Lisa - 2 Positive Caesarean Births (Mullingar and Rotunda Hospital), GDM on Insulin, Severe IUGR, Fetal Medicine & NICU Journey
Aidan
Aidan arrived into the world at 38 + 5 by caesarean section in Midland Regional Hospital Mullingar. I had a relatively uncomplicated pregnancy, apart from gestational diabetes. I was diagnosed with GD around 27 weeks and had to go on insulin soon after that. Towards the end of my pregnancy the GD became harder to control, and I remember being sick in the week or two before he was born.
I was scheduled for an induction on the 5th of April and told to come into hospital for 8am. I woke in the early hours of that morning with my waters breaking. I rang the hospital, and they said to get myself ready and come on in then, not to wait until my planned 8am admission. I had some mild contractions on the drive over and felt excited that I was going into labour myself without induction.
I got to hospital around 7am and was admitted and settled in. A lovely midwife spent the first hour or so with me and a doctor came to see me just before 9am. I was examined at that time, and it was determined that my waters were only partially gone, and I wasn't dilated at all really. I was not going to be going into labour anytime soon. Myself, my husband, and the team agreed to go ahead with induction as originally planned. I was still having some regular pains/contractions at this point. My induction began with prostaglandin at about 9.10am. The next pain/contraction I had after this felt different to the ones before, I felt awful, really "off" in a way I can't describe. We could hear the baby's heartbeat and as I started to feel unwell, the heartbeat slowed right down. Everything got a bit hectic then and lots of people arrived into the room. A doctor and my midwife spoke to my husband and I about the need for an emergency c section. The baby was not reacting well to the prostaglandin and needed to be born asap. I was frightened initially of needing general anaesthetic and not being awake when the baby was born. But as we made our way to theatre, we could hear his heartbeat start to come back to normal and it felt like everyone breathed a sigh of relief. The atmosphere felt less urgent and panicked and a lovely calmness came over me. I was ready to meet this baby and knew these people would get him here safely. I had an epidural and it felt like forever waiting for my husband to be allowed in. Aidan was born at 10.03am. We didn't know he was going to be a boy and I remember the excitement of my husband checking if it was a boy or girl.
My recovery was straightforward, I had a pico dressing which I think really helped my scar healing. I was surprised though how long more the procedure took after Aidan was born, that part felt very long to me. I spent 3 nights in Mullingar and was so well looked after by the midwives and nurses. One student midwife called Bianca really stands out to me for her care and kindness. When I came home, I needed blood thinning injections for 10 days and I roped my sister (who is a nurse) into doing those for me, I had enough of injections after the few months of insulin! Overall Aidans birth was a really positive experience despite the need for an emergency section.
Cara
My second pregnancy was unfortunately more complicated than my first. I had gestational diabetes and insulin again, this time from 17 weeks. A few weeks later at my anomaly scan at 22 weeks we found out that our baby was measuring very small, less than the 1st centile. We were told about the different reasons this can happen and given the option to have some testing done to determine the cause. Best case scenario for us was going to be a diagnosis of IUGR (intrauterine growth restriction). We decided to do the testing and were referred from Mullingar to the Fetal Medicine team in the Rotunda, Dublin. Within a few weeks we had our test results back and a confirmed case of severe IUGR. Although IUGR was still a worry, we were so happy and grateful that the more serious potential causes had been ruled out. I have to say here that the support I received from my friend and midwife Katie was incredible, she went above and beyond to help us navigate a scary time.
The next few months consisted of A LOT of appointments. I had growth scans weekly to track how baby was growing and told to prepare for delivery at 34/35 weeks. I knew at this stage too that I would be having this baby by c section and it would have to be in the Rotunda, as they have the NICU facilities there that this baby would need. The baby was growing week on week but never getting above 0.4 centile. It was explained to me that a tiny baby like this would not like the stress of an induction or long labour and we felt the safest option for us was a section. At 34 weeks I went in for my usual growth scan and this time I was seen by a different doctor as my usual team were all away. This doctor raised some concerns again about the possibility of the baby having an underlying genetic condition, apart from IUGR, causing the growth restriction. This was based on some subtle physical abnormalities she picked up on the scan. We were thrown back to the worry of a more serious issue being present. I was sent to Holles St for a fetal MRI and had some more scans. A week later the call was made that it was time to deliver. I was admitted on a Wednesday evening for a planned section on Thursday morning at 35+1. I had a steroid injection on the Wednesday night and again the Thursday morning to help baby's lungs mature, which is common before delivery of a premature baby. The morning of the section was lovely and calm. Although we were nervous about what the future held for this baby and any potential conditions they may have, we felt excited and ready to start life with this new little person, whatever life that would be. I was in the ward waiting to be called and had visits from my consultant and the neonatologists who would be present at the birth and looking after baby in NICU.
I got called to theatre and walked down with my husband. I had an epidural which didn't work initially, I could still move my legs and feel the cold with an ice test. I had my epidural redone and Cara was born at 12.45pm weighing 3lbs. Our tiny girl was thankfully otherwise healthy. I got to have Cara on my chest for a little while before she went to NICU which I was told wouldn't be possible, so I was so thrilled with that. Cara had some extensive tests done in her first 24 hours of life because of the concerns of an underlying condition. Thankfully, those tests all came back clear. Cara spent 8 days in NICU in the Rotunda to "feed and grow". She was well enough then to be transferred to the special care baby unit in Mullingar. Every day she was getting bigger and stronger and surprising us all with her strength. There were little milestones she was reaching everyday like being dressed for the first time or having her ng tube removed. The day she graduated from an incubator to a cot was especially emotional for us. We got to take her home at 26 days old. My recovery from this section felt much easier initially, I was up moving around much quicker and felt very well in the first week or two. But I had a few setbacks in the next couple of weeks which I think were a result of not resting enough, we were on the road every day to spend time with Cara in hospital and we also had a 2-year-old at home too. Everyone I encountered through my pregnancy and Caras birth were nothing short of incredible. The Fetal Medicine midwives in particular were so caring and supportive.
Lisa with her son Aidan, shortly after his birth at Mullingar Hospital
Lisa holding her tiny daughter Cara’s hand in the NICU of Rotunda Hospital.
