Maternal Healthcare - What did it look like for you?

It's been a strange process being in a 'system' of healthcare, monitoring, recording and ticking boxes. I have never realised the full impact of the 'pregnancy system' now i am sailing to the end of this journey i reflect on how let down i feel by the care I have been offered and being offered.

Since starting this fertility journey in 2015, I have attended more appointments then i can count and have been let down, disappointed and frustrated by so many inputs that have felt 'unhuman' at such a 'human' time. I don't want this blog to be a bashing of health professionals as wow there are some amazing one's out there, but what is interesting is the de humanisation jobs become for some and the impact that then has on the people accessing it.

The IVF process was mind blowing to us, we didn't know what to expect, we didn't know we had choices and we went with what was giving to us as we were so lost in a world of unknown. After every loss, explanations were brief and information was shared that wasn't helpful or didn't make sense. I remember one appointment being informed my miscarriage was a 'chemical miscarriage' so wasn't classed as a 'proper' miscarriage. For someone falling pregnant any loss is a loss, and to be informed that from a health professional was a huge blow. This same professional informed me my surgery properly wasn't the reason I had falling pregnant, again taking away any hope I had mustered up. It's strange the way people feel they need to say this stuff, sometimes some things are better left unsaid. It was from these appointments I started to learn more about my body and really connect with what was going on with it. I started to engage in the clinic in the way I needed too but use research as a tool to how i could support myself, something I wrote more about that here How to try and grow a baby!- I knew I was choosing to be in this healthcare system as we were committed and knew the help was what we needed however I chose to challenge and do what felt was best for me, which helped me feel I was taking control of what was happening and contesting anything that I didn't agree or believe.

I find as i talk to others, they feel worried or scared about doing this, going against the system of care we should be grateful for and yes i am but actually taking a step back, this is my body and my mental health and shouldn't i be looking after myself in all this?.

When falling pregnant we moved into the next 'system', we were quickly discharged from the clinic which felt scary as although they had challenged us in some unhealthy ways there was a weird safety developed through those appointments and that medical care. We had a scan at 7 weeks and found a peanut sized baby and a beating heart, from there it was to the doctors and the 'normal' maternal care. I was so excited and nervous for that first appointment, however was sadly disappointed as my midwife was tired, informed me of this, became quite stressed at the computer and paid no attention to us being an IVF pregnancy and any worries I held around this. Maybe there was a lack of education, maybe there was no need to be worried or maybe I just wanted more nurture and care at a time I was so happy but so incredibly nervous.

I left that appointment sad, let down and the excitement i thought i would feel dissipated quickly.

A number of years back I decided I wanted to be a midwife, I wanted to specialise in substance misuse or young people and felt I had the skills and care that could be offered in this role. I sadly wasn't accepted (due to my maths GCSE) however now look back and realise the medical side would have challenged me as what I have learnt and seen is that it is very medical in a lot of ways. I feel I can see a new branch of care coming through from the students I have worked with, maybe that's a varying approach or maybe it's new blood in the job, whatever it has that care has felt warm and supportive, however there still seems a set of procedures to tick and boxes to fill.

One of the things I have learnt in this long journey is what my needs are and what I want from this pregnancy, I have learnt from friends about their experiences and this has allowed me to make informed decisions about what I want and what feels right for me and my baby.

I don't agree we should have to just 'get on with it' as that's what it's always been like, how many times do we hear, well you didn't have that choice years ago, did you not or where we all just too scared to go against a system of care that develops fear and anxiety within us.

With being an IVF pregnancy they like to induce you at 40wks (your due date), I knew induction wasn't something I wanted (if it could be avoided), I therefore knew I would go to 42wks before this decision needed to be made. The NHS guidelines are now at 41wks, however only moved from 42 a few years back. Induction was first discussed with me very early on, my midwife didn't give me enough solid information to make me feel it was something that was necessary so I chose that I would refuse the 40wk induction. I am also part of a North East birthing group and enquired on this, finding out the risk was possibly around women over 40. I was then asked if I would like to be booked in at 41wks, which I refused and finally agreed at 42wks, with a statement of 'maternal choice' written down in my notes. What makes me frustrated around all this is the essence induction is discussed so early, like it's become a standard way of birthing, yes it is needed at times but do we need to be introducing into conversation so early?

