Sunday, 11 January 2015

Born asleep: A story of loss and hope

Thirty four years ago today, on a pretty similar bleak, grey day that only January can produce I was just walking into a parallel bleak grey mindset that has remained a part of me ever since. I was a patient in the then locally infamous Newham Maternity Hospital at Forest Gate awaiting the birth of our first child. A naiive 23 year old, I read every childcare and pregnancy book available to man and even borrowed my friend's midwifery book. This was either a blessing or a mistake because I devoured this too-pragmatically observing that although some awful things can happen-most people deliver safely.

My pregnancy was uncomfortable, I enlarged to the size of a small blue whale, had constant sickness, fatigue and raised blood pressure. My registrar (I never saw the consultant until the day of delivery-he was much too important)was contentious from the off-disbelieving my dates. As a young "primagravida" (I picked up all the terms) I was suspected of knowing nothing... or having a brain... and when I argued and said that I had felt movement at the correct time for a first baby-she dismissed it as wind.  She then reset my dates from 17 January 1981 to 28 February 1981!

I felt massive panic! I knew I was a novice at this pregnancy game but I knew my dates were not that far adrift. Cutting a long and painful story short-at about lunchtime on 11 January a baby monitor was strapped to my expanding girth and there was no rhythmic heart beat-just a dull empty crackle. 

Then, the worst 36 hours of my life began. I eventually delivered a 4lb 8oz boy at 10-30pm on 12 January 1981.The breech birth was incredibly traumatic, painful and it was only due to the skill of the midwives that I came through in one piece. The NHS at its best-and its worst! Forest Gate Maternity hospital was busy, overcrowded, under-funded and had a bad reputation due to various cases of baby death and professional mistakes.(Sound familiar?) We had many complaints and indignities throughout the process-but the skill of the midwives got us through. A catalogue of errors would have made a lawyer rub his hands and I am sure we could have sued successfully.

We discussed with our GP what action to take-we were never inclined to litigate. After all-this would not bring Jonathan (that's what we called him) back, it wouldn't make us feel better and nothing positive could come from this. As far as we could see, it would put more financial pressure on an already restricted service. Instead we made formal complaints and decided next time to attend University College Hospital-which we did, under the amazing "Prof" Brant-the total antithesis of the consultant I had previously had. Later, I had equally excellent care at Furness General Hospital with my last child in 1993. 

I blundered through the stages of grief and adopted the approach that if people ignored that we had had a baby-I would tell them! Cathartic for me -maybe not for them!There was no grief counselling then! I had my first piece of published writing in Parents magazine and campaigned for recognition of stillbirth-it was still taboo in '81! Luckily, people like Esther Rantzen suddenly began campaigning for better care and charities like SANDS (est 1978) started to gain a higher profile. I went onto have four more pregnancies-resulting in three live births.So NHS fails: one NHS successes: three! Had I litigated I think I would still be firmly locked into the anger stage of grief and may not have had other children, so I am glad I made the choice. 
Stillbirth is something, until you or someone you know experiences it, that people believe is rare and consigned to the history books. Sadly it isn't. Its still far too common. Amazing leaps forward have been made in pre-natal care and some very premature babies now survive. I myself was premature weighing only 3lbs-again because the placenta didn't function properly-but due to an amazing obstetrician Mr Garth Stoneham I survived and so did my mum. It seemed incongruous that I survived in 1957 and yet my son died in 1981. However, I do believe, that despite the standard of care I received, with a failing placenta, confusion over dates, a breech birth, I think retrospectively we would have been very lucky to have a successful outcome, but of course we will never know. 

Thankfully, according to research "Perinatal mortality rates have fallen by a third since 1982. It is felt that general improvements in healthcare, midwifery and neonatal intensive care are bringing about the gradual decline in deaths". 

I do become concerned that a lack of funds, resources and staff; which certainly contributed to my loss, is once again becoming apparent today. This always leads to a vicious circle of low staff morale, damage to reputations and possible closure. I hope that this will not happen! In an overworked system someone with problems or fitting the at risk demographic will be less secure.

According to research on 2012 "a study of stillbirths in England showed the risk to be significantly higher where the growth restriction was not detected antenatally, suggesting this is an important avenue for reducing stillbirth rates in the future. It concluded strategy should focus on improving antenatal detection of growth restriction and subsequent management of pregnancy and delivery!"

 Surely, with the correct level of resourcing this is am area which can be improved. It is very hopeful, as long as financial cut backs don't prevent such progress. I am not foolish enough to believe that all stillbirths can be eradicated; it is part of natural selection; but any improvement for mothers is good and I like to think that as few people as possible would go through this traumatic experience as possible. Which is why we must fight tooth and nail to retain the quality of the NHS and ensure that we demand the continued support for our local services. Standards must always come under scrutiny and care must continue to improve. However, continued bad publicity and criticism must reduce-we could complain ourselves out of a service at all! Newham Hospital was soon replaced by a new and hopefully better hospital; but this won't happen at Furness-more likely the maternity service in its current form will disappear. Funding restrictions can be disguised as "improvement". Thirty four years on don't let us slip into the past-to an under-funded, poorly valued system used as a political football by the Tories! It's our NHS let's fight to keep it!



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