0:00:02 > 0:00:03Hello, ward 4, midwife speaking.
0:00:03 > 0:00:07Oww! Don't panic, it's going to be over soon.
0:00:07 > 0:00:09With the highest birth rate in 40 years...
0:00:09 > 0:00:11Look what you've done!
0:00:13 > 0:00:15You are just amazing. Look at him.
0:00:15 > 0:00:18..midwives are under more pressure than ever before.
0:00:18 > 0:00:19You are kidding me.
0:00:19 > 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 > 0:00:316lb 11oz, I reckon. He's about 6lb 11oz and a half.
0:00:31 > 0:00:32Oh!
0:00:32 > 0:00:35..as the midwives deliver the next generation...
0:00:35 > 0:00:37The scary bit is, you're all going to be midwives.
0:00:37 > 0:00:39CHEERING
0:00:39 > 0:00:40..with care...
0:00:40 > 0:00:44Oh, please help me. We'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 > 0:00:54You'll be absolutely fine, I told you, I'll be with you, OK?
0:00:54 > 0:00:58It does touch you. This is the reason we do what we do.
0:00:58 > 0:01:01It's OK! You smell nice.
0:01:01 > 0:01:02It's more than a job. It's...
0:01:02 > 0:01:05You're part of somebody's life, and they never forget you.
0:01:22 > 0:01:25Every woman will come to an antenatal unit for at least
0:01:25 > 0:01:28two scans during pregnancy, to pick up any problems.
0:01:32 > 0:01:34When a complication is detected, mums need to come in
0:01:34 > 0:01:39more regularly. And, for some, it becomes their daily routine.
0:01:44 > 0:01:46At the University Hospital in Cardiff,
0:01:46 > 0:01:49there are number of specialist clinics,
0:01:49 > 0:01:52caring for the most serious maternal and foetal cases across South Wales.
0:01:57 > 0:01:59Li Plim?
0:01:59 > 0:02:03Sarah Bendham is a specialist midwife on the antenatal day unit.
0:02:03 > 0:02:05Hiya. That's OK, you spoke to me on the phone.
0:02:05 > 0:02:07Nice to meet you.
0:02:07 > 0:02:10Li is 33 weeks into her first pregnancy.
0:02:13 > 0:02:15I feel like a whale.
0:02:15 > 0:02:18You're not too bad, you're fine.
0:02:18 > 0:02:21Li has been coming in every day for the past two weeks
0:02:21 > 0:02:23due to concerns over her baby's growth.
0:02:23 > 0:02:25BABY'S HEART BEATS
0:02:25 > 0:02:28Li is known to have a small baby, and we keep an eye on
0:02:28 > 0:02:32our small babies with movements, making sure mums are happy.
0:02:32 > 0:02:35The scan that Li's having as well helps to give us
0:02:35 > 0:02:38an idea of the health of the baby, because we don't know what's
0:02:38 > 0:02:41causing it, whether it is just genetic that she is carrying
0:02:41 > 0:02:46small babies, or if it could be that she is growing a small baby
0:02:46 > 0:02:49because the placenta's not functioning or the cord isn't functioning,
0:02:49 > 0:02:52or something isn't getting through that needs to get through.
0:02:53 > 0:02:58I would say my pregnancy has been quite...difficult.
0:02:58 > 0:03:01It's not something straightforward like what everybody else thinks.
0:03:01 > 0:03:04It's not just finding out that you're pregnant,
0:03:04 > 0:03:08go for your natal scans and then just pop the baby
0:03:08 > 0:03:11when it's after 40 weeks - it just doesn't go that way.
0:03:13 > 0:03:16Babies born before 37 weeks are considered premature,
0:03:16 > 0:03:19and there are concerns that if Li's baby stops growing,
0:03:19 > 0:03:21it'll need to be delivered early.
0:03:22 > 0:03:25The longer we can keep a baby in utero and keep them
0:03:25 > 0:03:27where they need to be and where they're nurtured
0:03:27 > 0:03:29as much as we can, then we do.
0:03:29 > 0:03:32But if anything changes over the next couple of weeks,
0:03:32 > 0:03:35if the growth stops, we would need to take the baby out
0:03:35 > 0:03:37in order to save the baby.
0:03:39 > 0:03:44Today, the baby seems to be fine, and will be scanned again tomorrow.
0:03:44 > 0:03:45All right then, thank you. Take care.
0:03:45 > 0:03:49All right, see you tomorrow then. Ta-ra, Li.
0:03:49 > 0:03:50Well, it is nice to send them home
0:03:50 > 0:03:53and know that they are another step closer to term,
0:03:53 > 0:03:56and, I mean, for Li, she's what, 33 weeks now?
0:03:56 > 0:03:59So she's got four weeks to go. Four weeks of a battle, possibly,
0:03:59 > 0:04:03but, you know, at least we know that we can, we're here for her.
0:04:03 > 0:04:07And it does feel good, there is a lot of...job satisfaction,
0:04:07 > 0:04:08I think is the word,
0:04:08 > 0:04:12to know that we're able to help these pregnancies through.
0:04:17 > 0:04:21Helen Jane is a midwife practitioner.
0:04:21 > 0:04:23Hello, how are you? Not too bad, you all right?
0:04:23 > 0:04:25I'm all right, yes, thank you.
0:04:25 > 0:04:28Every day, she visits different departments of the hospital
0:04:28 > 0:04:31where expectant mums have been admitted.
0:04:31 > 0:04:35Well, I'm going over to see one of our antenatal ladies,
0:04:35 > 0:04:38her name's Carly Harris, she's having her third baby
0:04:38 > 0:04:42and she's, em, a patient in Coronary Care at the moment.
0:04:42 > 0:04:45So I'm just coming over to do a tracing of the baby's heart.
0:04:47 > 0:04:49Carly is 32 weeks pregnant,
0:04:49 > 0:04:52but was rushed in last night with extreme heart palpitations.
0:04:55 > 0:04:57Hello there, it's Carly, yes? Yes.
0:04:57 > 0:05:01We haven't met before, I'm Helen, I'm one of the labour ward midwives,
0:05:01 > 0:05:03I've come over to do a tracing of the baby's heart.
0:05:03 > 0:05:06That OK? Yeah?
0:05:06 > 0:05:08Are you feeling the baby move? Yeah, she's really...
0:05:08 > 0:05:10Lot's of movement? Yeah. Oh, it's a girl, is it?
0:05:10 > 0:05:12Little girl, yeah. What do you have at home?
0:05:12 > 0:05:14I got two boys. Two boys? 12 and six.
0:05:14 > 0:05:18Oh, that's really good, excellent. OK.
0:05:20 > 0:05:21There she is.
0:05:21 > 0:05:22BABY'S HEART BEATS
0:05:22 > 0:05:24So what are the names of your two boys?
0:05:24 > 0:05:27Levi and Jayden. Ah, right. It's going again.
0:05:27 > 0:05:30Yeah, don't worry, try and ignore those alarms
0:05:30 > 0:05:33if you can. I know it's hard, isn't it?
0:05:33 > 0:05:37A normal heart rate during pregnancy is 85-90 beats per minute.
0:05:39 > 0:05:42My heart rate went up to 199 last night.
0:05:42 > 0:05:48I can't really catch a breath, because it's like, chest pain, so...
0:05:48 > 0:05:52I thought because my heart was going so fast, her heart would be racing.
0:05:52 > 0:05:55No, her heart is lovely actually, very good.
0:05:55 > 0:05:58So you didn't have these problems with your first two? Not my two boys.
0:05:58 > 0:06:01Must be a thing with girls. Must be!
0:06:01 > 0:06:04We'll have trouble with this one. Aww...
0:06:04 > 0:06:07ALARM RINGS
0:06:07 > 0:06:10Don't worry now, don't worry.
0:06:13 > 0:06:16Right, I think we can probably take that off now, it's absolutely fine.
0:06:16 > 0:06:19So no worries about baby so far? No worries about baby.
0:06:19 > 0:06:20OK, great.
0:06:20 > 0:06:24OK, see you tomorrow, Carly. Thank you, bye. Take care now, bye-bye.
0:06:24 > 0:06:28Carly has been known to the cardiac team since childhood,
0:06:28 > 0:06:32and after her last baby was advised not to get pregnant again.
0:06:32 > 0:06:36Well, basically, yeah, I was born with a congenital heart defect,
0:06:36 > 0:06:40it was back to front, all the four chambers were upside down and inside out.