Then there's the graph, the graph of anxiety, the graph that every women whatever shape or size you are, you have to stay on the graph and if you don't well it's time to head to hospital for another scan (bearing in mind this is all measured with a tape measure). I understand every doctors surgery can't have fancy scanning machines but that line needs to lend a little. Which I guess is why I am blogging as I feel the NHS system needs to become flexible with women's rights and needs around birthing.

I spoke to a friend recently and she asked if it's okay for me to have all these wants from my birth, I was astonished that in 2019 we still aren't fully informed or aware, that the birth is our birth, ours and our babies, meaning it's our choice how it happens as it's one of the most powerful experiences we will go through, it's the first journey you do together mother and child, shouldn't that therefore be your choice.

Conversations are hard and what i have learnt is that EVERYONE has an opinion, you take what you want, you chose what feels best, there's no right or wrong as it's what's right for you, but for me it feels this intrinsic sense of the NHS guidelines isn't always right and we should be encouraged to be flexible and not always feel we are harming our babies by not ticking the boxes. I drank wine throughout my pregnancy, the odd glass when i wanted it from the 2nd trimester, i ate soft cheese and runny eggs. I went to gigs, i walked miles and miles in Scotland on holiday, i taught yoga from day dot, i carried things around, i slowed down when my body told me too but i lived my life the way it felt right. I chose not to tell my midwife as i told her one thing and the concern on her face made me stop instantly. It's what's right for you and none of the above maybe but for me i knew what my body needed/wanted and what made me happy and surely if i am happy my baby is.

I feel lucky to be educated through friends and my own reading, I have taken a lot from instagram accounts such as Olivia at The Birth Rising and Emma at Mamalina around going slow, listening to your body and your birth rights. I have also been influenced by some incredible friends, by their honest sharing and empowering birth stories, there talking has allowed me direction in my own pregnancy and hopefully allowing me to make the right decision's for myself and my growing family.

How excited are you?

It's a question I keep getting asked and rightly so, why wouldn't folk, the thing we have wanted for so long is happening, am I excited though, it really is a hard question to answer.

I like to be honest, I am not one of those people who just says yes, as that's what people want to hear, so when asked if I am excited I respond with honesty and say I am not sure, worried, scared are definitely some of the feelings that feel more apt. I certainly now understand when friends have suffered from baby blues and postnatal depression why they haven't shared it, as from being pregnant there is an expectation a pregnant women should be excited.

I feel excited buying bits for baby's arrival, preparing the nest, feeling them move and thinking of the experiences were going to have together as a family. What worries me though is the change to come, this change everyone likes to tell me about from their experience. I worry about the change in my relationship with my doggies, which yes, I know will change but I feel sad that it will as these dogs have helped me survive at the hardest of times. I feel sad at the change in my relationship with Sammy, how moody I am with indigestion, peeing loads and feeling heavy, so when I am tired, sleepless and being a milking machine I know I aint going to be the best laugh in town. I have been so use to the little family I have created and the expectation of never having children that to suddenly be ready feels a bizarre and unknown feeling. I guess one I have to admit I am not sure how excited I am for.

9 months off, for some reason I won't call it maternity and make the joke of it being a sabbatical, what this is about I am not sure, but there's something deep rooted in me that doesn't want to be just a Mum and maternity leave feels so unknown to my identity it's like I can't connect fully to what's about to happen. I am definitely trying to enjoy these last few months of pregnancy, my anxieties have passed now and I do know this baby is going to arrive, however it just being my life (without work) for 9 months feels strange and scary and something I don't know how you ever prepare for.

You have an identity that changes over the years and i know mine changed when it came to fertility, now being pregnant, something won't let me forget that journey, i am proud of how far i have come and holding this pregnancy feels surreal, i am trying to be prepared for the next change, my identity will change, how can it not, i guess i just don't know how ready i am and feel sad saying goodbye to the one i have built during my fertility journey.

Anyone going through their own journey, i don't wish to not have this pregnancy, i am so overwhelmed it's happened for us, i don't want to sound selfish or ungrateful as i am not, its my own process of change i am trying to understand, and in all this change is happening all around me and i am slowing learning how to move with it.

So with 5.5wks until due date i will be going slow, moving with gentle flow and making the most of these last few weeks with my bump. Change is a coming and i am looking forward to it (just with a hint of trepidation).

What's really in our control?

