by Jo Pavey
The medical staff remained calm and professional but I could read concern in their faces. I imagined they were all thinking, ‘This is bad,’ but I didn’t say anything. I didn’t want my worst fears to be spoken aloud in case they became real.
They did a C-section, and got our baby out as fast as they possibly could. After that nervous pause, we were so, so relieved when he let out his first cry. Gav cut the cord and Jacob, our little baby boy, was handed to me by the wonderful, kind Dr Larry. I gazed into Jacob’s magical little face and kissed Gav. I felt huge waves of joy, more powerful than anything I’d ever experienced. We were overwhelmed with happiness. Our baby was simply gorgeous. ‘He’s so beautiful,’ I whispered to Gav, but our relief was short-lived. This incredibly special moment was interrupted when he was quickly whisked from my arms. Jacob was making tiny distressed whimpering noises. We weren’t aware of the normal colour of a newborn, but thinking back now, I remember he was extremely pale, almost white. The medical staff could see instantly he had lost nearly all his blood and they took him away at once. Where had all his blood gone?
I lay there powerless. I was still being sewn up and was literally paralysed from just above the waist down. I could hardly move a muscle. They whisked Jacob away to give him an immediate blood transfusion – but they didn’t know what had happened, and whether it would solve the problem. They immediately transfused a huge amount of blood into him, and things were stable but desperate at the same time. Where had it all gone? Into his brain? His stomach? What if it had caused massive internal damage?
They tested and tested. It was the longest wait I’ve ever undergone. I was trying not to let my mind race. Trying not to think at all. Just waiting for the news. Eventually – an eternity later – they returned. We were so thankful he was okay. It had been very, very close, but the blood transfusion worked. He had responded. When he was born, his haemoglobin level was two: the normal level for a newborn is in a range of around 14 to 24. We had to wait a further twenty-four hours for the results of a series of tests and scans and it was a very worrying time. The doctors were still baffled, but when they took a blood test from me, and analysed the sample, they realised what had happened: most of Jacob’s blood had pumped into my body. It wasn’t a placental abruption, but something very rare. Some of the staff said they hadn’t seen it in the thirty years they had worked at the hospital. Just a few hours before we had arrived at the hospital for our induction appointment, a small membrane between Jacob and me must have broken down, so that every time his heart beat, it pumped his blood out of him, and into me. It was incredibly rare, and usually fatal. The doctors said this could have only been going on for a short amount of time and Jacob would only have survived perhaps another two hours inside me. And there was absolutely nothing I could have done about it.
The fact that I had been booked to come into hospital for an induction had nothing to do with the life-threatening emergency that was discovered. I was purely there because he was a bit small. I’d been told to get to the hospital by 7.30 a.m., so if I hadn’t needed to get up early, I may have slept in and by the time I noticed reduced movement of my baby and had actually been seen by a medical professional, it would have been too late. Somehow sheer luck saved him. It was such a miraculous coincidence that I was in the hospital for a different reason at the crucial time. If I stop to think about it – and I do regularly – the chain of events seems almost unbelievably fortuitous and it brings back a lot of emotion.
I didn’t see Jacob for a while. They had whisked him off to the Special Care Baby Unit (SCBU) and I was unable to move because of the emergency anaesthetic. Until I got the feeling back into my legs, I couldn’t see my new baby. They couldn’t wheel an entire bed into the SCBU. I had to wait until I could get into a wheelchair. I remember desperately willing the feeling back into my legs. During this time, Gav went back and forth with our video camera so that I could see Jacob. I longed to be with him. When I could finally sort of work my legs enough to get into the chair, they took me to see him. By this time he already looked much better, but to go into a ward full of high-dependency machines beeping and see tiny babies fighting for their lives is something no antenatal class can prepare you for. I felt at once completely responsible for this tiny new life, and yet totally powerless.
