This topic is very emotive and I have struggled as to how to present it here. Please, if you have had more than one premature baby, I am not blaming you, or wanting you to feel anymore guilt that you do already. I'm just putting some thoughts out there, of my own, I am not judging anyone's choices.
"So, when are you planning to have another?" It's a question I am asked often. Sometimes I can answer with a grin "no way Jose", sometimes factually "when there is a definitive treatment for pre eclampsia that doesn't involve swift delivery of the baby", and sometimes it sends me scurrying in tears. It's no secret. I want another baby.
But, as much as I adore my son, and don't get me wrong, I am grateful every single day for the care that kept him alive, I don't want another NICU baby. I am not mentally strong enough. As discussed before, due to various risk factors, my recurrence risk is around 80%, my consultant guesses she could get me to 30 weeks.
A lot of the time on my blog, I share the sadness of seeing your baby in hospital, of watching everything they go through, of keeping that bedside vigil, of weathering the highs and lows, the amazing soaring highs, and death-defying crushing lows, of a premature baby's fight for survival.
But there's another side to the story. The mother (and the father). Like most pregnant women I had read books, watched television shows, I bought the magazines and I bought the dream. No one talks in any detail about premature delivery, of what happens if you don't get your "normal experience". Yes, you see the odd success story, but magazines never explore the real story.
I feel cheated. Personally and at a deep level, cheated. I am so angry I didn't experience a contraction. I looked forward to labour, to experiencing it, being present in it, that challenge of pushing a watermelon out of the eye of a needle, I wanted it! I wanted that closeness with my husband, that moment of crowning, those final pushes, the baby delivered on to my flesh, the first furtive breast feeds, the finding out the gender together. I wanted it, I bought it, I expected to get it.
The reality is, I didn't get it, and I am not alone. But for me, we have stopped. No more babies. And its bloody hard to have made that decision, other people who had babies the same time I had Joseph have new ones now. And that will never be me. And it sucks. I try and be noble about it, but I feel robbed.
There are many reasons babies come early, most commonly there is no definitive reason. Therefore the ability to assess the risk of recurrence is somewhat impeded. The common reasons, such as incompetent cervix, can be mitigated with a stitch, but these are not 100% effective. Reasons such as infection cannot be predicted, and so little is known about recurrent infection and the risk of premature labour and delivery.
But what if you know. What if you've had three or four or more premature babies. What I haven't ever really explored here is cost. The avereage of cost of a NICU stay is £838. Not a week. A day. £838 a day! Joseph was in 76 days, admittedly not all at this high level of care, but his stay would be estimated at around £65 000. And that doesn't include my cost, two nights in HDU, surgery with double the staff of a normal section, and a 7 night stay afterwards.
Premature babies cost a lot of money, in our case, Joseph is well, and hasn't really cost the NHS any more than your normal baby. However some of these babies require an ongoing investment of care, both from the health service, and then in the educational sector later on.
I don't know what the answer is. I do know there are a lot of women who have had more than one premature baby that have no idea why their babies have come early and have been told "its one of those things". I know other mothers who have had very good follow up care and have gone on to have full term births next time, with stitches or progesterone therapy, and most often, both. I know women who have had pre eclampsia in first pregnancies who have gone on to have fine second pregnancies.
But I know women who have been advised not to go again, and have. Again and again, have premature babies. My husband has a relative who lost her life having her last baby.
I think the answer here is research and education, and straight talking from professionals. My own consultant was incredibly tactful when discussing my recurrence risk. She asked me if we were considering more, I said, probably no, but maybe. She ran through my risk factors. I ased her straight out "come on, if we're better off getting a puppy, just say so, please", I had to really press her, and then eventually she said it "yes, get Joseph a nice puppy, please!"
I think we should know the true cost of having early babies. I think we should know the long term risks. I think to make informed choices we need to be more open about what we are dealing with, risk of death (both baby and mother), the use of very finite resources, and the possibility of long term consequences for the child as it ages. Let us make a choice, but let us be informed.
Not everyone is as lucky as me, to know the reason their child came early. Not everyone is as lucky as me. I never thought I'd have a baby, so to me, to have one baby, is an enormously massive, wonderful gift. Yes, I long for more (and a pink one would be nice) but I have my baby. Not everyone is as lucky as me.