5 Mar 2015

Anxiety

My second child, Jack, is tiny for his age. He doesn't grow properly, and has poor gross motor skills. He doesn't care - he hurls himself round like a child twice his size. He's being measured again next month, and if his growth is still too far under what it should be, he will probably need a referral to check up on him. He's currently on the 9th centile for height, and 50th centile for weight. He is a BALL and he bounces accordingly. He's normal, otherwise, developmentally, so we don't worry too much.

Jack suffered from intrauterine growth retardation (IUGR) when he was inside me. My bump stopped growing at 34 weeks. When I was in labour at 42 weeks, my bump measured 33cm. It should have been around 42cm. His smallness was noted, but no action was taken. It was assumed by my midwives that I was losing a lot of weight from my marital split, and therefore I had a smaller bump.
To demonstrate how small I was:
34+5 with Jack. 20w with current baby.

I put on 8lb total in that pregnancy. At 38 weeks, a different midwife worried he was breech and sent me for a scan. His foetal weight was estimated at 7lb. At 40 weeks, my usual midwife finally sent me for a growth scan, because I was on call for a homebirth with a clinically SFD baby. They estimated his foetal weight at 8lb, and sent me home to wait for birth.
He was born two weeks later, at 42 weeks precisely, on my sofa after a predictably short labour. I was due to be induced six hours later, but had a strong feeling that having my waters broken or labour augmented would be the wrong decision. I also woke up the day before he was born convinced he would die. I'd had a lot of negative thoughts like that in the buildup to having him, but that was an acute, passionate feeling of something going wrong.
He suffered decelerations during his second stage of labour, but since I was at home, there wasn't much to be done except push harder. He was born in fine fettle, quiet and alert with a head of long, gingery hair. But his cord had nearly killed him.

Jack's cord had two, true, figure-of-eight, tight knots in it, about 10cm apart. One true knot is fairly rare, and is one of more common causes of stillbirth. Two knots is so rare as to be reported in medical journals. They had been in place since around the 9th week of pregnancy. They could have tightened, and killed him, at any point from them. They'd reduced his placental flow. They'd given him a thick, horrible cord. They'd tightened as he was being born. The backflow from this caused me to have a fairly horrible haemorrhage as I lay cuddling him.

He survived. I'm still not sure how. He weighed 7lb 12oz, which was 25th centile using the universal centile system, 8th centile for my particular variables. His growth scans had overestimated his weight considerably. In comparison, his older brother was 9lb 1oz, and almost two weeks earlier.
Isn't he gorgeous?

His birth has left me with anxiety and fear about this baby like you wouldn't believe. I am under consultant care, more for the haemorrhage and IUGR than the knots themselves. There is no way to predict or diagnose true knots before delivery. I'm having growth scans to check this baby grows to my schedule (which predicts a term birthweight of around 9lb) and also to check umbilical flow. I want another homebirth, but nothing can be decided until they know the baby's growth is OK.

This would be fine and reassuring (and it is), except I've also got a lot of bad feelings that have resurfaced about Jack's pregnancy. I suffered from severe antenatal depression when I was expecting him, primarily because my ex left. I wasn't concerned about his lack of growth. I didn't care. I'm quite sure had I displayed any concern for my tiny bump, they would have perhaps picked something up sooner. Instead, I ignored it. I ignored him. It was easier.
I get flashbacks. All the time. They're usually related to significant pregnancy events, like midwife appointments, endless blood tests and scans, but also the general condition of pregnancy is a reminder. I never wanted to feel how I did when I was expecting Jack again. I never wanted to wake up hating the world, dreading the day ahead, fearing every phone call, not wanting to leave the house.
But I do.

Not all the time. But the flashbacks are vicious and they hurt. They are like normal pregnancy anxiety + the anxiety I should have had for Jack + guilt + anger that I was ever made to feel like that. I cry a lot, and I let myself do it. I'm trying to get this grief and anger and pain and terror out of the way, in the most natural way I can think of. I sat on it last time. I can't do that again.

In many ways, feeling like this is normal. Feeling like this a natural consequence of my last pregnancy. Pregnancy is never just about THIS baby, it's about all the babies that have been before.
It may also be related to the B12 deficiency anaemia I get in every pregnancy. B12 is one of those vitamins that you don't realise you need until you haven't got enough. Then your nerves stop working properly, you faint a lot, you become depressed, you feel so tired you might die, and you go a ghastly luminescent colour. I haven't had my blood tested since November, but I suspect it's contributing to the feelings of doom.

It's just hard. It's hard to talk to happy, first time pregnant ladies and compare notes, without sounding like a doom-laden horror crow. I've never wanted to be a woman who terrifies people with birth stories, but it seems to happen anyway. It's hard to be honest when people ask how it's going, to not just weep because I can't walk properly (possible side effect of birth injury, I've got physio next week, thank god) and I'm so tired, and I'm so scared.

But it's not all the time. And the crucial difference is that I want this baby. I'm terrified because I want him to be OK so much. I want a safe birth. I want a healthy child. I want to be well afterwards - I really wasn't well after Jack was born, because of birth injuries and haemorrhaging, and I'm afraid of that happening again. I want so much that most people take for granted with their pregnancies, and all I can concentrate on is how it might go wrong.

I've not written this for sympathy, or anything really except in the hope that giving it an audience might help somehow. If anyone wants to see the double knotted cord, shout and I'll send you the picture - it's way too grim to post on here though.
Only 18 weeks to go!

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