We were in hospital for five days in the end – not very long, considering how ill Jacob had been. Our parents had travelled up from Devon when he was born, but were not allowed to see him for the first three days due to the swine flu epidemic. I’d always planned to breastfeed, but at first I had to express milk as they were still running constant checks on Jacob and he couldn’t feed directly. The nurses had to fetch me nearly every hour during the night as there is nowhere to sleep in the SCBU. After a few days of steady improvement, the doctors agreed he was ready to go home. It was only then, when given permission to go home, that the intensity of the experience and birth – and how fortunate we had been – truly hit me. I was full of emotion as we wrote a thank-you card to all the medical staff before we left. Without them, we wouldn’t have our gorgeous little boy. The ‘what ifs’ do haunt me. What if he hadn’t been small, so we hadn’t needed that induction? What if the ward had been full that morning? I cannot express how grateful I am for how things turned out and how lucky I feel. And I feel so, so deeply for others less fortunate than myself and Gav – because I know how close we came to experiencing such great sadness.
The day we took Jacob home from hospital, we felt the most enormous sense of happiness and relief. I’d been shell shocked. The panic, the surgery, hormones, his dramatic arrival, his pallor – it was almost too much to take in. One of the oddest things is that because he had so much blood transfused into him he couldn’t have the heel-prick test babies have in hospital, when nurses collect a few drops of blood to test for serious conditions such as sickle-cell anaemia or cystic fibrosis. Even when Jacob was a few days old, when he was stable and healthy enough, they couldn’t do this simple test on him because the blood going around his body, pumping through his veins and arteries and heart, wasn’t his. It was the blood of a wonderful stranger who donated it in return for nothing more than a cup of tea and a biscuit. That simple, generous act saved our child’s life.
Putting our newborn in the car for the first time was a surreal experience I’m sure all new parents can relate to. We felt we should drive at 10 miles an hour all the way home. Being a little family, finally settled back at home in familiar surroundings, was amazing.
For me, everything changed. My perspective shifted completely. Worries that had bothered me became insignificant. All that time worrying about my running targets, my training sessions, my race results! Now I was overwhelmed with happiness and love for this tiny little bundle who was dependent entirely on us. We had always had hopes and dreams for our own lives; now we had them for someone else too.
CHAPTER 19
Motherhood and Marathons
As soon as we got home we didn’t have time to dwell on the worrying moments we had experienced. Every parent knows the insanity of the first few weeks with a new baby: the exhaustion of sleep deprivation, and not always knowing the difference between day and night. Interestingly, though, I think being an athlete running a high mileage helped with the tiredness. I was well used to feeling fatigued from training, and removing that was a good starting point. But I did find the early days tiring, although I think the happiness does help to get you through.
I was the first one in my antenatal group to have their baby. It was quite fun to be the first to go along to the coffee shop meet-ups actually presenting a baby. With regard to routine, Gav and I are definitely quite relaxed. We found humour in our ‘go with the flow’ attitude when we compared ourselves to some of our antenatal group friends who were following baby routine books to the letter. There is no right or wrong way; every parent should do what works for them and what fits with their lifestyle and values. And I don’t think anyone should ever feel judged. As Jacob grew older an
d we established more of a loose routine, it did start to get easier, but we faced some additional challenges over the next few weeks and months.
After a few days at home, I started to find breastfeeding extremely painful. I persevered, but the pain became unbearable. When I developed a fever and excruciating pain down my back I reached for the painkillers I’d been prescribed after the Caesarean. I had stopped taking them for the post-operative soreness, but as they’d been given to me at the hospital, I knew they were safe to take when breastfeeding. The pain intensified even through the painkillers. I was overcome with weakness, so Gav packed Jacob in the car and drove me to A&E. He had to support me as I shuffled into the hospital while pushing Jacob in his pram. It was a long walk, and I collapsed inside the door. Before I knew it, I was in a wheelchair being whisked up to a ward. My temperature was high and my heart rate was over 140, which is very high for an athlete. My normal resting heart rate is around 40 beats per minute. They were worried I could go into sepsis. I was diagnosed with mastitis and stayed in hospital for three days on a course of intravenous antibiotics, with Jacob by my side, so I could continue feeding him.
