Jo

Age at interview: 34
Age at diagnosis: 30
Brief Outline: Jo was expecting her first child. Three weeks before her due date she started to bleed and called an ambulance. She had suffered a placental abruption. On arrival at hospital she had an emergency caesarian to deliver her son.
Background: Jo is a teacher, married with two children. White British.

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During her first pregnancy, Jo felt a general malaise, although did not pin point anything being wrong. At seven months she developed slightly high blood pressure and oedema (swelling) and went into hospital for checks, but doctors thought is was nothing too serious. Three weeks before her due date, she went to the toilet and noticed some bleeding. The bleeding increased and so she immediately phoned the hospital and they sent an ambulance. Although she had never been in labour before she had an instinct that something was wrong, and that she should stay calm and not push. The ambulance crew asked her if she felt like pushing, and she said no. Once she arrived at hospital, the crash team was called and she had an emergency caesarean to deliver her baby. She was later told she had had a sudden onset of pre-eclampsia, which they thought had caused the placental abruption, but they couldn’t say definitively.
 

Looking back, Jo said that she never really felt that well during her pregnancy. She went on to have an emergency caesarean after suffering a placental abruption, caused by the onset of pre-eclampsia.

Looking back, Jo said that she never really felt that well during her pregnancy. She went on to have an emergency caesarean after suffering a placental abruption, caused by the onset of pre-eclampsia.

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Six weeks into the pregnancy I started a new job which was just when the morning sickness kicked in and I was a teacher at the time, in a special, a new special needs school which had brand new carpets throughout which smelt vile and my sense of smell was just, well I’d never experienced anything like it. So I spent the whole of the first few weeks in my new very stressful job dealing with this vile smell of carpet and various other things.
 
The job, my job, was very demanding I was teaching post-16 students with profound and multiple learning difficulties. Which was often very physical. Emotionally challenging, you know, there was a lot of battling. There was issues with the people I was working with as well. So it was an unhappy, working time really. 
 
Which consequently I was often finding myself very stressed very upset, just generally not very happy and ended up taking quite a bit of time off work, through sort of stress and anxiety really. Which obviously when you’re pregnant is not, is not ideal. 
 
In hindsight, looking, you know, having had a subsequent pregnancy where I felt fine throughout, I realised actually that with my first pregnancy I really wasn’t feeling well. But I couldn’t have pin pointed what it was. It was a general kind of malaise, just really not feeling right. And, so, actually for the first six months of my pregnancy, there was nothing, there was no, there was no problem. My blood pressure was fine. Everything was fine. There was a bit of a glitch with my glucose tolerance test. I went and re-did that but then that was fine. 
 

Jo started bleeding at home, an early sign that her placenta was breaking away from her womb. The crash team were waiting for her at the hospital. Her immediate thought was 'who's dying'?

Jo started bleeding at home, an early sign that her placenta was breaking away from her womb. The crash team were waiting for her at the hospital. Her immediate thought was 'who's dying'?

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So I went and I said to [husband]… you know, “I’m bleeding.” And he said, “Oh shall I ring the labour ward then?” So he rang the labour ward, and the midwife said, “Oh well, just make your way in, but if it gets worse phone an ambulance.” And by this stage I’d never heard of placental abruption. I didn’t even know what a heavy blood loss in late pregnancy would be an indication of. I had no idea.
 
So as [husband] sort of went back to go, well he had to go back to get his wallet together and phone and stuff to drive me into the hospital, I said, “Ooh actually I think I’m bleeding a bit heavier. Could you phone an ambulance?” And although I am prone to a little bit of neurosis. It would be very unlike me to say, “Phone an ambulance.” Because I would normally, “oh no, I don’t want to trouble anyone. I’ll make my way in”.
 
But, so anyway, they turned up about fifteen minutes later, took me downstairs to the lounge where they did a sort of very quick examination and said, “I think we’ll, we’ll take you in.” I still had no idea that what was going on was so serious. Even though I was in considerable pain, by this, by this stage, it was agonising, continuous pain. And so I lay in the back of the ambulance and I remember the paramedic, she kept saying to me. “Do you feel like you’re in labour?” “I don’t know. I’ve never been in labour before. I haven’t got a clue.” “Do you feel like you want to push?” And I said, I was clear that no I really, do not want to push, and it was. I’m still amazed even now. I think it must be an instinct or something that I knew that pushing would be a very bad thing to do. But I knew that panicking would be a very bad thing to do. And ordinarily, I quite like a bit of a panic, but I just, I just knew that I had, I just had to stay calm.
 
The ambulance seemed to take forever to get to the hospital, because they got lost coming out of the village. So we trundled along and eventually got there and everything was still quite calm in the ambulance, the paramedics hadn’t put their siren on or the lights on. So I just thought oh this is just a routine journey.
 
