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Archive for the ‘pregnancy’ Category

Accessing fertility treatment on the NHS is a question of ticking the right boxes.  We haven’t been able to have a second child, despite trying for the last three years.  I have had to go through undignified testing, including a laparoctomy and I have been diagnosed with ‘unexplained infertility’ which effects around 10% of couples who have been trying for a baby for more than a year.  The recommended action for this is In Vitro Fertilisation (IVF), only I’m not entitled to funding for this because we already have a child together. 

NHS resources are finite, and I’m not complaining that we’re not entitled.  It is disappointing, and it’s hard to decide whether to pay for private treatment.  It costs around £5,000 with a 1 in 3 chance of success.  Should we spend this on trying to give our daughter a brother or sister, or should we keep hold of the money to make sure she is financially secure in later life?  Of course, we are extremely fortunate to be able to make this choice – £5,000  is out of the range of many couples I know.

What is horrifying though is how eligibility criteria varies throughout the country.  Tory MP Grant Shapps has 3 children thanks to IVF and he contacted every single PCT in the country in June last year to find out their policy.  He found that two PCTs were refusing to offer IVF at all. 80% of PCTs aren’t providing the three IVF cycles set out in NICE guidance in 2004.

Shapps found that in one area, a woman would be too young to be considered, and in others the same woman would be too old.   For instance, in Lincolnshire, IVF is funded if the mother is aged under 35, in Hampshire and the Isle of Wight, it is only funded to women aged over 36 (despite the fact that IVF is significantly less effective each year after a woman turns 35).  In Wiltshire, there was a very narrow window for having fertility problems – you had to be aged 31-35 to be offered assistance.

More than half of trusts wouldn’t fund IVF to people who had previously had treatment and 1 in 6 wouldn’t offer it to people who’d had privately funded IVF before.  These inconsistencies mean that as well as the added trauma of not being able to plan your family in the way you assume you will, you are also at the mercy of rules seemingly made up at random with no medical thought put into them.  The full report is available here  if you want to read up further.

This isn’t the first time we’ve experienced fertility woes. When my husband and I first decided to have a family, I assumed I’d be pregnant within a couple of months.  All the other women in my family had got pregnant straight away – sometimes without meaning to – and I’d never had any reason to suspect I’d be any different. You could set your calendar by my periods and I was starting reasonably young, at 28.

I did get pregnant quite quickly, but sadly lost the pregnancy at nine weeks.  I was still optimistic, I read all about miscarriage and I knew that first pregnancies carried a higher risk of miscarriage than subsequent pregnancies. As four more early miscarriages followed, each taking their own emotional toll, I tried to ignore that the chances of never having a baby were increasing.  I eventually went to my GP and was referred to a miscarriage specialist.  I was so lucky, he was an amazing man.  Unlike many of the consultants I read about on fertility forums, he had a genuine interest in keeping pregnancies going and didn’t just fob me off to try again.

After a battery of tests, he deduced that the likeliest reason for my pregnancies failing was that the placenta didn’t form properly and needed drugs to improve the conditions.  When I got pregnant again, I was closely monitored and with the help of progesterone and heparin I gave birth to a beautiful baby girl exactly three years after I first started trying and two weeks shy of my husband’s 40th birthday.  Nothing prepared me for the joy of watching her sleeping face and the feel of her skin against mine.

I was so lucky to live near to a leading fertility hospital and that my PCT paid for this.  I have no doubt that without this help I would have gone on to have further miscarriages and it’s very possible that my little girl wouldn’t be sitting next to me now eating her breakfast.

I have heard it said, in real life and reading the comments on the bottom of newspaper articles, that fertility treatment shouldn’t be funded by the NHS at all.  Leaving aside the moral question of whether children are a right or a privilege, the emotional impact of infertility can not and should not be underestimated.

I grew up in a big family and pictured myself as the mother of a big brood; laughing and joking on days out, serving long breakfasts at the weekends and my husband and I holding hands and watching proudly as our children left home and it was extremely difficult to come to terms with none of this happening. Looking to a future with no children seemed so bleak.

Comments from friends and relatives that couples with no children had the happiest marriages, that God would give us a child when the time was right and that if all else failed we could always adopt, were really not helpful, no matter how good the intention behind them.

