Being Pregnant in Scotland

Sometimes things went wrong, you were caught unprepared and helpless, and patience seemed to be the only way out.

First Trimester
When I was pregnant with Ethan, it had been an almost stress-less experience. Things went so smoothly that when I was pregnant again, I thought nothing about it. I was to be taught a lesson, not small, indeed.
I went to the GP soon after I knew I was pregnant. I thought I would be scheduled an ultrasound scan soon, like what happened back home. However, ultrasound scan and everything else had to wait till after the first trimester. Here, they did not believe there was anything they could do in the first trimester and would rather focus their resources on the more stable second and third trimesters. I was prescribed folic acid, told to eat a healthy balance of food (and hence no need for multi-vitamins) and given some information about pregnancy (a book called 'Ready, Steady, Baby' among other leaflets). Also, I applied for a card that would entitle me to free medicine from thence until the child is 1 year old. From the leaflets, I realised that it was unlikely I would get another ultrasound scan at the later stage. This was a disappointment, as I had wanted to know the sex of the baby.
The day I was to go for the first of my two ultrasound scans, I had bleeding. I was rather scared, as this never happened with Ethan at all. I was referred to the Maternity Triage Unit after the dating scan (which put my EDD as coincidental upon the memorable date of 11/9). After an hour's wait and some talking with the midwife, a doctor finally examined my cervix and told me the bleeding was likely from there. Thereupon, I was 'discharged' and told to call them if there was more profuse bleeding. There were a couple of such bleeding incidents, but never one to require more attention. Some weeks later, I no longer observed it.
Anyway, from then on, it's every 6 weeks to see the community midwife at the University Health Center or the National Health Service centre at Lauriston Building, both near where we are living. The midwife would measure your womb, and from there, conclude how much the foetus has grown. There would be no more ultrasound scans unless they thought it necessary for some disconcerting reasons. They would use an ultrasound device to listen for the baby's heartbeat. Blood tests they took a lot, and I was told to take iron tablets due to low haemoglobin levels in my blood. After that, I had to take a few more blood tests to check the level again and again. It got back to normal towards the end of my third trimester, and they even took another blood test to check my ferutin level. I was never to know the result of that though, because I went into labour before the next midwife visit. But here I jumped sequence.
The later part of the first trimester was accompanied by the very common symptoms experienced by most pregnant women. So common that I wished fervently I was the uncommon type, in vain. I craved for foods back home and lost my appetite for many of the foods here. A very serious situation as I was doing the cooking then and I just couldn't take 'simple, repetitive' dishes any more. Added to that, I felt tired easily. Sometimes I attributed it to a mental state, but whether psychological or not, I had to feel what I felt and preparing unexciting meals and craving for meals unattainable were my daily ordeals.
Second Trimester
All these mundane complaints evaporated in the most sudden and unexpected manner one day - one single day. During the 18th week, I received a call from the screening test nurse on the blood tests for Spina Bifida and Down Syndrome screening I had done two weeks before. I was told I was in the high risk group for Down Syndrome - 1 in 200 as opposed to about 1 in 600 or 800 in women my age. I was given the option to do amniocentesis for a diagnostic result, which carries the same risk of miscarriage. I had to reply within 2 weeks since any abortion after the 24th week was impossible and they would need about 3 weeks to get the results out from the amniocentesis.
Initially, as I put down the phone, I was still in a fairly calm state - this was just a screening test, wasn't it? And I had been prepared for such a result should it occur - wasn't I a pessimistic person by nature? Then, with a shock, I realised I had not been prepared for this. I had expected an all-clear result. I hadn't thought over it carefully enough what I would do should the result come back positive, as it did. What a lesson in decision making!
Surfing the internet for the double test, the triple test, the quadruple test, and all sorts of combination of ultrasound scan and blood tests, which periods of gestation were most accurate for which tests, the two diagnostic tests - CVS and amniocentesis - available and their associated risk of miscarriage, I got even more worried. Jianming borrowed some technical journal on the screening tests and a Down Syndrome book. We read and deciphered the statistics of risk, false positive rate, false negative rate etc. Discovered I was just a number in this statistical game. Only thing is, I am not just a number, but a human being, and a human being capable of anguish and despair. The more I read, the more sure I was that the baby inside me was not normal. Why else would my HCG levels be high and AFP levels be low? Nobody could explain why but with a 'normal variation of hormones in the blood'. Why then, would this test be developed if there were 'normal variations'? So into despair and indecision I sank - should I take the amniocentesis? Later, I decided against it and that must be the best decision I have made. What if the result came out to confirm that I had a Down Syndrome child? Would I then go on to the next stage of abortion? Could I? If not, then I must live with this certainty inside my womb. And no one can be truly prepared for such a baby until you first set your eyes upon the baby. At least now, it's an uncertainty, and I could still hope in the remotest corner of my mind - for a healthy baby. But hope, I dared not. And after making the decision not to do the test, I cried again. It was so until there was no turning back - when the time came that would make it too late for me to do the amniocentesis anyway - then I felt all was settled and at least I need not think about doing this test or not. Life was still teary for a week or two after that. Then, I managed to put this at the back of my mind and tell myself to enjoy the precious few months I had left that would be relatively carefree and mobile.