0:06:40 > 0:06:42So, obviously a lot of surgery had to be done
0:06:42 > 0:06:44in Great Ormond Street from a baby,
0:06:44 > 0:06:48so as soon as I was like three months, they done the first op.
0:06:48 > 0:06:51When I was four they did the second op,
0:06:51 > 0:06:54and then obviously when I was 11, they done a third op in the Heath.
0:06:54 > 0:06:57Honestly, since I've had my last surgery,
0:06:57 > 0:07:01this is the only bit of trouble I've had, since I...since I was 11.
0:07:03 > 0:07:06Working alongside Helen, and overseeing Carly's obstetric care,
0:07:06 > 0:07:08is consultant Dr Claire Francis.
0:07:10 > 0:07:13Hi, Carly. Pull this round a minute.
0:07:13 > 0:07:15I just wanted to come and say hello today really,
0:07:15 > 0:07:17and have a chat and catch up.
0:07:17 > 0:07:21When we saw you in the beginning of the pregnancy we were all fairly positive
0:07:21 > 0:07:24and optimistic that this pregnancy would go the way the other two went,
0:07:24 > 0:07:28because your two first babies were - considering you've got a major heart problem -
0:07:28 > 0:07:29quite straightforward, weren't they?
0:07:29 > 0:07:31We were hoping things were going to go the same,
0:07:31 > 0:07:34and unfortunately, probably the stage in your pregnancy,
0:07:34 > 0:07:37the fact that your heart isn't quite normal
0:07:37 > 0:07:39and being pregnant on top, has just pushed you into this
0:07:39 > 0:07:41extra, sort of, fast rate,
0:07:41 > 0:07:44with all the palpitations that you're getting.
0:07:44 > 0:07:47I suspect it's not necessarily going to go away completely
0:07:47 > 0:07:48until you've had your baby.
0:07:48 > 0:07:51I know, because I've been ill. But I think it is going to be a case
0:07:51 > 0:07:53of waiting to see over the next few days
0:07:53 > 0:07:55whether the medication does the job,
0:07:55 > 0:07:59or whether we're going to get to the stage where you become unwell again. Yeah.
0:08:03 > 0:08:06Hello, antenatal clinic. Midwife speaking, how can I help you?
0:08:16 > 0:08:20Jamila is 32 weeks pregnant with her second child.
0:08:22 > 0:08:24Everything was normal until three weeks ago
0:08:24 > 0:08:28she developed an unusual liver disorder that causes severe itching.
0:08:30 > 0:08:31Jamila?
0:08:32 > 0:08:34Hiya. Hello, you all right?
0:08:34 > 0:08:36Yeah, not too bad, you? Sitting in the far corner.
0:08:36 > 0:08:39I know, I never sit there usually, it's so hard to hear anything.
0:08:40 > 0:08:42Let's have a little look.
0:08:42 > 0:08:46It's a condition that affects fewer than one in 1,000 pregnant women.
0:08:47 > 0:08:50Jamila has obstetric cholestasis,
0:08:50 > 0:08:52which is an itching problem in pregnancy.
0:08:52 > 0:08:55It's characterised obviously by the itching,
0:08:55 > 0:08:59more so with palms of hands, soles of feet and worse at night.
0:08:59 > 0:09:03She's had it before, so unfortunately for her she knew what was coming.
0:09:03 > 0:09:06The itching did kind of get worse towards the end
0:09:06 > 0:09:09of my last pregnancy, but it was summer last time as well.
0:09:09 > 0:09:12This time round I recognised the symptoms,
0:09:12 > 0:09:14so I thought I'd better call up.
0:09:14 > 0:09:17A developing baby relies on the mother's liver
0:09:17 > 0:09:20to remove bile acids from the blood.
0:09:20 > 0:09:23Anything with a bile acid over 40 is classed as severe.
0:09:23 > 0:09:26Hers were 59 last week.
0:09:26 > 0:09:31If uncontrolled, there's a risk of foetal distress and premature birth.
0:09:31 > 0:09:35OK, I'm going to take you off now because that looks beautiful. OK, thank you.
0:09:35 > 0:09:37OK, can you manage? Yep, thanks, Sarah.
0:09:37 > 0:09:40Yep, no worries, take care. See you next week.
0:09:41 > 0:09:43'This time round when I knew I had it again
0:09:43 > 0:09:47' - and I knew - as soon as I felt that itching I knew what it was.'
0:09:47 > 0:09:51I even considered not reporting it for a while,
0:09:51 > 0:09:54because I just didn't want to face all this again.
0:09:54 > 0:09:57Jamila's previous pregnancy turned out fine, and she
0:09:57 > 0:10:01and her husband Mark now have a healthy two-year-old son, Bruce.
0:10:02 > 0:10:06It seems to be exclusive to pregnancy
0:10:06 > 0:10:10and vanishes just like that as soon as you give birth.
0:10:10 > 0:10:14From what I understand they don't really know why it happens.
0:10:14 > 0:10:19It's not the itching itself that's the problem, you can handle that.
0:10:19 > 0:10:20It's what the itching represents
0:10:20 > 0:10:25and, you know, we just want to make sure that the baby's healthy, so...
0:10:26 > 0:10:31In hindsight, I realise how lucky I was that Bruce was fine
0:10:31 > 0:10:32and that I have a healthy baby,
0:10:32 > 0:10:36and that, as much as possible, everything was perfect.
0:10:39 > 0:10:41So in a sense, this time round,
0:10:41 > 0:10:44being far less naive, I'm much more worried...
0:10:44 > 0:10:48about actually what the risks really are and what this condition means.
0:10:51 > 0:10:53LIFT DOORS OPEN
0:10:56 > 0:11:00Next on midwife Helen's round is another woman in coronary care.
0:11:03 > 0:11:07Alison is 35. She's pregnant with her third child.
0:11:12 > 0:11:16Two weeks ago, I thought I had a cold, thought nothing of it,
0:11:16 > 0:11:20a bit worn out, thinking, "Oh, this is like constant flu."
0:11:20 > 0:11:23And to find out that...
0:11:23 > 0:11:28it was obviously a lot more serious than that.
0:11:28 > 0:11:3129 weeks pregnant, Alison was rushed into hospital
0:11:31 > 0:11:33with pneumonia and chest pains.
0:11:34 > 0:11:37Alison has rheumatoid heart disease,
0:11:37 > 0:11:40which is a disease of the valves in the heart.
0:11:40 > 0:11:44This is about as serious as it gets with structural heart disease
0:11:44 > 0:11:48and pregnancy, and the condition that Alison has is very complicated
0:11:48 > 0:11:52and very advanced, and women die of this in pregnancy.
0:11:52 > 0:11:57Until this pregnancy, Alison's heart problems hadn't been detected.
0:11:57 > 0:11:59SHE BREATHES HEAVILY
0:11:59 > 0:12:02This is something that she's had for a very long time, just that
0:12:02 > 0:12:06the degree of heart disease wasn't as bad when she was younger,
0:12:06 > 0:12:09so she got away with her first two pregnancies without any problems.
0:12:09 > 0:12:12Now that it's got a bit worse, as is the natural history of this condition,
0:12:12 > 0:12:15she's just got to the point where her body doesn't have the reserves
0:12:15 > 0:12:18left to take her through this pregnancy in good health.
0:12:18 > 0:12:19For the last three weeks,
0:12:19 > 0:12:23the doctors have been trying to stabilise Alison's heart condition.
0:12:23 > 0:12:26She has another month to go to get to full term.
0:12:27 > 0:12:30Knock, knock. Hi, Alison. All right?
0:12:30 > 0:12:33How we doing? I don't feel good today.
0:12:33 > 0:12:36Don't you? In what way?
0:12:36 > 0:12:40They took some blood today. Did they? And that doesn't help.
0:12:42 > 0:12:45There's hardly got any blood in there to take!
0:12:45 > 0:12:47Well, they've taken it all now, have they?
0:12:47 > 0:12:49I think so. I don't think there's any left.
0:12:49 > 0:12:51Let me just cover you up.
0:12:51 > 0:12:54So do we have a firm plan now for delivery, or are we still...?
0:12:54 > 0:12:57Well, he said, he said what they're going to do,
0:12:57 > 0:13:02they're going to sit down and decide what they think's the best way
0:13:02 > 0:13:06of getting baby out basically, because obviously my heart is...
0:13:06 > 0:13:09You've had two normal deliveries, haven't you, yeah?
