0:00:02 > 0:00:04Hello, Ward 4, midwife speaking.
0:00:05 > 0:00:07Don't panic, it's going to be over soon.
0:00:07 > 0:00:10With the highest birth rate in 40 years...
0:00:10 > 0:00:11Look what you've done.
0:00:12 > 0:00:16Oh, congratulations!
0:00:16 > 0:00:19..midwives are under more pressure than ever before.
0:00:19 > 0:00:20You are kidding me,
0:00:20 > 0:00:23we have a lady on the table in theatre waiting to come out.
0:00:23 > 0:00:25We filmed in busy maternity departments
0:00:25 > 0:00:28in Birmingham, Manchester and Cardiff...
0:00:28 > 0:00:33- 6lbs, 11oz, I reckon. He's about 6lbs, 11oz and a half.- Oh!
0:00:33 > 0:00:35..as the midwives deliver the next generation...
0:00:35 > 0:00:38The scary bit is, you're all going to be midwives.
0:00:38 > 0:00:40CHEERING
0:00:40 > 0:00:41..with care...
0:00:41 > 0:00:42Oh, please help me.
0:00:42 > 0:00:44We're here, we're here, we're here.
0:00:44 > 0:00:45..and dedication.
0:00:45 > 0:00:49My baby's life is in your guys' hands. That's it now.
0:00:49 > 0:00:52Not good for the stress levels, this job, at all.
0:00:52 > 0:00:55You'll be absolutely fine, I told you I'll be with you.
0:00:55 > 0:00:58- It does touch you. - This is the reason we do what we do.
0:00:58 > 0:00:59It's all right, it's OK.
0:00:59 > 0:01:01You smell nice.
0:01:01 > 0:01:04It's more than a job, you're part of somebody's life
0:01:04 > 0:01:05and they never forget you.
0:01:20 > 0:01:25- This is it.- Push, push, push. Push, push, push.
0:01:25 > 0:01:27St Mary's in Manchester
0:01:27 > 0:01:30is one of the busiest maternity hospitals in the northwest.
0:01:31 > 0:01:35There's two ladies that... Intensive HTU care is room nine and ten,
0:01:35 > 0:01:37so they can easily be doubled up.
0:01:37 > 0:01:42Over half of all expectant mums seen here are classified as high risk.
0:01:43 > 0:01:46It's the midwives' job to manage this rising number
0:01:46 > 0:01:48of complicated pregnancies and challenging births.
0:01:48 > 0:01:51Oh... Hello, trouble.
0:01:52 > 0:01:54Triage Unit, midwife Heather Massey speaking.
0:01:54 > 0:01:57Years ago, women with very serious conditions were told
0:01:57 > 0:01:59"You'll never be able to have a baby",
0:01:59 > 0:02:01and they were advised not to have a baby.
0:02:01 > 0:02:05But now the medical management of these women is so much better.
0:02:05 > 0:02:07If they're well enough to get pregnant,
0:02:07 > 0:02:09we support them through that pregnancy.
0:02:10 > 0:02:14Come on, mister. I would like some crying, please.
0:02:14 > 0:02:18Oh, what are we doing, sir? A good cry is good.
0:02:18 > 0:02:22It's a massive challenge to get them through pregnancy.
0:02:22 > 0:02:25Hello, it's Susan, diabetic midwife.
0:02:25 > 0:02:28Some women have put their own health at risk to achieve
0:02:28 > 0:02:30that dream of having a baby.
0:02:30 > 0:02:33So a huge amount of time
0:02:33 > 0:02:38and resources are spent looking after women who are very complex.
0:02:41 > 0:02:45We've probably got about 32 ladies coming this afternoon.
0:02:45 > 0:02:48Hiya, Lydia. Hello! Hello, darling.
0:02:51 > 0:02:54Susan is a specialist midwife who works closely
0:02:54 > 0:02:58with colleague Greta to support pregnant women with diabetes.
0:02:59 > 0:03:04We've seen a huge increase in pregnant woman with diabetes,
0:03:04 > 0:03:08specifically with type 2 Diabetes, and that's because
0:03:08 > 0:03:15obesity is an epidemic in the UK, and a consequence of obesity is diabetes.
0:03:15 > 0:03:18So we've got really mad busy clinics.
0:03:18 > 0:03:19So today is March.
0:03:19 > 0:03:23- Yeah. You haven't had a scan today, no?- Yes, I have.- Have you?- Yes.
0:03:23 > 0:03:25Definitely will never be without a job!
0:03:32 > 0:03:35I blame that book for my pregnancy.
0:03:37 > 0:03:41Fifty Shades Of Grey, basically, has put me here.
0:03:41 > 0:03:44When you mention the name Karla, you've just got to laugh,
0:03:44 > 0:03:49cos you just get the picture of a very bubbly, happy girl.
0:03:49 > 0:03:51- Have you read Fifty Shades Of Grey? - No.
0:03:51 > 0:03:54- Have you not read it?- Uh... - What about your wife?
0:03:54 > 0:03:58If you write down the name, I will see that...
0:03:58 > 0:04:01- I'll write the name down for you. - Thank you.
0:04:01 > 0:04:02You just never forget Karla.
0:04:02 > 0:04:05Actually, when she came through the door this time,
0:04:05 > 0:04:08just straight away - "Oh, my goodness."
0:04:09 > 0:04:13Karla is in the last two weeks of her pregnancy with her third baby.
0:04:14 > 0:04:16She has type 2 diabetes
0:04:16 > 0:04:20and needs to attend a clinic every two weeks for a checkup.
0:04:20 > 0:04:22- You look lovely today. - Oh, thank you.
0:04:22 > 0:04:24I thought I'd get dolled up, considering I'm coming here.
0:04:24 > 0:04:26Ah. Take a seat.
0:04:26 > 0:04:29- Have you got a urine sample for me, pet?- I haven't, not yet.
0:04:29 > 0:04:30I'm ready to rock, though, for one.
0:04:30 > 0:04:33- You know where the bathroom is, don't you?- Yeah, yeah, yeah.
0:04:33 > 0:04:37- OK.- Pregnant woman, I know where every bathroom is.
0:04:37 > 0:04:38SHE LAUGHS
0:04:41 > 0:04:44The Diabetes Clinic has seen its numbers double
0:04:44 > 0:04:45in the last ten years.
0:04:47 > 0:04:51With having diabetes, the risks of hypertension are higher,
0:04:51 > 0:04:52the risk of miscarriage is higher,
0:04:52 > 0:04:55the risks of congenital abnormalities
0:04:55 > 0:04:57is, you know, five/sixfold.
0:04:57 > 0:04:59So we're seeing a lot of these ladies,
0:04:59 > 0:05:02and the whole pregnancy is quite intense and very time-consuming.
0:05:06 > 0:05:09- That's not very big, is it? - Look at that.
0:05:09 > 0:05:11Think where you got...
0:05:13 > 0:05:15BABY'S HEART BEATS
0:05:15 > 0:05:17That's fine, Karla.
0:05:17 > 0:05:20I told you that I'd get to 38 weeks.
0:05:20 > 0:05:21You said that right at the beginning.
0:05:21 > 0:05:24I did, didn't I? I said and you were like...
0:05:24 > 0:05:28"Stop worrying. Stop worrying. I'll be fine."
0:05:29 > 0:05:32Karla's diabetes means her baby
0:05:32 > 0:05:35is five times more at risk of being stillborn.
0:05:35 > 0:05:38Greta's been telling me about how brilliant your blood sugars
0:05:38 > 0:05:40have been over the last couple of weeks.
0:05:40 > 0:05:43I know. I couldn't have got them any more perfect. Unbelievable.
0:05:43 > 0:05:45So, that's all that hard work you've put in.
0:05:45 > 0:05:46Honestly, it is.
0:05:46 > 0:05:48We all have, though, haven't we? We've all done it.
0:05:49 > 0:05:53We need Karla's blood sugars absolutely perfect
0:05:53 > 0:05:58in these last few days of her pregnancy, and it's not,
0:05:58 > 0:06:01"We're at the end, so we're OK now and can relax."
0:06:01 > 0:06:04Not until that baby literally is delivered,
0:06:04 > 0:06:06in the mother's arms, can we relax.
0:06:09 > 0:06:11That's what I have to do every morning.
0:06:11 > 0:06:13This is slow-release insulin.
0:06:13 > 0:06:16I inject in my stomach because I've had two C-sections
0:06:16 > 0:06:18and I don't feel a dicky-doo-dah in there.
