Alison and Philip Armstrong’s Story

The date was 14 May 2003 and I remember the moment vividly.  It was early in the morning, and after an agonising two-week wait, I’d jumped out of bed to perform a pregnancy test.  Philip and I had just been through our first cycle of IVF and the result would be known in five minutes.  I couldn’t bear to look at the little indicator square on the tester kit, so I covered it up and then waited for what seemed like an eternity.  Finally, after five minutes, I very slowly uncovered the kit to reveal a cross – I was pregnant!  In this moment, years of uncertainty, heartache, hope and fear ended and the experience of pregnancy began. 

During the first two trimesters of my pregnancy, everything was wonderful.  I experienced very little in the way of morning sickness, instead only having a general feeling of nausea from time to time.  My obstetrician was extremely happy with our progress and all our test results revealed a healthy mother and baby.  Each week, I read my pregnancy books to find out all about the baby’s size and progress.  I followed the books’ recommendations for diet and exercise to the letter.  Philip and I attended ante-natal classes and a yoga workshop, in preparation for the “ideal” birth that I had in mind.

Things became a little less smooth in the third trimester, when I developed carpel tunnel syndrome.  My hands, wrists and forearms were constantly painful and I had to cut back to part-time work and wear splints.  The pain kept me awake at night and there were many times when I walked around crying at nighttime.  My physiotherapist advised me to plunge my hands into jugs full of ice when the pain became severe, so our freezer was constantly full of bags of party ice. 

As my due date crept closer, I began to experience swelling in my feet and legs.  It wasn’t long before I had to swap my enclosed work shoes for sandals and then, in my final week of work, I was forced to wear thongs, as nothing else would fit.  I wasn’t worried though, as everything was still going well and, in the words of my obstetrician, my blood pressure was always “perfect”.

I finished work the day before Christmas Eve, thinking I had three weeks to prepare for our baby’s birth.  Somewhere in the back of my mind, I had a vague feeling that the baby might be early and I wouldn’t have everything ready in time, but I just dismissed this as nerves.  We celebrated Christmas Day quietly with family and, although I was feeling very heavy, tired and hot, everything was fine.  We certainly had no idea of what would happen in the next few days.

I think things really started to change from about the 27th of December.  Philip tells me that I had been complaining of bad headaches in the days leading up to this, but I don’t remember these.  My first memory of there being a problem (though I didn’t realise it at the time) is that I couldn’t lie down to go to sleep.  I remember lying on the bed that night and feeling as though I was suffocating, unable to breathe.  It was an awful feeling.  I would lie down for a few seconds and then sit up and have a coughing fit.  Eventually, I propped myself up with a pile of pillows and slept, fitfully, sitting up.  The same thing happened the following night and so I was feeling very tired during the day. 

It was the 29th December and, at 37 weeks, I found myself feeling so uncomfortable in the morning that I didn’t know whether to sit, stand or walk around.  Whatever I did, I wanted to be doing something else.  I’d developed pain under my ribs, but dismissed this as being the result of all the coughing I’d been doing at night.  During the entire pregnancy, I hadn’t taken a single paracetamol tablet, but now I took a couple and prayed they would bring me some relief.  The pain subsided enough for me to sit and watch television, so I concluded that I must have pulled some muscles with all my coughing. 

I also felt rather breathless, and just generally very uncomfortable, but assumed this was all a normal part of pregnancy, since the books spoke about feeling breathless towards the end and it was a hot summer.  I told Philip that I didn’t know how I was going to get through the remaining three weeks of the pregnancy.  We were going to see my obstetrician that afternoon and I secretly even contemplated asking her to book me in for a caesarean, because I couldn’t handle what I believed to be the normal discomfort of pregnancy any longer. 

A c-section was the last thing I had ever wanted, but now it seemed like a welcome thought.  I remember thinking that I must be somehow “weak” if I couldn’t deal with the physical complaints that (I thought) all pregnant women endured.