0:13:09 > 0:13:14Yeah, but because of my heart, they really don't know what the best way is. OK.
0:13:14 > 0:13:17So they've got to think of a safe way for the heart, I think.
0:13:17 > 0:13:19For you and... Yeah.
0:13:20 > 0:13:24'She was quite quiet today I thought, but I think it's just
0:13:24 > 0:13:27a combination of her being in for such a long time,
0:13:27 > 0:13:30possibly not sleeping as well, that's probably it, I think,
0:13:30 > 0:13:32and missing her two boys.
0:13:32 > 0:13:35And it's a long time for her to be in as well,
0:13:35 > 0:13:38and obviously she's anxious about, you know, what's going to happen,
0:13:38 > 0:13:40how she's going to have this baby.
0:13:40 > 0:13:42But, no, I think she seems OK.
0:13:43 > 0:13:46Right, we'll see you over the weekend, OK? OK.
0:13:46 > 0:13:48Take care now. Bye, Alison.
0:13:48 > 0:13:50I find the midwifes are brilliant,
0:13:50 > 0:13:56because they explain it to me in a way I sort of like, understand.
0:13:56 > 0:13:59We're possibly easier to talk to than cardiologists
0:13:59 > 0:14:02and, you know, maybe they can, we're a bit more perhaps
0:14:02 > 0:14:06down to Earth with what we tell them, especially with Alison.
0:14:06 > 0:14:09I think she does need things explaining to her
0:14:09 > 0:14:11in quite simple terms.
0:14:11 > 0:14:14I find sometimes it's really hard to understand
0:14:14 > 0:14:16because of my learning disabilities.
0:14:16 > 0:14:20So I find that really hard, to find what's going on really.
0:14:28 > 0:14:31After concerns over her latest scan,
0:14:31 > 0:14:33Li was admitted to the ward last night.
0:14:35 > 0:14:37See, there's no need to worry, we do all the worrying.
0:14:39 > 0:14:41She's been assigned to midwife Emily.
0:14:41 > 0:14:45So Li is deemed high risk at the moment, for two reasons.
0:14:45 > 0:14:49One - because of baby measuring a little bit small, and we're
0:14:49 > 0:14:54slightly concerned because she's had a bit of abnormal blood results,
0:14:54 > 0:14:59and her blood pressure's been sitting a little bit higher than we'd like.
0:14:59 > 0:15:03It's 7am, and the doctors have more test results.
0:15:03 > 0:15:04Knock, knock.
0:15:05 > 0:15:07A nice wake-up call.
0:15:07 > 0:15:08SHE LAUGHS
0:15:08 > 0:15:10How are you feeling this morning?
0:15:10 > 0:15:14Blood pressure's up a little bit, lots of protein in the urine
0:15:14 > 0:15:17as well, plus the blood tests, one of them is slightly elevated.
0:15:17 > 0:15:21And all that together is this blood-pressure problem in pregnancy, pre-eclampsia.
0:15:21 > 0:15:26The cure is always delivery, so it is the right thing to do.
0:15:26 > 0:15:29But if we couldn't induce you, you'd still need delivery,
0:15:29 > 0:15:31and that would be Caesarean section now.
0:15:31 > 0:15:34But you're definitely in the right place, see you later. OK. Nice to see you.
0:15:34 > 0:15:37Sorry, horrible wake-up call. No, it's OK.
0:15:38 > 0:15:41'At the moment she's late 34 weeks,
0:15:41 > 0:15:45'so it's a little earlier than we'd usually like to induce someone.
0:15:45 > 0:15:49Anything less than 37 weeks is something we deem premature.
0:15:49 > 0:15:53It's a bit daunting. I'm not physically and emotionally prepared
0:15:53 > 0:15:59for...labour yet because it's, it's only 34 weeks.
0:15:59 > 0:16:04It's actually six weeks away, so I'm not prepared for it yet,
0:16:04 > 0:16:08to be honest with you. I'd rather have a C-section.
0:16:08 > 0:16:11I'm sure she'll be in the mindset, "Just get it over and done with."
0:16:11 > 0:16:14But we want to give her the best chance possibly to get
0:16:14 > 0:16:20into labour herself. Because the more we do, the more interventions,
0:16:20 > 0:16:22the more things may change, and not necessarily for the better.
0:16:37 > 0:16:39Jamila is back for more tests.
0:16:39 > 0:16:42Thank you. This time to make sure her liver condition
0:16:42 > 0:16:45is confined to pregnancy, and not a longer lasting problem.
0:16:45 > 0:16:49So you're the unlucky one that gets the early start then? THEY LAUGH
0:16:49 > 0:16:51This is cold now, sorry. That's all right.
0:16:53 > 0:16:54As well as scanning the liver,
0:16:54 > 0:16:56they also take the opportunity to check the baby.
0:17:00 > 0:17:04..looks fine, Jamila, OK? So let's have a look at baby now.
0:17:04 > 0:17:07Here we go, little face peeping out at you there, look.
0:17:07 > 0:17:10Oh, yeah. See the little eye? Facing the same way.
0:17:10 > 0:17:12Nostrils there as well. Oh, wow, yeah!
0:17:12 > 0:17:13JAMILA LAUGHS
0:17:13 > 0:17:16And lips, see the top lip just coming over there? Yeah, yeah.
0:17:18 > 0:17:21So just going to get all the measurements now, Jamila, OK? OK.
0:17:23 > 0:17:25But there's a concern about the baby's measurements.
0:17:25 > 0:17:26Thank you.
0:17:26 > 0:17:29So Jamila is sent to see specialist midwife Sarah.
0:17:34 > 0:17:38Everything else has grown, bar the tummy.
0:17:38 > 0:17:41So it's, unless the bile acids are starting to affect baby maybe.
0:17:42 > 0:17:43SHE SIGHS
0:17:43 > 0:17:49So potentially, we may have an issue with baby.
0:17:49 > 0:17:51But we don't know until we see -
0:17:51 > 0:17:54you can see the consultant tomorrow and we can make a plan from there.
0:17:54 > 0:17:58OK about the, the...? About where we're going, yeah?
0:17:58 > 0:17:59OK?
0:18:02 > 0:18:05All right, thanks, Sarah. If you want me, you know where I am. I will.
0:18:05 > 0:18:07Thank you so much. Take care, Jamila.
0:18:09 > 0:18:13Well, as Jamila knows, they can cause stillbirth.
0:18:13 > 0:18:15So it's just a case really of seeing what else is going on
0:18:15 > 0:18:17and keeping a close eye on this baby.
0:18:19 > 0:18:22I'm OK. It's just this up and down...
0:18:22 > 0:18:26The rollercoaster started like this, and now it's more like this.
0:18:27 > 0:18:30Thing is, as a parent, it's a stressful time anyway,
0:18:30 > 0:18:33and when you're told bad news it's even more stressful.
0:18:34 > 0:18:36I do wonder what else is going on,
0:18:36 > 0:18:39there's something else going on, we need to sort it.
0:18:39 > 0:18:42And the last thing we want is a stillbirth - not fair.
0:18:51 > 0:18:54BABY'S HEART BEATS
0:18:54 > 0:18:58Just four hours into Li's induction, there's a problem.
0:18:58 > 0:19:03Baby's starting to show signs of getting a bit stressed,
0:19:03 > 0:19:05so we don't want to prolong this whole process.
0:19:07 > 0:19:12So the idea is, by breaking your waters, we're taking away
0:19:12 > 0:19:16that cushion between the baby's head and your cervix,
0:19:16 > 0:19:19so by taking it away the head will come down harder
0:19:19 > 0:19:23onto the cervix, and hopefully make it dilate a bit more.
0:19:23 > 0:19:26And also release all the hormones
0:19:26 > 0:19:30that bring on contractions. All right?
0:19:31 > 0:19:34Li has been joined by her husband, Eng Su.
0:19:36 > 0:19:38All the way up through on that gas.
0:19:42 > 0:19:44All right?
0:19:47 > 0:19:49LI SOBS
0:19:50 > 0:19:54As the baby becomes more distressed, the doctors are called.
0:19:56 > 0:19:57SHE MOANS
0:19:57 > 0:20:01Focus on your breathing. You're doing really well.
0:20:03 > 0:20:04That's it, come on.
0:20:08 > 0:20:11This heart rate is still going down quite a lot, OK?
0:20:11 > 0:20:14And it's quite slow to recover as well.
