Showing posts with label pregnancy. Show all posts
Showing posts with label pregnancy. Show all posts

Thursday, 12 June 2014

Thoughts on a Miscarriage

When I was 19, I discovered I was pregnant. It was far from ideal. I was young and I was a penniless student. The father of the baby was someone I had fancied for a very long time, but he was not a good man. He was a liar and a cheat. He and his girlfriend were in an on/off relationship, and he frequently cheated on her. He cheated on her with me. Whilst I fancied him, at that time, I suddenly realised he could not be the father of my baby - he was nowhere near ready emotionally. In all honesty, I did not want to be a mum. Whilst I had always been against abortion, I did seriously consider it as an option. Fortunately, the decision was taken out of my hands.

One morning, about three days later whilst visiting a home for homeless young mothers, I started bleeding. I bled on to the chair I was sitting on and the manager of the home pointed it out to me. I was so embarrassed. I cleaned myself up, got in my car and drove home. I retreated to my bedroom for the next couple of days. I bled heavily, passed large clots and had the worst cramps I had ever experienced. I phoned my mentor and told her I wouldn't be in. I said I had come down with a terrible cold.

After about two days, I began to feel better. The bleeding, whilst still heavy, was settling down and the cramps were improving. I don't know what my mum thought: I had told her I had a terrible cold, but she could see I wasn't like I normally am with a cold. She has never asked me about it. I saw the man that evening when I went out. I just acted like normal around him. I felt only relief that I was not still carrying his baby.

I returned to placement that Monday, just five days after the bleeding started. I was a student nurse at the time and was out with the health visitor. I was surrounded by babies and young children, and yet this didn't bother me. In fact, the only thing which I was concerned about was bleeding and leaving a mark on someone's couch.

A year later, I had a placement on a gynaecological ward. I struggled to understand how people were so emotional when they miscarried. For me, at that time, the miscarriage was a blessing. And yet, there I was trying to support women who were going through a miscarriage or a threatened miscarriage. I struggled to understand their grief. The only thing which hit me was the fact that I never sought help of any kind when I was miscarrying; in fact, no one knew I was pregnant. And yet, there were a number of women who had been admitted for an evacuation of retained products of conception ( a D&C, as it is more commonly known) due to the risk of leaving the products within the uterus. I had even used tampons to control the blood loss! I realised how dangerous that was during this placement.

About a year after my placement, I thought I was pregnant again. Whilst that pregnancy would not have been planned, and again, I would have been single, I had almost finished university and was more emotionally ready to handle a pregnancy and becoming a mother. I felt guilty about the fact I never mourned the first pregnancy, and felt repulsed at my callousness regarding it. A pregnancy test, however, quickly ruled out that I was not pregnant.

To this day, no one knows of that pregnancy. But whenever I think about it, I felt guilt and sadness at the fact that the pregnancy, which was unwanted, turned out in such an awful way. Even now, that miscarriage brings tears to my eyes.

Saturday, 31 May 2014

Pregnancy Dos and Don'ts

Pregnancy can be a scary time for many women. The advice changes frequently, and whilst well-meaning, the advice given by women of older generations might not be thought of as current practice today. It is therefore imperative that women know what current guidelines and research recommends they do or do not do throughout pregnancy

Pre-pregnancy

Before a woman becomes pregnant, she should ensure she and her body are well prepared to cope with the changes she will experience over the next nine months. However, over half the babies born in the UK are not planned pregnancies and therefore women may not have prepared their body for the demands of pregnancy. Folic acid is an important B vitamin which can significantly reduce the risk of a woman having a baby with a neural tube defect, such as spina bifida. Ideally, women should start taking 400mcg per day at least twelve weeks before she plans to become pregnant, and until she is twelve weeks pregnant. The neural tube develops very early in pregnancy. Some women (such as diabetics, epileptics who those who have a family history of neural tube defects) may require higher doses of folic acid, which need to be obtained on prescription. Folic acid, at 400mcg, is available over the counter. Women should also ensure that they are as healthy as possible before they become pregnant.

Weight is an important issue, with women at either end of the spectrum at increased risk of pregnancy complications. Whilst this does not mean women who are underweight or who are obese will have these pregnancy complications, it does increase the risk that they will happen. These complications include pre-term labour, intra-uterine growth restriction (a baby which hasn't grown well and is much smaller than it should be - this increases the risk of stillbirth and complications for the baby following delivery), microsomal baby (a baby much larger than it should be), maternal health complications, such as gestation hypertension (raised blood pressure not associated with the other symptoms of pre-eclampsia, pre-eclampsia and gestational hypertension, and stillbirth.