It was after the last miscarriage that things got very dark.  I’m sure it was partly hormones, I was bursting into tears all the time, I lost interest in a job I’d previously enjoyed and had all the guilt that entailed, I couldn’t hear about anyone else getting pregnant without thinking ‘What about mmmmmmmeeeeeeeeeeeeeeee?’ .  I know from talking to other couples with fertility problems that I am not the only one who begged her partner to leave her so he could have children with someone else.

In fact, it’s only recently that I was able to tell my husband that during a mad moment, I considered throwing myself in front of the train I was waiting for on the way to work.  It wasn’t thinking about him or my family that stopped me doing it either, it was the fact the train was coming in too slowly and I didn’t think it would kill me.  At that moment life seemed so futile and I seemed so pointless.

I think it’s irrelevant that in the past people have had to get on with it if they couldn’t have children.  We have made medical advances that mean that no one should have to feel like I did.  If you can’t offer IVF to every childless couple, at least make the system fair!

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Back in 2007, the Department of Health published a report entitled “Maternity Matters”. This document included the explicit guarantee that by the end of 2009, all pregnant women (medical needs permitting) would be able choose whether to give birth in either a consultant-led unit, a midwife-led unit or at home. This was welcomed enthusiastically by midwifery and childbirth organisations, but was it realistic or just pie-in-the -sky? Health Secretary Alan Johnson pledged an extra £330 million of funding to achieve the goal, but within a few months maternity units started to complain that the Primary Care Trusts were not passing on the cash. The Royal College of Midwifes (RCM) claimed that units were dangerously short-staffed already, unable to afford to hire the 5000 more midwives needed to even come close to implementing Maternity Matters. They estimated that at least 2 more years would be needed. The National Childbirth Trust (NCT) agreed, stating that “They will struggle enormously to fulfil these pledges.” So, now we’re into 2010. The deadline has passed. Amazingly, the Government is insisting that 95-99% of Primary Care Trusts have achieved their goals, so we must be living in a golden age of maternal choice. How can this be? According to the NCT, only 60% of women actually live near enough to a midwife-led birth centre for it to be a realistic option. And the ongoing massive staff shortages mean that such centres are often closed on a short-term or even a long-term basis. As for home births, well… The overall rate for England is less than 3%. The NCT believes that it would be over 5% if women genuinely could choose. I hear, over and over, stories from women who desperately want a home birth but are denied it, for spurious “medical” reasons, because midwives are not properly trained and therefore not confident, or again, simply not enough staff to go round. Until this Government or the next one puts a substantial amount of money into meeting these wonderful-sounding promises, many many women are going to end up in consultant-led units, when they would have preferred otherwise. Will this be a good experience for them? Will they get the births they hoped for? Watch the new fly-on-the -wall documentary “One Born Every Minute” (Channel 4) and see what you think.

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Did you know this week is Contraceptive Awareness Week?

“If you are over 35, ovulating, having regular periods, unprotected sex and you know you or your partner is not clinically infertile, every month there’s a chance you’ll get pregnant.”

A salutory tale currently being told by the Family Planning Association in it’s campaign Conceivable.

Apparently the number of unplanned pregnancies and abortions is on the rise in the over forties age group. And this is felt to be due to an ignorance in this age group about fertility.

I’m not an ignorant one – I know a heck of a lot about infertility, having been treated for it and had two children whilst in my 30’s using the then most sophisticated form of IVF. I’m the type to have researched very thoroughly before taking a course of action.

So how come exactly 2 years ago I found myself having a myriad of blood tests via my GP and was on my knees with something that just would not go away? I mentioned my period had disappeared and this was enough for a good look at the possibility of early menopause. I was pleased really – like many women, getting rid of this monthly curse would be bloody great quite honestly. Except my friend burst my bubble back at home after the doctors appointment by saying: have you actually done a test? No – not with my history (she knew it) and having had unprotected sex for 12 years and not one pg as a result!

You know where this is going. The conclusion to this is sitting right next to me now with a sniffly cold – we’re playing Russian roulette with the keys! He’s gorgeous, my little gift for my 42nd birthday. But he has turned my world upside down. None moreso than the first trimester of his pg. I felt I was losing my mind. I can see how the abortion rate in these circumstances is so high!