0:20:14 > 0:20:17We need to deliver you, and the answer is
0:20:17 > 0:20:20we need to take you to theatre and do a Caesarean section, OK?
0:20:20 > 0:20:24So I'll get one of the nurses and we'll take you down. Back in a moment.
0:20:24 > 0:20:27LI SOBS
0:20:31 > 0:20:34Once we broke her waters, that cushion went between the baby
0:20:34 > 0:20:39and the cervix, and baby dropped down quite quickly,
0:20:39 > 0:20:42which shocked baby a bit too much, really.
0:20:42 > 0:20:45And because she wasn't even in established labour,
0:20:45 > 0:20:49the choice was made to come straight to theatre.
0:20:49 > 0:20:53Li's baby will be delivered prematurely at 34 weeks.
0:21:14 > 0:21:15Connected.
0:21:18 > 0:21:21All right, guys, it is a boy.
0:21:21 > 0:21:23They're just going to give him some inflation breaths
0:21:23 > 0:21:25just to help him breathe, OK?
0:21:25 > 0:21:28But because he's little he's going to struggle breathing on his own,
0:21:28 > 0:21:32so that's why we're giving him the breaths.
0:21:32 > 0:21:35He's little, but we expected him to be little.
0:21:35 > 0:21:36OK?
0:21:39 > 0:21:40BABY CRIES
0:21:40 > 0:21:42..cry, yeah? Yeah.
0:21:44 > 0:21:45That's more like it.
0:21:49 > 0:21:51He's doing really well, all right?
0:21:51 > 0:21:54He's doing all the things that we'd want him to be doing.
0:21:55 > 0:21:57So we're going to weigh him.
0:21:57 > 0:22:00Chances are they probably will take him over to neonatal unit,
0:22:00 > 0:22:02just because he is really little.
0:22:02 > 0:22:06But, again, we were expecting that, weren't we? He's doing really well.
0:22:07 > 0:22:11So it's 3lb, 13oz. He's not needing much support.
0:22:11 > 0:22:14His saturation, so his oxygen levels are coming up really well,
0:22:14 > 0:22:16and he's got a lovely heart rate, he's nice and pink.
0:22:16 > 0:22:19Mmm-hmm. All right? Do you want to see him?
0:22:19 > 0:22:21Yes, please. Yeah, meet your son!
0:22:26 > 0:22:30NEONATAL NURSE: Hello. Congratulations.
0:22:30 > 0:22:33He's needing a bit of help with his breathing just at the moment,
0:22:33 > 0:22:35so we're going to take him round to the neonatal unit, get him
0:22:35 > 0:22:38in a little incubator, yeah? And we'll look after him round there.
0:22:38 > 0:22:40And when you're able to come round,
0:22:40 > 0:22:42you can come round and see him then, yeah?
0:22:42 > 0:22:44All right, so don't you worry, we'll look after him.
0:22:48 > 0:22:50OK?
0:22:50 > 0:22:54He's gone to neonatal unit just so he can be helped with the breathing,
0:22:54 > 0:22:57and just observed really, to make sure that he is stable.
0:23:00 > 0:23:03This is the thing with labour and childbirth,
0:23:03 > 0:23:05you never know what's going to happen.
0:23:06 > 0:23:09Things can change like that. In this case they did.
0:23:12 > 0:23:14Li will need to spend time in recovery
0:23:14 > 0:23:17before she is able to visit her baby in neonatal.
0:23:20 > 0:23:24You've been here before, Bruce, haven't you? Several times now.
0:23:24 > 0:23:27Next morning, Jamila has returned with her husband to see what
0:23:27 > 0:23:31obstetric consultant Dr Griffiths makes of her baby's growth.
0:23:31 > 0:23:33I think the midwife was slightly concerned
0:23:33 > 0:23:36about the scan results yesterday. OK, sure. It looks like this.
0:23:37 > 0:23:4295% of all babies will fall in between those two outer lines. OK.
0:23:42 > 0:23:44And this is what baby's done.
0:23:44 > 0:23:46There, there, slight drop off, but actually,
0:23:46 > 0:23:49in terms of slight off, you're talking millimetres. OK.
0:23:49 > 0:23:52And essentially, it is a little bit of a tail-off,
0:23:52 > 0:23:54but I wouldn't do anything about it. Great.
0:23:54 > 0:23:56Usually what you find is, lots of these charts
0:23:56 > 0:23:59get these odd little bumps of going down
0:23:59 > 0:24:00and the next one is back to normal.
0:24:00 > 0:24:03And it's one of the disadvantages of scanning every two weeks,
0:24:03 > 0:24:06it's probably the earliest you can scan together.
0:24:06 > 0:24:09Yeah, and this was nine days apart. Exactly, yeah.
0:24:09 > 0:24:12I did say, if you weren't concerned, I wouldn't be concerned.
0:24:12 > 0:24:14Thank you, nice to see you.
0:24:14 > 0:24:19Oh, I love Mr Griffiths, he's just so practical.
0:24:19 > 0:24:22And I was saying to Mark, it's kind of this tug of war, I think, between the consultants
0:24:22 > 0:24:24who are practical and don't want to see you,
0:24:24 > 0:24:27and the midwives, who want to make sure everything is OK,
0:24:27 > 0:24:29but they want to see you all the time.
0:24:29 > 0:24:31They just want to make sure everything is perfect for you
0:24:31 > 0:24:33and the baby, and I love them for that.
0:24:33 > 0:24:36We surveil their pregnancies and keep a lot of time
0:24:36 > 0:24:39and effort into helping them get these pregnancies to term,
0:24:39 > 0:24:41which is ultimately what we want.
0:24:41 > 0:24:44We want these babies healthy and happy, we want these mums happy
0:24:44 > 0:24:47and healthy, which is the ultimate goals of midwives anyway.
0:24:53 > 0:24:56Do you want me to try and adjust that a bit for you? Let's see if we can...
0:24:56 > 0:24:57Oh, thank you.
0:24:58 > 0:25:02The day after her arrival, Carly's heart is still racing.
0:25:03 > 0:25:06All right then. Take care now, see you soon. Bye.
0:25:11 > 0:25:14Dr Francis is with heart specialist Dr Masani,
0:25:14 > 0:25:18who has known Carly as a patient since she was a child.
0:25:18 > 0:25:20She's tough as old boots, isn't she?
0:25:20 > 0:25:23She's a great girl actually, and she's very resilient,
0:25:23 > 0:25:26but she's obviously got a good systemic ventricle, that's the thing.
0:25:26 > 0:25:30Her systemic ventricle can cope with heart rates of 180,
0:25:30 > 0:25:32which is pretty impressive.
0:25:32 > 0:25:35So there's nothing we can do to sort of, fix it electronically?
0:25:35 > 0:25:38It's drugs. It's got to be... And you're happy with Flecainide?
0:25:38 > 0:25:41Yeah, yeah, I've got no problem with that.
0:25:44 > 0:25:47The next day, and the drugs bring Carly's heart rate down
0:25:47 > 0:25:50to a normal level.
0:25:50 > 0:25:53And she's visited by her mum Jacky.
0:25:53 > 0:25:55Hi, Mum, all right? Hello, my darling.
0:25:56 > 0:26:00God, you had me a nervous wreck. Hi, you OK? Nice to see you.
0:26:00 > 0:26:05So glad for seeing you. God, I've been so worried about you.
0:26:05 > 0:26:07Oh, my God. Heartbeat has stayed down.
0:26:07 > 0:26:11All I've done is cry and pray and cry and pray.
0:26:11 > 0:26:12Cry some more. Oh, don't...
0:26:13 > 0:26:17TEARFUL: You scared me so much yesterday. You really scared me.
0:26:19 > 0:26:21I'm fine, honestly now.
0:26:21 > 0:26:25No, but...you looks beautiful, and you always looks beautiful,
0:26:25 > 0:26:29but you haven't got as much colour as you had in your face the other day.
0:26:29 > 0:26:32And, to me, your lips looked a little bit blue.
0:26:32 > 0:26:35Yeah, but they did say, you know, "You've got a very unique heart."
0:26:35 > 0:26:37Unique heart? It was back to front,
0:26:37 > 0:26:41it was inside out, it was full of holes,
0:26:41 > 0:26:43everything and anything went wrong.
0:26:43 > 0:26:46And maybe five, ten years previous you would never have survived.
0:26:46 > 0:26:49Yeah, all it is, it's just this pulse has got to stay down,
0:26:49 > 0:26:51but it's been at 72 all night now.