0:06:18 > 0:06:19SHE LAUGHS
0:06:20 > 0:06:24What you've got to understand is that I weighed...
0:06:24 > 0:06:25I weighed a lot, yeah?
0:06:26 > 0:06:30I was probably about...near enough 23, 24 stone.
0:06:30 > 0:06:32The doctor did turn round to me and say,
0:06:32 > 0:06:34"Either lose weight, Karla, or die."
0:06:34 > 0:06:38So, I lost a lot of weight and, you know,
0:06:38 > 0:06:40it was all about pot for me.
0:06:40 > 0:06:41As soon as I cut that out,
0:06:41 > 0:06:44the weight just kind of started plummeting down.
0:06:44 > 0:06:48Karla lost ten stone in an attempt to control her diabetes.
0:06:48 > 0:06:50Now she needs to manage it even more carefully
0:06:50 > 0:06:52for the health of her baby.
0:06:55 > 0:06:59Now I've got to take this one, yet again, in the belly.
0:06:59 > 0:07:03Diabetes can be a huge responsibility on a woman
0:07:03 > 0:07:07and we really empathise, but with Karla
0:07:07 > 0:07:14she has the added burden that her baby has got some problems
0:07:14 > 0:07:18that will need attention and specialist care afterwards.
0:07:19 > 0:07:22This is her at 22 weeks.
0:07:23 > 0:07:27If you look here at the bottom, there is, like, a lump
0:07:27 > 0:07:30there at the bottom in between the legs.
0:07:30 > 0:07:33That's actually the exomphalos that's poking through.
0:07:34 > 0:07:37Karla's baby has an exomphalos,
0:07:37 > 0:07:40a rare condition that affects around one in 5,000 babies.
0:07:41 > 0:07:45A weakness in the abdominal wall means that some of her baby's
0:07:45 > 0:07:48internal organs have developed outside the body.
0:07:50 > 0:07:53I was terribly, terribly shocked at the time when they told me.
0:07:53 > 0:07:57I was... I didn't know what to do.
0:08:01 > 0:08:03The baby will have surgery soon after she is born.
0:08:05 > 0:08:08But the size and seriousness of the condition
0:08:08 > 0:08:10will only be known at birth.
0:08:12 > 0:08:17It breaks me inside to even see this little thing, and I'm just praying
0:08:17 > 0:08:20that one day I'll wake up and there she is fast asleep, and all well.
0:08:21 > 0:08:26SUSAN: As a mother myself, and as a woman, your heart goes out to her,
0:08:26 > 0:08:31cos nobody wants to hear those words that your baby has something wrong,
0:08:31 > 0:08:36but I see my role as a midwife who's there as an advocate
0:08:36 > 0:08:40and a support for women. And as a team, we hope
0:08:40 > 0:08:47to carry Karla through this pregnancy, so that she's...
0:08:47 > 0:08:49emotionally stable and able to cope
0:08:49 > 0:08:52with what's to come once the baby's delivered.
0:08:53 > 0:08:55I'm prepared for the worst.
0:08:55 > 0:08:59- TEARFUL:- No matter what's wrong with her, I don't care.
0:08:59 > 0:09:00I want to cuddle her.
0:09:00 > 0:09:02I so much just want to give her a cuddle.
0:09:10 > 0:09:12SIREN BLARES
0:09:18 > 0:09:20Triage Unit, midwife Heather Massey speaking. Can I help you?
0:09:23 > 0:09:25Heather is one of the large team of midwives
0:09:25 > 0:09:28working on the main delivery unit.
0:09:28 > 0:09:30And what is your hospital number?
0:09:30 > 0:09:32Today, she is in charge of Triage,
0:09:32 > 0:09:35offering 24 hour emergency assessment
0:09:35 > 0:09:37and advice to pregnant women.
0:09:37 > 0:09:38Transfusion are on the phone.
0:09:40 > 0:09:42There's two ladies coming in as well.
0:09:42 > 0:09:44'We have to be ready for anything.
0:09:44 > 0:09:47'We're seeing more and more ladies with complex medical needs,'
0:09:47 > 0:09:49ladies with conditions that sometimes I've never heard of,
0:09:49 > 0:09:52and I've been a midwife and a nurse for a very long time.
0:09:52 > 0:09:54Is your baby moving OK?
0:09:54 > 0:09:57'You just hope you're not going to find anything that you can't cope with.'
0:09:58 > 0:10:01Stephanie? Hi, Stephanie, my name's Heather.
0:10:01 > 0:10:03I'm going to take you through to one of the rooms, OK?
0:10:03 > 0:10:05See if we can get you out of this wheelchair.
0:10:07 > 0:10:10I'm sure some porter will tell me the correct way to push a chair.
0:10:12 > 0:10:14Are you all right to just pop on the bed for me?
0:10:16 > 0:10:2023-year-old Steph is seven months pregnant.
0:10:20 > 0:10:21How are you feeling now?
0:10:21 > 0:10:23Still out of breath and I keep getting chest pains.
0:10:23 > 0:10:25You've still got the chest pain. Right.
0:10:25 > 0:10:29She's been rushed into hospital by her husband, Dan.
0:10:29 > 0:10:31So when did this start, the breathlessness?
0:10:31 > 0:10:35Yesterday, I collapsed in Tesco's.
0:10:35 > 0:10:40- Right.- And since then, I've been having...a real tight chest.- Right.
0:10:40 > 0:10:42Breathlessness and then sharp, stabbing pains.
0:10:42 > 0:10:44I'm just going to do some observations
0:10:44 > 0:10:47and check that your baby's not been affected by your breathlessness.
0:10:47 > 0:10:50- OK, is that all right?- Yeah.
0:10:50 > 0:10:53Steph has a complex congenital heart condition
0:10:53 > 0:10:56that was only discovered after getting pregnant.
0:10:57 > 0:11:01No, baby sounds fine, but obviously we just need to make sure
0:11:01 > 0:11:04that baby's happy with what's been happening with you.
0:11:04 > 0:11:07- OK?- Yes.- Then I'm going to get a doctor to come and see you.
0:11:09 > 0:11:14I have symptoms which I've had on and off all my life,
0:11:14 > 0:11:17but I didn't realise that every time I have them
0:11:17 > 0:11:19there's a chance that it could be fatal that time.
0:11:22 > 0:11:24'She is a complicated case.'
0:11:25 > 0:11:29Women with a cardiac condition, obviously the body is put
0:11:29 > 0:11:31under extra pressure by the pregnancy,
0:11:31 > 0:11:34and as the pregnancy grows, the heart is put under more pressure.
0:11:37 > 0:11:39The danger for Steph is that her heart
0:11:39 > 0:11:42and lungs may not cope with the strain of the pregnancy.
0:11:42 > 0:11:44LOUD HEARTBEAT
0:11:44 > 0:11:46Well, they were very clear at the beginning
0:11:46 > 0:11:50of what we were risking - well, what I was risking.
0:11:50 > 0:11:52We spent three years trying for him,
0:11:52 > 0:11:57we wanted this chance so much, we wanted to give him a chance, so...
0:11:57 > 0:12:00She's trying to get as far into the pregnancy as she can.
0:12:00 > 0:12:03No matter what happens to her, she wants...
0:12:03 > 0:12:05him to have the strongest chance.
0:12:14 > 0:12:18- All right? - Yeah, I'm OK.
0:12:18 > 0:12:21After a night of observation, Steph's symptoms have settled,
0:12:21 > 0:12:23and she's back home in North Wales.
0:12:27 > 0:12:30When I found out about my heart condition,
0:12:30 > 0:12:34they sat me down and explained that they couldn't guarantee...
0:12:34 > 0:12:38the pregnancy. They couldn't guarantee that I'd come out of it,
0:12:38 > 0:12:40and that gobsmacked me at that point.
0:12:42 > 0:12:45Despite all signs that the baby was healthy,
0:12:45 > 0:12:48the medical team gave Steph the option of a termination
0:12:48 > 0:12:50for the sake of her own health.
0:12:52 > 0:12:54To me, there wasn't a choice.
0:12:54 > 0:12:57Already I knew he was there, and that was it.
0:12:57 > 0:13:01From very young, I dreamt about having a family of my own,
0:13:01 > 0:13:05and I always saw children as my main goal in life.
0:13:06 > 0:13:07Yes, I'm living, but so is he.
0:13:09 > 0:13:11It is her choice. Erm..
0:13:13 > 0:13:16Yeah, very worried, very scared for her. Scared for them both.