I applaud this campaign actually. I spent my teenage and university years terrified of an unplanned pg. My twenties grappling with gyny problems that were a blight on my life. My thirties on a roller coaster of treatment whilst struggling to keep some perspective. I didn’t expect to have slipped right back to the beginning again in my forties. But I should have. And so should you.

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I felt sickened when I heard about the ordeal experienced by Victoria Anderson at the hands of Susan Rose, an Independent Midwife who cared for her during her pregnancy and home birth. A mismanaged pregnancy and birth led to not only health problems for the mother but a life long physical disability for her child.

Sadly the media and commentators have used this case to vilify the practice of homebirth with glib declarations that homebirth is unsafe. Jeremy Vine on his radio show posed the question whether homebirths should be banned and concluded that they were indeed unsafe. That it was the individual midwife who was dangerous, not the practice of homebirth itself, seems to be a concept too tricky to understand. An anecdote has led to sweeping generalisations. The fact is that studies have shown that homebirth is as safe, or safer than hospital birth for low risk women. When a hospital delivery goes wrong due to negligence, incompetence or staff shortages, no-one decrees hospitals to be an unsafe place to birth a child. Yet when a home birth goes wrong there is much wringing of hands and mutterings that a home is not a suitable place for a child to be born. If a hospital birth goes wrong there is sympathy for the mother, if the same happens at home she is often blamed for being selfish or misguided.

I write this not as an ardent pro-homebirther. In fact my children were all born in hospital, in a variety of modes. I have welcomed the numbing bliss of the epidural in equal measure to the euphoria of a drug free birth. Whilst I know homebirth is safe it just wasn’t a personal option for me. I write this weary of the incorrect, alarmist tone the media seems to take today whether it be because they are too lazy to research an informed opinions or in their strive for sensationalist headlines and snappy soundbites. Contrary to what the media would have you believe, this story isn’t about the unsafe practice of homebirth but the unsafe practises of this particular midwife. In fact if you read the story carefully the error was in her antenatal care where gestational diabetes was undetected and this triggered the cascade of events leading to this tragedy.

For many women homebirth is a reasonable option; scaremongering and incorrect reporting and distorted emphasis should not set the tone. If I was a mother trying to decide where to give birth to my child reading some of the commentary of this case would scare me witless. The tragedy of this case is not just the physical and emotional damage inflicted upon this mother and her baby but that scaremongering and sloppy journalism may also damage the concept of homebirth per se, a choice which for the majority of women is a safe and valid option.

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8 boys wanting a girl

Last night I watched “8 boys wanting a girl”, as a mum of 3 boys followed by a girl I thought perhaps the programme might carry thoughts I would resonate with and it did, but very few. How can any mother knowingly destroy perfectly healthy male embryos just because they aren’t female? I found this even harder to bear knowing she had four beautiful boys already, knowing that those 5 unwanted male embryos could have turned into wonderful, individual little beings – just like her sons, just like my sons, if given a chance. What is so different here to terminating a pregnancy at 12 weeks because the foetus is male? it all leaves a very sour taste in my mouth.

Then there was the mum of four boys pregnant with her fifth baby after attempting naturally. This lady I did feel empathy for. Growing up I had always presumed I would have a little girl. I am an only child and had a very close relationship with my mother, I always assumed I would have that bond with my own daughter one day, an assumption that was fuelled by the loss of my mother when I was only 21. I was and am still, very feminine and as a child adored playing with dolls – all female (my favourite I name Jennifer). Of course I would have a girl someday. I had spent years rehearsing for her arrival.

When that “someday” came I went mad and purchased a bag full of girl’s clothing, I truly hadn’t even considered the fact I might have a boy. At 20wks we asked at our ultrasound. “It’s a boy”. “”what did you say?”, I didn’t think I had heard correctly. Sure enough, there he was, my son, in all his full spread eagle turtle glory. I didn’t feel sad, more shocked – this wasn’t the plan! where was my baby Jennifer? what would I do with a BOY?! 22wks later he arrived and it was love at first sight. The only time my heart twanged for Jennifer was when the latest Mini Boden catalogue landed on my doormat. Boy’s clothing is so unattractive. I lusted after stripey tights and Mary Janes.

16 months later my second bundle arrived, another boy, just as gorgeous as the first and that’s when the comments started, mostly from friends and family with new “pigeon pair” families, they thought they were clever for having “one of each” and commented “I’ll bet you’ll go for a third, we’re stopping at two now we have the perfect family, a boy and a girl” with a gloating smile.

