Patient Stories:Naomi Nevin

It was January 10th 2022, when everything changed.

I was attending my big scan in The Rotunda at 21weeks on my 5th pregnancy (3 daughters and 1 miscarriage). Bar having Covid at the end of the first trimester, the pregnancy had been alright until that point. At the end of the scan, the lovely midwife sonographer told us that she had 2 concerns that needed further investigation. The first was that I had complete placenta previa and a bleed close to my c-section scar. The other concern was that the baby had a shadow near his bowel. I was straight onto google when I got home and once I read about PA, I just knew I had it. I just seemed to tick most of the boxes.

The next number of weeks I had lots of scans trying to figure out what was going on. At 26weeks, it was confirmed that I had PA and an MRI was organised for the following week to see the level was at. I was also referred onto the PA Multi-Disciplinary team. It was explained to me that my case would be discussed at their next meeting where they would plan my baby’s delivery, that would be performed by two oncology gynaecologists as it would most likely result in a hysterectomy. I was told that if I experienced any bleeding to come straight to the hospital and that all going well delivery would likely be between 34 and 36 weeks. We had already decided that this baby would complete our family, but I never expected to be faced with a hysterectomy at 35.

My consultant recommended that I reach out to PAI for some support as most people have never even heard of it. I emailed the page and the lovely Naomi Cooney responded almost immediately and arranged to call me two days later. It was so nice to chat to someone non-medical that I didn’t have to explain anything to and just understood how I was feeling. Naomi also gave me so much practical advice about what to expect and what to plan for. It made me feel less alone as I was assured that all the feelings and fears I had were normal. I also reached out to The Rotunda’s Perinatal Mental Health Team. I had been linked in with them before and knew that I would probably need them at some point.

At 28weeks I had a tiny bleed, I rang my consultant and was told to come straight in and to bring a bag. I was admitted for monitoring and given steroids to prepare the baby. The scan was reassuring but I was told that the safest thing was to keep me in until the MDT met and decided on my plan. It was a very long week waiting and worrying about what could happen. During this time, one of the Oncology Gynaecologists from the Mater, came to see me. I remember how kind he was and started the conversation with “Congratulations on your pregnancy, I’m so sorry that this has happened to you “. He asked me if I wanted more children after this and said that a full hysterectomy was the safest option. He went through all the details of what the surgery would involve.

Unfortunately, my girls couldn’t visit due to Covid restrictions and Dave popped in when he could. Even though I was physically surrounded by people, it was a very lonely time with a racing mind. I got myself into a little routine to pass the days. After a few days, one of the lovely midwives arranged for my girls to be allowed into the garden to see me.

The MDT decided that delivery would be at 34 weeks in The Mater Hospital. The MRI had shown that it was likely that my placenta had come out of my uterus and that there was one area where it appeared to be very close, if not stuck, to some blood vessels. I was told that I would need interventional radiology to insert a balloon device into my Aorta to help control bleeding and possibly stents into my ureters. An anaesthetist came to see me and explained that I would need to be under general anaesthetic as the risk of bleeding was so high even prior to delivery. The good news that day was that they were letting me home, but I was not to be alone and I had to come straight back in if I had anymore bleeding. It had also been decided that I was to be admitted at 32weeks. I was delighted to be going home but I also felt a bit like a ticking time bomb.

I remember feeling such relief when I was admitted at 32weeks. It had been so hard leaving home and saying goodbye to my girls, but I knew it was the right call. I was constantly scared of something happening. I felt like I had to have everything ready just in case. I couldn’t see past the delivery date. I tried to keep my mind in check but at times I did think that there was a real possibility that I might not make it through the surgery. This was such a scary thought as a mammy for 3 young girls. There was still a lot of unknown with the baby too. We wouldn’t really know what was wrong with him until he was born. I had to keep reminding myself that there was a plan in place to keep me and my baby safe.

On the morning of my surgery I was transferred to The Mater. I remember when the trolley arrived for me, I got really emotional, I knew I was in the best possible hands but I was terrified. Dave was allowed stay with me until I got brought into the prep room. At this point, an IV line was put in both my hands, I was given a spinal block and an epidural was placed for pain relief after surgery. I was then put asleep before a central line and arterial line were placed in my neck and wrist. I knew there was about 20 odd people waiting in theatre but I never saw them. I am truly grateful for this decision.

The next thing I remember is being woken up in recovery. It’s a bit of a blur but I remember lots of faces. At this point I was told that my surgery had gone as well as it possibly could have. I lost approximately 1litre of blood but was currently been given 500mls back as they had used a cell saver machine. They were happy for me to return to The Rotunda that evening. I was told that my baby had needed some breathing assistance when born as he was sedated due to being born under general but he was doing well. I was then told that he had a rare medical condition that required him to be sent straight to Crumlin or Temple St and they were just waiting on a bed. I asked could I see him. Thankfully they brought him to me as they were preparing to leave. I got to touch him and named him Zach. I am so grateful that it was allowed happen as at this point, I did not know when I would next see him. I also got to see Dave very briefly and then he made his way to Crumlin. With the help of my nurse I started hand expressing in recovery to start building up my supply every 2/3 hours.

I was transferred back to The Rotunda that night and brought straight to HDU were I remained for 3 nights. This was by far the most difficult few days of my life. Being separated from my baby was awful. He was going through lots of tests and had surgery at 30hours old. Due to visiting restrictions, only Dave was allowed visit me but I wanted him to be with Zach. He came in briefly a couple of times and collected the milk I had expressed for Zach. I hit my lowest point mentally, I couldn’t even speak to anyone bar Dave and spent a lot of time crying. 48hrs after surgery my epidural was removed, and I was told if I got mobile that I’d be able to visit Zach the following day. I got myself moving and the following day I walked out of HDU into a taxi straight to Crumlin. The next few days I travelled back and forth to Crumlin from The Rotunda. Walking back into The Rotunda was very hard emotionally. I was discharged 6 days after surgery. We got Zach home from Crumlin exactly one week later. Due to his condition Zach is going to need lots of further medical care but it was so good to get him home to meet his sisters.

The weeks following, we were in the new-born bubble as we all recovered. About 7/8 weeks later I started showing signs of trauma. I was referred to a Birth Trauma Clinic in The Rotunda by my perinatal mental health midwife. At this point it was determined that I would benefit from some trauma therapy. This really helped me process everything. I have also been linking in with the PAI Support group and hearing other women’s stories has really helped me on my own journey.