Part 27 - Preterm pre-labour rupture of the membranes

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One of the few things I had brought with me to the hospital from Herm was my laptop, so after a few hours of restless sleep, I gave up trying and researched all I could on ‘waters breaking early’ instead. 

The baby lies in an amniotic sac of fluid or ‘waters’ and ‘waters breaking’ means that the sac has ruptured or broken. Waters normally break around the time that labour is due but in around 2% of pregnancies they break early. The medical term for this condition is PPROM, which stands for preterm pre-labour rupture of the membranes and means that the waters have broken before the baby has reached full term (37 weeks).

Intrauterine infection is present in around third of women with PPROM but in most cases it happens without any infection being present. The reasons for these cases is unclear, however it has been linked to heavy smoking during pregnancy.

At that time, I didn’t have any signs of infection and I wasn’t a smoker so it was considered just ‘one of those things’. I couldn’t help thinking however that the Goddess of the Moon had a role to play in all this and certainly that role became clearer in the days ahead.

I had thought that once the waters break, the pregnant lady immediately goes into labour but I discovered that this isn’t the case, contrary to the scene depicted in many a film (the recent Bridget Jones is a classic example of this).

When waters break early, the treatment is dependant on the stage of the pregnancy. There is an increased risk of going into labour prematurely and this brings with it the health risks for the baby of early birth, which are obviously greater the younger they are. There’s also the risk that if the pregnant woman doesn’t go into labour that she and the baby are at risk of infection.

The specialists had to balance these two considerations. If the waters had broken because of infection, then there would be an increased risk of the baby getting the infection and delivery may have to be immediate. 

When the waters have broken but there is no infection present, as in my case, then while both of us were still at risk, the immediate risk is lesser and the treatment depends again on the stage of pregnancy.

It was agreed that I would remain in hospital for the initial 24 hours so that I could be monitored for infection and have steroids administered to help the baby’s lungs fully develop.  Furthermore, if I was going to go into early labour then it is more likely to happen in that 24-hour period following the waters breaking.

My body was continuously replacing amniotic fluid to protect the baby, but as the sac was broken it was not retained and was constantly trickling out of me.  It was the strangest sensation and I had to wear pads to collect the fluid, which I needed to change regularly.  The fluid was a clear/pinkish colour and I had to keep checking that this didn’t become greenish or brown, which would indicate infection. I was encouraged to drink lots of water to enable the body to use this to create the amniotic fluid.

I found it funny – the Goddess of the Moon was up to her tricks again.  Earlier on in the pregnancy I had made a real fuss about the due date as the dating scan at 12 weeks had given me an earlier date than the clinic.  I couldn’t understand the reason the medical profession would work from the computer generated date, when I quite clearly knew the exact date of conception because of the clinical manner in which the baby had been conceived.

I was concerned, back then, of intervention at 40 weeks as the specialist I initially saw told me that he wouldn’t want me carrying the baby beyond the 40-week period.  Thus I had been very keen that the medical profession use the date given to me by the clinic as this would ‘buy’ me an extra four days of pregnancy before any talk of intervention.

Now however, the earlier due date was working in my favour because it meant that I reached the ‘safe’ 34 weeks four days earlier than if we had used the due date given to me by the clinic. Thus when Monday arrived, I’d reached 34 weeks per the dating scan and I was administered the final steroid. I could almost hear the midwives sighing with relief that we’d managed to get to that date without me going into labour.

Over the course of that initial 24-hour period in hospital, I saw three different specialists and they all agreed that I should be allowed to go home and continue life as normal, except no baths, no sex and no teaching yoga.  I was to return to the ward every other day for monitoring and to check for any signs of infection by continuing to regularly take my temperature and check my discharge. 

The intention was to keep the baby in utero for as long as possible, but no longer than 37 weeks when the baby is considered full term.  At that point I would need to have a Caesarean delivery as the baby was breech and without the amniotic fluid, there was no way it could turn now. This was far from ideal as I was still adamant that I didn’t want to have a Caesarean section and I was going to do all I could to fight for a vaginal delivery.

I raised the issue with each of the specialists in turn.  My lovely lady specialist was adamant that that wasn’t going to be an option. Another was aware that the Hannah Term Breech Trial had been flawed and that while there were risks with a breech delivery, there were also risks associated with a Caesarean Section and it was a case of seeing what happened.  The other wouldn’t give an opinion either way and left me with some hope that possibly I could convince him of a vaginal breech delivery when we got to decision day.

