Monday 17 January 2011

Again and Again

This topic is very emotive and I have struggled as to how to present it here. Please, if you have had more than one premature baby, I am not blaming you, or wanting you to feel anymore guilt that you do already. I'm just putting some thoughts out there, of my own, I am not judging anyone's choices. 

"So, when are you planning to have another?" It's a question I am asked often. Sometimes I can answer with a grin "no way Jose", sometimes factually "when there is a definitive treatment for pre eclampsia that doesn't involve swift delivery of the baby", and sometimes it sends me scurrying in tears. It's no secret. I want another baby.

But, as much as I adore my son, and don't get me wrong, I am grateful every single day for the care that kept him alive, I don't want another NICU baby. I am not mentally strong enough. As discussed before, due to various risk factors, my recurrence risk is around 80%, my consultant guesses she could get me to 30 weeks.

A lot of the time on my blog, I share the sadness of seeing your baby in hospital, of watching everything they go through, of keeping that bedside vigil, of weathering the highs and lows, the amazing soaring highs, and death-defying crushing lows, of a premature baby's fight for survival.

But there's another side to the story. The mother (and the father). Like most pregnant women I had read books, watched television shows, I bought the magazines and I bought the dream. No one talks in any detail about premature delivery, of what happens if you don't get your "normal experience". Yes, you see the odd success story, but magazines never explore the real story.

I feel cheated. Personally and at a deep level, cheated. I am so angry I didn't experience a contraction. I looked forward to labour, to experiencing it, being present in it, that challenge of pushing a watermelon out of the eye of a needle, I wanted it! I wanted that closeness with my husband, that moment of crowning, those final pushes, the baby delivered on to my flesh, the first furtive breast feeds, the finding out the gender together. I wanted it, I bought it, I expected to get it.

The reality is, I didn't get it, and I am not alone. But for me, we have stopped. No more babies. And its bloody hard to have made that decision, other people who had babies the same time I had Joseph have new ones now. And that will never be me. And it sucks. I try and be noble about it, but I feel robbed.

There are many reasons babies come early, most commonly there is no definitive reason. Therefore the ability to assess the risk of recurrence is somewhat impeded. The common reasons, such as incompetent cervix, can be mitigated with a stitch, but these are not 100% effective. Reasons such as infection cannot be predicted, and so little is known about recurrent infection and the risk of premature labour and delivery.

But what if you know. What if you've had three or four or more premature babies. What I haven't ever really explored here is cost. The avereage of cost of a NICU stay is £838. Not a week. A day. £838 a day! Joseph was in 76 days, admittedly not all at this high level of care, but his stay would be estimated at around £65 000. And that doesn't include my cost, two nights in HDU, surgery with double the staff of a normal section, and a 7 night stay afterwards.

Premature babies cost a lot of money, in our case, Joseph is well, and hasn't really cost the NHS any more than your normal baby. However some of these babies require an ongoing investment of care, both from the health service, and then in the educational sector later on.

I don't know what the answer is. I do know there are a lot of women who have had more than one premature baby that have no idea why their babies have come early and have been told "its one of those things". I know other mothers who have had very good follow up care and have gone on to have full term births next time, with stitches or progesterone therapy, and most often, both. I know women who have had pre eclampsia in first pregnancies who have gone on to have fine second pregnancies.

But I know women who have been advised not to go again, and have. Again and again, have premature babies. My husband has a relative who lost her life having her last baby.

I think the answer here is research and education, and straight talking from professionals. My own consultant was incredibly tactful when discussing my recurrence risk. She asked me if we were considering more, I said, probably no, but maybe. She ran through my risk factors. I ased her straight out "come on, if we're better off getting a puppy, just say so, please", I had to really press her, and then eventually she said it "yes, get Joseph a nice puppy, please!"

I think we should know the true cost of having early babies. I think we should know the long term risks. I think to make informed choices we need to be more open about what we are dealing with, risk of death (both baby and mother), the use of very finite resources, and the possibility of long term consequences for the child as it ages. Let us make a choice, but let us be informed. 

Not everyone is as lucky as me, to know the reason their child came early. Not everyone is as lucky as me. I never thought I'd have a baby, so to me, to have one baby, is an enormously massive, wonderful gift. Yes, I long for more (and a pink one would be nice) but I have my baby. Not everyone is as lucky as me.


  1. I found your post a real education. I'm lucky, both of my pregnancies were straight forward. With the exception that I carry Group B strep and potentially could have lost my boys at any stage. I didn't. I also understand your feelings regarding having more children and the decision you've made, 20 years ago hubby and I were told point blank we would never be able to have children. A real blow to the solar plexus! Good post!

  2. I agree with Fiona, I feel more educated about it now. I look forward to the rest of the week :)

  3. I agree 100% with your feelings. I too would love more than anything to have another baby but for different reasons (mainly due to PND). My baby wasn't prem but I had to have a section because he was breach. I feel like I am not a true woman/proper mum because I have never felt a contraction and I didn't give birth to my baby - he was taken from my womb. I have always seen myself as the mum of a girl but I have a boy.

    But at the end of the day I am a mum and I love my boy more than words can say. I am so lucky and I wish I could pass my luck onto all those without babies who want them more than anything else in the world.

    Thanks for sharing once again xx

  4. I read your post feeling both priviledged and ashamed. Blessed that we have both experienced motherhood against the odds, and guilty for having conceived another child not knowing if s/he will arrive early.
    I respect your choice to not have another biological baby, you are educated about the condition which caused Joseph's early arrival and the almost certain consequences. If I were you I'm not sure I would be strong enough to make that decision but I'd like to think I might be.
    For us, with infection being the likely cause last time, we have an 83% chance of a term delivery this time. I really hope this happens and that another tiny baby does not have to suffer too, and I know I will blame myself if something 'unexpected' happens again. I just can't let go of that dream of having a healthy pregnancy/birth/baby and for that I feel very selfish - almost like by having that experience it will heal all the hurt. I realise though that if that does not happen I risk double the pain and suffering for all of us.
    I hope you can find peace with your decision and I do think you should save your blog posts in an archive for Joseph, as he deserves to know what an amazing Mummy he has :)
    (((big hugs)) xxx

  5. Heidi
    I have 3 little boys, all were born prem, my first 33+3 who needed 10 days in scbu for phototherapy, feeding and growing

    2nd 33+3 No need for scbu at all, 8 days on postnatal for phototherapy and feeding.....

    3rd 29+2- 8 weeks nicu/scbu and a lotof admissions for chest since

    After each child was born the consultant assured me there was no reason they had arrived so soon, and that there was no reason ishouldnt become pregnant again and indeed supported me in choosing homebirth!

    There are no certainties in childbirth and pregancy, if you had afull term first child,there is no guaremtees you willget a fll trm sbseqent, and many people i know have hadpreemie first babies and full term after that.
    I dont think anyone should feel guilty about the choices they make regarding future pregnancy...its personal to each of us.
    My choice was like yours to go on and try again.....
    Kylie and other people have for their own reasons chose not to.......
    I dont believe there is a clear cut right or wrong to be found......
    I hope yourpregnancy goes well.... andthat you have your normal,full term pregnancy :-) but even if not,dont beat yourself up about it........ take care ss

  6. WOW, this is tough! I had no idea of the costs and I am a Mum of twins born at 27+3 with 59 days on NICU. My two came early after I had to have emergency bowel surgery. I hope that I will fall pregnant and have another baby one day and I hope that they will be born full term. I don't think there is any reason why not though this post has now got me thinking. Thank you Kylie. Do keep writing these posts it is good to challenge people, to challenge ourselves. You are amazing and strong, and a beautiful writer x