It was lovely to return home again properly, although Jacob had to go back to the hospital regularly for blood tests to check his haemoglobin. It also became clear that poor little Jacob had terrible reflux. He would bring up the milk I had just lovingly (and painfully) given him, usually all over me. It not only caused piles of laundry – the least of our problems – but it caused him awful discomfort and distress, so he was more unsettled than he should have been. It was heart-rending to hear our tiny little baby in such pain. Some babies get it worse than others and Jacob suffered an extreme version of it. When I was pregnant, I’d glance through the mother and baby catalogues with pictures of babies all lovingly tucked up in their Moses baskets, beds or prams, quiet as mice and sleeping soundly by themselves. Some babies might well do that, but Jacob was definitely not one of them, the poor thing. He couldn’t be put down after a feed for many weeks. He had to be held in an upright position for at least an hour and a half otherwise an entire feed of valuable breast milk would make an instant and unwelcome reappearance. By the time it was safe to put him in a more horizontal position, it would virtually be time for the next feed again.
If we risked cutting it slightly short, perhaps putting him down an hour after a feed, within seconds it would be regurgitated and he would cry. Sometimes he would vomit anyway, no matter what we did. It was so severe that when I arranged to meet other mums from our antenatal group in a favourite coffee shop in Teddington, I’d have to take four or five huge muslin cloths, and complete changes of outfit for him and me, just in case. As well as being awful for him, it was all a big palaver. I felt like I spent every moment of these groups mopping up. But it was always nice to be in the company of other new mums like Denise and Helen and for their babies, Zane and George, to become Jacob’s buddies, as well as to give each other support, though they all thought I was completely mad trying to get back to running!
Our GP referred us to a consultant who gave us medication for Jacob’s reflux, which he assured us would ease his symptoms and discomfort. It did, but there was an awful lot of it. For every single feed, he had to have four syringes of different medicines, all of which had to be kept in the fridge. It was a crazy time – we sometimes felt unsure about giving him so much medicine, but were assured it was the kindest thing to do to make him more comfortable. When he was a bit older we propped up his mattress with a pile of books to create an incline, which helped. We also found ourselves at the GP’s at least every two weeks to get antibiotic eye drops for a chronic eye infection Jacob had come down with. But, like any parent, we just dealt with it and muddled through.
Unfortunately, there was another more serious drama to come. When Jacob was four months old, he developed a high temperature and I couldn’t get him settled. Instinctively I knew something was wrong so we decided to go and have him checked out at A&E to be on the safe side. He was admitted, screaming inconsolably, so they could test him and find out what was wrong. He started to labour when breathing, and it was found that he had Respiratory Syncytial Virus (RSV), which was causing severe bronchiolitis. He also had gastroenteritis, and over the next twenty-four hours he started to deteriorate in a scary way. He was wired up to all sorts of monitors and given extra oxygen. I was expressing milk so that I could feed him small amounts by bottle as well as giving him sips of the rehydrating solution Dioralyte. By the second evening his gastro symptoms were so severe, he was taken off food. His breathing continued to deteriorate. The medical staff considered moving him to another hospital where he could be ventilated. It was all so worrying. By now, he was visibly dehydrated. The hospital was so busy there was a delay of some hours before a doctor could come and put an intravenous line in for a drip. I was so anxious, and on my own as after the first night Gav was not allowed to stay beyond the end of visiting hours at 9 p.m. Jacob was mostly asleep, but there was no way I would even consider dozing off for two minutes on the pull-out bed next to him. I scrutinised his oxygen saturation monitor literally minute by minute. The level kept getting worryingly low. His tiny stomach and the skin between his ribs were sucked in as he laboured to breathe. When he was awake, he was distressed, but his cry was silent. He was too weak to make a sound.
It was 2 a.m. when they finally came to insert an IV line. I found it extremely distressing to watch as the doctor and nurses tried without success to get a line into his tiny veins, until eventually they had luck with a vein in his foot, and went away. However, almost immediately, the line came out. The nurse called the doctor on the phone, but they had moved on to deal with another emergency. By now Jacob was seriously dehydrated. His skin was dry; his lips cracked. I knew I had to get fluids into him or he might not make it. It sounds dramatic, but I had experience as a physio working in Intensive Care wards, so I took it into my own hands to make up an electrolyte drink for him and give it to him in a sterilised bottle. He took it. The nurse was flustered as she’d only just qualified, telling me it wasn’t protocol to allow me to do that, but I needed to do what I knew was right and I could see that his dehydration was becoming life-threatening. The staff were clearly overstretched at this busy time and they had been trying their best, so I got on with it myself. And slowly, slowly, Jacob started to rally. His condition was frightening for a while, and we remained in hospital for several days, eventually feeling so relieved that he was going to be all right.
