From bump to birth

Amna childrenPregnancy. Childbirth.  A state that (many) women have experienced since the beginning
of time. It’s a state that brings on delight, euphoria. The little being growing inside our bellies. From a mere jot of blood to a human being, fully formed. Before science, it was shrouded in mystery. Your belly grows as the baby grows. Your body’s wracked with sickness. Or maybe it isn’t. Perhaps it’s just the one baby, or then again two. Maybe it’s more. As the bump rises, so does the tiredness. It’s epic. Personally, I felt like I’d been hit over the head with a sledgehammer. You lose precious grey cells. Memory becomes an abstract thing that you no longer remember you had one.

Fear plays a part too. Is the baby healthy? Brain, heart, kidney, spine – all intact? Fingers and toes? And let’s not forget the mothers-to-be. As host to the babe within, it’s like we’re being leeched. Sometimes we’re afraid to admit how we’re truly feeling, disclosing our anxieties, the little niggles, the whispers that things may not be all right. That’s the thing, you see. Given pregnancy has been around since the year dot, women have – for the most part – done it and got through it. You do your duty and move on. It’s a rite of passage. Mother and baby survive. Then again, maybe they don’t.

Fortunately, medicine has advanced so much that fewer women die in childbirth. Ultrasound scans are available so we can monitor the health of the baby. Yet despite all this progress, the UK still has one of the highest rates of death through premature birth in Western Europe. Complications relating to preterm birth are the single largest direct cause of neonatal death. While teenage pregnancies are significantly lower, women are having children much later in life. In fact, the fertility rate of women in their 40’s has overtaken that of women in their 20’s. Although we older women may feel like spring chickens, our internal mechanics may suggest otherwise. It’s shocking that little focus is put on the age factor and its implications on pregnancy. On the NHS, scans are offered at approximately 12 weeks and 20 weeks. And that’s it. If you’re not feeling so good, expectant mothers are encouraged to speak to their midwife, but they’re not necessarily offered another scan because of the additional cost involved.

But surely the health of a mother and her unborn child is paramount? I was under the care of Professor Mark Johnson and his approach to ensuring all three of my children’s wellbeing was brilliant. Ongoing research into understanding the reasons behind premature birth are critical and will inevitably help reduce the burden on our healthcare system not only in the UK but worldwide. Collaboration is crucial, after all, why should midwives and obstetricians be at loggerheads? The health of the baby and mother should be at the centre; there should never be a territorial battle over who does what. What should matter is to listen to an expectant mother and to treat her concerns seriously.

My last pregnancy wasn’t so smooth. My baby was small. I had gestational diabetes. I had a chest infection which lasted four weeks. Generally, I was feeling lousy – far worse than during my other two pregnancies. In my 35th week, I had some more blood tests. They highlighted an elevated liver function. I had this test done every other day and the results pointed to Obstetric Cholestasis, a liver disorder that occurs in around one in 140 pregnancies in the UK. It’s a condition where the normal flow of bile out of the liver is reduced. Chemicals in the bile called bile salts can then build up and ‘leak’ into the bloodstream. This causes affected women to have increased levels of bile salts in their blood. Undetected, if a baby is carried to term there’s a risk of stillbirth. As a result, my daughter was delivered at 37 weeks. Thankfully, she was fine. I, however, developed post-partum pre-eclampsia ten days after she was born. While I was pregnant, I never showed any symptoms and, for that matter, I had no idea you could get it post birth. Luckily, it was spotted. I was re-admitted into hospital and given the necessary treatment.

But here’s the rub: the care I received during and after my pregnancy was all done privately. The tests and additional ultrasound scans I had are not necessarily routine on the NHS. If we all agree that ensuring a healthy pregnancy and birth (and aftercare) are critical and would reduce the cost and burden on our health service, then shouldn’t every mother be entitled to the same care irrespective of whether they go privately or through the NHS?

I support Borne not only because of Mark Johnson and his team’s dedication to finding ways to understand and prevent premature birth, but also because their work will have a direct impact on society as a whole. That, actually, is something to shout about.

Amna Boheim – award winning author of The Silent Children





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