Miraculously, I lost the morning sickness once my mind was occupied by this devastating news. And after I sort of got over it, I was at my most energetic highs and optimal condition. At times, I didn't even feel like I was pregnant. Second trimester thereafter was the best part of the pregnancy, physically at least, albeit with such a dark cloud hovering above. I went out with Ethan, even when Jianming couldn't afford the time to come with us, and managed to drag such highs into the early part of third trimester even. I so wanted it to last and linger longer, I dreaded the day when my attention would have to be divided between Ethan and the new baby and my freedom curtailed.
I did not announce my pregnancy to friends from then onwards. Any friends who knew about my pregnancy were told before the news of the screening test results. I kept mum, as this was still an uncertainty, yet an uncertainty that made it difficult for me to accept 'congrats' from unknowing friends, innocently happy for me.
Still, my moods were roller coastal rides. I could not remember the reasons that would get me low and then those that would get me back on the normal track. I think having someone to talk to helped matters. I always felt a bit more cheerful after a chat with some of the mothers here.
I was also not interested in the sex of the baby any more. To me, if the baby was born healthy, that would be the greatest joy I could get. Boy or girl, it did not matter. It was like, I could suddenly see the point of view of the health care system here in not bothering to scan for the sex of the baby - there was no reason for it.
Another change that occurred to me was my interest in a natural childbirth without pain killers. I figured then that if I were on epidural, I would be free to think unhappy thoughts. But if I had to deal with the labour pains, then I could keep my mind off other things. Later I was to learn that the health care system here is such that one will not be admitted to the hospital till the contractions come in intensively, by then it would be too late for epidural unless the labour is too prolonged. Anyway, I read about natural childbirth and began to subscribe to the idea more and more, regretting I had not known these with Ethan.
Third Trimester
I shall date third trimester from the time when I began to feel too lazy / tired to even go out and yet would still try to make myself do so for that last scrap of relative freedom. I should have cherished my time with Ethan more during these times, and not have scolded him as much. How little I knew then of the degree of estrangement my relationship with Ethan would get once the new baby arrived!
Visits to midwives were still as usual, though it's every three or four weeks now - I would rather the frequency was low since it was troublesome to visit midwives when you had to bring a toddler along, prepare lunch, bring him to playgroups etc.
Some time in my 36th week I think, I began to feel very itchy, especially at night, at the soles of the feet, palms of the hands and abdomen. Later, it could be itchy just about anywhere.
Ethan started nursery on 26th August. It was a 2.5hr event where the parent could finally have a bit of a breather while the kid interacts with the teachers and children. However, the first few days were shorter hours and parents had to be around to 'acclimatise' the child. On the same day, I took another series of blood tests during my visit to the midwife, one such was due to my complaint of itchiness.
On 27th August, I received a phone call from the hospital - phone calls were never good news, I realised. I was asked to go to the hospital - they suspected I had a rare condition called obstetrics cholestasis, a kind of liver malfunction. So, I went to the Day Assessment Unit, which has the same long waiting time as the Triage Department. The baby's heartbeat was put under monitoring, I had more blood taken. I was told to go back again on Friday, 29th August for further monitoring.
On 28th August, Ethan had the accident at night, and on Friday we took him to the Royal Hospital for Sick Children to have the open wound stitched up. In the afternoon, I left for the Royal Infirmary. There my cervix was examined by a doctor who later told me she would schedule me for an induction of labour on Monday, 1 Sep. There was a chance of distress to the foetus should I continue my pregnancy with this condition, and stillbirth rate was also increased.
So, I went to cut my hair, did a few things here and there - I couldn't remember what. Then I chanced upon some chats in the internet among mothers diagnosed of the same condition and felt that an induction was afterall not that necessary. And I didn't want to risk having a caesarean.
Hence, on Monday morning, I went to the Day Assessment Unit with the intention not to be induced. An ultrasound scan checked the amniotic fluid level. However, it did not check for the sex of the baby, being the policy of the hospital. Later, I was sent to the labour ward and there began my long, long wait. I told the midwives that I did not wish to be induced. They told me to talk to the doctor, who would come in to see me. The doctor, when she finally came, said the current guideline from the Royal College of Surgeons is that there is no need to induce labour after the 38th week if constant monitoring of the foetus shows no problem. So, she suggested we take another blood test to see my enzyme level and decide after that. Waited 2 hours for the blood test result, only to have the midwife tell me that the blood samples were lost. Re-took, re-waited. By the time I left the hospital, it was 6.30pm, I had decided not to get induced. I was asked to make an appointment for 3 Sep to go back to the hospital for monitoring of the baby.
I wondered then, if I were not making things more troublesome for myself this way, as I had to go back constantly to the hospital to monitor the baby, whereas one induction of labour could have settled things. But, knowing how busy life would get for Jianming as well when the baby was born, I thought it better to delay the birth and let the baby decide his/her own birthday.
Yet, things would have it that labour pains came at 1.45 am the next day. I woke up to the usual pains and went to the toilet. But the pains did not go away this time. As I had epidural very early with Ethan, I did not know how the contractions felt like, and timing them was haphazard. So, by the time I reached the hospital and waited another hour, I was admitted to the labour ward immediately. Would be tough to call these Braxton Hicks contractions, I thought at that time, they was so unbearable when they came. Anyway, this is for another story, I suppose. Sometimes I think that if the doctor had not examined my cervix on Friday, my labour would not have come in so early. But of that I could only surmise.