We did indeed try to conceive again – we always planned a large family. I have to confess to a brief dalliance with Chinese lunar calendars and reading up on the Shettles method. I spent a good proportion of my third pregnancy daydreaming of a perfect pink Cath Kidston nursery only my daydream baby turned out to have testicles, the first thing I touched after “catching” my son underwater with my own hands after the most beautiful home waterbirth. I spent the next few days on a high in babymoon bliss, head over heels in love with my new blue bundle and then the comments started in earnest, cards arrived with “better luck next time” “another boy – wow so much testosterone, poor you”. My new son received hardly any gifts, being another boy he didn’t seem worthy I guess. My elderly aunt even commented when I was pregnant “if you have a girl I’ll buy her a pretty dress”, baby boy number 3 arrived and she didn’t even send a card.

Now, for those of you reading who have less than three of the same gender you really have no idea what it is like to be on the constant receiving end of sympathy from strangers, the constant implication that your all blue team is inferior to a mixed, perfectly blended one. I defy any mother in this situation to not develop a twinge, a tug on her heartstrings when you hear of yet another “perfect pigeon pair” new baby arriving. Whilst I cannot and do not agree with PGD or the extreme feelings I saw in this documentary I will defy any of you with less than three of a kind to comment negatively having never walked in the shoes of a single gender mum. For some reason there seems to be a gulf of difference between just two of one gender and then three.

Eighteen months later we conceived our fourth child. The comments started immediately, I felt that if I did produce a fourth boy I would receive commiserations from everyone rather than congratulations. Upon learning that I was carrying a girl I decided to not share with anyone, mostly because I couldn’t handle the “well done, you must be so happy” comments I knew we would receive. Each one of those comments felt like a knock to my beautiful boys, somehow implying they weren’t good enough. I found myself fiercely protective of my boys and told the world I wanted another boy as mine were so beautiful. So when my daughter arrived – a girl after three boys, I could finally say “my daughter”. But it didn’t feel any better than saying “my son”. I much prefer to dress her in blue or yellow than pink and she hates wearing dresses. She is the biggest tomboy, loves Star Wars, Ben 10, climbing, lego, picking her nose. She is fiercely independent, will never hold my hand, doesn’t like hugs and would rather play with her brother’s action men than Barbies with me, certainly not the rose tinted mother/daughter relationship I expected or longed for when I just had boys. In years to come it is more likely to be one of my cuddly boys who takes me shopping or invites me to take a central role in their wedding preparations.

I just wish the women in the documentary could really see what they have already, how lucky they are, but maybe I am writing this with the benefit of hindsight. How must their sons feel knowing “mummy wants a girl?” or heaven forbid in years time they watch the documentary knowing they are only here because “mummy wanted one last try for a girl – I didn’t want 5 children” I wish they could give up on their dream of a girl, because that’s all it is really…..a dream…and we all know the reality is usually very different. They want the fantasy, the pink, the tutus….I don’t blame them, I did too, but that’s not the way it is and I blame society, I blame the stupid preconception held that the perfect family is “one of each”, because my perfect family is the one I have, MY children, each one of them special and unique, regardless of their x or y chromosomes. Hopefully one day the ladies on the programme will realise that too.

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Baby Brain

I couldn’t resist writing about this: the claim – – being pregnant doesn’t turn you into a forgetful loon!

Not many mums will agree with that – we all remember the fuzzy headed feeling of pregnancy, the lack of ability to remember anything. It seems to last for years for some of us! And the science seemed to support it – there is lots of research that does suggest cognitive changes happen during pregnancy. Wanting to know more, I have the good fortune to have access to the original article, which is hidden behind a paywall.

What is it then, that we are able to do despite the growing bump, according to this study? We can count backwards in threes. We can remember lists of 16 words. Even after a delay. We can substitute numbers for symbols really quickly.

These are standard psychological tests of memory and processing speed, but do they really have anything to do with what we do? And the difficulties we find when we’re pregnant? The authors acknowledge these problems – but of course the media reporting doesn’t mention it. The authors suggest that maybe there aren’t problems in memory per se – but perhaps problems are due to attention. That growing bump becomes more important, and paying the Sky bill gets forgotten not because your memory is shot, but because you don’t pay attention to it.

Now what was I saying??

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