0:13:17 > 0:13:21Even if that means at the risk of my own life,
0:13:21 > 0:13:24I will try and protect him. Cos that's what a mum does.
0:13:29 > 0:13:32She is brave and full of hope.
0:13:32 > 0:13:36I could never call anybody stupid for having that desire.
0:13:38 > 0:13:41People will always take a risk, won't they?
0:13:41 > 0:13:45They've been dealt a bad lot of cards, really, and it could have
0:13:45 > 0:13:50major consequences, but she obviously has the need to have a baby.
0:13:52 > 0:13:56It's an instinct in a woman, isn't it? To be a mum.
0:14:10 > 0:14:13Midwives in the specialist antenatal clinics at St Mary's
0:14:13 > 0:14:17in Manchester support over 2,000 pregnant women every year,
0:14:17 > 0:14:20with a wide range of medical conditions.
0:14:20 > 0:14:22That's quick. Very good.
0:14:22 > 0:14:26So I'll get one of the doctors in to come and review you,
0:14:26 > 0:14:29and then they can decide when we need to do the next scan.
0:14:30 > 0:14:34Midwife Charlotte works closely with the doctors to offer support
0:14:34 > 0:14:35every step of the way.
0:14:36 > 0:14:41We do see a lot more high-risk women,
0:14:41 > 0:14:44so we have to be a lot more knowledgeable from a medical side,
0:14:44 > 0:14:47rather than midwifery and obstetric side as well.
0:14:51 > 0:14:54Well, at least we got a parking spot today.
0:14:54 > 0:14:56Makes a change.
0:14:56 > 0:14:58Sophie and Prince are expecting their first baby
0:14:58 > 0:15:00in eight weeks' time.
0:15:02 > 0:15:04We were pretty certain that we were having a girl because...
0:15:04 > 0:15:05We couldn't find any bits.
0:15:05 > 0:15:08At one point she opened her legs as well,
0:15:08 > 0:15:11and they said "Oh, yes, we're pretty sure she's a girl."
0:15:11 > 0:15:13I don't know. I think I always wanted a girl more
0:15:13 > 0:15:15because I feel they're easy to manage.
0:15:15 > 0:15:17- How wrong am I?- Yeah!
0:15:18 > 0:15:20Our concern at the moment was,
0:15:20 > 0:15:23obviously cos I've got the condition achondroplasia,
0:15:23 > 0:15:25we didn't know how I'd carry the baby,
0:15:25 > 0:15:28and so it's all a learning curve with it being our first pregnancy,
0:15:28 > 0:15:32of how the whole experience will be, but then also
0:15:32 > 0:15:35we're not sure if she's going to have the same condition as I've got.
0:15:35 > 0:15:37So that's going to be a whole another learning curve.
0:15:40 > 0:15:42Sophie, do you want to come through?
0:15:42 > 0:15:44Sophie has a rare genetic disorder that affects
0:15:44 > 0:15:46the growth of her bones and causes
0:15:46 > 0:15:49the most common form of short-limbed dwarfism.
0:15:50 > 0:15:54I know I've just left you with everything! Sorry.
0:15:54 > 0:15:55CHARLOTTE AND SOPHIE LAUGH
0:15:55 > 0:15:58Oh, no, it's all right. You've got a whole lot to be carrying already.
0:15:58 > 0:16:01Pop up on the couch, we'll have a listen to baby's heartbeat.
0:16:01 > 0:16:04- Is that low enough for you there, you all right?- Yeah.
0:16:04 > 0:16:07So there's the top of your uterus now.
0:16:07 > 0:16:09So no wonder you're feeling that hardness right under your ribs,
0:16:09 > 0:16:13- cos the top of your uterus is right up there now.- Yeah.
0:16:13 > 0:16:16'Sophie is actually the first lady with achondroplasia
0:16:16 > 0:16:20'that I've looked after in pregnancy, so it's a new experience,
0:16:20 > 0:16:24'but we're not looking at Sophie as someone with achondroplasia.'
0:16:24 > 0:16:26She is a pregnant woman who has come to us for care
0:16:26 > 0:16:29and that's, I think that's the most important thing.
0:16:29 > 0:16:31It's cos she's a woman having her first baby,
0:16:31 > 0:16:33having her first pregnancy.
0:16:33 > 0:16:35BABY'S HEART BEATS There you are.
0:16:35 > 0:16:37It is nice to hear this cos then you know
0:16:37 > 0:16:40that she's all right and everything's...
0:16:40 > 0:16:41- It's reassuring, isn't it?- Yeah.
0:16:46 > 0:16:48Sophie, toes pointed.
0:16:48 > 0:16:50So it's hips forward until the ball comes in,
0:16:50 > 0:16:52push it back as far as you can, back in again.
0:16:53 > 0:16:57Out, in, out, in, out, shake it all about.
0:16:58 > 0:17:02Yeah, I've been married just over four years now.
0:17:04 > 0:17:08Having a family was on both of our list of things to do.
0:17:08 > 0:17:10(Come on. Big push.)
0:17:10 > 0:17:12Well, I always wanted to be a dad.
0:17:12 > 0:17:15For me, that's going to be the most amazing feeling in the world.
0:17:15 > 0:17:19Finding the right person, doing what was, I think, half the struggle.
0:17:19 > 0:17:20SOPHIE LAUGHS
0:17:23 > 0:17:25Sophie is a Paralympic athlete
0:17:25 > 0:17:28and came fifth in shot put and discus at Beijing.
0:17:30 > 0:17:33The main hope was to make it to London 2012.
0:17:33 > 0:17:36The competition was really difficult
0:17:36 > 0:17:39and unfortunately, we didn't get selected.
0:17:39 > 0:17:42So, erm, even though the disappointment
0:17:42 > 0:17:48was so big at the time, we thought, "Let's try for a family, then."
0:17:48 > 0:17:49- Good.- OK.
0:17:49 > 0:17:52Obviously you don't know if you're going to be gifted with a child,
0:17:52 > 0:17:55and I wasn't too sure if my disability would
0:17:55 > 0:17:58make that decision for me in any way
0:17:58 > 0:18:00but then, once I did become pregnant,
0:18:00 > 0:18:04you start to think then if there's going to be any complications
0:18:04 > 0:18:07with me carrying a baby, and with the fact that there
0:18:07 > 0:18:12would be a 50-50 chance with us of passing on dwarfism to her.
0:18:12 > 0:18:13I hope she doesn't decide to come out now.
0:18:17 > 0:18:20- Can you feel her twitching?- Sophie's baby's limbs are being monitored
0:18:20 > 0:18:22for signs of a slowdown in growth.
0:18:24 > 0:18:26But it won't be until her next scan
0:18:26 > 0:18:29that Sophie will finally know if her baby has achondroplasia.
0:18:31 > 0:18:34It's all just a waiting game now, really.
0:18:34 > 0:18:38Not that I'll love her any less and not that she'll mean any less to us.
0:18:38 > 0:18:40I'll just worry that bit more
0:18:40 > 0:18:42about how she's going to cope in life.
0:18:44 > 0:18:46It must be a really big decision for,
0:18:46 > 0:18:51for a couple knowing that they've got a genetic condition that,
0:18:51 > 0:18:53when they do plan to have children,
0:18:53 > 0:18:56there's that risk there that that genetic condition is passed on.
0:18:56 > 0:18:58I think on this occasion, it would be wiser
0:18:58 > 0:19:01if we read the instructions before putting it in the car.
0:19:01 > 0:19:03Nah, don't worry. There you go. Done it.
0:19:04 > 0:19:07- How do you get it off? - SOPHIE LAUGHS
0:19:07 > 0:19:10'Sophie's worried that that could be potentially the case, and until'
0:19:10 > 0:19:13she's seen the scan and it's been confirmed one way or another,
0:19:13 > 0:19:18she won't be able to sort of get past that, until she knows for sure.
0:19:26 > 0:19:28Feels like the middle of the night, don't it?
0:19:28 > 0:19:31Jeannie's only just gone to bed over the road as well.
0:19:34 > 0:19:36Karla has reached the end of her pregnancy,
0:19:36 > 0:19:40and due to having had two previous C-sections,
0:19:40 > 0:19:42she's having planned surgery to deliver her baby.
0:19:43 > 0:19:46Yeah, I'm sure the way she's kicking this morning,
0:19:46 > 0:19:47she's coming out kicking and screaming.
0:19:50 > 0:19:53Karla's baby will have an operation soon after she is born.
0:19:57 > 0:20:00I think it's come round pretty quick, you know.