0:26:51 > 0:26:54They tried me on a new drug and it kept it down, so...
0:26:54 > 0:26:57The best thing is you're in the hands of Dr Masani, and you know
0:26:57 > 0:27:01he is absolutely great, he's brilliant at what he does.
0:27:01 > 0:27:03He's at the top of his profession.
0:27:03 > 0:27:05And, you know, I've got a crush on him.
0:27:05 > 0:27:07CARLY LAUGHS
0:27:07 > 0:27:10Because they've got such a brilliant heart unit here,
0:27:10 > 0:27:13and they did tell Carly after she had Jayden,
0:27:13 > 0:27:18"Now, listen, Carly, under no circumstances get pregnant.
0:27:18 > 0:27:21"No circumstances, not pregnant."
0:27:21 > 0:27:22And she got pregnant.
0:27:24 > 0:27:26But... I'm going to tie her legs together after this.
0:27:26 > 0:27:30You know, I think she thought her body clock was kicking off.
0:27:30 > 0:27:33She's got a little girl now, so...
0:27:33 > 0:27:35It's Dr Masani.
0:27:35 > 0:27:38Oh, God. I'm going to marry that man.
0:27:40 > 0:27:43I've had the hots for this doctor now for, like...
0:27:43 > 0:27:4512 years. 12 years.
0:27:45 > 0:27:48Hi, Carly. You all right?
0:27:48 > 0:27:51Thank you, Dr Masani, I know you're busy.
0:27:51 > 0:27:54Everything's under control right now, I've got a couple
0:27:54 > 0:27:58of patients to see and it sounds like you've got your hands full,
0:27:58 > 0:28:01but we can get together over the weekend and we'll have that chat.
0:28:01 > 0:28:03Brilliant, because I know you're so busy,
0:28:03 > 0:28:05and I don't want to take up your time,
0:28:05 > 0:28:09but you know, you're always like... God, I trust everything you say.
0:28:09 > 0:28:15Oh, thank you so much, thank you. Cool. All right.
0:28:15 > 0:28:18OK. Talk to you soon.
0:28:18 > 0:28:22OK, thank you, thank you. You've still got that lovely smile.
0:28:22 > 0:28:23Thank you.
0:28:27 > 0:28:29Love you.
0:28:29 > 0:28:32Love you too. I'll be down on Sunday. Ta-ra, baby girl.
0:28:35 > 0:28:37If Carly's heart remains stable,
0:28:37 > 0:28:39she'll be able to go home in a few days.
0:28:44 > 0:28:47You're a wanted woman today. SHE LAUGHS
0:28:47 > 0:28:48I know, I'm always wanted.
0:28:50 > 0:28:54At 33 weeks pregnant, Alison has recovered from pneumonia.
0:28:55 > 0:28:58Her heart condition has improved,
0:28:58 > 0:29:01but the team are still concerned about how it will cope in labour.
0:29:03 > 0:29:08I mean, all I know is there is talk of a C-section.
0:29:08 > 0:29:12And that they, I have heard, the latest I have heard
0:29:12 > 0:29:15is she's definitely, definitely got to come out at 36 weeks.
0:29:16 > 0:29:20'I suppose it's hard because at the moment I don't want a C-section,
0:29:20 > 0:29:24'but then if it's in the best interest of the baby,'
0:29:24 > 0:29:27then I'll do whatever's best for her.
0:29:28 > 0:29:32Here you go, Mum. Baby's heart beating away there nicely.
0:29:32 > 0:29:34Can you see that just in here? Yeah.
0:29:34 > 0:29:37And the little one's head is down at the moment.
0:29:37 > 0:29:39Oh, she's just...
0:29:40 > 0:29:43'Being a mum means the world to me,
0:29:43 > 0:29:46because I didn't have a very good start in life.
0:29:46 > 0:29:49For the first, say, six and a half years...
0:29:49 > 0:29:52I didn't have a very nice life at all.
0:29:53 > 0:29:55So I suppose, in a way,
0:29:55 > 0:30:00I want to give to my children what I never had.
0:30:00 > 0:30:02And I suppose I want them to live
0:30:02 > 0:30:05a life I would have liked to live when I was a child.
0:30:07 > 0:30:10And, yeah, it was just over a year ago
0:30:10 > 0:30:15I lost a baby girl through a miscarriage.
0:30:15 > 0:30:19So this pregnancy is very, very special to me.
0:30:23 > 0:30:26At the moment, I think we just carry on
0:30:26 > 0:30:28as far as the pregnancy is concerned.
0:30:28 > 0:30:31Baby's scan today is very normal, so from the baby's perspective,
0:30:31 > 0:30:33we haven't got any major worries.
0:30:33 > 0:30:37If you're well enough to get all the way to 36 weeks,
0:30:37 > 0:30:40then there might be the possibility of you having a normal delivery.
0:30:40 > 0:30:43That's the best we're going to aim for. Yeah.
0:30:43 > 0:30:47I think if we're looking at delivery before 36 weeks,
0:30:47 > 0:30:49then I think it's increasingly likely that we're going to be
0:30:49 > 0:30:51looking at Caesarean section.
0:30:51 > 0:30:55It is hard, you know, this is what's going to happen,
0:30:55 > 0:30:58you ain't got much choice in this, you know.
0:30:58 > 0:31:03I appreciate that. I understand the reason why, but it's hard.
0:31:03 > 0:31:07And I suppose, the other two were natural births...
0:31:07 > 0:31:09But you were well then. And now just the extra burden
0:31:09 > 0:31:12of being pregnant has just tipped you into heart failure.
0:31:12 > 0:31:15So, we'll see how things are in between. Yep.
0:31:15 > 0:31:17If we could make Alison not pregnant,
0:31:17 > 0:31:19her heart function would improve considerably,
0:31:19 > 0:31:20certainly she'd get no worse
0:31:20 > 0:31:23and she could get quite, sort of, rapidly better within a week.
0:31:23 > 0:31:25As far as the long term concerns, I think
0:31:25 > 0:31:26her heart disease is such
0:31:26 > 0:31:30that she's probably going to need fairly major cardiac surgery
0:31:30 > 0:31:32to replace that abnormal valve that she has.
0:31:37 > 0:31:39It's 10.45 at night,
0:31:39 > 0:31:42and Jamila and husband Mark have rushed into the delivery suite.
0:31:45 > 0:31:49She's reached 39 weeks without her liver condition getting worse
0:31:49 > 0:31:50or needing to be induced.
0:31:50 > 0:31:52SHE GROANS
0:31:52 > 0:31:55Are you still managing to focus? Yeah.
0:31:55 > 0:31:57Midwife Alison has examined Jamila,
0:31:57 > 0:32:01and found her to be in the advanced stages of labour.
0:32:01 > 0:32:04How are you feeling about the bed, are you happy to stay up a bit more?
0:32:04 > 0:32:05I'm all right.
0:32:16 > 0:32:18This baby's hurting me round the front.
0:32:21 > 0:32:24That's good news though, because at least it's not back-to-back. Yeah.
0:32:27 > 0:32:29She's making all the right movements.
0:32:29 > 0:32:32It looks like she's pushing with the contractions, so...
0:32:32 > 0:32:36Oh, it hurts, it hurts, it hurts, it hurts.
0:32:36 > 0:32:38Let's have a look, sweetheart.
0:32:38 > 0:32:40You're nearly there!
0:32:45 > 0:32:47JAMILA GROANS
0:32:56 > 0:33:01Well done. Just popped your waters.
0:33:01 > 0:33:03I'd forgotten about that. LAUGHTER
0:33:03 > 0:33:06Oh, this hurts.
0:33:06 > 0:33:08I'm going to get somebody else in the room.
0:33:08 > 0:33:11The position you want to deliver in, it's sometimes good to have someone
0:33:11 > 0:33:14to hold the leg for you, is that all right? OK, yes please.
0:33:18 > 0:33:22I'm just going to gently examine you and make sure that you are fully,
0:33:22 > 0:33:23if that's all right.
0:33:23 > 0:33:25Oh, it's nearly out!
0:33:26 > 0:33:29I can't, I can't...
0:33:29 > 0:33:33Listen, listen, you're there, you've done most of it.
0:33:33 > 0:33:37You're nearly there now, sweetheart, let's put this in here.
0:33:38 > 0:33:39SHE GROANS
0:33:43 > 0:33:46Relax that leg, just relax that leg. That's it, well done.