Anyway as we pulled into the entrance of the hospital, I obviously passed a massive blood clot at that stage and then the ramp got stuck on the back of the ambulance. They couldn’t get me out very quickly. But even so I was just sort of lying there thinking, okay, something, something is happening here. And as soon as, the minute that they got the ambulance door to work, as soon as the wheels on the trolley hit the ground, then there was sirens and an awful lot of people, and running down the corridor. Like, well it was like something off Casualty really, and I heard someone shout, ‘Crash team’.
 
It sounds quite dramatic [laughs]. At the time I was thinking crikey, crash team. Whose dying? Is it me? Am I dying? I don’t feel that bad. I mean I’m in quite a lot of pain, but I don’t think I’m about to die. You know, is the baby okay?
 
And, and then they cut my clothes off. I remember getting hold of my crocs and throwing them across the room. And waving a consent form in front of my face, saying you know, “Do you consent to you…” Well I don’t even remember what the consent form was for, but, and they put the Doppler on my on my tummy which was, I’m so glad they did that, because then they made a point of really saying to me, “You can hear that can’t you? You can hear him can’t you?” I was like, “Yes.”
 
And the next thing I was be

Jo's first baby was born by emergency caesarean after she had a placental abruption (the placenta separates from the lining of the womb). She felt the care she received after the emergency was over made no allowance for what she had been through.

Jo's first baby was born by emergency caesarean after she had a placental abruption (the placenta separates from the lining of the womb). She felt the care she received after the emergency was over made no allowance for what she had been through.

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Yes, and the next day, I just kind of, I just got on with it. I remember the enormity of what had happened just didn’t hit me at all. I just thought, oh well, I had something, something happened yesterday and I just got on with it. And there was a girl opposite in the, the post natal ward said, “Oh is this your second baby?” I said, “No, it’s my first.” She said, “But you seem to know what you’re doing.” 
 
You know, and I just got on with it, but I was just left in a corner and literally I was in a corner and there seemed to be no allowance for the fact that I’d gone through something really horrific. I was, you know, I was routine. I was the same as everybody else. They kept trying to get me to take painkillers. Even though I was quite clear that I’m not in pain. That was then, that was their only concern, “Oh take these paracetamols.” So I was sort of hiding them because I wasn’t in pain. 
 
I wasn’t given. I had about five minutes breast feeding support. Which was pitiful really. No one explained, no one explained anything to me really. They were worried, the physio came round and said, “Oh you know, you must do your pelvic floor exercises.” And I thought, “Well okay.” Yes. I just, it was pretty rough in the hospital actually. Afterwards.
 
I remember one night. I was in for a few nights. I pressed the buzzer, which was the first time I pressed the buzzer and I don’t know whether she was a midwife or a midwifery assistant came through and just yanked the curtain back, “What’s the matter?” And I can’t remember what the problem was, but you know, the baby was crying and I was quite distressed and I knew, my son wasn’t, he wasn’t a happy bunny. There was nothing physically wrong with him I think, other than being starving because I was trying to feed him. And obviously my body’s priority at that time was not lactation. It was, you’ve just lost an awful lot of blood and had a bit of a trauma so breast feeding’s not going to be happening very well. But I was so adamant that I wanted to feed him myself. They just, the hospital just said, “You can give him 4 ml if you want.” And that was it. They were happy just to shove a bottle in my hand, but not actually sit down with me and say, you know, we understand you want to try, but realistically when you’ve had something that dramatic happen, it’s going to, might take a bit longer and that kind of thing. 
 
So I was desperate to get out of the hospital. I felt I was getting no support there at all. And then when I went home, I didn’t really get any support from the community midwife was concerned. I just got a lot of, “Oh you’ve been very lucky. You’ve been very lucky.” And that was it really.
 

Jo still feels she is slightly detached from her son, because of his birth was so sudden and quick.

Jo still feels she is slightly detached from her son, because of his birth was so sudden and quick.

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I think I felt, and I still do to a degree actually if I’m really honest, feel slightly detached. I mean I love him dearly, but I think it was because I had, you know, this, it was so sudden. It was so quick, his birth, that I actually think, well how do I actually know he was mine. I wasn’t there. [Husband] wasn’t there. He doesn’t look like me, you know, there’s all these funny things go through your head and when you sort of… and I just think, oh how do I know? I just have to trust them, that they gave me the right child. And it’s really, really hard and especially where my daughter was born, because I was conscious and I was, you know, I saw her come straight out. And I felt awful. I thought well I didn’t have that with him. And it, you know, it really has. I mean I know in future I’m going to have to work a lot harder at my relationship with him because of it. So yes, its, I think what happened is, its, so there I’m finding it much, much easier to talk about now. I think it still will be there for different, it’ll come up at different stages of my life I think. I think it’s a bit simplistic to say, oh you know, I’m over it now, because I’m not, I am over it to a degree but I don’t think I’m going to forget, you know, that day or the implications of that day, ever, I don’t think.