In the afternoon, Philip and I went to the hospital for my obstetrician’s appointment.  I had difficulty walking from the car park to the hospital building, a fairly short distance, as I was so out of breath.  As soon as I saw the obstetrician, I told her that I felt awful.  She took my blood pressure and, instead of uttering the usual “perfect”, didn’t say a word, but instead gave me a container and asked me to produce a urine sample. 

I had trouble producing much urine at all, but the obstetrician told me she only needed a small amount.  She went into a small room, came back out and showed me a little chart.  She then said that my protein level was at the highest end of the chart, before announcing, “You’re having a baby this afternoon”.  I said, “You’re kidding” and she said no.  My first thought was that the high protein level in my urine obviously indicated that I was about to go into labour and the baby was about to be born.  My second thought was that I hadn’t finished washing all the baby’s clothes. 

The obstetrician then told me that I had severe acute pre-eclampsia and gave me a brochure about it.  I remember it was at this point that I started to realise things were not okay.  I asked the obstetrician if I was going to be okay (and remember suddenly wondering if I could die).  She said I was as long as we got the baby out soon.  I couldn’t bring myself to ask if the baby was going to be okay.  The obstetrician told me that she knew I had been keen for a natural birth but that the baby needed to be delivered straight away and that it would take too long to induce me. 

Delivery was scheduled for an hour’s time and we were sent straight to the labour ward.  Along the way, I really began to struggle to breathe, so Philip grabbed a nearby wheelchair and pushed me the rest of the way.  I was shown into a room in the labour ward and then Philip left to go and collect my bags and the video camera from home.  We were both trying to process what was happening. 

Philip told me later (much later) that, while I was in the toilets producing my urine sample, the obstetrician had told him that the situation was extremely serious and that I was dying.  She said that, if the baby wasn’t delivered immediately, the baby and I would both die and that, in all her years as an obstetrician, she had never seen blood pressure as high as mine.  I was in immediate danger of having a stroke or a heart attack.  Philip was asked to remain calm and give no indication of any of this to me, so he dealt with it all on his own, so I wouldn’t panic.

While Philip was collecting everything from home, the anesthetist visited me.  He told me it was possible that I may need a general anesthetic, if my blood platelet levels were very low.  This is when I first felt really upset about everything, as I could cope with a caesarean but desperately wanted to be awake when the baby was born and for Philip to be allowed in the theatre as well.  The anesthetist also told me that it isn’t unusual for people to get worse in the 24 hours after the delivery, before they get better.  A short time later, I received the news that my platelet levels were high enough for me to have a spinal block, which was very welcome news!

By this stage, I was starting to get very concerned as to whether Philip would be back in time.  There was no way I wanted him to miss the birth.  I asked the midwife if it was possible for them to start later if Philip didn’t return in time, but she said it wasn’t.  She assured me that the baby wouldn’t be born for about 30 minutes after I went into theatre, so that Philip should be back for that part.  As the time drew closer, with no sign of Philip, the midwife put a disposable camera on the table beside my bed (ready for the staff to take photos if Philip hadn’t arrived).  Just as it was time for me to go to theatre, Philip walked in.  I have never been so glad to see him!

The whole experience surrounding the birth was surreal – I describe it as feeling as though I was in the Twilight Zone.  Fortunately, Philip videoed (nearly) everything and I’m so thankful to have the tape to watch.  When the obstetrician announced, “It’s a girl!”, I remember feeling very happy, but also thinking to myself, “I think I’m supposed to cry now”, because, in all the visions I’d had of myself giving birth, I saw myself crying tears of joy.  In reality, though, I just didn’t feel compelled to cry.  I felt a mixture of happiness, relief that our daughter, Alyciana, was actually born (so that we would both be safe), tiredness and nausea. 

Later, after we were back at home, I felt terrible because I remembered feeling too sick to hold Alyciana and, as a result, pushing her away when they’d offered her to me.  Finally, when I watched the video of her birth quite a number of months later, I cried tears of joy because I saw that I actually had held her immediately after she was born.  I had only declined the opportunity to hold her a second time.  Months of guilt and grief, that I hadn’t even fully recognised, were lifted at that point. 

