On the bad news side, the birth did not go well, and the long-term outcomes are not clear at the moment. It's funny to read that last blog post with all the assumptions I was making- particularly that the baby hadn't arrived because she was happy in there. Turns out she was anything but happy. This is a cautionary tale about listening to your body and your baby during pregnancy, and about trusting your instincts when you feel like something might be wrong.
Basically, two days after I wrote that blog post I was still sitting around waiting for something to happen. The Braxton Hicks contractions were getting uncomfortably strong, but beyond that there was no progress. I spent the day emailing my mother, chatting to friends, and otherwise relaxing. Later in the evening I put together the new stroller- and it was right about then that I noticed the baby hadn't been moving for a while.
There were certain things she always moved for- if I drank a cup of tea, if I ate pasta, if I bent over to pick something up- and I'd done all that in the preceding couple of hours. No movement. I noticed it when I bent over to put something together on the stroller- normally when I did that she'd brace both feet against my stomach like she was about to fall out. Didn't happen. Initially I wasn't too worried, but then I tried a few other things to get her moving- drank a glass of cold water, ate a banana, lay on my right side- and when none of those worked either I started to get a little freaked out.
My husband and I debated whether it was just because she was squeezed in there (they're supposed to slow down as you get towards labour) or something more serious. In the end we decided to call the hospital and ask- and they told us to come straight in. All the way there we were still joking about making this a practice run for the real labour. We were so preoccupied we didn't even notice that the weather was more than a little stormy.
As soon as we got there they put a monitor on my stomach, and to our huge relief the heartbeat was there and solid at 140 beats per minute. But there was definitely no movement, and as we watched the heartbeat was dropping to 80 beats per minute. Within 15 minutes they had the doctor there, and she took one look at the trace and decided we needed to do a caesarian right then. Within an hour I was in the operating theatre. It all went so fast we didn't have a chance to panic. I was totally calm- a little relieved, even, since the wait was finally over. The whole thing seemed unreal.
They tried to do an epidural but couldn't get it to work, so the worst case scenarios continued- first a caesarian, then a general anaesthetic.
When I woke up a couple of hours later I was in a quiet room with my husband sitting by the bed- and no baby. Turns out she wasn't doing too well. Her umbilical cord had been wrapped six times around her legs and by the time she was born her heart had stopped beating. It started again spontaneously, but by then she'd inhaled a bucketload of meconium and had to be intubated and breathed for. She had to be flown up to the city on the Royal Flying Doctors Service- but it also turns out that the storm had been one of those once-in-a-century affairs, and in fact the plane couldn't get down because the weather was so bad. So, 12 hours after she was born they finally came to get her, and they wheeled my bed out into the hallway as they wheeled her incubator past so I could see her for the first time.
My husband drove up to the city straight away (a five hour drive on one hour's sleep) while I was left behind on my own in the hospital. Thank goodness for my wonderful friends who rallied into shifts to make sure I wasn't left alone, because I would have been a complete wreck if it wasn't for them (them, and the morphine-on-tap). The next day in world record time I was out of bed and on a plane myself to follow Sophie to the city. I had to stay in a different hospital for three days, but after that my husband and I were able to move into parents' accommodation at the neonatal intensive care unit.
For the first few days she was on a ventilator, sedated, and had tubes in every available vein to feed her and keep her blood pressure and numerous other functions working. It was horrible to see. The first time I got to hold her, they transferred the whole bundle of Sophie and her wires onto a pillow on my lap- as someone said, it was like cuddling a VCR instead of a baby. The oxygen deprivation had caused a condition called hypoxic ischaemic encephalopathy (HIE), in which there is bleeding and swelling on the brain. Her level of injury is classed as the highest- grade 3- because she also suffered seizures. The MRI scan looked pretty bad.
But against all odds (apparently some 75% of babies with her level of injury die) she began to get better within a few days, and she was soon sucking, swallowing, moving, listening and watching, doing everything a normal baby should. In the long term she could have cerebral palsy or almost any kind of disability, but for now she's showing signs of an absolutely remarkable recovery. The hardest part is not knowing what comes next- we now face years of developmental testing, knowing that bad news could be around any corner. For now, though, we'll just count our blessings. According to the midwives, if we'd left it even a couple of hours longer she'd be dead.
So here's what I want to tell people who might find this by Googling various terms:
1. Be aware of your baby's movements and learn what feels normal. When something doesn't feel normal, don't be afraid to check it out. My doctor told me not to bother keeping a fetal kick count, but now I wish I had- that would have told me faster that something was wrong.
2. Baby hiccups- we've now read that increased hiccups from 36 weeks (4 or more bouts a day lasting ten minutes or more) can be an indicator of fetal distress. I asked doctors and midwives repeatedly if her hiccup bouts were okay, and they all said yes. She was hiccuping five times a day for 20 minutes each time. Insist on more investigation. It's written in What to Expect When You're Expecting under fetal distress if you need to back yourself up.
3. Hypoxic Ischemic Encephalopathy- I still don't know the long term outcome for Sophie, but I'll tell you this- according to the literature a baby with grade 3 HIE should be on a feeding tube for months because they can't suck (amongst trhe numerous other things they can't do). Well, she can suck- she can do everything. So don't lose hope. We had 19 days in intensive care and another 7 in hospital, and now we're home and everything is looking good.
4. Even in a totally healthy pregnancy, even when you're overdue, things can still go wrong. So don't drop your guard.