0:20:00 > 0:20:03Yeah, YOU think it's come round pretty quick.
0:20:04 > 0:20:05Come on, kid.
0:20:06 > 0:20:08Karla's 20-year-old daughter, Terrie,
0:20:08 > 0:20:09will be supporting her throughout.
0:20:11 > 0:20:15It's like our work has got her to this point,
0:20:15 > 0:20:20and it's about delivery now. And, as a midwife, you want to almost
0:20:20 > 0:20:23give her some strength to get through the other side.
0:20:24 > 0:20:25Hello!
0:20:25 > 0:20:28THEY LAUGH
0:20:28 > 0:20:32- I know, finally got here. Yeah.- Hi.
0:20:32 > 0:20:33- You OK?- Yeah, yeah.
0:20:33 > 0:20:36You look a bit tired. Have you not slept very well?
0:20:36 > 0:20:40No! You know that's another way for "You look rubbish!"
0:20:40 > 0:20:42No, no, no. You just look tired.
0:20:42 > 0:20:43I expected that.
0:20:43 > 0:20:46Can I give you a big hug? Cos I'm going to be busy...
0:20:46 > 0:20:48- Yeah.- ..and I won't see you going in there.
0:20:48 > 0:20:50Oh, come here. Thank you so much.
0:20:52 > 0:20:54You take care, and I'm thinking about you.
0:20:54 > 0:20:58'I don't know how I would be in her situation.'
0:20:58 > 0:21:00We can't wait.
0:21:00 > 0:21:02'You never forget there's a huge journey for Karla'
0:21:02 > 0:21:04the other side of delivery,
0:21:04 > 0:21:08and you really do feel for her, and you hope this little girl
0:21:08 > 0:21:14of hers has got the same character and strength and attitude
0:21:14 > 0:21:17that Karla has, that'll bring her through
0:21:17 > 0:21:19this difficult few days of her life.
0:21:20 > 0:21:22How are you feeling? Are you worried about anything?
0:21:24 > 0:21:27Yeah, I'm worried about you, being my birthing partner
0:21:27 > 0:21:32in this traumatic situation, and then I'm worried about baby.
0:21:32 > 0:21:35I'm scared to see her as well as, like, really excited,
0:21:35 > 0:21:37because how am I going to feel when I see her?
0:21:42 > 0:21:45Well, I can't change my mind now, can I?
0:21:47 > 0:21:50Only after Karla's baby is born will surgeons know
0:21:50 > 0:21:52the full extent of her health problems.
0:21:53 > 0:21:55Oh, God. This is a bit...
0:21:56 > 0:22:00My mum's one of those people that'll put up a front,
0:22:00 > 0:22:03she'll act as strong as anything, but she's fragile.
0:22:06 > 0:22:09I think she's scared if anything happens, like anything bad
0:22:09 > 0:22:12happens to baby, cos I don't think she'd be able to handle it.
0:22:14 > 0:22:19- All right, Karla?- Yeah. - Paediatrician's here.
0:22:19 > 0:22:20OK.
0:22:20 > 0:22:22KARLA CHUCKLES GENTLY
0:22:22 > 0:22:25- I love you. - Love you more.
0:22:29 > 0:22:30OK.
0:22:34 > 0:22:35That's the waters gone.
0:22:35 > 0:22:39- PAEDIATRICIAN:- And most of the pushing on the chest.
0:22:39 > 0:22:40OK, here she comes.
0:22:45 > 0:22:46OK.
0:22:48 > 0:22:49Hello there, little one.
0:22:52 > 0:22:54OK, nice and gently, now.
0:22:55 > 0:22:57Hello.
0:23:05 > 0:23:06BABY CRIES
0:23:06 > 0:23:08Oh, my baby girl.
0:23:08 > 0:23:11Oh, she's beautiful. How are you?
0:23:12 > 0:23:14KARLA SOBS
0:23:17 > 0:23:18Thank God for that.
0:23:20 > 0:23:24Oh, look at you. She's gorgeous, Karla. Well done.
0:23:27 > 0:23:29Karla, Karla, quick look.
0:23:30 > 0:23:31KARLA AND TERRIE: Aww!
0:23:41 > 0:23:44How did the exomphalos look? Did it look that big?
0:23:44 > 0:23:48I couldn't see it that much but...let's just take the next step.
0:23:49 > 0:23:53Just feeling overwhelmed now. I can't wait to see her again.
0:24:03 > 0:24:04BABY CRIES
0:24:05 > 0:24:09Karla's daughter, Bella, is taken to intensive care
0:24:09 > 0:24:13for the paediatricians to assess the seriousness of her abdominal defect.
0:24:16 > 0:24:19The defect itself is only three or four centimetres
0:24:19 > 0:24:21but the actual amount of stuff out there is quite a lot,
0:24:21 > 0:24:25and the maximum damage to the sac with the exomphalos out is a ten,
0:24:25 > 0:24:29at its maximum point. There's a small bowel in there.
0:24:29 > 0:24:34Getting everything back in one go is sometimes impossible.
0:24:35 > 0:24:38I think we'll have to wait and see when we're down to theatre,
0:24:38 > 0:24:40how it looks and how everything goes back.
0:24:42 > 0:24:44SUSAN: It's a reality check.
0:24:45 > 0:24:50You know, she's carried Bella all these months, and this is it.
0:24:50 > 0:24:55She's got to get through surgery and Karla will be
0:24:55 > 0:24:58so anxious that things go well.
0:25:12 > 0:25:15Hello, midwife speaking. OK, yeah.
0:25:18 > 0:25:21It's been three weeks since Steph's blackout,
0:25:21 > 0:25:24and the team at the hospital's Cardiac Clinic have been
0:25:24 > 0:25:26running tests to discover the reason why.
0:25:27 > 0:25:30- The baby been moving around OK? - Yeah.
0:25:30 > 0:25:32- Any more dizzy spells?- They've been getting more frequent,
0:25:32 > 0:25:35but I don't know if that's cos I'm getting to the end of the pregnancy
0:25:35 > 0:25:37- and that's putting more strain on. - Yeah.
0:25:37 > 0:25:39Just have a seat on the couch
0:25:39 > 0:25:42and then I'll just have a feel of your...stomach.
0:25:44 > 0:25:46- Does that feel like a bone there?- Yeah.
0:25:48 > 0:25:49Spot on.
0:25:49 > 0:25:52Midwives here work closely with the team
0:25:52 > 0:25:54from the Manchester Heart Centre,
0:25:54 > 0:25:57who support over 80 pregnant women a year with cardiac problems.
0:25:57 > 0:25:59Get these on, Stephanie, I need you to relax
0:25:59 > 0:26:02- and be as still as you can for me, sweetheart, OK?- Yep.
0:26:02 > 0:26:05'Ladies like Steph previously may never
0:26:05 > 0:26:07'have even got to childbearing age.'
0:26:08 > 0:26:11If that's the choice that they've made, then we're not there
0:26:11 > 0:26:12to say that they can't do it, we're
0:26:12 > 0:26:14there to say, "These are the risks",
0:26:14 > 0:26:17and they go into that knowing what the risks are.
0:26:21 > 0:26:24Have you got names planned and everything?
0:26:24 > 0:26:26- Er, yeah. His name's Aiden. - Aiden?- Yeah.
0:26:26 > 0:26:29'People might argue that she's made the wrong decision
0:26:29 > 0:26:31'or she's been selfish.
0:26:31 > 0:26:33'I'm not in her shoes, I've never had a heart condition,
0:26:33 > 0:26:36'I've not had the discussions with my husband about what would happen'
0:26:36 > 0:26:38if that was the scenario.
0:26:38 > 0:26:41So I can't pass judgement.
0:26:41 > 0:26:43All I'm there to do as a midwife is to support her,
0:26:43 > 0:26:46irrespective of what the outcome might be.
0:26:49 > 0:26:51The strain of the pregnancy on Steph's heart
0:26:51 > 0:26:54is becoming a real concern for the team.
0:26:54 > 0:26:57- Hello, hi.- Have you had any more blackouts?
0:26:57 > 0:26:59- Not complete ones, have I? - - Not complete, no.
0:26:59 > 0:27:03- Not complete ones? You've had some that are...?- I've been getting black spots again.
0:27:03 > 0:27:07Do you remember the 24 hour ECG recording we did last time you came?
0:27:07 > 0:27:10We've got that now and have analysed that yesterday.
0:27:11 > 0:27:14That shows that there are periods where your heart slows down
0:27:14 > 0:27:16and the rhythm becomes very abnormal.