Women should also give up smoking in the pre-conception period. smoking throughout pregnancy increases the risk of intra-uterine growth restriction, pre-term labour and stillbirth.

Pregnancy
No specific additional calories are required until the third trimester, and even then, it is only an additional 200 calories per day which are required. Dietary advice has changed considerably over the last generation. It also varies widely throughout the world, often with advice from the USA different to over here in the UK. This advice is based on UK recommendations. Once encouraged, liver is now something women are advised to avoid due to the high levels of Vitamin A found within it. The quantity of Vitamin A varies widely within liver, and the safe level of Vitamin A consumption during pregnancy has been greatly debated. The safety of consuming liver during pregnancy is, therefore, not known. All other meat should be thoroughly cooked to prevent infection with toxoplasmosis. Pre-packed meat, such as ham, is considered safe to eat in the UK.

Eggs are something pregnant women worry about. In the UK, women should buy eggs which display the Lion mark. To avoid the risk of salmonella, eggs should be well cooked, and homemade products which use raw eggs should be avoided. Factory produced products which contain raw eggs, such as mayonnaise, are pasteurised. If they are pasteurised, they are safe to eat.

Consuming certain cheese can cause an infection called listeriosis, which can be fatal to an unborn baby. Soft cheeses with white rinds and mouldy cheeses should only be eaten if they have been thoroughly cooked. All other cheese are safe to eat. Likewise, pasteurised milk, or boiled unpasteurised cow's milk is safe to consume. Yogurts and ice cream are also safe, including soft ice cream which has been pasteurised.

Certain types of fish are high in mercury, which can be damaging to an unborn baby. Fresh tuna should be limited to two portions per week or a maximum of four medium sized tins of tuna. Shark, marlin and swordfish are also high in mercury and should be avoided. Up to two portions of oily fish (and fresh tuna counts as oily fish) may be eaten per week. Smoked fish, such as smoked salmon, is considered safe to eat, and sushi may be eaten providing it has been frozen. Shellfish should be thoroughly cooked prior to eating.

Unless the woman has an allergy to peanuts, peanuts are safe to eat in pregnancy. Pate of all kinds, including vegetarian pate, should be avoided. Food hygiene is important during pregnancy. Fruit and vegetables should be washed thoroughly, and all soil removed to reduced the risk of toxoplasmosis.

No safe limit for alcohol consumption on pregnancy has been established. Therefore, the current advice is to avoid alcohol completely. One to two units once or twice a week are possibly safe although there is no conclusive research, and it is therefore best to avoid it.

Caffeine may be consumed up to 200mg per day. Whilst coffee provides high sources of caffeine, it is also present in tea, coke and chocolate.

Smoking has been linked to a number of complications of pregnancy, including preterm labour, low birth weight and an increased risk of stillbirth. Women should be offered the option of a referral to smoking cessation services, and, if needed, certain nicotine replacement therapies can be used, and are available on prescription.

Exercise during pregnancy should be encouraged. Women should continue their normal exercise regime as long as they want to and feel comfortable doing so. However, they need to be aware of changes to their body which could affect balance and the risk of injuries. They should not try and reach peak fitness levels during pregnancy. There is some research which suggests that babies of mums who exercise during pregnancy are better able to cope with labour. Pelvic floor exercises should be commenced and continued during pregnancy. The pelvic floor cannot be too tough, and a strong pelvic floor will help with labour and will recover better after labour.

Perineal massage can also be beneficial. This involves using sweet almond oil and gently massing and stretching the perineum (the area between the vagina and anus). This will reduce the risk of tears during labour. It can be quite uncomfortable at first, but many women find it more acceptable than a tear or an episiotomy (cut).

During pregnancy, sex is generally safe, although at the end of pregnancy, it may cause Brakton Hick's (false contractions). However, some women may be advised to avoid sex, including women who have had heavy bleeding during pregnancy and women whose membranes (waters) have gone. Women's sex drive may change during pregnancy, or they might wish to try new positions.

Flying is safe, but may require a doctor or midwife's note in the final trimester. Remember, however, that women are at increased risk of DVTs and PEs (blood clots) when pregnant anyway, and flying, due to the enforced period of reduced mobility, further increases the risk. Women should keep hydrated and mobilise as much as possible. Women should check with the airline before booking a flight, particularly in the third trimester, as different airlines have different rules concerning the latest gestation they will allow women to fly and from what gestation they require a doctor or midwife's note.