I spoke to the midwives at length about breech delivery too and enquired whether any of them would be able to facilitate this delivery, but the answer was a resounding ‘no’. There is now a lot of fear surrounding vaginal breech delivery and many midwives are not trained to support such a birth.

It was frustrating and yet I was still so determined. I prayed with increased vigour for a resolution that would find the baby miraculously turning and tried to keep my thinking positive. 

Around this time, I emailed my four University friends and shared with them the recent events and my desperation to avoid another Caesarean Section. One of them had had a planned Caesarean section as her son was also breech and the another one had experienced both an emergency and a planned Caesarean Section. Both were keen to allay my fears and assure me that a Caesarean birth could be both empowering, intimate and beautiful.

While I was still stubbornly resistant to the idea of a Caesarean Section, their comments did get me thinking.  I knew without doubt that my experience of Caesarean Section had not been empowering, intimate or beautiful, yet I began questioning whether that was due to the placenta previa more than the procedure per se.

I was released from hospital that Monday late morning and returned home to find the book I had ordered on the Saturday “The Universe Has Your Back” by Gabrielle Bernstein, had arrived. This book is about relinquishing the need to control our lives, to transmute fear into love, find safety in the face of uncertainty, joy in what might otherwise be pain and to recognise that the Universe has your back. It was certainly well timed.

If there was one thing I needed to be reminded of right now it was that the Universe had my back and that there was a greater plan at work here.  Deep down I already knew this, but I realised that I needed to try to come to terms with the possibility of a Caesarean Section and address all the fears that were attached to this.  I had to see the love, and strengthen my faith in a peaceful outcome, whatever that may mean.

My colleagues thought I was mad returning to work on the Tuesday with my waters broken but the specialists believed that this was the safest option for me as it meant I was sitting for most of the day.  They were all nervous though and there were jokes of a delivery in the office.

I felt fine, albeit that I was constantly leaking amniotic fluid and I couldn’t feel the baby kicking so easily now, so there were moments of minor panic. However, the more I read my new book, the more I started to realise that this was all a lesson in overcoming fear and stepping into a place of love and trust instead. 

I felt this overwhelming need to try and get on top of my workload and finish off loose ends. This feeling increased that evening and I had a fretful night’s sleep as I ran over in my mind all that I needed to do to ensure that my workload was in a position to handover to someone else.

I woke up feeling energised and raring to get on with the day. Firstly, however I needed to get in the sea, as I just felt I needed cleansing and grounding ahead of the day. We all traipsed down to the beach and I remember the intimacy of it and mentioned to E that I didn’t think I would be back again for a while and that we needed to capture this moment just the three of us.

I had to go into the hospital that morning so that my temperature could be checked and for the baby’s heart to be monitored. Basically this means that two flat devices (sensors) are held in place over the baby bump by elastic belts and the baby’s heart beat is recorded on a chart and checked for any abnormalities.

I also had to press a button each time the baby kicked so the midwives could monitor the baby’s movements.  Other than that I got to lie back and read my book, which was constantly reminding me to turn to love and away from fear.

After that I headed into the office and worked as quickly as I could to tie off loose ends.  I remember being so focused and busy that I didn’t even stop to eat anything. I had resigned from my job a few months earlier but a replacement had not yet been found.  So I wrote notes detailing all aspects of my role so that someone could easily come in and pick this up from me if necessary.

By 5pm I was finished and it was a huge weight off my mind. I felt like I could finally relax, although I had this sense that I needed to go to a church and pray. E and Elijah joined me and we tried our local church, St Andrews, where E’s Dad’s ashes are kept but this was strangely closed.  We visited E’s Dad’s grave nonetheless, which felt appropriate in the circumstances.

We then headed to St Martin’s church, as it was the next closest one to us, and it was only when we arrived that I realised why we had been directed here.  Outside the church is a granite standing stone or Menhir dating from 2500 – 1800BC, which is shaped as a female figure and is known as La Gran’mère du Chimquière. New brides place flowers on her head for luck and she is adorned with flowers on May Day.

I couldn’t help feeling that I needed her energy and wisdom in my life now too, so I touched her, said a prayer, gave thanks and asked for her support. We then briefly visited the church and I prayed to Mary for a miracle.  I still wanted the baby to turn from its breech position and I was hoping for Divine intervention!

I felt comforted by our church visitation and returned home feeling that now I could relax as everything was completed. It was perfect timing for a facial appointment I had booked later that evening as a post-retreat treat, an opportunity to finally relax, or so I thought!