. I desperately wanted an all-natural birth. I had been practising my hypnobirthing techniques daily and wanted to use them. With Zach in breech this pushed my ideal labour and birth further away from us. 

What the heck is an ECV? Is short terms two people push your baby around to try and get the head to face down and into the pelvis. It is exactly as it sounds. Brutal. ECV stands for External Cephalic Version. External being from the outside, cephalic being the head and version being turning. So turning the head from the outside as a rough explanation. Here is why they do it and the risks involved.

As Zach is a Cardiac baby, we had to have the go-ahead from his doctors at the Evelina hospital. This also meant having the procedure done at the Evelina/St Thomas’. So, Myself and Emmanuel did the drive into central London the day of the ECV. It had to be done at the Evelina as there is a risk of inducing labour. We needed Zach to be born where his doctors and surgeons were and not need to be shipped across London in an ambulance from our local hospital.

What they actually do in an ECV

They put heart monitors on my belly to listens to Zach’s heart. They monitored Zach’s heart for 30 minutes. He always started moving around when the monitors were on me. I imagined him trying to kick them away from him. The doctor explained that they are really loud for the babies inside. It must be quite a shock, like having your house suddenly start playing loud, bass-filled music. After some time watching the heart monitors they gave me an injection of salbutamol, which works to dilate the blood vessels. This helps to reduce contractions and relax the muscles that are supporting the baby. Salbutamol makes your heart race and your hands shake. It is very unpleasant but thankfully its effects do not last for long. The midwife described it as being flustered. I would say it’s like being high (on life of course) but without the fun bit, just the shaking.

Next my blood pressure and oxygen levels were measured periodically whilst Zach’s heart rate was still being monitored. The midwife and doctor left us alone for a while to let the drugs kick in and the monitoring to continue.

When they came back they checked in with me to see if the salbutamol had taken effect yet. It most certainly had. I felt like I was running whilst laying on a bed. My breath was short and fast and my body was shaking as if I had just squatted 90kg fifty times over. I knew I needed to stay as calm as possible during the procedure so that they had the best chance at moving him. Emmanuel held my elbow (my hand was behind my head) and I started to take long deep breaths. I found a spot on the ceiling to focus on and tried not to think too hard about anything at all. Which is much easier said than done when you have salbutamol and adrenaline rushing through your body. 

The first thing they did was to disengage Zach’s buttocks from sitting in my pelvis, which means they press really hard to try and lift him upwards. They then pushed Zach’s bum up towards my ribs. They paused and the other person moved his head down towards my hips. They did this step by step movement a few times.  This was all fairly bearable. The worst was the hand that was holding Zach’s bum. It was also pressing into me so hard that I felt like my intestines were being squashed down. It was like having a hard-blunt object held in place on a bruise. This was certainly not fun.

They managed to move the Zach some of the way round. Then he must have stuck out his little hands and pushed away or something because that was as far as he would go. He refused to tuck his head in. He refused to let his bum travel any further up. I was in agony from the pressure and they had to stop. The second they moved their hands away he swivelled right back to where he started.

I imagined Zach’s little face in there scrunching up in annoyance at all the disturbance. Kicking his legs out and doing everything he could to stay put. Then when he was back to his favourite position, I imagined him snuggling his head back into where he liked it best. His peace restored. I wanted to explain to him that he needed to help out and move around. But he was comfortable where he was.

It took me a few moments to recover from the first attempt. I soon wanted to try again. It was agony, but I was determined.

ECV take two

They looked on the ultrasound to confirm Zach’s position. He was back with his head under my right rib. This time the midwife and the doctor swapped roles. The midwife took Zach’s bum and the doctor his head. This time round was just as painful but I managed to breathe through it. Again, he got half way around and wouldn’t tuck his head in. They had to move him back to the original position. They can’t leave him half way. So back he went. That was it. The second attempt failed.  

The doctor and midwife advised me that now I needed to speak to my care team and we can go from there to make a decision on what to do for the birth. I knew there and then that it was either going to be a higher risk breech vaginal birth or a C-section that I was facing. I was devastated. We had just been through all of that for what felt like nothing.

Because Zach has a heart condition a breech birth adds more risk. I knew I would be advised against it. These are the statistics. 1 in 1000 babies come into problems in a normal straight forward vaginal birth. Its 2 in 1000 for breech. So the odds just doubled right there. Then with a cardiac baby they go way higher. A caesarean section is 0.5 in 1000. Clearly the odds are in favour of the caesarean section, but I really didn’t want to have major abdominal surgery and need to recovery myself just as my baby will be having his heart surgery himself. There is of course a small chance the baby will then turn by itself. The odds are 3 in 300. I was not happy leaving that hospital. I felt like I had failed somehow. I wanted so badly to be travelling across London back home thinking about my beautiful birth. But no such luck. Not today.

Back at home, laying on my sofa the day after I felt like I had run a marathon. My stomach felt bruised all over and it was painful to move. I was so determined to get him to turn that I spent the rest of that day upside down trying to encourage him to turn. He didn’t.  All I could do was continue to hang upside down and hope. I watched a lot of movies hanging off the edge of the sofa that week.

Risk of an ECV

Just in case you are being offered one here is what they told me about the risks.

Less than 3% of women have an ECV and it causes their waters to break or for the baby to go into distress. If this happens it means you would need to have the baby pretty soon. Possibly via a C-section there and then, or at least within 24 hours.  There is a slight chance that it causes the placenta to come away and cause bleeding. Or it can cause labour to start. The midwife and the doctor where I had mine done at St Thomas hospital in London explained that for them, one woman last year and one five years before that had to have a C-section due to waters breaking at the ECV. That’s it. It is very low odds, but just in case be ready and have you hospital bag with you. That’s what we did. Take some paracetamol for the soreness afterwards and you will be ready for anything. I personally didn’t take any painkillers, preferring to just soldier it out.

It has a 50/50 success rate, some hospitals are slightly lower at a 40% success rate which is the national average. It’s worth trying it if you want to have a natural birth. It’s worth practising those deep breathing and relaxation techniques as well. Be prepared for it to hurt because it does. But so do a lot of things in life. Like labour.