After her emergency, Jo had a short period of flashbacks. During her next pregnancy she was very anxious the same things would happen again.

After her emergency, Jo had a short period of flashbacks. During her next pregnancy she was very anxious the same things would happen again.

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I suppose I started having the flash, I had flashbacks, probably when he was about, it started happening when he was about three or four weeks, where I had these awful. They weren’t exactly hallucinations, but a kind of, I might sort of turn round and just imagine seeing him, [son], in the pram all covered in blood and things, and actually it was really quite bleugh… But then I think I was sort of aware enough, I was telling myself, I know what this is, this is post traumatic stuff, I’ve got here. And I thought well, I didn’t actually mention it to anyone because I knew what it was. I knew why, I sort of knew why it was happening. So I felt you know, I could sort of control it myself really, which probably was a bit of a silly idea in hindsight. But … I thought well he’s not lying in the pram covered, the pram covered in blood you know, so…
 
Acutely like that for a few weeks. I think it was more, you know, part possibly influenced by hormones, so you know, the usual, usual, length of time that, you know, first two, three months something like that. And then it sort of changed into something else. It wasn’t that kind of graphic feeling. But it was more manifested itself in my relationship with [son] actually. Because I think I felt, and I still do to a degree actually if I’m really honest, feel slightly detached. I mean I love him dearly, but I think it was because I had, you know, this, it was so sudden. It was so quick, his birth, that I actually think, well how do I actually know he was mine. I wasn’t, wasn’t there. Mark wasn’t there. He doesn’t look like me, you know, there’s all these funny things go through your head and when you sort of… and I just think, oh how do I know? I just have to trust them, that they, they gave me the right child. And it’s really, really hard and especially where my daughter was born, because I was conscious and I was, you know, I saw her come straight out. And I felt awful. I thought well I didn’t have that with him. And it, you know, it really has. I mean I know in future I’m going to have to work a lot harder at my relationship with him because of it. So yes, its, I think what happened is, its, so there I’m finding it much, much easier to talk about now. I think it still will be there for different, it’ll come up at different stages of my life I think. I think it’s a bit simplistic to say, oh you know, I’m over it now, because I’m not, I am over it to a degree but I don’t think I’m going to forget, you know, that day or the implications of that day, ever, I don’t think.
 
And did you feel, I mean how did you feel about the pregnancy? Did you feel anxious about it?
 
Oh terrible. I think every day I cried. Usually in the shower for some reason. I suppose no one was there to see me. Every day, I thought is today the day my placenta’s going to fall apart again? Yes, it was, from the moment, you know, she was conceived, to literally the moment she came out I was anxious.
 

Jo felt that she bonded differently with her son after his emergency birth than she did with her daughter.

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Jo felt that she bonded differently with her son after his emergency birth than she did with her daughter.

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And what about the impact on your relationship and family?
 
I think my husband has been frustrated at times with my relationship with our son, because I always felt like their relationship was very easy, but I wonder whether it’s because [husband] held him first, and [husband] spent that first hour with him and I didn’t and its always like [husband] seems to know more of what [son] needs. He responds to his needs much better than I do. But now I think may be its just because he’s male, and [son]’s male and I don’t necessarily get boys’ stuff. You know, whereas with my daughter I completely, oh you want to do that, oh I can understand that. So maybe I’ve attributed things to the, the, the birth event that maybe I shouldn’t have done. But yes, I must say [husband] has been at times frustrated with how I deal with [son]. And also he was, after [daughter] was born and I was very honest, with him, and I said, “I don’t, I don’t feel for [son], what I feel for her. It doesn’t physically feel the same.” And he found that very hurtful. And he said, you know, “Yes, I’ve noticed this issue with [son]. With you and him.” Well it’s a lot better now, its lots better, but it just, it was very, very, apparent to me, in those few weeks after I’d had her that I just felt so differently. It was awful. And I felt I should be honest with him. And you know, it was a different experience. Yes, I think he found that hard.
 
Your daughter is 15 months old, is it improving?
 
Yes. Oh yes, yes. If I don’t feel like it, I think apparently again it was the few weeks after she was born, because my hormones were probably all rife at the time. But no, I don’t feel, it’s not as acute now. I think, like I said, it’s more of a gender thing or I think you just parent your children differently anyway because they’re different people. So their needs are going to be different and the way you respond to them is going to be different. And I perceive that now. But at the time I couldn’t see that so clearly.