The Two Week Wait
10 Questions To Ask Your Care Provider
Your Pregnancy Care Options
Common Symptoms in Early Pregnancy
Six things you may not know about the hours after a caesarean birth
What is Informed Choice?
How to Plan for Postpartum
A Quick Guide to Breastfeeding
In this week’s episode I interview Melanie who shares her experience as a BRCA1 gene carrier. With a strong family history of breast and ovarian cancer, Melanie made the decision to have a double mastectomy five years ago. Despite a link between BRCA1 and low egg count, Melanie fell pregnant naturally and takes us through her pregnancy from first trimester morning sickness to hospital classes via zoom. She delivered vaginally and admits that the reassurance and support she received from a student midwife is something she’ll never forget.
“I’ve got the BRCA1 gene mutation, which means I’ve got a higher chance of getting breast and ovarian cancer. The likelihood of developing those cancers significantly increases after the age of 35. There is a lot of breast cancer prevention out there but not so much for ovarian cancer. The symptoms of ovarian cancer are symptoms that women have every day; it’s not easy to diagnose and it’s often diagnosed in the late stages. It’s been recommended that I have a hysterectomy after I have had my children and it’s something I definitely will do,” says Melanie.
“My mum’s side of the family has a long history of breast cancer; it was always on our minds as it’s so prominent in our family. My mum was diagnosed with ovarian cancer seven years ago and her doctors tested her for the BRCA1 gene; my sister and I had a 50 percent chance of having it and we both do. We have yearly check-ups, we have yearly MRIs and in the second year they found a lump in my sister’s breast, she was 24. It was picked up so early and she did chemo for three months and then had a double mastectomy. Then it was my turn to consult with the doctors and I knew I couldn’t live with that fear and anxiety – ofwondering if and when I was going to find a lump. I’d helped my mum and my sister through their recoveries and it was something I wanted to do seen my mum and sister’s recovery so I knew it was something I wanted to do; it was made easier by knowing what was coming. It was a no brainer, really. I just got to the point where I was looking at my breasts and all I could see was the harm they could do to me.
Melanie had the double mastectomy and reconstruction done in one operation which took close to eight hours. She admits that once she’s had her children and has surgery for a hysterectomy, it will be a weight off her shoulders. When she was first diagnosed with the BRCA1 gene, her doctors told her there was also a connection to low egg count and when she was tested, it proved correct. She discussed IVF with her partner as it also allowed them the benefit of gene identification; embryos can be tested for the BRCA1 gene. But then Covid hit, IVF clinics closed and there was a one year wait to start the process. Luckily, they conceived naturally.
“I booked into Sandringham Hospital; a few friends had a great experience there and that was really comforting to me. I did shared care with my GP and did a few hospital preparation classes via zoom and yet nothing could prepare me for going into labour at 37+1 on my second last day of work!
“I was getting ready to go out for dinner when I noticed I was cramping. We only lasted an hour in the restaurant and then we went home to pack as I hadn’t even packed a hospital bag. The hospital encouraged me to stay at home till my contractions were closer together so I got in the shower as I was already in a lot of pain and James was madly packing our bags. They were strong and lasting for a minute or more so we went to the hospital about 9pm. We had to stay in the waiting room for a while and then a midwife called me in and told me she would do an internal to see if I was in active labour. She got a shock when she discovered I was 8-9cm!
“It feels like a bit of a blur now but I remember standing there and thinking this is really happening. The midwives were really supportive and so was James. They dimmed the lights and put calming music on but I was just in my head, struggling through the contractions and I asked for the epidural. The midwives really encouraged me and supported me but they also listened to me and I was so relieved when the anaesthetist came. The minute the epidural kicked in I felt like a completely different human. I had a student midwife who was amazing; she was calming and reassuring and she encouraged me to have a rest. Levi’s heartbeat started dropping a bit and they warned me that a few doctors would come in but I didn’t have to worry; it was a standard procedure.
“They told me they wanted me to start pushing. The student midwife looked at me and showed me how to hold my face and tuck my chin in, she told me to keep my breath in while pushing and then exhale. I watched her and copied her and I’ll never forget that; I couldn’t have done it without her. They gave me an episiotomy and he was out within fifteen minutes. He was placed straight on my chest. Having the epidural definitely helped when I was getting stitched up but I just focussed on Levi. They were concerned about my blood loss but to be honest I didn’t care at the time – I probably should have – but I was just so focussed on my baby.
“No one mentioned bringing Levi to my breast so they obviously had read my file. They showed us how to bottle feed and James gave Levi his first feed which was really special. I stayed in hospital two nights and on the fifth day I noticed I was so emotional; I started crying over nothing…it just felt like my emotions were out of control. Of course, it’s so normal but it was still a shock to feel out of control.
One baby BRCA1, Double mastectomy, Shared care, Student midwife, Episiotomy, Epidural
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