Early Pregnancy Tests and Stress.

I sometimes wonder if the days before home pregnancy tests, were not so bad after all? Obviously it's a good thing that women can plan and make important lifestyle choices from early conception. If we're in the habit of  indulging in rather more than the occasional glass of plonk, like to jump out of planes or ride horses over fences, then of course it makes sense not to put ourselves at risk of internal or external injury. Likewise, it's a good thing to take folic acid from early pregnancy, and for some of us it's essential to be certain what's happening from day one in order to make that all important decision.

But, you know I also see a whole lot of stress that our mothers and grandmothers didn't need to experience, because that kind of instant information was not available. When my Mum got pregnant, it was customary to wait until the second missed period before going to the doctor for a check up, and although that might seem like an interminably long time to wait, I can see some benefits. Most women will have a pretty good idea that they're pregnant by about 6 weeks after the last period, and by waiting for another couple of weeks before seeing a medical professional there's a chance to quietly come to terms with the very private wonder of the possibility of new life growing within. There was a chance to keep that knowledge to yourself without the need to announce it to the world at large. 

These days, the availability of home pregnancy tests creates a different kind of stress. Many very early pregnancies end in miscarriage without a woman even knowing that she was pregnant, yet thanks to a quick pee on a stick in the privacy of your own bathroom, that late period has now become an emotionally traumatic event that could have been unnecessary. Then there's the stress of a very faint positive result on a test, because for some women it's simply too early for the presence of HCG (pregnancy hormone) to give a strong result. So then we have women spending a lot of money on repeat tests which they then spend days, anxiously examining in minute detail, for conclusive proof of pregnancy. Am I really pregnant? Am I just bonkers? And then, if I am, how soon should I tell people? What about if I announce my pregnancy and then miscarry? When should I see a doctor of midwife? Is 5 weeks pregnant too soon? What about all those things I shouldn't eat - and Oh my God I think I ate a piece of blue cheese on Thursday night!

Early pregnancy seems to have somehow become this incredibly intense, anxiety provoking state that means a woman hasn't time to exhale before she's already concerning herself about the management of every aspect of her body. Personally, I'd like to see more of a balance between responsible behaviour and relaxed delight. Perhaps all pregnancy tests should come with a free health message. 'Congratulations, you're pregnant! Now chill out and enjoy! 

Or maybe I'm just a middle aged stargazer?  

Teenage Pregnancy - A Positive Story

As my last two posts might have come across as weighing too heavily on the negative aspects of teen pregnancy, I'd like to share a positive story which goes to prove that it's always good to be open minded. I've changed all identifying details in order to preserve confidentiality.

Several years ago as a community midwife, I had a fourteen year old girl on my case load. Carla was referred to our team by Social Services due to her age, and also because her family were already known to them because of poverty issues. Carla was one of six children being raised by a single mother - Mary, on a local council estate. I always tried to keep an open mind when visiting a new family, but as I pulled up outside their home, I felt resigned to another very difficult situation. The house was at the end of a cul-de-sac and had an overgrown front garden, littered with rusting bikes and the obligatory old sofa. The window next to the front door was cracked and held together by sticky tape and the whole place had a very neglected feel about it. The door was opened by Mary, a tired looking woman in her late forties, who nonetheless seemed happy to see me and ushered me into the living room. There were no carpets anywhere, the place was a chaotic mess of boxes and piles of clothes, and what furniture there was, appeared ancient and falling apart. 

Carla sat quietly on the sofa, head down and clearly very nervous. She seemed incredibly young and shy and very unlike the other defiant and mouthy teenagers I'd worked with. She was the kind of kid you just want to wrap your arms around. There was also a small boy asleep on another sofa and Mary sat beside him, affectionately stroking his head. She explained that he had a fever and was home from school as a result. As we talked and Mary shared some of her family history, it became apparent that she was actually a deeply caring and supportive mother to her children - two of whom had already left home. She acknowledged that Carla's pregnancy wasn't ideal, but that she would support and help her through it all. Carla barely spoke - clearly too shy to say much, but after a brief examination and careful history taking, she managed a warm smile and seemed happy to accept ongoing support and midwifery care. 

I saw her a few more times during her pregnancy which went well. She had a boyfriend - another quiet and shy boy who obviously wanted to be a part of what was happening. I wondered how on earth they'd cope after the baby was born, as the house was so overcrowded that Carla already shared a bedroom with two younger brothers. 

I asked her how she planned to feed her baby and was pleasantly surprised when she said that she wanted to breastfeed. Mary spoke up at that point and said she'd help as she'd successfully breastfed her own six children. I was hopeful that with support Carla would at least give breastfeeding a try. I was very concerned about their ability to maintain adequate hygiene for bottle feeding which needs scrupulous attention to cleanliness.

On my first visit following the birth, I walked in to find Carla sitting on the sofa, staring with rapt attention at her tiny baby boy who was contentedly breastfeeding like a dream. All was well and Carla said that she was finding breastfeeding fine and her baby seemed happy and contented, and indeed he looked a very peaceful little boy.  By my visit on day ten, it was clear that everything was going brilliantly. Carla was recovering well with no health problems, the baby was feeding beautifully and gaining weight, and Mary was taking everything in her usual calm stride, with little concern other than the usual one of making ends meet. She'd given up her own bedroom for Carla and the baby and seemed relatively unperturbed by it all.

I told Carla that she should be really proud of herself, and that I wished I could take her round to visit some of my other older Mum's so she could show them how to breastfeed! Her eyes shone with pride and I knew that somehow she'd grown in confidence and self esteem.

When I handed over their care to our local health visitor, it was with the knowledge that whatever happened in the future, Carla had excellent support, and despite family poverty had made the best possible start to raising her child. 

I don't know what happened long term, as soon after, I changed my job. But I do remember feeling less concerned about the well being of Carla and her baby, than I had previously about some other mothers from more affluent backgrounds. With good support, anything is possible.