Interview 27

Age at interview: 30

Brief Outline: Had problems getting pregnant because of polycystic ovary syndrome. Conceived after taking Clomid; also used acupuncture. Now 16 weeks pregnant, and pregnancy is progressing well.

Background: Occupations' Mother- research manager, Father- IT solutions architect. Marital status' married. Ethnic background' White British. Partner of Interview 28.

She had polycystic ovary syndrome and took the fertility drug clomifene (Clomid). She also found...

And I was also really lucky with the kind of fertility service at the hospital I was referred to. I was diagnosed with something called PCOS, which is polycystic ovary syndrome, which does make getting pregnant somewhat complicated, because you don't ovulate. And I was given a drug called Clomid, clomifene citrate, the technical term, and you have to be monitored quite closely on that drug, and that was really hard particularly when you're working full time. You have to go back to the hospital every, just about every week to have an ultrasound to see what's happening, because it can have serious side effects. So that was really trying, and it made me realise that anything like IVF just wasn't for me. I just didn't have the, I suppose emotional and physical resilience to have that much interference really, with what is essentially quite a private process, so I'd had four or five cycles of Clomid. And again it's not a nice drug to take; you can feel very sick and you just don't feel good on it at all, and I was feeling as if things were really getting out of my control. I think we both felt that, that, you know it was something about us, but at the moment things were being done to us and I came across a - I'm trying to think of a way to say this without saying - a clinic in London. It's a private clinic, who provide a very holistic type of care. It specialises in acupuncture, nutrition, but most of the staff are dual qualified, so either nurses or midwives, and they've also got acupuncture. And they specialise in fertility and maternity kind of care, and that was a revelation really, to have an hour to sit and talk to somebody about what it felt not to be getting pregnant. I think it's always helped, knowing the reason why I wasn't getting pregnant. If it had been unexplained fertility I think maybe I'd have had more of a desire to try different techniques, but, kind of, I knew what was wrong. 

So I started having some acupuncture and that I think just helped me feel a lot better, and I continued with the Clomid as well, so I was doing these things in conjunction. We kind of synchronised the acupuncture with the Clomid cycle and my cycle and I had, I did two cycles of Clomid while I was having acupuncture as well, and I'd had a review at this clinic I was attending in London, in the big city [laughs] and I'd- I'd decided that we'd give it another go, just with acupuncture and Clomid before maybe seeking - there was a surgical procedure that my local hospital were offering me. And I - I felt really strange one week, as if my period was about to start at any moment, but it didn't, and I'd been away at a conference. And when I got home it was actually the night England were playing Portugal and I used to do a lot of work in Portugal, so I'd been watching the football match and texting my friends in Portugal, and I just did a pregnancy test. And I must have done about twelve or twenty tests over the last two years, and so I really wasn't expecting a positive result, and it was faintly positive, and we were frankly stunned, and terribly excited, but also terrified, to be honest. 

She felt ill taking clomifene (Clomid) and could not get clear information about this. She wanted...

The first time I took Clomid I think was probably the worst. Bizarrely it also coincided with the weekend my sister went into labour, so it was kind of a bizarre weekend as it was. But it - it makes you feel - there's a slight, slight time delay, but it makes you feel like you've got a really, really bad hangover. You're kind of hungry, but when you look at food you can't face it. You feel kind of, almost, slightly bloated, quite nauseous. It - for me it triggered migraines and even though I phoned NHS Direct [pause] they couldn't tell me whether - or their advice that I go immediately to a doctor if I had any side effects from any drugs but they wouldn't tell me whether it was a contraindication to take Migraleve with the Clomid and - so that was really frustrating, and in the end I just did it. Because there was no way I was going to phone the GP on Sunday afternoon because I'd got a migraine. It just didn't feel reasonable. So just really heavy going. It - it's quite hard to describe [sigh]. It did seem to affect me less, each time I took it, but there was always the dread in the back of my mind, that, you know, it was going to be really awful again. So -

So is there anything you can do to alleviate the symptoms?

