Won one, lost one By Kate

We got lucky first time with Rosie. She was the result of one of the four in five pregnancies that ends with a baby. Second time round that luck took a holiday.

Instead of expecting a brother or sister for Rosie early in October as we had thought, we discovered from our first scan that we weren't expecting a baby at all. Our embryo had stopped developing at just over eight weeks and no heartbeat could be detected. A missed or "silent" miscarriage. The radiologist's mouth tightened into a line of regret. "Es un aborto," she said, "Lo siento."

We were stung by disappointment and slightly stunned, but took the bad news calmly. "Ah well," I said to Theo as I climbed off the scanning table, "That's that, then." It would explain why I had been experiencing so few pregnancy symptoms, especially during the last fortnight or so. Everything had come to a full stop.

When we got home, the tears came. Although I was already counting my blessings (better to lose a pregnancy early on; I know I can carry a healthy baby; I know I can get pregnant fairly easily; maybe a slightly bigger gap between children would be better; at least this takes the pressure off our return to the UK etc. etc....) it was still a sad loss and some grief was inevitable. Theo comforted me, as best he could. For him, the initial disappointment had rapidly changed into concern for my well-being. Cuddling Rosie helped me too.

But now we had to turn to the practicalities of the situation. Our radiologist had told me to go to hospital either today or tomorrow...but was vague about the details. A bit of research online told me most of what I needed to know and a friend who'd been through the same thing a few years before told me the rest. I would need a medical procedure called ERPC (Evacuation of the Remaining Products of Conception), once known as D&C (Dilation and Curettage). A straightforward operation performed under general anaesthetic. Bearing that in mind, we elected to go the following morning in the hope that I would be home that same evening.

Accordingly, we arrived at Urgencias Maternidad, Hospital La Paz at nine o'clock the next morning. Theo had taken the day off work so he could look after Rosie and support me as much as possible. We signed in and I was taken off to be scanned again. The staff were kind and friendly (a couple of the younger medics even attempting some reasonable English) and although none of them offered sympathy, they put me at my ease.

I had done the right thing by not eating any breakfast, although the news that I had had a few mouthfuls of water was greeted with some consternation. Eventually they judged I hadn't had enough for it to be a big problem. I was told to remove my clothes and jewelery, then put in a wheelchair and taken to a small ward for two on the fourth floor. It all felt strangely familiar as the room was identical to the one I had stayed in for five days after having Rosie. Except this one couldn't come close to the view we had had on the eleventh floor and the circumstances couldn't be more depressingly different.

Theo and Rosie came to give me a hug and bid me a temporary farewell, then I was joined by an older woman who was given the other bed as she waited to have a bladder operation. I smiled politely and did my best to keep up with her Spanish, using my own imperfect command of the language to explain why I was at La Paz. She nodded sympathetically and told me (I think) that she had also had a miscarriage. But she now had three healthy adult sons to her name, so not to worry. Although she suspected the miscarried baby would have turned out to be a girl and that made her feel sad. I nodded sympathetically in my turn.

A couple of nurses came in, gave me some forms to sign, then popped a couple of pessaries inside me to "soften things up" for the coming procedure. I was then left to relax in my bed and read.

An hour and a half later, it was time to go. My bed, with me in it, was wheeled down to the operating theatre. Outside it, I was asked the same succession of questions by five different people (No, I hadn't eaten since last night, Yes I'd drunk a little water this morning, but not much etc. etc.) Bafflingly, one junior anaesthetist asked me in broken English about the importance of the decision I had made. Confused, I replied, "Es un gestation interrumpido. Es un aborto. Este operacion es necesario, no?" He agreed it was. I think he had been under the impression that I was aborting a live fetus, for some reason.

The operation itself went without a hitch. The most painful part was having two needles inserted into the back of my left hand for the various drips, but the rest was plain sailing. The medical team helped me onto the operating table, stuck my legs in stirrups, tested my blood pressure, sluiced my nether regions with shockingly cold antiseptic then inserted a nozzle in my mouth...and I promptly passed out.

The next moment (probably about twenty minutes or so later) I came round trying to push this strange foreign object out of my mouth with my tongue. When I opened my eyes and saw various medics gazing down at me I remembered where I was. I felt amazingly refreshed and realized this was probably the first time I had slept really deeply since I had had Rosie, more than thirteen months earlier.

"What luxury," I said in Spanish, "Can I have some of that stuff to help me sleep at night?" They smiled and I was wheeled back to the ward, still attached to the drips, and was left to snooze off the effects of the anaesthetic for the next couple of hours.