Pregnant or newly delivered livestock can carry infections, particularly sheep. These infections include chlamydiosis, Q fever, toxoplasmosis and listeriosis. These all may cause infection in the mother and miscarriage or stillbirth of the baby. Women are therefore advised to avoid lambing, calving or kidding and to not have any contact with aborted lambs. Clothing should be washed separately to normal clothing. A primary infection with toxoplasmosis during pregnancy, or immediately before, can have an impact on the pregnancy and the baby. Cats are one source of toxoplasmosis, and so women are advised to avoid changing cat litter, or should wear gloves when doing so. Women should also wear gloves when gardening during pregnancy due to the risk of the soil having been contaminated with cat faeces. Tests are available for most infections to confirm whether the woman has already been infected. However, these are not routinely offered to women in the UK. Women in high risk groups, such as those who keep sheep, may wish to discuss the possibility of screening early in pregnancy with their midwife.

Whilst pregnancy may appear to come with a long list of dos and don'ts, and it can at first appear a little overwhelming with conflicting advice coming from all directions, women should talk to their midwife or doctor if they have any concerns. There will usually be information available in their handheld records. Advice should be obtained from reputable sources, such as the NHS website to ensure the advice is current, up-to-date and evidence based.

Book Review - The Two Week Wait

Plot Summary
The Two Week Wait by Sarah Rayner is a novel about two women desperate to become mothers. Following a health scare, Lou wants nothing more than to become a mother. Her girlfriend has other ideas, and so they split up. Lou is unable to afford to pay for treatment herself, and is unwilling to join the NHS waiting list. She therefore contacts an old friend, who is prepared to go through the treatment with her and to be the father of the conceived child. Coincidentally, he already has frozen sperm stored, and therefore they do not have to wait six months to ensure they sperm is free from transmissible diseases.

At the same time, Cath is desperate to try IVF. She and her husband have been struggling with infertility for a while. They have now decided to use an egg donor, and are matched with Lou. This means that they also pay for Lou's IVF, thereby allowing her to afford the treatment, but meaning they take half the collected eggs.

Review

I found this book immensely interesting. This may simply be because I can identify with the two women in their need to become a mother. The characters seemed real, and the book discussed the struggles they all go through. Despite the fact that this book is a sequel to Rayner's first book, One Moment, One Day, I had not read the first book (being instead drawn to the title of this book on the shop shelf due to my own personal circumstances) and do not feel as though I was joining the story part way through.

The writing was good, the research had been done and as a consequence, the book was enjoyable. Definitely a book I would recommend.

Thursday, 10 April 2014

What Actually Happens in Labour?

After my long stint on labour ward for my placement, I have decided to write about what really happens in labour. The media shows unnatural labours. Soaps and movies have women believe labour will entail her waters popping and going everywhere, a pain, a push and a baby. Shows such as One Born Every Minute obviously want to show the most exciting births. But normally, labour is not like that.

Check out the article I have written about what really happens in labour. Let me know what you think!

Wednesday, 9 April 2014

What do babies really need?

What should parents really buy for a newborn? In view of a post I wrote a little while back, this is an article I wrote on Helium about what newborns really need. Check it out and let me know what you think

Friday, 4 April 2014

Not Having Children

Not Having Children is an article I have written about how I feel being a childless woman. Sometimes, being childless affects me more than other times. Reading through this article, I was particularly affected at the time.

Let me know what you think about it.

Sunday, 26 January 2014

Making Plans

Wow! It's been ages since I've posted on here! Please forgive me.

So, I'm planning on starting trying for a baby this year. It is both really exciting and so, so scary. I've spent the last couple of months busily trying to find as much information as I can about it all.

I had started out thinking I would go down the 'home insemination' route in a hotel room in a city called Aarhus in Denmark. They offered just what I wanted - anonymity. I could use an anonymous donor and they wouldn't know anything about me, either. I could do it all in the privacy of my own room (in the hotel). There were a few problems with this, the main being getting to Aarhus was either very expensive or very long. There are no direct flights there from local to me, meaning I would have to catch a connection in Copenhagen. Secondly, I have irregular cycles, so it would be quite difficult to plan.

So, I then started looking at other options. The first I found was a small practice, again in Aarhus (I think), which was run by midwives and which offered insemination. It seemed a lovely place, from the website, and I emailed them and they do treat a lot of British women. However, there were the same issues there, really.

