Conditions that threaten women’s lives in childbirth & pregnancy

Anna

Female
Age at interview: 22
Age at diagnosis: 21

Brief outline: Anna delivered her second child in hospital and was discharged home. She soon felt unwell and developed septicaemia very quickly. She was admitted to intensive care and had to have a hysterectomy.

Background: Anna lives with her partner and two sons. White British..

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Interviewed 14 months after event. Invasive Group A streptococcal infection.
 
Anna was pregnant with her second son, her first having been born early (at 33 weeks) when she was 19. The pregnancy went well and she went in to labour naturally. But as labour progressed they discovered that the baby was back to back and had to twist his shoulders to get him out. However, he was a good weight and Anna felt OK, so was discharged later the same afternoon. It was 21st December and she wanted to be at home with her family so close to Christmas. She went home in the afternoon, and found when she got home she wasn't feeling great - dizzy and in pain in her stomach. But she thought it was normal post-labour symptoms. She tried to rest and during the night was able to breastfeed her new baby. However, next morning she still felt very unwell. A midwife visited and said that if she did not improve in 24 hours then she should call again. However, within hours she felt she had difficulty breathing in addition to the pain in her stomach. Her partner called an ambulance, and a rapid response team was at the house within 2 minutes. 
 
On the afternoon of 22nd December she was rushed to hospital where doctors ran lots of tests. They identified the infection quickly and put her on two types of antibiotics to try and tackle the infection. She was admitted to intensive care (ICU). Doctors explained the situation, saying that they were hoping that the antibiotics would sort out the infection, but if they didn't, they would have to resort to "Plan B". Anna surprised the doctor by asking what that was, and he explained that it would have to be a hysterectomy. While shocked, Anna was very grateful to have been given that information. She felt that it gave her and her family a day or so to come to terms with what might have to happen. 
 
Unfortunately the antibiotics were not able to stop the infection, so a day later she was sent down to have a hysterectomy. She asked them to save her ovaries if possible (which they were able to do, but she later discovered they were no longer viable). She was unconscious in ICU from 24 Dec - 1st January. She has many memories of her time in ICU, in particular the terrible frightening nightmares she had while in the drug-induced coma. The surgeons had to operate twice, as some infection remained on one of the ovaries, but went through the same horizontal scar - she was very grateful that they only cut her once, and horizontally. She feels that she can hide this scar quite effectively, which has a positive effect on her body image, whereas if she had had a vertical scar, she would have felt much more "damaged".
 
Her baby was lucky not to have picked up the infection, and stayed at home being cared for by his father and Anna's mother-in-law.
 
Once she was out of danger, Anna was transferred to a general ward, where the care was not that great, and she asked to be discharged quickly. She left hospital on 12th January to get back to her baby and family. However, she was still very weak, needing a walking stick for many weeks and help doing the basic everyday functions of walking up stairs, getting in and out of the bath etc. Anna was offered follow up counselling through the hospital at 6 weeks, which she had, but found it was too soon, and not that helpful. She has seen ICU regularly for follow up, which has been helpful. However, as the year progressed she became more and more down about her experiences. Initially she was fighting the physical symptoms of having been so ill, and the shock of nearly dying. But as time has gone on, the disappointment at the hysterectomy and not being able to have another child (in particular a daughter) have grown. She has been depressed and has had dark thoughts. Before the one-year anniversary she sought help and has been having cognitive behavioural therapy CBT for several weeks, which has really helped her start to move on from the experience. She is also on anti-depressants and has been put on hormone replacement therapy (HRT).
 
At times she has felt very isolated, and as though the support was not there when she needed it, which was not only while she was still in hospital, but in the months afterwards when she was trying to come to terms with everything. She worries that her absence has had a negative effect on her children, although found her partner coped very well and was very strong for everyone.
 

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