Rosie and Theo returned to find me well-rested and reaching the exciting climax of my novel. It was then a matter of hanging around until a doctor could be persuaded to check me over and discharge me. Eventually one bustled in after Theo used the simple expedient of waving Rosie meaningfully at the nurse receptionist and saying the baby would need to go home for supper and bed very soon.

I was told I could breastfeed Rosie that evening provided I expressed the first lot of milk to get rid of any lingering anaesthesia. Then I was given an information sheet telling me what to expect over the next few weeks and what symptoms to look out for in the event of an infection. After that I was free to change back into my clothes and go. Which I did.

It was the next day that we discovered I hadn't only left the remains of an embryo behind me at Hospital La Paz. Unfortunately my wedding ring had slipped from the plastic folder where I had thought it would be safe and was most probably well buried among the hospital refuse by now.

I am very hopeful that a new wedding ring and a new pregnancy will both be forthcoming before too long. After all, you've got to try and be philosophical about these things sometimes.

Yes, She's Sitting Comfortably by Kate

In the UK, the NHS allocates you two routine ultrasound scans during pregnancy, here in Spain you get three full scans plus a quick once over every time you have an appointment with your obstetrician. Seeing as we got sent to the specialist radiology department at one of Madrid's biggest hospitals for our twenty-week looksee, we didn't realise that our appointment at our usual obstetrics clinic was for the complete scan minus an obstetrician. That's why my boss' lovely wife came too as part of our ongoing quest to get officialdom to decide my bump is at risk if I continue my teaching job too long.

Our next mistake was to join the queue at the wrong room and wait there until our obstetrician's assistant kindly pointed out that we weren't on her list and maybe we should check downstairs. Having taken the details for the appointment over the phone, doubt was immediately cast on my imperfect understanding of Spanish - we hadn't received the usual follow up confirmation by post. But a quick scouting mission by Theo and Marina established that I had got the date and time right, but the wrong room. It turned out we should have been waiting another five doors down.

We amended this and presented ourselves to the assistant who was brusquely herding various other bumpees towards their scans. She was less than overjoyed to see us and only grudgingly accepted that we formed part of her morning's work after we pointed at my name on her appointment list. Marina, having also experienced our doctor at her least helpful (during our abortive attempt to secure the baja), was shocked by her unhelpful attitude.
"They don't need to be so rude!! What's the matter with them?" Theo and I, having by now spent a lot of time among the white-coated acolytes of the Spanish medical system, were more philosophical. I just hope we don't get a bum deal on the staff front during the actual birth.

So, in we went at last and Marina once again launched into her preamble to try and encourage a recommendation for the baja por emarazada del riesgo, only to be briskly headed off at the pass by the information that we would need to consult the obstetrician, not the radiologist for that sort of thing. Another wasted trip for Marina. Although by compensation, she did get to join Theo and I in viewing our rapidly growing offspring looking sprightly inside the womb.

By now, she's pretty much finished developing her main organs, so a quick check of brain, heart and fetal movement was the main order of the day. Everything appeared to be present, beating and twitching as it should be, so the radiologist was quite satisfied and even gave a us a quick tour of our daughter's main body parts in English. The one problem at this stage is that Fosbella is neatly wedged in an upright sitting position - as I already suspected from numerous proddings at my belly's topography and by noting the position of her kicks and hand taps. To use the official term, she's breech, which is not ideal for a natural birth.

Of course, we still have more than six weeks to go and the statistics are reassuring - most breech babies do turn round before labour begins, (some leaving it to the very last minute). I'm very much hoping young Fos will duly oblige as I'd rather not have a C Section if I can avoid it. In the meantime, the advice is to spend time on hands and knees, waggle your pelvis around while it's higher than your head (this is not very easy with a large bump, believe me), sit up straight, do yoga and tell your foetus to please get off its arse and do a headstand. It's all got to be worth a try.

The Internal View by Kate

Almost five weeks late, Fosbella foetus finally got her second proper scan. Actually, it's her fourth, if you count the ultra-sound part of the amniocentesis test and the quick check our local obstetrician gave her since we first saw her picture.

This time we had to take the train to yet another hospital in Madrid (Ramon y Cajal) where we had been told (the day before) we had a ten o'clock appointment. As it turned out, so did about twelve other people so, in fact it was another hour and a half later that we finally got ushered in to see the radiographer.

Once more, my belly was slathered with cold lubricating gel and the scanner was slid and pushed against various parts of my abdomen while Theo (with the best seat in the house again) got a variety of views and cross-sections of our fast-developing offspring.

"Lively, isn't she?" commented the radiographer (my translation) in a mixture of admiration and exasperation as our progeny wriggled and squirmed and resisted all attempts to capture her best side.