So is started looking in to alternatives to that. Copenhagen itself has a number of fertility centres. Only I don't think you can go in and just buy sperm. So that got me thinking. What with my irregular cycles, it would probably be better to have the whole process medicalised to some extent. I haven't spoken to the clinic yet - I'm still a few months off trying yet - but I think IVF would probably be the route I would need to go down. and compared to over here, it actually seems relatively inexpensive.

So, I'm going to contact the clinic but have spent some of today coming up with questions I would need to ask them. Here is my list so far:

1-I'm aware of the need for close monitoring (USS, bloods etc). How do most of your women from overseas do this? Is it possible to get some of the monitoring done at a provide health centre in the UK? Will this be covered by the fees I pay you?
2-Will there always be someone involved in my care who speaks English and who is able to let me know what is going on? Will forms and literature be available in English for me? What about if I telephone?
3-How do I obtain medication? Will I need to get it in Denmark, or will you provide me with a script so I can get the medication back in the UK? Will there be any problems taking the medication on the aeroplane? Please explain the side effects of the medication and the regime. I understand some of the medications will be dependent on scan and blood results, will the new regime be available over the phone/email from you even if I have monitoring done in the UK?
4-What will the total cost be per cycle? Excluding medications, are the prices I see on your website what you will charge me? How much does the medication cost? Are there any ways I can bring down the cost?
5-How many women do you treat annually? What is the success rate, per cycle, of women delivering a live infant? How many cycles, on average, do women take to conceive a live infant?
6-At the time of embryo transfer, how many embryos will be transferred back to my uterus?

So that is all the questions I can think of at the moment, but will post more if I come up with them. If you have any other questions I should ask, please let me know.

Monday, 23 April 2012

Artificial Insemination

OK, following on from my post about being desperate for a baby, I have been doing some research.

Actually, I had started doing the research about a year ago. About a year ago, I also came to the conclusion that, in the UK, artificial insemination is very, very expensive. How could I afford to pay these fees and raise a baby? There are a huge number of other problems, too, which I encountered. Namely, since the change in the anonymity laws a few years ago (2005, I believe), there has been a huge reduction in the number of sperm donors, and more importantly, in the amount of sperm available.

From my research, there is only the opportunity to have artificial insemination in clinics in the UK. These clinics, and I'm not yet sure of my position on this, have the say on whether or not they treat a single woman. I understand that, as health professionals, they are responsible for their actions and omissions, and if inseminate someone who turns out to abuse or neglect that child, I suppose they, technically, could be held accountable for that.

However, people choosing to have a baby the conventional way have to seek no approval whatsoever. When the mother-to-be presents to the midwife, or the GP, they do not have to prove that they are going to be good parents.

Another thing with which I am not too comfortable, is the HEFA registration. I understand fully that there is a risk, a small risk, of that child unbeknown to them, meeting and falling in love with a half-sibling. However, getting pregnant with a one night stand may also pose the same risk, greater perhaps, as the semen could be ordered from anywhere in the country; a one night stand is likely to be had nearer to home.

Also, with the child having the right to know who their birth father is when they are 18 years old, or younger of getting married, I believe, what does HEFA do? Do they send a letter out on the child's 18th birthday? Or do they let the child contact them? What if it was never the right time to tell the child? What if the child was never in the right situation to process such information?

Having thoroughly thought all this through, I have decided that using a UK fertility clinic over here is not the right route for me.

There is at least one website on the internet which matches people up; men who are willing to donate and women wishing to receive sperm. In theory, this is great. It matches those in need with men of altruistic nature. However, there is no sort of screening. I know I mentioned considering a one night stand, but I don't think it is something I would be able to go through with. I just wouldn't feel comfortable using this service.

So, I have found an alternative. Denmark still allows anonymous donation of sperm. A huge proportion of their customers come from overseas, including the UK. And they provide sperm for self artificially inseminating. I mean, this is great. They ship to the UK. The sperm itself costs a minimal amount, the delivery is the major cost. They advise the use of two straws (I assume these are the equivalent of vials) per insemination. Now, if the delivery charge is like ordering from an online store, and the delivery charge is per order, rather than per item, then this is affordable. If, however, the delivery charge is per item, then it will be cheaper to fly to Denmark and self artificially inseminate in a hotel over there. I am, however, awaiting a response.

This is something I can definitely see myself doing. However (and this may be too much information) but my periods are a bit all over the place. I think the reason, or the main reason for this, may be because I have a few stone to lose. I have decided that I will lose this over the next six to nine months, and then go ahead with my plan.