0:27:17 > 0:27:22What that means to you is that we would recommend
0:27:22 > 0:27:24- that you have a pacemaker fitted for that.- OK.
0:27:24 > 0:27:26It's a thing called Complete Heart Block,
0:27:26 > 0:27:28and we need to do it now, really.
0:27:30 > 0:27:34The intention, if you're happy with this, is that we'll admit you today
0:27:34 > 0:27:38to the maternity ward, and tomorrow afternoon I'll put a pacemaker in.
0:27:38 > 0:27:41Would it be better to induce me and just have him born first?
0:27:41 > 0:27:43- No.- No?!
0:27:43 > 0:27:47- HE LAUGHS - I think we need rhythm safety for you,
0:27:47 > 0:27:51- for whichever mode of delivery, you know, comes.- OK.
0:27:54 > 0:27:55- OK?- OK.
0:27:55 > 0:27:58'Complete Heart Block is dangerous because we know that some'
0:27:58 > 0:28:01patients may die of this, and we can't wait until the baby's born
0:28:01 > 0:28:05before we implant the pacemaker, because if her heart was to stop,
0:28:05 > 0:28:08then potentially, her life would be at risk, and clearly then
0:28:08 > 0:28:10the baby's life would be at risk
0:28:10 > 0:28:13and that's not a risk that we're prepared to take.
0:28:14 > 0:28:17- I need to ring Mum.- Mmm-hmm.
0:28:27 > 0:28:29I'm petrified now.
0:28:31 > 0:28:32Aiden, what are we going to do?
0:28:34 > 0:28:35What are we going to do?
0:28:40 > 0:28:44But I've been a bit too lucky all the way through, to be fair.
0:28:50 > 0:28:52SHE SIGHS
0:28:52 > 0:28:53I'm sorry, Daniel.
0:28:53 > 0:28:55Oh, Steph, you don't have to be sorry.
0:28:57 > 0:28:58OK.
0:29:03 > 0:29:06It's not ideal having surgery in pregnancy,
0:29:06 > 0:29:08particularly surgery on the heart.
0:29:10 > 0:29:12But she knows that she's got no option
0:29:12 > 0:29:15and it's something that she's really got to go through.
0:29:15 > 0:29:19And you just hope that it all goes well, because potentially,
0:29:19 > 0:29:22for her, it's a one-in-a-lifetime opportunity to be a mum.
0:29:29 > 0:29:32It's Susan at St Mary's.
0:29:32 > 0:29:34I was just ringing to see how her blood sugars are.
0:29:34 > 0:29:37She's not left her diary with you, has she?
0:29:38 > 0:29:42This is, for a lot of ladies, what they've dreamed of
0:29:42 > 0:29:47since being a little girl, and that's what drives them at all odds
0:29:47 > 0:29:53and at the expense of their own health to have a pregnancy,
0:29:53 > 0:29:58to feel real like you, just like anybody else.
0:29:59 > 0:30:02But it's huge for us,
0:30:02 > 0:30:08as a service that is under a lot of pressure, to deliver for women.
0:30:08 > 0:30:12There's a lot of expectation on us as midwives,
0:30:12 > 0:30:15and we feel that day to day.
0:30:24 > 0:30:27Now, this is alien to me. You know, I feel really...
0:30:27 > 0:30:29I get anxious about here as well, do you know that?
0:30:29 > 0:30:31Here, let me.
0:30:31 > 0:30:3424 hours after her caesarean section,
0:30:34 > 0:30:38Karla is visiting her baby daughter Bella in Intensive Care.
0:30:38 > 0:30:42- Oh, my goodness.- Isn't she tiny? - Oh, she's beautiful. Oh, Karla!
0:30:42 > 0:30:44- Isn't she beautiful?- She is.
0:30:49 > 0:30:52Bella will have surgery today to try
0:30:52 > 0:30:54and repair the defect in her abdominal wall.
0:30:59 > 0:31:02It's got to be done. Yeah, I'm worried.
0:31:04 > 0:31:06I don't really, you know, want her to have the operation,
0:31:06 > 0:31:09but she's got to and that's the only way we can get her home.
0:31:10 > 0:31:13This last little bit, yeah? This last little bit for her.
0:31:16 > 0:31:19I've just got to let her go, haven't I?
0:31:19 > 0:31:20And just let them deal with it now.
0:31:23 > 0:31:25I can't do this now.
0:31:27 > 0:31:31I don't want to say goodbye to her, I don't want to.
0:31:31 > 0:31:32I don't want to go down to theatre.
0:31:32 > 0:31:35I don't want to go in that room. I went in that room yesterday
0:31:35 > 0:31:37and it scared the living daylights out of me,
0:31:37 > 0:31:41just being in there with Terrie, let alone her.
0:31:41 > 0:31:42It sounds awful, don't it?
0:31:43 > 0:31:46It really does sound terrible.
0:31:52 > 0:31:56- TERRIE:- She can only be so strong for so long. Yeah.
0:31:56 > 0:31:58She's got me, I'll make sure she's all right.
0:32:04 > 0:32:07If you want to say bye-bye now, you can.
0:32:07 > 0:32:10Right, good luck, beautiful, and do us proud.
0:32:19 > 0:32:22Any baby who needs an operation within one day of life
0:32:22 > 0:32:24is having a risky operation.
0:32:26 > 0:32:28The first thing we're going to do is make sure
0:32:28 > 0:32:30the bowel looks healthy through the membrane.
0:32:30 > 0:32:32Then we're gently going to reduce it, which means push it back
0:32:32 > 0:32:36inside her tummy, and if we fill her tummy up with lots and lots of bowel,
0:32:36 > 0:32:38it's much harder for her lungs to fill with air
0:32:38 > 0:32:41and for her to breathe on her own, and that can cause problems as well.
0:32:41 > 0:32:43So, there a lot of things to think about.
0:32:48 > 0:32:50It's panicking.
0:32:51 > 0:32:54You've got no control over the situation.
0:32:54 > 0:32:57You've got to literally trust a complete stranger
0:32:57 > 0:33:00to make sure that your kid's all right.
0:33:03 > 0:33:07In theatre, surgeons reach the critical part of the procedure.
0:33:08 > 0:33:10It comes quite nicely.
0:33:18 > 0:33:19That's great, thank you.
0:33:19 > 0:33:22Bella's bowel is carefully squeezed through the base
0:33:22 > 0:33:25of her umbilical cord and back inside her body.
0:33:28 > 0:33:29OK.
0:33:35 > 0:33:38Yep. OK, that's the sac.
0:33:41 > 0:33:43- Did you do it? - Yep, all done. How are you?
0:33:43 > 0:33:45Oh, I'm all right.
0:33:45 > 0:33:49She's doing fine. Everything's back inside where it should be.
0:33:49 > 0:33:52Tummy looks good, tummy button looks good.
0:33:52 > 0:33:56- Is it an inny or an outy?- It's a sort of half and half at the moment.
0:33:56 > 0:33:59I hope it'll be an inny but we'll have to see
0:33:59 > 0:34:02how she heals, but it looks nice and neat at the moment.
0:34:02 > 0:34:03- Thank you.- My pleasure.
0:34:03 > 0:34:05And when can I have a cuddle?
0:34:06 > 0:34:08- Probably now.- Really?!
0:34:08 > 0:34:11Yeah. You should be able to pick her up very soon.
0:34:12 > 0:34:16Going to go and cuddle my baby now. Going to cuddle her.
0:34:16 > 0:34:18LAUGHTER
0:34:18 > 0:34:20- Oh, my God. - There you go.
0:34:20 > 0:34:23It's amazing, innit? How clever are they?
0:34:24 > 0:34:25I can't believe it.
0:34:28 > 0:34:31Come here. Hello.
0:34:32 > 0:34:38- There you go. - Oh, my Lordy. You're so tiny. Hello!
0:34:38 > 0:34:40Hello, it's Mummy here.
0:34:40 > 0:34:41Ooh.
0:34:44 > 0:34:46You're so beautiful.
0:34:49 > 0:34:52This is the moment I've dreamt of.
0:34:52 > 0:34:54This is the moment that's kept me going.
0:34:54 > 0:34:59This is, like, kind of the moment that's drove me through all the way.
0:34:59 > 0:35:00You're so beautiful.
0:35:07 > 0:35:08I never want to let you go, do I?
0:35:15 > 0:35:18Oh, look at her. Isn't she gorgeous?
