‘I spent hours listing pros and cons of ending my pregnancy’
As a GP I’m very aware of the heartache of pregnancy loss. Would the decision haunt me?
Michael and Caroline McCarthy, who had a termination in Liverpool at 24 weeks after learning her baby would not survive. Photograph: Dave Meehan/The Irish Times
On January 3rd, 2018, at 03.34am I delivered my third child, at Liverpool Women’s Hospital. He weighed just one pound and seven ounces, and we named him John George after his dad’s great grandfather.
The reason I was there and not at home in my own maternity hospital was that my husband and I had decided to terminate our pregnancy. I was 23 weeks and four days pregnant and it was just over three weeks since we had discovered our baby would not survive once born.
This was the most distressing three weeks of my life, where I hid away from the world and waited for the day I would end my pregnancy. Every morning I woke up crying and wishing myself to miscarry. Every time I felt my baby kick I was overcome with feelings of sadness and guilt.
I was delighted to discover I was pregnant in August 2017. As a GP I am very aware of the heartache of pregnancy loss, but having had no problems conceiving, no history of miscarriage and two previous straightforward pregnancies and deliveries, I had no anxieties about my pregnancy.
Tears of joy
At my booking visit in early October I cried tears of joy when I saw my little baby wriggling about on the ultrasound screen. After this visit, we excitedly told our two children that Mummy had a baby in her tummy and stuck the ultrasound photographs proudly on our family notice board.
Over the next eight weeks my belly started to swell and our plans for the coming months included our expected new arrival.
Then on December 11th, at our baby’s routine 20-week anatomy scan, our world changed forever. Within minutes all the excitement of the previous few weeks was taken from us. We wanted to know if we were having a boy or a girl, instead we found out our baby would not survive.
My baby had no kidneys and as a result there was no amniotic fluid. His lungs could not develop properly without the fluid, but he wouldn’t need his lungs or his kidneys until after birth, so the pregnancy would probably carry to term. I had two options: carry my baby to term and he would either be born dead or die shortly after birth or travel to the UK to end the pregnancy.
Those first few days were a haze of panic and tears. My immediate instinctive response was that it would be better to end the pregnancy. But once the initial shock of the diagnosis subsided doubts started creeping in. I still looked pregnant, I still felt pregnant and I could still feel by baby moving.
I had been warned that due to my gestation, they would need to inject potassium into the baby’s heart to stop it beating, before inducing labour to start.
I was completely and absolutely consumed thinking about this. I spent hours doing up lists of the pros and cons of continuing or ending the pregnancy.
How could I carry on like this in this strange sort of limbo where I am grieving for the loss of a baby that is still alive and actually growing inside me? That would be so difficult for me both physically and emotionally and for our children.
But how could I decide to have potassium injected into my baby’s heart? How could I live with that decision? Would it haunt me forever? And what about the baby, what was best for him? Would he experience discomfort during or after labour later in the pregnancy? Could he feel discomfort now?
Ever since I discovered he was not cushioned in fluid I was very careful about how I sat or lay down or moved, I was worried about compressing him further.
We eventually decided to end the pregnancy and my details were sent on to Liverpool Women’s Hospital.
I started lightly humming a nursery rhyme. This was the last time my baby would hear my voice
I spent two anxious days waiting for the promised phone call but when they contacted me initially it was to say they could not accommodate me. Their unit was too busy. My maternity hospital advised looking up the British Pregnancy Advisory Service website and arranging care through them.
I felt abandoned and so completely alone. The idea of attending an abortion clinic was terrifying. I wanted to be cared for in a maternity hospital. I spent three days attempting to telephone different maternity hospitals in the UK. Most of the phone calls ended in uncontrollable sobbing.
Thankfully, a few days later I learned there was a cancellation in Liverpool and was offered an appointment.