0:33:48 > 0:33:50JAMILA SCREAMS
0:33:50 > 0:33:53Don't panic, it's going to burn like mad.
0:33:53 > 0:33:58Just take the gas, all right? Puff away on that gas like mad, all right?
0:33:58 > 0:34:04Breathe, breathe, breathe, breathe, breathe. There, head's out.
0:34:04 > 0:34:07Hello, baby.
0:34:07 > 0:34:11Just relax that leg for me. Hey! There we go. Well done.
0:34:11 > 0:34:13BABY CRIES
0:34:13 > 0:34:14Here he is.
0:34:14 > 0:34:17The baby's born. That's my baby!
0:34:18 > 0:34:22That's my baby. He's here. Why didn't you tell me my baby was here?
0:34:24 > 0:34:27Oh, my baby's here.
0:34:30 > 0:34:32CRYING CONTINUES
0:34:34 > 0:34:36Oh, I couldn't think, I'm so sorry if I wasn't listening.
0:34:36 > 0:34:38MARK: Don't be silly!
0:34:38 > 0:34:40It's a boy.
0:34:40 > 0:34:43Go on, Mark, are you going to? Go on, Mark.
0:34:48 > 0:34:50It's quite tough, it's quite gel-like.
0:34:53 > 0:34:55Shh-shh-shh. Mummy's here.
0:34:57 > 0:35:01In less than four hours, Jamila gives birth to a healthy baby boy.
0:35:01 > 0:35:05So what's his name? Toby. This is Toby.
0:35:10 > 0:35:133.4...
0:35:13 > 0:35:173.6 kilos, which is 7lb, 15oz.
0:35:17 > 0:35:22Cholestasis, now that she's delivered will probably be OK.
0:35:22 > 0:35:24Her bile acids will drop slowly,
0:35:24 > 0:35:27liver function will come back to normal
0:35:27 > 0:35:30And she'll stop itching, which is the main thing.
0:35:30 > 0:35:36I'm so happy, I'm so glad he's OK. (I'm so glad he's OK.)
0:35:43 > 0:35:47After a week in hospital, Carly has been discharged
0:35:47 > 0:35:50and told to take it easy.
0:35:50 > 0:35:52Well, basically since I've been out of hospital
0:35:52 > 0:35:54it's just been like, decorating, new carpet,
0:35:54 > 0:35:58that's down, and by the end of the week it'll be done.
0:35:58 > 0:36:01To protect her heart from further strain,
0:36:01 > 0:36:03she's booked in to be induced at 37 weeks.
0:36:04 > 0:36:10Yeah, what it is, not too much on the heart you know, thing,
0:36:10 > 0:36:13but on the baby situation now, how she's going to cope
0:36:13 > 0:36:17if my blood pressure drops too low or something, you know,
0:36:17 > 0:36:19I just hope it goes a straightforward birth.
0:36:29 > 0:36:36Hello baby. Oh, look at you. Hello, my darlings. Hello!
0:36:36 > 0:36:40Alison's pregnancy has reached 35 weeks with no further complications.
0:36:42 > 0:36:45Every other day, she is visited by her partner Paul
0:36:45 > 0:36:48and their two boys, Luke and Josh.
0:36:52 > 0:36:55Alison hasn't been able to go home for the last six weeks.
0:36:55 > 0:36:59The furthest she's allowed with her boys is to the hospital shops.
0:36:59 > 0:37:01Go over to the Thomas books then.
0:37:01 > 0:37:05I do try and explain to them what's wrong with Mummy,
0:37:05 > 0:37:08but they don't really fully understand, you know,
0:37:08 > 0:37:10and, "Mummy's in the best place,"
0:37:10 > 0:37:13you know, and, "Let's go and see Mummy."
0:37:13 > 0:37:16Just try and cheer her up for that couple of hours that we're here,
0:37:16 > 0:37:20and it makes her smile, so that means a lot.
0:37:21 > 0:37:24I love seeing my boys. My boys always cheer me up.
0:37:26 > 0:37:27They always cheer me up.
0:37:27 > 0:37:30Have a look at them ones, love, see they're all the same.
0:37:30 > 0:37:34'It's sad to see Alison the way it is now and sort of,
0:37:34 > 0:37:36I really feel for her at the moment
0:37:36 > 0:37:38and I wish she would just get better soon.
0:37:38 > 0:37:40Thank you, ta-ra.
0:37:48 > 0:37:50The team have got together in the last couple of days,
0:37:50 > 0:37:54the cardiologists, the obstetricians, and the plan is to
0:37:54 > 0:37:58deliver Alison's baby by Caesarean section on Tuesday morning.
0:37:58 > 0:38:01I think she was hoping maybe she would just have this one naturally,
0:38:01 > 0:38:04but, you know, I'm sure she understands that
0:38:04 > 0:38:06this is probably the best option for her.
0:38:06 > 0:38:10Good morning, Alison. How are you this morning?
0:38:10 > 0:38:14Not too bad. I just can't wait to see her now. Yeah, no, I'm looking forward to seeing her.
0:38:14 > 0:38:17Cos you've been in for six weeks, and how do you feel
0:38:17 > 0:38:20about having a Caesarean this time? Because I know...
0:38:20 > 0:38:23I said, it's like, I'm not 100% happy.
0:38:23 > 0:38:26I was hoping to have the epidural,
0:38:26 > 0:38:28but they said it's just far too risky.
0:38:28 > 0:38:31So, they said it's going to have to be the C-section,
0:38:31 > 0:38:33which is a lot safer option.
0:38:33 > 0:38:35Yeah, I I'll probably come to theatre with you actually,
0:38:35 > 0:38:37you see, because I'm working
0:38:37 > 0:38:40and I'll be bringing the baby over to see you, and you can have
0:38:40 > 0:38:44her on your chest for the whole of the time the operation's going on.
0:38:44 > 0:38:48But then because you're probably going to go back to cardiac intensive care,
0:38:48 > 0:38:49aren't you, that's the plan?
0:38:49 > 0:38:52Because you're going to go back there afterwards,
0:38:52 > 0:38:55they wouldn't be able to have the baby there with you,
0:38:55 > 0:38:59so baby will go into the nursery in special care.
0:38:59 > 0:39:02But, you know, you will definitely see her the minute she's born,
0:39:02 > 0:39:04and you will hold her as soon as possible.
0:39:04 > 0:39:07Yes, that would be nice, just so I can...
0:39:07 > 0:39:09I mean, she's bound to be anxious,
0:39:09 > 0:39:15I think anybody would be anxious so she's obviously doubly anxious
0:39:15 > 0:39:17about the problems she's got, but...no,
0:39:17 > 0:39:19I was quite happy with her today,
0:39:19 > 0:39:24I think she fully understands everything that's going on, and, no,
0:39:24 > 0:39:28I think she's quite looking forward to it really, to seeing her baby.
0:39:28 > 0:39:30Let's go and see baby.
0:39:30 > 0:39:33Let's see our little one, OK. Have you thought about a name?
0:39:33 > 0:39:39Yep, Oliver. Oliver. Very nice. Like the baby opposite you. He's Oliver as well.
0:39:39 > 0:39:41Oh, that's lovely.
0:39:41 > 0:39:43Li is now well enough to visit her baby.
0:39:47 > 0:39:49I'm Helen, I'm looking after little...Oliver, is that right?
0:39:49 > 0:39:51Yep, Oliver.
0:39:51 > 0:39:53Just over here.
0:39:55 > 0:40:00OK, so... How's that?
0:40:02 > 0:40:03Is he OK? Yeah, he's lovely.
0:40:03 > 0:40:06When he first came, all right, he just needed a little bit of help
0:40:06 > 0:40:08with his breathing with the oxygen.
0:40:08 > 0:40:11So, he's just getting a little bit of oxygen that was just helping,
0:40:11 > 0:40:13but I've taken him off his oxygen
0:40:13 > 0:40:15and he's just had his nappy changed about ten o'clock and he's been,
0:40:15 > 0:40:19just been on his own just in there and he's doing really nicely.
0:40:19 > 0:40:22He's smiling. Yeah, it looks like he's smiling.
0:40:24 > 0:40:26Oh, congratulations. Thank you.
0:40:29 > 0:40:31Do you want to have a little cuddle?
0:40:33 > 0:40:37He's just so tiny and I'm a bit scared that I'll just break him.
0:40:37 > 0:40:39No, you won't break him.
0:40:39 > 0:40:41Do you want to touch him then? Yeah.