0:35:18 > 0:35:21There you are. I'm not going to argue with you.
0:35:21 > 0:35:24She's beautiful, absolutely beautiful.
0:35:24 > 0:35:28We want a photograph on our wall, Bella, we do.
0:35:28 > 0:35:31I could sit here all day with you, you're nice and warm.
0:35:31 > 0:35:36'I think we can learn a lot from how Karla managed that pregnancy.'
0:35:36 > 0:35:42She just stayed amazingly positive and just really strong,
0:35:42 > 0:35:44and she believed in her baby.
0:36:04 > 0:36:11At that stage, you didn't know that I had achondroplasia,
0:36:11 > 0:36:15- and you can't really tell from those pictures, can you?- No.
0:36:15 > 0:36:16Not really.
0:36:16 > 0:36:21Sophie is seven months into her pregnancy and is having a scan today
0:36:21 > 0:36:25to find out if her baby has inherited her dwarfism.
0:36:25 > 0:36:29Then they finally said at about six months that you had achondroplasia,
0:36:29 > 0:36:32and there was nothing they could do about it, and
0:36:32 > 0:36:34"Cross each bridge when it came to it" sort of thing.
0:36:34 > 0:36:36Well, I bet that was a shock for you,
0:36:36 > 0:36:39- cos you didn't know anything about it, really.- No, I didn't.
0:36:40 > 0:36:44Around one in 25,000 babies a year are born
0:36:44 > 0:36:49with this condition, and Sophie was the first in her family to have it.
0:36:49 > 0:36:55My legs were extremely bowed, so we had to straighten the legs out.
0:36:55 > 0:37:01The operation was very painful and very traumatic
0:37:01 > 0:37:06and left me in a wheelchair for about a year.
0:37:06 > 0:37:10And this is something that I am extremely worried,
0:37:10 > 0:37:13that if she ever had to go through,
0:37:13 > 0:37:17if it was just a case of her having short arms and legs and having
0:37:17 > 0:37:21to deal with society being a bit cruel, you know,
0:37:21 > 0:37:24we'd teach her to be fine with dealing with that
0:37:24 > 0:37:25and make her into a strong person.
0:37:25 > 0:37:27It's the medical side of things
0:37:27 > 0:37:30that is the thing that's worrying me the most.
0:37:33 > 0:37:37I have that fear, knowing how difficult it has been at times
0:37:37 > 0:37:40to live with, that I've passed on this condition to her.
0:37:44 > 0:37:49I know it's come from me, and you go through those feelings of guilt,
0:37:49 > 0:37:52thinking, "Was it selfish of me to have a child with this condition?"
0:37:57 > 0:37:58Looking at it from another angle,
0:37:58 > 0:38:01if my parents had known about me and then decided,
0:38:01 > 0:38:04"Oh, because she's achondroplasia we don't want to have her",
0:38:04 > 0:38:07then I wouldn't even be here.
0:38:07 > 0:38:10So... It's just all the emotions going on in your head.
0:38:11 > 0:38:15- I need the toilet again. - Do you?- Nightmare.
0:38:15 > 0:38:18Early in the pregnancy, Sophie and her husband
0:38:18 > 0:38:22decided against genetic testing, because of the risk of miscarriage.
0:38:22 > 0:38:25Instead, they're relying on scans to chart
0:38:25 > 0:38:27the growth of their unborn baby.
0:38:27 > 0:38:28We'll just have a quick look round.
0:38:28 > 0:38:32There is a 50% chance that Sophie could pass on dwarfism to her child.
0:38:34 > 0:38:37Now, she will finally know the outcome.
0:38:37 > 0:38:38Thigh bone...
0:38:41 > 0:38:42All right.
0:38:43 > 0:38:45- Hello.- Hiya.- Hi.
0:38:47 > 0:38:51Erm, I was just looking at your scan before we came in,
0:38:51 > 0:38:55and the head's grown as much as we would have expected
0:38:55 > 0:38:58on this, on the average line, and this is the tummy.
0:39:00 > 0:39:05And this measures the thigh bone, and what we can see there
0:39:05 > 0:39:08is that baby's legs haven't grown as much
0:39:08 > 0:39:11- as we would have expected them to. - Right.
0:39:11 > 0:39:18- And is actually shorter than we would expect.- Okey-doke.- OK.
0:39:18 > 0:39:19So it's looking pretty certain?
0:39:19 > 0:39:22It does look as though baby's got achondroplasia, which...
0:39:24 > 0:39:26..wasn't what you were hoping for, was it?
0:39:26 > 0:39:31Well...no, but as long as she's healthy.
0:39:37 > 0:39:38- Hello.- Hiya.
0:39:42 > 0:39:45- So you've seen the doctor already today?- Yes.
0:39:45 > 0:39:49It's looking like she's definitely going to have achondroplasia. Erm...
0:39:51 > 0:39:53So how do you feel about it all now?
0:39:53 > 0:39:57Erm...all right. I have to go home and take it all in, really.
0:39:57 > 0:40:00- That's it.- That's how I am.
0:40:00 > 0:40:03It's, you know, discuss it with my husband and...
0:40:03 > 0:40:04And, you know, everything's fine.
0:40:04 > 0:40:07You're really healthy in the pregnancy, which is really good.
0:40:07 > 0:40:11- And the baby's well. - Exactly, that's the main thing.
0:40:11 > 0:40:14- And you've got your date for the caesarean section.- Yes. Yes.
0:40:14 > 0:40:16- So you've got a date to work to. - Yes, counting down.
0:40:21 > 0:40:23I'd be lying to say that I didn't have that tiny bit of hope,
0:40:23 > 0:40:27thinking, "Oh, maybe her legs have grown a lot
0:40:27 > 0:40:30"and she'll be absolutely fine, and there'll be no problems."
0:40:30 > 0:40:35So, still felt that little bit of disappointment,
0:40:35 > 0:40:41but that's a bit of a strong word. I still felt emotional and worried
0:40:41 > 0:40:43and all those things, but it takes
0:40:43 > 0:40:45you a while to take in that information.
0:40:46 > 0:40:49She's grown up with achondroplasia.
0:40:49 > 0:40:53She knows her daughter has to do that, so it's difficult.
0:40:53 > 0:40:57And she just wants the reassurance that everything's going to be OK.
0:41:00 > 0:41:02Why should it be any different now?
0:41:03 > 0:41:06I mean, as long as she's still healthy,
0:41:06 > 0:41:08it doesn't really matter if she's a dwarf or not.
0:41:08 > 0:41:11Listen, there's nothing you can do about your condition, dear.
0:41:11 > 0:41:14- There's nothing that's... - No, I know.
0:41:14 > 0:41:18..a problem for it, and I know that, because you've done so well,
0:41:18 > 0:41:20even if we have to go through the hard times,
0:41:20 > 0:41:24you wouldn't be the same person if you didn't go through those things.
0:41:24 > 0:41:25You're right.
0:41:26 > 0:41:29So don't think about it as the worst thing in the world
0:41:29 > 0:41:32that could have happened, think about it -
0:41:32 > 0:41:34this may be the way she's meant to be
0:41:34 > 0:41:37because she has something greater in the world to do.
0:41:39 > 0:41:43She'll have been put here for a reason, to make a difference.
0:41:43 > 0:41:45Exactly.
0:41:45 > 0:41:46Yep, you're right.
0:41:56 > 0:42:00So, how are you feeling yourself?
0:42:00 > 0:42:02Scared, to be fair. Very scared.
0:42:05 > 0:42:11Baby's very happy in there. That's an ideal trace, that.
0:42:11 > 0:42:12Good.
0:42:14 > 0:42:17Eight months into her pregnancy, Steph is having surgery
0:42:17 > 0:42:20to fit a pacemaker to help control her abnormal
0:42:20 > 0:42:22and life-threatening heart rhythms.
0:42:24 > 0:42:26I think it's easier for me, more straightforward for me,
0:42:26 > 0:42:29cos I'm not the one who's going to be sitting outside the theatre
0:42:29 > 0:42:32and having that hour drag on for half a lifetime.
0:42:34 > 0:42:36The main thing is staying strong for her.
0:42:38 > 0:42:40It's what we chose as parents to do.
0:42:41 > 0:42:43She had the choice, we made the decision...
0:42:44 > 0:42:47..and we have to live with the consequences.
0:42:49 > 0:42:52It is a big deal that this pregnancy is occurring.
0:42:52 > 0:42:54There's a lot of complications,
0:42:54 > 0:42:59so, you know, there is a sense that Dan may feel a bit helpless.