No. [Sigh] Not really, and they - it's to be - to be honest I think I joined various kind of email based discussion forums, like that, so I'd known from kind of other women that the side effects could be pretty grim. And the consultant kind of played them down, but when I went back the second time, she just said well, "No there's nothing else, you just" -you know. It is what it is. It does overload your system, and I think any time you try to adjust hormone levels it does kind of put everything out of sync, really.

You said it made you realise that you wouldn't be able to cope with IVF?

Yeah.

Tell me, did you discuss that with your husband?

Yeah, we talked about it a lot and [sigh] I suppose it, it's interesting whenever I talked to people and said, that you know IVF really wasn't on our list of options, they said, "Oh is it a religious thing that's coming through?" And, and for me it wasn't. It was, I suppose, it was nobody's ever promised me that I had a right to have children and I felt that for some people it's obviously the right decision, but I think my assessment of it was, I've really struggled doing the Clomid, and getting scanned, and, you know, having sex according to a timetable, and that's nothing compared to the kind of invasiveness of IVF, and so that, combined with the - my relatively high rate of miscarriage just made me feel that it would be another two, three, four years of heartache, really.

They decided to tell friends and family she was pregnant early on, so they could support her if...

It was, it was hard, because it was a really hectic time at work. We were moving offices, and I'm the manager, and I couldn't just like, sit down and say, "I couldn't possibly lift those boxes", and you know, I wasn't stupid, but you know, there are times, particularly when people don't know, you can't stop. 

And I was very tired during those first few weeks. And we also made the decision to tell friends and family really quite early on, in fact before we'd had the first scan, because we knew that there was a high chance that I might miscarry, and we're both quite close to our family, and we thought it would be an awful lot to expect them to support us, if they didn't know that I was pregnant, you know, to phone up one day and say, you know "Mum, I've had a miscarriage, oh and by the way, I was pregnant, briefly". Because they - all the family had known what we were going through. 

They knew we were trying, obviously, so, and again we had a couple of raised eyebrows that we told people when I was only probably - we didn't really quite know - but it was probably seven or eight, seven, eight or nine weeks when we told people. I didn't tell work then, obviously, but close friends and family. And I'm really glad I did because we also wanted to celebrate, anyway, you know, because as I said, we did feel it was such a positive event, even if it didn't, you know, come to fruition, so we told people at my niece's first birthday party, which was lovely, and everyone was so, so happy for us and so supportive. So I think it was a good decision.

She had heard conflicting advice about drinking alcohol in pregnancy. It can be difficult to know...

And, you know, there's been a whole thing this week about safe or non safe levels of alcohol during pregnancy, and it seems that everybody's got an opinion about what's good and what's bad for pregnant women. And it is really hard to kind of read and understand exactly what the risks and benefits are. Because I have one friend who said, you know, that a glass of red wine every now and again actually thins the blood and reduces the chance of miscarriage. And you get a report out this week saying basically it's - you know - you're killing your baby, roughly, by having, you know, even smelling alcohol. And as it happens, I mean, I haven't felt like alcohol at all. You know, the smell of it just puts me right off, but it is really, really difficult to feel secure about what you're doing. And something else I notice, I actually kind of popped out, as it were, really early on, by week thirteen I had a visible bump and I was really breathless. And the books were saying that shouldn't be happening for at least another three or four weeks yet, and I, I got quite anxious about that, because it's my first pregnancy, and you know, everything's a mystery. I was reading in one of the books, and suddenly it said, but about 50% of women experience breathlessness from about week twelve of pregnancy, and suddenly it was like, oh right, okay, I'm actually in the 50% not, you know, this strange freak - these strange freaky people who don't suffer like that, at all. So it's - you know - I - you know, I - my work is about providing clinical information to people, and making - helping people make informed decisions, but sometimes there is so much information around, and even credible information, you just don't really know where to get the kind of precise advice from, to be honest.

So how do you decide what to believe and what not to believe?