After about fifteen minutes, the radiographer gave a satisfied nod and told us everything was fine. She then gave us a tour of various cross-sections through Fosbella's bits and pieces, which all appear to be present and correct at this stage. The one thing I didn't get to see was a full head and body view, or even a sense of her face, which was a disappointment, although I did see inside her nostrils, which was something I suppose.

Any hope that the stills taken by the radiographer would offer some sort of clue as to Fosbella's external features were also in vain, although the inside view of her spine is pretty impressive. Theo, who did get a quick glimpse of her face assures me she has my nose (I'm not entirely convinced that's a good thing), although he also says she bears a striking resemblance to Skeletor. At least her internal organs all seem to be aesthetically arranged. True beauty, after all, is on the inside.

The Kindness Of Strangers by Kate

So here we are back in Madrid and suddenly I've been promoted on the Metro. In the last few days complete strangers have been giving up their seats in crowded carriages and inviting me to have them instead. This is both touching and gratifying and one of the best bits so far about my abdomen sporting a now unmistakeable bump.

Spaniards - generally speaking - are very much in favour of children, babies and pregnancy and I'm just starting to appreciate that fact. It doesn't help us insert ourselves and our potential new Madrilena into the Spanish ante-natal system (they're chocka and trying to book ourselves to have our now overdue anomalies scan is proving to be a bit of a struggle) but it does bathe things like Metro journeys in a benevolent glow.

So back to the beginning for a quick recap. Theo and I abandon contraception at the beginning of the year and get on with business as usual. Just as the weather gets seriously hot I start feeling unusual. Alcohol and caffeine are suddenly unattractive to my taste buds, my breasts feel a bit strange and I keep getting ravenously hungry, but just don't fancy eating anything. I break out in the type of acne I only get when there is extra progesterone in my system (experience with previous contraception). I can't remember when my last period was, but I start feeling suspicious and report the symptoms to my experienced sister (four children). She admits they sound fairly classic, but counsels against any over excitement about the situation just yet. I don't actually feel excited anyway, just a tad queasy.

Theo has gone off to a residential camp for a week. On the phone I tell him about my suspicions. He forbids me to self-diagnose until he gets back. I pass the next six days feeling disinclined to eat or drink anything sweet. How did I get this virtuous?

Theo returns and we do the pee stick. The line flames up positive even before I have a chance to pull my knickers back up. Theo is very excited about the prospect of suddenly probable parenthood. I feel justified.

The next few weeks pass in a heat haze and Theo is highly solicitous, dealing patiently with my new found fussiness about food and giving me lots of back rubs and foot-massages. I milk it.

We get back to England to see friends and family, lie to the NHS about our current address and book ourselves in to see a midwife and radiographer in Bristol.

The first scan seems fine, as far as these things do. We suddenly realise there really is a living thing in my belly, not just a collection of physical symptoms. We also realise we're two weeks further on than we thought. A bump - still smallish - obediently appears below my midriff. I scour Bristol's charity shops for roomier clothes. The midwife takes lots of blood out of my arm and nods approvingly when I tell her I don't drink or smoke and I fully intend to breast-feed. Theo doesn't watch the blood extraction part.

First hitch when we are told we have a high risk of our foetus (now christianed Fosbury) having Downs Syndrome. This is upsetting news. I calm down a bit when I realise that a 1 in 65 risk still means it's less than 2 per cent. Nevertheless, we opt to have amniocentesis and thankfully that all goes fine.
“Look out for its feet!” says Theo at one point during the procedure.
“Oh, I've stuck loads of needles in babies, don't worry about it,” says the consultant cheerfully. He doesn't on this occasion, thankfully.

A few days later we are back in Spain and the initial news from the amnio is good. The three chromosomes which are affected if Downs Syndrome is present are normal. Phew. Two weeks later we learn that in fact, all the chromosomes are normal and we are growing a female. We change the foetus' name to Fosbella.

Which brings us up to date as, having registered with the Spanish health system, we wait for our next scan (although most possible anomalies were checked at 17 and a half weeks and nothing untoward was seen then, so we're not hugely anxious). Anyway, it seems like a good plan to get it done as soon as possible, so we are considering paying for a private scan or pulling strings to see if we can get one done when we are back in Bristol for a wedding.
Meanwhile, I am busy committing foetal-related words in Spanish to memory. Luckily, being medical, they are largely the same as their English equivalents, just pronounced in a more Spanish way. Disappointingly, “scan” is not “escano ultra-sono”, as we had hoped. Never mind. In the meantime, I will keep on enjoying my new Metro privileges.