0:42:59 > 0:43:01I'll be even better when I'm going back that way.
0:43:01 > 0:43:04But it is emotional, he is just a mix of emotions
0:43:04 > 0:43:06and he doesn't really know where he's at some of the time,
0:43:06 > 0:43:08but I think he's done really, really well.
0:43:10 > 0:43:15She means the world to me. Steph's turned my life around.
0:43:15 > 0:43:17I kind of got lost in my teenage years,
0:43:17 > 0:43:21and then when I met Steph, I kind of found the old me again.
0:43:24 > 0:43:29I'm a recovering alcoholic and my life was going nowhere.
0:43:29 > 0:43:32And she's my rock, she's what keeps me strong.
0:43:33 > 0:43:35I don't know what I'd do without her.
0:43:35 > 0:43:37I don't even want to think about it.
0:43:44 > 0:43:47We're going to implant a permanent pacemaker for Stephanie
0:43:47 > 0:43:50through one of the veins just under the left shoulder.
0:43:54 > 0:43:56Throughout the operation
0:43:56 > 0:43:59the baby will be closely monitored by the maternity team.
0:44:00 > 0:44:05We've got Mum on a tilt to make sure that the blood supply
0:44:05 > 0:44:07to baby's good, and Catherine, the midwife,
0:44:07 > 0:44:09is monitoring the baby with a CTG machine,
0:44:09 > 0:44:12and we're just sort of standing by in case there's a problem.
0:44:18 > 0:44:22Two pacing leads are fed through a vein directly into Steph's heart.
0:44:23 > 0:44:27- Might be pushing top of the left shoulder, OK?- OK.
0:44:31 > 0:44:34I've got the lower chamber lead in, the most important one in.
0:44:34 > 0:44:36Now we're after the second one, if we can get that bit.
0:44:43 > 0:44:47Yeah, there's been that many complications and things gone on.
0:44:47 > 0:44:51We have spoke, me and Steph, that it could all go wrong, and...
0:44:51 > 0:44:55Steph told me what she wants me to do if the worst happens.
0:44:58 > 0:45:00If the choice is between her and Aiden,
0:45:00 > 0:45:02then it's to be Aiden all the way.
0:45:04 > 0:45:07I agree with her, but I don't want to lose my wife.
0:45:12 > 0:45:14I don't want to lose either of them.
0:45:19 > 0:45:21The two pacing leads are in.
0:45:21 > 0:45:26I'm now trying to make a pocket for the pacemaker under the skin,
0:45:26 > 0:45:29and then we'll pop the pacemaker in and sew her up, fingers crossed.
0:45:32 > 0:45:35Once the pacemaker is connected to the pacing leads,
0:45:35 > 0:45:39it will send electrical pulses directly to Steph's heart.
0:45:39 > 0:45:42- Yeah. Pacing well with a good... - Little bit of pulling now.
0:45:46 > 0:45:50By stabilising the heart, the team are giving Steph the best chance
0:45:50 > 0:45:52of surviving to the end of her pregnancy.
0:45:56 > 0:45:59Better than I expected. Phew.
0:45:59 > 0:46:03- Happy?- Yes, very much. Very much. Right.
0:46:04 > 0:46:06- NURSE: Here we go.- Hello.
0:46:06 > 0:46:07Good to see you.
0:46:09 > 0:46:12- How are you feeling? - OK, actually.
0:46:12 > 0:46:14Yeah. Just glad to be back with her now.
0:46:17 > 0:46:21We are now happier she has the pacemaker and it's working,
0:46:21 > 0:46:24than we were previously, going into labour without that,
0:46:24 > 0:46:27because that would have been a very high-risk situation
0:46:27 > 0:46:29and that's why she's had all this input,
0:46:29 > 0:46:32to make it as safe as we can possibly make it.
0:46:32 > 0:46:33There's no guarantees
0:46:33 > 0:46:36but at least we can put everything in place to, you know,
0:46:36 > 0:46:41try and have a live baby and a live mum at the end of the day.
0:46:55 > 0:46:59Hi, it's Mandy, I'm the midwife on the elective list today.
0:46:59 > 0:47:04We've got a patient called Sophie Gay, she's got achondroplasia.
0:47:04 > 0:47:09And so we, you know, we will need somebody there at delivery.
0:47:09 > 0:47:12I've been told that the baby has it as well.
0:47:12 > 0:47:15- You're asking me what you need. - How do you feel?
0:47:15 > 0:47:18- The cameras.- I've got- A- camera. - Right.
0:47:18 > 0:47:21Because of her condition and the small size of her pelvis,
0:47:21 > 0:47:25Sophie's only option for a safe delivery is a caesarean section.
0:47:27 > 0:47:30- Have you come in for a section, then?- Yeah.
0:47:30 > 0:47:34Because she has achondroplasia, they have to be very careful
0:47:34 > 0:47:37when they're doing the spinal anaesthetic,
0:47:37 > 0:47:39because they need to make sure it's in the right place
0:47:39 > 0:47:42and make sure she is anesthetised properly.
0:47:44 > 0:47:46Oh, it's racing a little bit.
0:47:46 > 0:47:48- Mm. It has been since last night. - Has it?
0:47:50 > 0:47:54- Yeah, I look stylish, don't I? - You do look amazing.
0:47:54 > 0:47:58Just ready to meet her now and just hope the operation goes well
0:47:58 > 0:48:01and without too many complications.
0:48:04 > 0:48:08She's putting on the bravest face I've seen in a while,
0:48:08 > 0:48:11but I think she wants the whole process to be done with.
0:48:11 > 0:48:13- Oh!- It's just like...
0:48:15 > 0:48:18I wish you could go through this, you little bugger.
0:48:18 > 0:48:21- Women have to do it all.- He will be going through it, trust me.
0:48:23 > 0:48:26- Going through into theatre now. Lots of people. Big room.
0:48:28 > 0:48:30Everyone is needed. We only...
0:48:37 > 0:48:39I think the spinal...that was the thing
0:48:39 > 0:48:41she was most apprehensive about,
0:48:41 > 0:48:45because of her anatomy being a bit difficult, a bit more...different.
0:48:52 > 0:48:56Hello. They are struggling to get the spinal in.
0:48:56 > 0:48:59He's on his third attempt now.
0:48:59 > 0:49:03Erm...so we're just waiting to see what happens.
0:49:08 > 0:49:11You don't like to think that there could be complications,
0:49:11 > 0:49:13and I'm just trying to stay positive
0:49:13 > 0:49:16because there's going to be a baby at the end of it.
0:49:22 > 0:49:23BABY CRIES
0:49:25 > 0:49:28Oh, dear. Oh, dear.
0:49:30 > 0:49:32SHE EXHALES
0:49:33 > 0:49:36- Well, she's not impressed at being born.- Oh, really?
0:49:36 > 0:49:39- I'll tell you that much. - Oh, dear me. What are you?
0:49:39 > 0:49:41- We had a right scream. - Oh, that's a good sign.
0:49:43 > 0:49:45- Uh-huh?- She's yours.
0:49:48 > 0:49:50- It's not that bad. - She's really gorgeous.
0:49:51 > 0:49:53She's beautiful.
0:49:54 > 0:49:56Look at you.
0:49:56 > 0:49:58BABY CRIES
0:50:00 > 0:50:02Is she photogenic like her midwife?
0:50:11 > 0:50:13- Aww.- Gorgeous, isn't she?
0:50:15 > 0:50:17Here's Mummy.
0:50:17 > 0:50:20Let me give you a kiss.
0:50:22 > 0:50:26- BABY CRIES - Oh, dear. Oh, dear.
0:50:30 > 0:50:34- I just can't believe this is my baby.- All yours.- Our baby.
0:50:37 > 0:50:39I can only go on my own experience,
0:50:39 > 0:50:42by how I felt becoming a mum for the first time.
0:50:42 > 0:50:46It's just amazing and you can never underestimate it, really.
0:50:50 > 0:50:51You smell nice.
0:50:57 > 0:51:01I just feel really content and happy.
0:51:02 > 0:51:07All my problems have disappeared, and nothing else really matters
0:51:07 > 0:51:10right now apart from our little family.
0:51:10 > 0:51:14Now she's here and we know she's got achondroplasia,
0:51:14 > 0:51:18it doesn't really matter at all, cos she's just so perfect to us
0:51:18 > 0:51:21and all those worries and everything just go out the window.
0:51:22 > 0:51:24- BABY CRIES - Oh. Hi.