Two weeks later, January 1st, 2018, we boarded a packed flight to Liverpool, full of people returning home after the Christmas break. I felt so conspicuous, as if everyone must know why this pregnant Irish woman was heading to the women’s hospital with a suitcase.
As soon as we arrived at the hospital the relief flooded over me. The receptionist smiled and ushered us into a room where she checked my details privately.
The midwife in charge came and explained what would happen. I had another ultrasound scan and the diagnosis was confirmed. Then I took the first medication – mifepristone – the purpose of which was to make me more susceptible to the effects of the second medication, misoprostol. Swallowing that was easy compared to what was to come. The consultant came to get our signed consent.
At the top of the form I could see the procedure neatly written in: “Feticide termination of pregnancy.”
This time there was no screen for me to see the ultrasound images of my baby. My husband sat close by my side and I clung to his arm tightly. There was the scratch and sting of the local anaesthetic going in, and then a tightening, contraction type feeling as the catheter was inserted through my abdomen, my uterus and into my baby’s beating heart.
Suddenly I could feel him moving. I started lightly humming a nursery rhyme. This was the last time my baby would hear my voice. The movement stopped and I knew our baby was dead. We were left alone in that huge ultrasound room, our heads bent forward, quietly crying.
Later that day we were brought up to the labour ward, to our special “Honeysuckle” room. The bereavement team in the hospital are known as the Honeysuckle midwives. They provide care and support for women and their partners experiencing pregnancy loss, including “compassionate induction”, the term they use for ending a pregnancy early in the case of a fatal diagnosis.
After a few hours my labour started. There was no excited anticipation; just pain in all senses of the word. I was given morphine and gas and air but of most importance was the midwife who stayed by my side reassuring and comforting me.
Very soon later my little baby came, a boy, still in his sack with the placenta attached. When she broke the sack not a drop of fluid came. I saw his perfect little face for the first time.
I felt that same post-birth relief and elation as I had after the birth of my other two children. The midwife wrapped him in a towel and I held him close. I felt at complete peace with my decision and just sat holding and staring at my beautiful son.
In the morning the midwife helped us dress John. We spent the day holding and looking at him and taking photographs. I wanted to know where he would go after we left, and if his clothes, blanket and teddy bear would be kept with him. I was reassured that they would.
The care we received at the hospital was exceptional, and stepping out of this bubble of love and kindness and re-entering the real world without our baby was terrifying.
The very women who are in most need of support and care when experiencing a crisis pregnancy cannot travel
All I wanted was to be back at home, to tuck my two beautiful little children into their beds and to climb into my own. But we spent the following hours sitting in full public view at the departure lounge of Liverpool’s John Lennon Airport waiting to board a flight home.
Two weeks later and accompanied by our families, we travelled back to Liverpool for John’s funeral. As my husband and I carried the tiny white coffin into the chapel, I looked at the silver plaque engraved with our son’s name and date of birth. I had such a strong yearning to hold him that my arms physically ached.
I will never forget John. For me, his birth story is a reminder of what is most important in our human world: kindness and compassion. My husband and I will always remember the compassionate and thoughtful care we received at Liverpool Women’s Hospital and how as a result we were left with some positive memories of the saddest day of our lives.
Reflecting on my experience now, in the run-up to the referendum, I realise how lucky I have been. Liverpool Women’s Hospital is no longer accepting referrals for Irish women after 20 weeks’ gestation, meaning there are women with stories like mine who will not be cared for in a maternity hospital.
There are also many women who cannot “travel for care” – including those living in direct provision centres, prisoners and those in financial difficulty – the very women who are in most need of support and care when experiencing a crisis pregnancy; whether that be due to an antenatal diagnosis such as mine, sexual violence or life’s often unfair and complicated circumstances.
Today, on what was my baby’s due date, I still feel full of sadness and grief, but also gratitude that I was afforded the opportunity to make the right choice for me, my family and my baby.
Since first writing this article, Caroline McCarthy and her husband Michael have joined the Together for Yes campaign