Prepare for a positive birth with The Birth Class

Episode 385

Elle

Following on from episode 383 where Sarah shared her surrogacy journey, this week we hear Elle’s side of the story. Elle and her husband Luke have four boys - Sonny born at 25 weeks, Alfie born via surrogacy and Taj and Lenny who were both stillborn. Elle takes us through her deepest grief and greatest hope including her three-year long IVF journey, NICU experience and the serendipity of finding Sarah and watching her grow baby Alfie. This story will stay with you long after you’ve listened.

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We conceived on our wedding night – or the night after – and that’s when we conceived. I was so excited but I look back now and think I was quite naive. I had bleeding in the beginning which was caused by a hematoma. Everything was looked good at the 12 and 20 week scans and then a couple of days after the 20 week scan that everything changed.

I’d taken the day off as I had a bit of a head cold and I was lying on the couch when I had a sharp pain in my lower belly. I stood up and there was a big gush of water and I knew it wasn’t good. I was really scared but hoping that everything was going to be okay. Luke drove me straight to emergency and we were taken up to a room where they did an ultrasound. Taj was moving but there wasn’t much fluid which confirmed that my waters had broken. They then did an internal and could feel the umbilical cord which meant it had prolapsed and at that stage we knew that delivery was imminent and he was too young for them to do anything. It was the biggest shock of our lives.

I hadn’t done any labour or birth preparation at that point. The midwives were beautiful and they talked us through the process, including a medication to induce labour. It’s such a blur because so much has happened since then. I had gas + air…it was really quick, about half an hour. The contractions were really close together. In hindsight I was so scared and I wish that I’d had the knowledge to spend time with him. I was a bit scared to look at him. The midwives dressed him and we had a cuddle and had photos taken. I’m so grateful for those photos but at the time I didn’t know what I wanted or needed. We were living in Darwin at the time so our parents flew up and they were able to meet him too. Leaving the hospital without him in my arms was the hardest thing I’ve ever had to do. My parents stayed for a few weeks and we’ve got such good, close friends who really supported us.

The longing to have a baby in our arms was so strong. We were really motivated to try again. They couldn’t give us a reason aside from premature rupture of membranes (PROM) so there was no closure in that way.

We assumed we’d fall pregnant easily again but there was three years between then and our next pregnancy. We were tracking ovulation and after 12 months we went to an IVF clinic because we’d done everything; we’d seen a naturopath, I was doing homeopathy, acupuncture, everything but nothing was helping. It was unexplained secondary infertility which was so hard to get our head around.

We got three embryos on our first round of IVF and over the next 18 months we implanted the next two embryos and they both failed. At the end of that I was at my lowest point. We were coming to terms with the fact that we weren’t meant to have any children. I felt so alone.

We had a break from IVF and went to the clinic in Adelaide for a second opinion. The doctor went over everything and she asked me questions about my period and it’s always been painful and heavy so she suggested looking into whether I had endometriosis. She discovered that I had late three stage, early four stage endometriosis and she managed to remove most of it and the next month we fell pregnant naturally. I didn’t even know what endo was; if I had known that it could have affected me, I would have looked into it so much earlier.

I felt ready and strong; I was feeling really positive. I returned to Adelaide and I found a private women’s clinic and the obstetrician I saw was the one who did my endometriosis surgery. I felt safe and comfortable in her care. I was having scans every fortnight to check my cervix because they thought that may have been the cause of my water breaking. I got to 17 weeks and they noticed a substantial shortening of my cervix. Normally they’d monitor but given my history of loss they admitted me to hospital to put a cervical cerclage in and that really built my confidence.

I was home at mum and dads house on bed rest. It was 25 weeks on the dot and that was a big milestone because it meant the baby was viable. I’d been out for coffee with girlfriends and I returned home and started having what I thought was indigestion pain. When they started coming regularly – and there was a pattern – I thought it was best to go to the hospital. They took us in straight away and did an internal and they could see that my cervix was fighting against the stitch; the top one had come undone and the bottom stitch was close to coming out. A doctor came to see us and told us that it was highly likely I’d have him that day, that he was breech and I would probably need a caesarean and perhaps a hysterectomy because of the way they’d have to cut me.

They gave me medication to try and stop the contractions and I lasted three more days till he was born. I had two doses of steroids in that time for his lungs and magnesium to help with his brain. The neonatal specialist came in to tell us what Sonny’s issues would be at his gestation and he took us through NICU to give us an idea of what life would be like after he was born. I had hope and I knew he was going to be alive when he came out. I could feel the contractions changing and could feel my cervix pulsating. They did an internal and they could see that the stitch was starting to rip my cervix so they took it out and he’d turned and was head down. For a really shocking and scary situation, everything that could have been on my side, was. That said, there was still so much unknown.