0:51:24 > 0:51:26If she has the sort of life that I've had
0:51:26 > 0:51:29and the opportunities that I've had, she'll be absolutely fine.
0:51:31 > 0:51:37I'll have to go down to his second favourite lady in the world.
0:51:37 > 0:51:39But I suppose if there's anybody you have to be second best to,
0:51:39 > 0:51:41it's your own daughter.
0:51:55 > 0:51:57- Oh, no. - How are you feeling?
0:51:57 > 0:51:58- OK.- Excited?- Yeah. Yeah.
0:51:58 > 0:52:00I mean it's... After all the complications,
0:52:00 > 0:52:02- it's nice to do something normal.- Yeah.
0:52:05 > 0:52:08Two weeks after having surgery to fit a pacemaker,
0:52:08 > 0:52:11Steph is almost full term,
0:52:11 > 0:52:14and is being induced so her labour can be carefully managed.
0:52:16 > 0:52:18She wants to give birth naturally,
0:52:18 > 0:52:22so will be closely monitored to see how her heart copes with labour.
0:52:24 > 0:52:28I'm quite surprised we finally got here after all the worry
0:52:28 > 0:52:31all the way through, and now doing something really natural
0:52:31 > 0:52:33and something what I've always wanted to do.
0:52:34 > 0:52:37The only time I'm going to feel completely relaxed
0:52:37 > 0:52:42is when Aiden's here, and I know that Aiden's fine and Steph's OK.
0:52:44 > 0:52:46- Hey.- What?
0:52:52 > 0:52:54She's determined to have this baby naturally.
0:52:56 > 0:52:59Five hours after the induction process began,
0:52:59 > 0:53:02Steph is in established labour.
0:53:05 > 0:53:06So, how are you feeling?
0:53:06 > 0:53:13Great, I think. Ask me in a couple of hours.
0:53:13 > 0:53:16Hiya, you all right? I'm Jackie, I'll be looking after you tonight.
0:53:16 > 0:53:19I'm going to take you round to the delivery room.
0:53:20 > 0:53:24From now on, midwife Jackie will manage Steph's labour
0:53:24 > 0:53:27in a high-dependency delivery room.
0:53:27 > 0:53:30Just putting ECG electrodes on
0:53:30 > 0:53:33so we can monitor Stephanie's heart rate throughout her labour.
0:53:35 > 0:53:37You know, we're just observing closely to make sure that
0:53:37 > 0:53:39there's no real abnormalities and,
0:53:39 > 0:53:42if there is, just get the doctors in as soon as we can.
0:53:42 > 0:53:45So at the moment, your heart is beating a little on the fast side,
0:53:45 > 0:53:48sort of around 107. At the moment, there are no paced beats,
0:53:48 > 0:53:51so that's your heart doing all of its work.
0:53:51 > 0:53:52Thank you.
0:53:54 > 0:53:57Have you got a contraction at the moment?
0:53:57 > 0:54:01Now your waters have gone. OK, you felt that then, yeah?
0:54:01 > 0:54:04That's good. Do you feel like you need to push?
0:54:04 > 0:54:08Yeah. I'm trying not to, though, yeah.
0:54:09 > 0:54:11SHE GROANS
0:54:11 > 0:54:14To minimise the strain of labour on Steph's heart,
0:54:14 > 0:54:18Jackie needs her to hold off pushing for as long as possible.
0:54:20 > 0:54:22Ughhhhh.
0:54:23 > 0:54:24- Got lots of pressure?- Yeah!
0:54:26 > 0:54:29Well done. You're fully.
0:54:29 > 0:54:31- I'm ready?- Yeah.
0:54:31 > 0:54:33Try and hold off just for a little bit longer, just let baby's head
0:54:33 > 0:54:36come down, because you've only got 30 minutes.
0:54:36 > 0:54:39You know, we don't want to put too much pressure on your heart,
0:54:39 > 0:54:42so that's why we only want to push for 30 minutes.
0:54:42 > 0:54:45So, if we hold off until you can't hold off any longer.
0:54:47 > 0:54:50Steph has just half the normal time to try
0:54:50 > 0:54:54and deliver her baby naturally, or the doctors will step in.
0:54:55 > 0:54:59Big, deep breaths. Big, deep breaths. Big, deep breaths.
0:55:01 > 0:55:03Hopefully, if she manages to hold off pushing,
0:55:03 > 0:55:05then we'll have a nice, normal delivery
0:55:05 > 0:55:08rather than having to get the doctors involved.
0:55:10 > 0:55:13- INTERVIEWER:- Hopefully, we'll have a baby soon.- Hopefully.
0:55:13 > 0:55:15I'll go back in.
0:55:15 > 0:55:18- Right, how are you doing? - Rotten.
0:55:18 > 0:55:20All right. Is it getting too much, Steph?
0:55:20 > 0:55:26Yeah, yeah? OK. Nice, deep breaths. Nice, deep breaths.
0:55:26 > 0:55:28Keep going. Put your bum on the bed.
0:55:28 > 0:55:32It's OK, it's OK. Well done. That's brilliant.
0:55:32 > 0:55:33I can see the top of your baby's head.
0:55:33 > 0:55:36That means you can push next time, yeah?
0:55:40 > 0:55:43Well done. Go on, again, come on, and again.
0:55:44 > 0:55:47Just relax your legs. Go on, that's fabulous pushing.
0:55:47 > 0:55:49Well done, well done.
0:55:49 > 0:55:52STEPH MOANS It's OK. Well done. That's brilliant.
0:55:52 > 0:55:54I just want to see my baby boy.
0:55:54 > 0:55:56- He won't be long now. - He won't be long now, hun.
0:55:56 > 0:56:01Just a little push now, Steph. Blow, blow. Nearly here.
0:56:01 > 0:56:03A little push...there we go! Well done.
0:56:11 > 0:56:13- Hello, baby.- Here he is.
0:56:13 > 0:56:16- There he is, there he is. There's your boy.- Congratulations, darling.
0:56:17 > 0:56:20- He's not breathing. - It's OK. He will do in a minute.
0:56:20 > 0:56:23- - Just going to have a little look at him, OK?- Yeah, yeah.
0:56:23 > 0:56:25- He's fine.- He's OK, don't worry.
0:56:25 > 0:56:27- DAN:- Come on, little man. OK, Aiden.
0:56:29 > 0:56:31- He is, he's fine. - There you go.
0:56:33 > 0:56:34BABY CRIES
0:56:39 > 0:56:41- Hey, my boy. - There you go.
0:56:41 > 0:56:44Hey. It's OK.
0:56:44 > 0:56:46You were giving me a fright, you were.
0:56:48 > 0:56:52You were making me worried, I didn't want anything to happen to you.
0:56:54 > 0:56:57I don't really know how it feels, to be honest.
0:56:57 > 0:56:58It's surreal, really.
0:57:00 > 0:57:02I dreamt about this for so many years
0:57:02 > 0:57:04and yet...it's hard to explain.
0:57:10 > 0:57:15You're my dream come true. Yes.
0:57:16 > 0:57:19I'm just so pleased that everything worked out for them.
0:57:20 > 0:57:22All she ever wanted was to be a mum
0:57:22 > 0:57:26and she was prepared to go through it despite all the risks.
0:57:26 > 0:57:27'But she did brilliantly.'
0:57:29 > 0:57:30Oh, he's lovely, Steph.
0:57:30 > 0:57:34Let me give him back to you, honey. Aww.
0:57:35 > 0:57:39Steph takes her baby home and we're on to the next one.
0:57:39 > 0:57:42The next challenge, the next patient that we have sleepless nights about.
0:57:44 > 0:57:47MUSIC: "For Once In My Life" by Stevie Wonder
0:57:48 > 0:57:52SUSAN: You can pass it on to the next lady and say, "Do you know,
0:57:52 > 0:57:56"there was very little hope for another baby and it did really well."
0:57:56 > 0:58:01So if there's, you know, if there is life, then there is always hope.
0:58:01 > 0:58:03Bella, look at Mummy.
0:58:03 > 0:58:07- Ba-ba-ba, ba-Babybel.- Look, she's giving big smiles as well.
0:58:09 > 0:58:12You know, all that hard work was worth it for everybody.
0:58:12 > 0:58:16We'll do it again next time. We'll go through it again.
0:58:16 > 0:58:17We'll do it again.
0:58:17 > 0:58:20- Aww.- I do genuinely love you ladies.
0:58:43 > 0:58:46Subtitles by Red Bee Media Ltd