It [sigh] it's tricky. I think trusting your instincts is quite a good one. I just do not feel like drinking alcohol. The most I've had is a really, really weak Pimms. I mean, it was literally that much Pimms and, you know, a full glass of lemonade. And that's all I've had, so, I suppose it's about, in some ways, it's about trusting your body about what it says you fancy. But also just cutting yourself some slack, that you know, you don't get any prizes for being, kind of, the super mother of the year, you know. I think it's about getting through the pregnancy, making sure you don't get too tired, drinking plenty - I've never drunk so much water in my life, I'm always thirsty, always hungry, but trying to make sure that I'm eating apples and oranges, and not M&Ms, Twix bars and what have you. But then again, you know, having chips once a week because, sometimes that's the only thing you really, really fancy. And I, you know, think a lot of pregnant women really beat themselves up about these kind of lifestyle issues. You know, lots of the books say you should be doing exercises and yoga, and all sorts of things. I mean I'm lucky if I'm awake by the time I get home [laughs]. So quite where you're meant to get the energy to do all of these other things from I'm not sure really. So I think it is about just being, being gentle to yourself, really, and you know, I had two lovely walks over the weekend, which were great and I felt so much better for them, but that was probably the first time since I've been pregnant that I've fancied, you know, taking the dog for more than a walk round the block. So I think waiting until you're ready for these things.

She did not like the way one doctor talked to her about her weight in pregnancy.

What else? Is there anything else that's sort of happened so far that's been an issue for you?

I suppose there - there was one. When I was first seen at the hospital that's going to deliver my antenatal care, and I had my kind of roughly twelve week scan there, and I saw a midwife, and I also saw some medical staff, and initially it was a very sweet student doctor. And it was quite funny actually, because we went and sat down in a room, and we could hear him talking to the nurse outside, saying, "Right, What do I do? What do I do next?" It's like, "You take her history". "But she's already seen the midwife, she's already had her history taken", and they were saying, "You're a doctor, you do it again", [laughs] so by the time he came in we were trying really hard not to laugh. But he was - no, he was charming and - my one question was that I'd, at that point, because I wasn't quite twelve weeks, I was still taking my metformin [a drug to induce ovulation], and I wanted to check what this hospital's policy was about me continuing, or discontinuing the drug, and he wasn't sure about that, so he said he'd go and talk to his - I presume it was his registrar, or equivalent, and after about five, ten minutes the registrar came back, and, you know, quickly reviewed my notes and was very I suppose dismissive actually, of the advice I'd been given about taking metformin, and said, "In this hospital we, we do things on a needs basis, and you've been fine so far, so you've no need to take it. We do things in an evidence based manner here", kind of thing, which didn't help because you go on the advice you're given. So, and then [sigh] he, and this is going to sound awful but he was frankly clinically obese. He was a massive man, and he started referring to me as a larger mother, and going on about my weight, and it was just really hard to take from somebody who was frankly four times my size, and it was just really difficult. And I'd also lost a huge amount of weight over the last couple of years. I'm not, you know, thin by any stretch of the imagination, but I felt kind of quite comfortable about where I was, and that was quite hard. You know, partly you just felt, "Where do you get off telling me, you know, lecturing me?" You know, saying, "We'll have to see you at thirty weeks because, you know, you're on the larger side", and all the rest of it.

What was his point?

Because allegedly - well, presumably - he said it's very difficult to visualise the baby, so we'll need to check at thirty weeks that we can still see it clearly. Which seems quite strange really, because, you know, women far larger than me have had very successful pregnancies, so that was, that was the only kind of sour note, really, that it just, it was quite difficult. Because I suppose I'd had a lot of support from my fertility consultant, who understood how ha- one of the things about PCOS [polycystic ovary syndrome] is it's really difficult to lose weight, because it alters your metabolism and, you know, it is really a struggle. But, you know, I had lost a lot of weight, so that felt quite hard.

She is worried about being rushed into decisions during labour without thinking it through, but...

I don't know. I - I've not got really, really strong opinions about it at the moment. I think what I'm scared about is being forced into making snap decisions, and being pressurised into having things I don't want. Having said that I want all the technology at my disposal at the click of my fingers if I feel that's necessary, so that is slightly contradictory. But, you know, I want everything in the background as a kind of insurance policy, but I'd like to kind of negotiate my way through it as we go. And as I said, you know, I quite fancy at least using a water birth as pain relief. And even, you know, staying in for the, for the full deal if possible. But in most units it just depends whether anybody else is using - most units only have one kind of water birth bath or pool or whatever they're called. So you can't usually guarantee whether that's going to be available.