When Jacob was born my mum had given me a little gift box which said on the top ‘A baby is more trouble than you’d imagined, but also so much more wonderful.’ This certainly rang true. The reflux continued to be tough to deal with. I ended up having to supplement him with the odd bottle of expressed milk or formula milk. I was producing more than enough milk, but he could sometimes bring back up an entire feed all over the floor. That was so frustrating. Conscious that he was so small at birth, 5lb 9oz – although not quite as tiny as they thought he would be, I worried about him getting enough food, but the consultant reassured us that he was doing well judging by the size of his thighs! Fortunately, he was happy to take a bottle. This feeding palaver went on night and day, but after ten months or so his digestion started to settle down. Even when he was getting bigger, and started being weaned on to solid foods, it was still an issue. We’d arrange to visit friends and I would think, ‘Okay, if I’m taking some baby food for Jacob, I must remember not to take anything orange . . .’ I was concerned about making stains on other people’s carpets. As it turns out, a surprising amount of baby foods are orange.
I had started to run again fairly soon after having the C-section. The official advice is that you shouldn’t do any exercise for at least six to eight weeks, but I must confess I did start earlier than that. I listened carefully to my body and felt ready to start doing something. I thought that being an athlete might make me ready to return to exercise sooner than average. I also felt that as whatever I did now was only af
fecting me – my body was one person again instead of two – rightly or wrongly that kind of gave me the permission to get on with it. I tried light jogging at first, feeling pitifully out of shape, but I built it up a little bit at a time. To begin with, I certainly noticed how weak my core muscles were due to the surgery. My legs felt strangely as though they weren’t properly connected to my body. I ran slowly around Bushy Park, but also on the treadmill, which Gav and I had invested in to help make training more flexible around the needs of a baby. For feeding purposes I could remain at home whilst still running. I could also avoid too much running around the streets late at night in the dark on my own as the winter months set in. Our Victorian terraced house in Teddington was open plan, so the treadmill had to be in the living area, which looked quite daft, and I would always run with the curtains shut, so as not to amuse the neighbours with my crazy exploits.
We were aware there would also be impracticalities and safety issues once Jacob was crawling around so, eventually, we had a shed built in the back garden, but in the early days the treadmill came into its own as I made up my own quick-fix fitness programme. Initially I struggled to overcome the uncomfortable feeling of impact through the Caesarean scar when running outdoors, so my first workouts were to ramp up the treadmill to a gradient of 9 or 10 and kind of shuffle or race walk at a good pace. Aerobically, it was very tiring and gave me the satisfaction of getting my heart rate up to a reasonable level, something I’d avoided for so long whilst pregnant.
Trying to claw back my previous level of fitness was fairly daunting. However much I liked to think I was still fairly fit, I had inevitably lost a huge amount of stamina and muscle condition throughout pregnancy and recovering from Jacob’s birth. I also had to be mindful of other postpartum issues, such as the tendency for ligaments to become looser. Gav and I talked about me returning to running, but in order to be competitive, I had the proverbial mountain to climb. To maintain a pace that a year earlier would have been something of a gentle warm-up felt impossible to begin with. It was a struggle, but also a return to something I loved. I was as exhausted as any new parent, coping with Jacob’s needs round the clock, and I’d been out of serious training for the best part of a year. It felt ridiculously hard sometimes, but it was a new challenge, and I kept going. As I gradually added more volume and intensity, things started to come together. All of us new mums can feel daunted about getting our bodies back to pre-pregnancy shape. I found I had to take one day at a time, be patient, and accept that my fitness regime had to be flexible around the needs of the baby, the rest of my family and my own tiredness levels. My advice is: listen to your body, don’t be tough on yourself and bit by bit, you’ll get there.