0:40:41 > 0:40:44Can you manage to put your hand through there?
0:40:58 > 0:41:00It's good for him to know that you're there
0:41:00 > 0:41:02and to hear your voice and to feel your touch.
0:41:05 > 0:41:07He's so cute.
0:41:10 > 0:41:13Baby Oliver will have a short stay in special care
0:41:13 > 0:41:15before being allowed home with Mum and Dad.
0:41:18 > 0:41:19PHONE RINGS
0:41:19 > 0:41:21Labour ward, midwife speaking.
0:41:21 > 0:41:23And is it your first baby?
0:41:23 > 0:41:25And when are you due?
0:41:25 > 0:41:27So it's your fourth baby.
0:41:27 > 0:41:29PHONE RINGS
0:41:32 > 0:41:38Having reached 37 weeks, Carly is in to be induced.
0:41:38 > 0:41:41She's joined by her mum and her partner, Matthew.
0:41:41 > 0:41:44Hello. You all right? Have you got your notes with you?
0:41:44 > 0:41:46Yes, I've got them in there.
0:41:48 > 0:41:50So what we'll do is we'll just settle you in at the top,
0:41:50 > 0:41:52and then...
0:41:53 > 0:41:56The general plan with Carly for her birth
0:41:56 > 0:42:01and her labour is to have an early epidural so she's quite comfortable
0:42:01 > 0:42:04and she's not in too much pain which is going to put stress on her heart.
0:42:04 > 0:42:06And just to let her labour normally,
0:42:06 > 0:42:09but ideally we don't want her to be in labour for too long.
0:42:09 > 0:42:12Just leave you on this for a little bit.
0:42:12 > 0:42:15Carly is being delivered early to avoid the risk
0:42:15 > 0:42:18of her going into spontaneous labour without medical support.
0:42:19 > 0:42:22Her heart is quite unpredictable so we need to ensure that
0:42:22 > 0:42:26all staff are available if something did happen.
0:42:26 > 0:42:29So, we're trying to time her induction and trying to time
0:42:29 > 0:42:32her birth sort of in the daylight hours
0:42:32 > 0:42:34when there's people about and on hand,
0:42:34 > 0:42:37so you need the consultant obstetricians,
0:42:37 > 0:42:41the consultant anaesthetists and as well as the cardiologists
0:42:41 > 0:42:44being involved as well, just in case something does happen.
0:42:47 > 0:42:52At 4am, Carly is given a fast acting induction gel,
0:42:52 > 0:42:55hoping she'll go into labour around midday.
0:42:59 > 0:43:02OK, pop that under your bottom.
0:43:02 > 0:43:05So this is just the gel, OK?
0:43:07 > 0:43:09Well done.
0:43:09 > 0:43:12Doing really well. OK.
0:43:12 > 0:43:15Fab. All right. Yep.
0:43:15 > 0:43:18So, we'll leave you on the monitoring for a little bit longer,
0:43:18 > 0:43:21just to check if the baby's happy with what we've done.
0:43:21 > 0:43:25And then, I'll take you off that and you can go back to sleep
0:43:25 > 0:43:27until it all kicks off. All right.
0:43:27 > 0:43:32So in six hours, what we'll do is we'll re-examine you,
0:43:32 > 0:43:36cos that's how long it takes till it's sort of all dissolved in really.
0:43:36 > 0:43:39So, if we re-examine you and then from that, hopefully,
0:43:39 > 0:43:42we'll be able to break your waters and then the labour will commence.
0:43:42 > 0:43:45So, we're hoping it's going to be enough
0:43:45 > 0:43:48and we'll have a baby today.
0:43:56 > 0:43:59It's the day of Alison's C-section.
0:43:59 > 0:44:01If you can sign your consent on there for me?
0:44:04 > 0:44:08The Caesarean section itself is a fairly straightforward operation.
0:44:08 > 0:44:11The risks for Alison are all related to her heart.
0:44:11 > 0:44:14We have to be very careful with her anaesthetic.
0:44:14 > 0:44:17There is that potential for tipping her into heart failure
0:44:17 > 0:44:20just by virtue of the anaesthetic itself.
0:44:20 > 0:44:23When she delivers her baby, there's quite significant changes
0:44:23 > 0:44:27in the circulation, and that can push her into heart failure.
0:44:27 > 0:44:31So yeah, the potential for risk is very high.
0:44:32 > 0:44:36Alison's partner Paul will be allowed into theatre to support her.
0:44:36 > 0:44:39This is really scaring me, you know,
0:44:39 > 0:44:43to see her have an operation, I've never seen an operation before.
0:44:43 > 0:44:48I'm just like, it hasn't hit me until now, until the day.
0:44:48 > 0:44:51I mean, I am strong for you, aren't I, but sometimes I do like,
0:44:51 > 0:44:54break down and I mean I feel a bit now, you know...
0:45:22 > 0:45:23How you doing there?
0:45:23 > 0:45:25Just nervous. I know.
0:45:29 > 0:45:32You're doing grand, it's OK.
0:45:32 > 0:45:34Listen, my dear,
0:45:34 > 0:45:38I need you to calm down and relax, you will be fine, OK?
0:45:39 > 0:45:42Yeah, you're doing so well, you really are.
0:45:42 > 0:45:45Try not to jump, I know it's easier said than done, but just...
0:45:45 > 0:45:49You are, you're doing very well.
0:45:49 > 0:45:51Lie down. On your side, that's it.
0:45:51 > 0:45:54Don't lie backward.
0:45:54 > 0:45:55That's fantastic.
0:45:55 > 0:45:57A second midwife, Tatiana,
0:45:57 > 0:46:01is assisting Helen with looking after Alison and the baby.
0:46:05 > 0:46:08She's kicking, she's all ready. Yeah.
0:46:08 > 0:46:12Alison is in one of the main operating theatres
0:46:12 > 0:46:16to be close to emergency cardiac services.
0:46:16 > 0:46:19Even for midwives, for me after ten years,
0:46:19 > 0:46:22it's a first case I have to come in the main theatre,
0:46:22 > 0:46:25so imagine how it is for her.
0:46:25 > 0:46:27OK, Alison?
0:46:27 > 0:46:31I'm just nervous that's all. Alison, Helen is here.
0:46:31 > 0:46:34I'll be taking this baby, so I'll bring her to show you,
0:46:34 > 0:46:36and I'll take her to resus here and Tatiana can bring her
0:46:36 > 0:46:39when she's dried off and all that, OK?
0:46:39 > 0:46:43Alison asked me if she could have her baby skin-to-skin
0:46:43 > 0:46:48as soon as she's out, so I said that I hope it's going to be possible,
0:46:48 > 0:46:51so hopefully they're both going to have this nice moment.
0:47:06 > 0:47:09There's nothing unusual.
0:47:09 > 0:47:12It's going well, all right? It's going well.
0:47:12 > 0:47:14Are you going to be all right?
0:47:14 > 0:47:16I will be, yeah. I'll be fine, won't I?
0:47:16 > 0:47:19You're braver than I am, aren't you?
0:47:28 > 0:47:30Hello! Perfect.
0:47:30 > 0:47:32BABY CRIES
0:47:37 > 0:47:42Here we go. Here we are, have a look.
0:47:42 > 0:47:44Oh! Oh!
0:47:44 > 0:47:48Oh, my baby. Oh, my darling.
0:47:48 > 0:47:51Oh, my darling! Oh, my baby! Oh!
0:47:53 > 0:47:56That was amazing, so quick.
0:47:56 > 0:47:58Thank you so much.
0:47:58 > 0:48:01BABY CRIES
0:48:05 > 0:48:07Yeah, she was born very quickly
0:48:07 > 0:48:10and in a very good condition for her gestation.
0:48:10 > 0:48:12Perfect.
0:48:12 > 0:48:15I can't see much at the minute.
0:48:15 > 0:48:17Everyone's around her, I can't see for the minute.
0:48:24 > 0:48:30Hiya. Congratulations, she's lovely, making a lot of noise.
0:48:30 > 0:48:35Shall I just take her and put her skin-to-skin with her? Please do, yeah.
0:48:35 > 0:48:38It would be nice to have a nappy on, but hey-ho.
0:48:38 > 0:48:40There we are.
0:48:40 > 0:48:43OK, darling.
0:48:47 > 0:48:49I think everything's gone fine.
0:48:49 > 0:48:53Really good. And it's a lovely baby, isn't she?
