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!

3 Mar 2015

Child Murder

Murder is the worst crime. It violently takes away life, often for little motive further than greed or perversion. It ruins countless other lives. When a child is murdered, these feelings are amplified by the loss of innocence, of potential, and the empathy for the fear the child would have felt. You would think, from reading the press, that all our children are at a constant risk of murder. You might be wrong.

Sometimes I think I'm the only person in the world that doesn't worry about my children being murdered when other children are murdered. Maybe it's because of the sheer statistical unlikelihood. About 300 children die through murder, neglect or indirect abuse a year, out of a child population of around 11 million. That is too small a number to be given as a percentage.

Maybe it's because my kids are still very young and almost always in my care. And boys, who are less well represented in the media when murdered unless it's either salacious or A SIGN OF BROKEN BRITAIN. But my youngest sister is 13, and regularly goes out on her own. I can't say I worry she'll be horribly murdered too often either.

Maybe it's because I've never been murdered myself. I've been assaulted a few times. I've lived on the same street as a child who was brutally attacked by a stranger in her house. I lived in Wisbech, murder capital of the fens, for several years. I live close to female serial killer Joanna Dennehy's stamping ground, but she seemed to prefer killing men, as well as close to where poor Ross Parker was randomly murdered by racist animals.
To be honest, if I have any worries about being murdered myself, it's usually as an adjunct to a serious sexual assault rather than as a spontaneous, single crime.

Maybe it's because I'm an unfeeling monster who doesn't care about other people.

Or maybe it's because I'm cynical of the press.
Most children are murdered by their family - usually by their parents. I don't fear I'm going to murder my children. I don't fear my children's father will murder them either, or in fact, any of their family. However, parents murdering their children is so common (at least three quarters of the total, if not more, there is no definitive statistical information at present) that the national media rarely report it. Even the infamous case of 'Baby P' Peter Connolley wasn't reported in the national press until he'd been dead a year, and only then because of the social services failings around his death. Honour killings (as they're rather genteely named) are well represented in the press, but more because of underlying Islamophobia than because the press genuinely cares about children murdered by parents. It's boring. It happens every week. It's not news, unless there's some perverted sexual aspect the press can report in horrified, gleeful detail.

HOWEVER, when a child goes missing, that's a different case altogether. Think back just in the few months. Alice Gross, missing, murdered, dismembered by a man who then selfishly killed himself rather than face arrest. Zaani Bevan, killed in a murder-suicide by her mother. And now, also in Bristol, it seems poor Becky Watts' body parts have been found after being missing for a few weeks.

Going back a few years: April Jones was abducted and murdered by a neighbour. Her body has never been found. Sarah Payne, abducted and murdered by a paedophile outside her house. Madeline McCann went missing on holiday in suspicious circumstances and has never been found. Holly Wells and Jessica Chapman, abducted and murdered by their school caretaker one weekend. Milly Dowler was abducted and murdered by a serial killer. Billie-Jo Jackson, going a bit further back, was murdered in her own garden and the killer has never been found. These are not the only ten girls to be murdered in the last eighteen years - far from it - but they are the poster children of violent crime. They are representative of the fears you have for your children when they step out of the front door to play. The monster lurking by the playground. The terror waiting by your back gate.

You'll note all of these victims are young. They're all female. They're all middle-class (with the possible exception of Zaani Bevan, who the press has now forgotten). They're all white. There is an actual name for this overreporting: Missing White Women Syndrome. It's in no way representative of the actual risks presented to your children.

The biggest killer of children in the UK is cancer. Not a lot you can do about that: you either get it or you don't. This is followed by accidental death, mainly through road accidents. 91 people are involved in traffic accidents every single day, resulting in death or injury. Sometimes, the press reports these, but only if they're really interesting. There are some interesting pie charts showing the change of cause of death by age of child in this report.

In short, you might be better off investing in cancer research, or teaching your children road safety from a very young age than worrying about the near-mythic creature, the killer lurking in the midst.

2 Mar 2015

Studying with the OU when pregnant

I'm a little over halfway through my fifth and sixth uni modules. It's going quite well, and I'm astonished that this is my penultimate year. I started 37 months ago!
I'm also halfway through my third pregnancy.

Pregnancy has given uni work a new dimension of difficulty that I didn't expect:

 - It is much, much harder to not procrastinate. I have lost all self-discipline. If I want to sit and watch two hours of Extreme Makeover: Home Edition and wail, then I do. I'm not particularly behind, but I do struggle to juggle it all.

- It is harder to remember everything. Baby brain is, unhappily, not a total myth. Some days I'm fine. Some days, I'm wading through mental custard.

- Pregnancy is not an illness. Alas, it causes me to be rather ill. Several months of morning all-day sickness, a wonky hip, sciatica, SPD, anaemia, and sheer exhaustion has somewhat knocked me for six. All these things are either resolving or in line for treatment, so hopefully I should feel better soon, but I recommend you aim for your first trimester to be in the summer break!

- My working habits have altered. Before, I got all my work done in the morning when I was full of the joys of spring. Now, I'm fairly useless first thing in the morning, and completely useless mid-afternoon. I have to work round it.

Despite all this, I'm doing OK. I actually got a pass one in my first level 3 TMA - my first ever pass one in an essay-based subject. I've dropped off a bit since then, but I'm hoping for a pass two overall. TMA writing is hard, because I feel woolly a lot of the time - not to mention stressed! It's so hard to remember everything and write something incisive.
The real challenge will be that I don't finish this year until I'm 36 weeks pregnant. I've got an EMA, which should be OK because I can put that together over time. It's the exam that worries me. Not so much from a "WHAT IF I GO INTO LABOUR???!!?!?" perspective, because that's unlikely. It's more about the sitting-uncomfortably-for-three-hours. BUT I WILL COPE!

Then I get my results around when the baby's due, when they'll have become a distant memory in a haze of sleepless feeds. So, hurrah!