Do I allow myself to recognise what I have been through, still going through and how that impacts on me now. People feel this journey has ended for us, because we are now pregnant, I am a Mum now and Sam a Dad so why would we worry, haven't we got what we wanted? 

What I have to come to realise is with pregnancy there comes a whole host of worries and I think at this stage I feel more anxious now then I ever have. Of course there are days of pure magic and enjoyment but reality can really hit at times and until this baby is in my arms will I ever fully believe that I am a Mum.

I work in mental health, I know anxiety, I have always suffered with low mood off and on through my 20's but anxiety didn't hit, it creeped in when IVF started and it's a monster hard to extinguish. This week has been incredibly difficult and I had the realisation on Tuesday afternoon (when my Mum told me I looked pale) that I was feeling pale, washed out and tired. 

Since IVF started in Oct 2017 it's been go go go, that's either the pressure  around a cycle, that two week wait to see if we had conceived or moving through the process of recovery after a failed cycle but also attempting to create a life that wasn't ruled by IVF. This week I suddenly realised life wasn't ruled by injections and fertility treatment, I was now a pregnant women, working, planning and taking on her final few months before motherhood arrived, however this then led me on the next worry path of labour and breastfeeding, two things people talk to me about so much however both being something I need to think about due to the possibility of early induction being advocated and the risk of not being able to breastfeed due to me having a breast reduction when I was in my early 20's. The internet is a beauty at times but also a total bitch, it has held both these elements for me this week and I have felt myself slowly sinking into a pit of worry and uncontrollable emotion. Sammy shared last night he could see I was worried but I had to remember this time last year we didn't think we would ever have a baby so whatever happens our baby will be loved and that's what's important, not if it breastfeeds or is born through medical intervention.

It made me think, what can I control and what can't I? Something I am sat heavily with today.

How I emotionally respond to our pregnancy.

People keep telling me how excited I should be, don't get me wrong I am excited, how could I not be. I do feel I can control what comes in and what goes out, therefore I feel I can control what I take on, if it doesn't feel helpful I may not respond but that's because I haven't found being told how I should feel is helpful.

How much internet use I take on board.

I think from today I am going to disable certain apps on my phone, I do this now and again but feel I am procrastinating a lot and getting involved in a lot of spaces that may not be useful for me or my mental health at this moment. So I can control what I allow myself to be involved in on the internet and social media.

An element of my birth.

With being an IVF pregnancy it is suggested your induced at 39wks due to the risk of still birth, the information around this isn't clear and my midwife hasn't pushed it so I have decided against it as I don't believe the evidence I have read and believe it's focused more on over 40's. However if I do need to be induced this maybe out of my control, however what I can control is the environment, I plan to have essential oil's in the room, to be moving and using yoga/active birth methods and hopefully using water, my birth is totally out of my control but the environment I am in can to the best of my ability be in my control.  

Breastfeeding.

When I was younger I had boobs that were so big, my back hurt, my career was impacted and I was known as 'Claire with the massive tits'. I changed this when I had a breast reduction in my early 20's, breast feeding at the time was not on my radar and although I was told of the possible impact it wasn't important to me at this time.  I have read a lot around this on the internet and many women successfully breast feed in some way, this maybe combined feeding but they do manage to get some milk to feed. What I can't control is if I can breastfeed, I will only know this when my baby arrives, what I can control is what I do to attempt to support breast feeding, it will be hard, using expressing/pumping will become part of my daily routine after feeding (if possible) and continuous skin to skin for the first few days and holding babe to breast to help stimulate milk production (if any is coming through). It may look different to what I expected but it feels important for me and our baby and therefore I can't control what happens but can attempt to control how I support my body in enabling this happening.

How I look after myself.

I work as a Counsellor with young people impacted by domestic, sexual and historic abuse, I have realised I am taking on a lot and have plans to make some changes from the end of this month, freeing up another day a week for me, babe (and the dogs). I can look at what my weekends include and do what feels good for me, walking, resting, knitting, nature, being with good people. We have a few holidays planned which feels exciting and relaxing, I can control what I allow into my life to feel good for me and my soul.

This week has taken on a level of emotional tiredness and has hit my like a bolt out of the blue, as I write this the sun shines in through my bedroom window, women's hour plays in the background, my manager just told me to take the day to rest (when I rung into work) and my husband just text telling me he loves me. My head maybe a bit wobbly but how I move through this life is a lot in my control and writing helps me remember that.