Once the stitch was out he was born 45 minutes later. On the last push he was still in the sac and they brought him over to me and I gave him a kiss and then they put plastic around him to keep him warm and then they took him to NICU to give him all the support he needed. He was in hospital for 12 weeks all up and was discharged just before his due date.

In the NICU, it’s one step forward and two steps back. They said he was doing really well. He was 780g at birth which was quite a good weight for his gestation. He had a brain bleed so that was the scariest part but it resolved on its own. He grew stronger and to be honest we were really lucky on our NICU journey. I just took it one day at a time. Luke took leave and then he got a position in Adelaide and he got it so the timing was perfect.

I was exclusively pumping and I was fortunate to have a god supply from the beginning and I was able to maintain that. I froze and donated a lot of milk and then I ended up feeding him for two years.

I had a lot of PTSD so I was seeing a psychologist during that time. By his first birthday we really felt like we could breathe easier; he was reaching his milestones and there were no issues we needed to worry about. He was 18 months when I fell pregnant, even though it wasn’t planned. I did the test and there definitely wasn’t a lot of excitement; we were apprehensive but I also felt like I had more control knowing that I had an incompetent cervix. The plan was to put the stitch in earlier – at 13 weeks – as a preventative along with progesterone pessaries. I was optimistic and I was feeling good.

I had fortnightly scans and the stitch was holding well. At exactly 21 weeks I was on the couch one night and I started having pains. They just kept coming. Luke was at work so my mother-in-law came around and took me to hospital and once I was there I had a bleed. They did an internal and they could see the cervix trying to open and they confirmed I was in early labour. I was devastated. The same plan was made, I would start on the nifedipine to stop contractions and the obstetrician came and told me we would try to get to 24 weeks. I kept having contractions overnight and I could feel my cervix pulsating and I just knew. My obstetrician came in the next morning and could see the stitch was ripping my cervix.

Lenny was born pretty quickly. My obstetrician did a scan and he was so happy there and it was my body that couldn’t do it. I was more prepared this time even though Luke was hesitant. Lenny stayed with us overnight. I felt stronger and more equipped that time, but my heart was so broken, I didn’t even know how we were going to get through it. I wasn’t the best mother to Sonny during that time…I saw my psychologist but a lot of the time I didn’t feel like talking. I felt quite alone and I retreated socially. It was really hard on our marriage too; I would want to talk but he would be withdrawn…we definitely felt like we couldn’t be there for each other in the way that we needed.

My obstetrician and the specialists suggested a trans-abdominal cerclage but they also said my case was quite rare in that my body continued to go into labour. We didn’t want to risk the heartache again so while we wanted another baby, I knew I wasn’t going to carry again. I’d looked into surrogacy mostly because it gave me some hope. I had this internal pull; I wasn’t ready to give up. Now that Alfie is here I feel like it was always meant to be.

There’s a well known lawyer called Sarah Jefford who specialises in and advocates for surrogacy and she has a podcast and a book….it was quite confusing to even know where to start. I remember hearing that the intended parents in Australia fair outweigh the amount of women willing to be surrogates which is why so many people go overseas to start their family. The only way to know is to put it out there so I put a post up about our interest in surrogacy and then Sarah’s sister Carla saw it.

It was just so easy, there was no awkwardness between us and it just felt right. I never have the words to say how amazing she is and how grateful I am…I just want to message her every single day! I had done the IVF before I met Sarah and we made three embryos and they were frozen so I knew they were ready to go.

I just trusted Sarah so much. Along the way a lot of my trauma came up and I really had to identify that and push it to the side and remind myself that Sarah had birthed four times before and she’s such a grounding force. I also wanted her to have the opportunity to birth in a way that she hadn’t before.

I did a bit of research into breastfeeding and spoke to a few mums who had induced breastmilk for their own babies who were carried via surrogacy. I went on the pill for a month because it mimicked the hormones of pregnancy, I also went on medication to prompt more milk production and from 34 weeks I was expressing and I was able to build up quite a good supply.

The labour and birth…Sarah was just incredible. She laid on the bed, breathing through three hours of contractions and all I wanted was for her to be able to get into the bath. As soon as she said she was feeling pressure they filled the bath. It was so special for Luke and I too…it’s been so traumatic for us so sitting there supporting each other was just amazing.

The plan was that I’d have the first cuddle and she wanted to hand him to me but the cord was really short so she got out of the bath and I cut the cord and had a cuddle. It was so emotional and so so special. He latched straight away and I just felt so lucky.

It’s taken so long and it’s been so hard that now it just feels so easy and magical. I don’t even care about the sleepless nights.

Topics Discussed

Cervical stitch, Endometriosis, Incompetent cervix, IVF, NICU, PROM, Secondary infertility, Stillbirth, Surrogacy

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