Following the birth, I was wheeled up to Intensive Care, Philip by my side.  Our new daughter wasn’t with me, but I don’t recall either being told where she was going (I found out later that Philip had been told she would need to go to the Special Care Nursery) or wondering where she was.  I remember it just seemed logical to me that she wasn’t with me, perhaps because everything was so medically oriented at the time.  Actually, I don’t think that I was really thinking about much at all, beyond the moment and what people were telling me to do. 

When I was first admitted to ICU, I had inflating pressure “boots” fitted, to help prevent Deep Vein Thrombosis.  I was also attached to a blood-pressure monitoring machine and there were tubes everywhere.  During the night, I was surprised by the lack of pain I felt; I didn’t realise that I was receiving pain-killers via a drip.  Staff members continually asked me if my pain levels were okay and I remember wondering what the big deal was in regard to pain (boy was that going to change soon!).

Once I was settled in ICU, Philip went down to see Alyciana in the Special Care Nursery and came back with two Polaroid photos of her that the staff there had taken.  He then rang my parents with the news that they were grandparents.  They were rather concerned when they heard that I was in ICU and I can only imagine how they must have felt upon hearing those words.  Later, a nurse let me use the ICU cord-less phone to ring them personally and let them know I was all right.

I spent most of the night in a kind of surreal half-asleep, half-awake state, with staff members monitoring me every 20-30 minutes.  During the night, I sometimes felt a brief moment of fear because I couldn’t feel the baby moving.  I’d then remember that I’d already had her and would really miss her.

The following morning, the head of the Special Care Nursery surprised me by wheeling in Alyciana to see me.  Philip and I both held Alyciana and had photos taken and then Philip fed her some milk, from the test tube that ran into the tube in her nose.  I was a bit shocked to see her with a tube down her nose.  I don’t know whether Philip had mentioned this or not the night before, but I was unprepared either way.

Later that day, I was transferred to the maternity ward.  Alyciana and I spent a total of nine nights in hospital, with Alyciana in the Special Care Nursery for the first seven nights.  I found the whole experience of having a baby in the SCN, even for such a relatively short time, very emotionally and physically draining.  Although, at six pounds, 13 ounces, Alyciana had no health issues, she had no energy to breastfeed initially.  Once we began the breastfeeding sessions, it was a matter of counting every second that she stayed on the breast, desperately willing her to keep going, and feeling really disappointed if she fell asleep or just struggled at a particular feed. 

Alyciana would have a “good” feed and I would be ecstatic at her progress, then later she would have a “bad” feed and I would feel devastated.  I often felt as if she would never make it home out of the SCN.  It sounds ridiculous now, but I just couldn’t imagine her consistently feeding well enough to be allowed home.  I remember that one midwife on the ward told me to prepare myself for going home without Alyciana.   The thought hadn’t even crossed my mind until that moment, and I just felt totally devastated.  Later, something would happen to make me think this worst-case-scenario wouldn’t eventuate and so I’d feel happy again.  It was an emotional roller-coaster.  In the end, Alyciana and I were able to leave hospital together.  I’m not sure how I would have coped if I’d had to leave her behind, as so many other families are forced to do.

It is now over three years since my experience with pre-eclampsia, and Alyciana is a happy, healthy and highly spirited child.  She is our little miracle.  I know, though, that I will never forget the emotions surrounding her birth.  When I was in hospital and feeling much better, my obstetrician looked at me and said: “We brought you back from the brink of death”.  She was right and I will be forever grateful that I just happened to have that routine obstetrician’s appointment that day and that I had such a good obstetrician.  The impact of the situation really hit me when I left the hospital and, for months, I felt a huge sense that Alyciana and I had cheated death and something was going to happen to one of us.  Pre-eclampsia leaves a legacy in so many ways.  

Our family was one of the incredibly lucky ones.  I think about the tremendous sadness that pre-eclampsia brings to so many people and know that a cure just has to be found.

Philip and I would like to dedicate our story to everyone who has been affected by pre-eclampsia and to thank all those who strive to raise awareness of this devastating condition and those who dedicate their lives to finding a cure.