0:48:53 > 0:48:56She's just over 5 lbs, OK?
0:48:56 > 0:48:59It's a good size, yeah.
0:48:59 > 0:49:02We couldn't expect any better, fantastic.
0:49:02 > 0:49:06So the baby's going to stay with us,
0:49:06 > 0:49:09not going to the neonatal unit as you saw,
0:49:09 > 0:49:11cos she was born in a perfect condition.
0:49:18 > 0:49:20I feel a bit sick.
0:49:20 > 0:49:22You feel sick? OK, it's OK.
0:49:22 > 0:49:26I feel really sick, I feel really ill. Like, my head hurts.
0:49:26 > 0:49:28Shall I take the baby, OK?
0:49:28 > 0:49:30Yeah. OK, darling.
0:49:30 > 0:49:33BABY CRIES
0:49:38 > 0:49:43Alison's blood pressure has dropped to nearly half the normal level.
0:49:43 > 0:49:45How are you feeling now? Bit better?
0:49:45 > 0:49:47I feel really sick. Do you?
0:49:47 > 0:49:52The anaesthetic team give her a drug to bring her blood pressure back up.
0:49:52 > 0:49:56You're doing well. It's moving nicely down.
0:49:58 > 0:50:01But as the C-section is completed,
0:50:01 > 0:50:05Alison's heart rate suddenly accelerates.
0:50:13 > 0:50:16She's checked by the cardiac anaesthetist.
0:50:24 > 0:50:26Right at the end, her heart rate became very fast
0:50:26 > 0:50:29so we got her reviewed by the cardiac anaesthetist.
0:50:29 > 0:50:31She seems very happy with Alison,
0:50:31 > 0:50:34so we're able to transfer her to coronary care
0:50:34 > 0:50:37where she's going to stay, probably for a couple of days.
0:50:37 > 0:50:40I mean, it's obviously a stressful time for Alison and Paul
0:50:40 > 0:50:42and they did both need support, so I think between us,
0:50:42 > 0:50:46Tatiana and I managed to keep everything calm
0:50:46 > 0:50:49and I think we were pleased with the outcome.
0:50:51 > 0:50:55It's over 12 hours since Carly's induction began.
0:50:55 > 0:50:57Yeah, that's better.
0:50:57 > 0:50:59My friggin' back is killing.
0:50:59 > 0:51:01There hasn't been any progress,
0:51:01 > 0:51:04so a second, stronger-acting gel has been given.
0:51:06 > 0:51:09She's just been bouncing on the ball.
0:51:09 > 0:51:12She's just had enough, she's tired now.
0:51:18 > 0:51:21Midwife Ruth Leonard is coming on shift.
0:51:22 > 0:51:26Hello, Carly. Hello, I'm Ruth. I'm here for tonight.
0:51:26 > 0:51:28How are you doing?
0:51:28 > 0:51:30I just don't know what to do for her now.
0:51:30 > 0:51:32It's just heart-breaking watching her now.
0:51:33 > 0:51:36Did you sleep last night? No. No?
0:51:36 > 0:51:39No. Have you been here since yesterday as well?
0:51:39 > 0:51:42Yeah, since last night. I don't know what to do with myself.
0:51:42 > 0:51:45They're just as bad as each other.
0:51:45 > 0:51:48Do you mind if I have a little feel of your tummy first?
0:51:48 > 0:51:51I know you'll have to lie on the bed, if that's all right?
0:51:51 > 0:51:53Just for a quick... I'll give my hands a wash.
0:52:03 > 0:52:04Big deep breaths.
0:52:06 > 0:52:09Your cervix is still the same as it was
0:52:09 > 0:52:12when Hannah examined you earlier on.
0:52:12 > 0:52:16It's, I would say, one centimetre.
0:52:16 > 0:52:19It would be difficult to break your waters.
0:52:19 > 0:52:24I was just hoping you would be about three or four centimetres.
0:52:24 > 0:52:29With pain relief, it is a bit early for an epidural
0:52:29 > 0:52:32because it's going to sort of keep you bedridden
0:52:32 > 0:52:34and if you're lying down,
0:52:34 > 0:52:38your labour's going to be slower than it will
0:52:38 > 0:52:41when you're walking about, so, as soon as we can,
0:52:41 > 0:52:45as soon as your cervix opens up a bit more and you show signs
0:52:45 > 0:52:47that you're going into labour,
0:52:47 > 0:52:50I will get you an epidural as soon as possible.
0:52:50 > 0:52:53Any questions? No. No, just a bit gutting.
0:52:53 > 0:52:54Yeah.
0:52:54 > 0:52:58We want it to crack on. She wants to have the baby, don't you?
0:52:59 > 0:53:03Going to be a stubborn little thing, girl, no doubt.
0:53:05 > 0:53:09With labour some way off, Carly is left to sleep for an hour.
0:53:10 > 0:53:13Don't be putting needles in her. She's already got enough.
0:53:13 > 0:53:18All right, see you later. Bye, Carl. Love you.
0:53:21 > 0:53:25OK, Carly, sleep well and just give me a shout if you need anything.
0:53:30 > 0:53:34She's getting a bit fidgety and restless at the moment.
0:53:34 > 0:53:36She won't be able to sleep,
0:53:36 > 0:53:39but at least she may be able to lie down and close her eyes
0:53:39 > 0:53:43and hopefully, if she does that, labour will progress quicker.
0:53:53 > 0:53:56BUZZER SOUNDS
0:54:00 > 0:54:03That was blooming quick! Come on in here.
0:54:03 > 0:54:06Come on, over in the bed.
0:54:06 > 0:54:11Before Ruth is able to help, Carly's baby had already been born.
0:54:11 > 0:54:14And your mum's not here. No.
0:54:14 > 0:54:17Back you go. Good girl.
0:54:17 > 0:54:19Give her a cuddle.
0:54:27 > 0:54:29BABY CRIES
0:54:29 > 0:54:32I'm going to cut this cord now.
0:54:34 > 0:54:37There we are. Just give her a little wipe down.
0:54:37 > 0:54:38That's the cord.
0:54:38 > 0:54:42Oh, you didn't get your epidural. I know, I delivered her too quick!
0:54:42 > 0:54:46That's good stuff that paracetamol then.
0:54:46 > 0:54:48Relieved, shocked.
0:54:48 > 0:54:50Mega-quick.
0:54:50 > 0:54:52She's absolutely gorgeous.
0:54:53 > 0:54:55Don't know, I left her to sleep
0:54:55 > 0:55:00and er... buzzed, and she was standing by the side of the bed
0:55:00 > 0:55:02and baby came out.
0:55:02 > 0:55:03Can't believe my mother missed it.
0:55:03 > 0:55:06They both missed it. I know.
0:55:07 > 0:55:10No, no. You are joking. Oh, did you not get...?
0:55:10 > 0:55:13Just now, just now.
0:55:13 > 0:55:15You're joking.
0:55:15 > 0:55:17Oh, my God! You're joking.
0:55:17 > 0:55:19Oh, my God! What?
0:55:19 > 0:55:23Oh! Oh, my God, let me see her.
0:55:23 > 0:55:27Oh, I'm so sorry. What happened?
0:55:27 > 0:55:29I just pushed her out, I was on my own.
0:55:29 > 0:55:31No stitches, no pain or anything.
0:55:31 > 0:55:33I'm so sorry.
0:55:40 > 0:55:44I'm so sorry. I'm so sorry.
0:55:46 > 0:55:48I'm so sorry.
0:55:48 > 0:55:52You OK? You all right? Yeah. Shocked. Have a sit down there.
0:55:53 > 0:55:55Hey, baby girl!
0:56:01 > 0:56:02Are you OK?
0:56:02 > 0:56:06Yeah, shocked I am. Well, you will be, you will be.
0:56:06 > 0:56:08I thought we'll have a quick half of lager in the pub,
0:56:08 > 0:56:12looking to get you a pizza or some fish and chips or something.
0:56:12 > 0:56:16I thought my God, my God! Carly-Ann!
0:56:16 > 0:56:19"Look," I said, "I need... She's coming, she's coming."
0:56:19 > 0:56:22I stood on there, felt like I needed a poo and she just come out.
0:56:22 > 0:56:25I delivered her on my own, I caught her.
0:56:25 > 0:56:30Oh, my gosh. Oh, my poor baby.
0:56:30 > 0:56:33So proud, just shocked, yeah. You know.
0:56:33 > 0:56:34Can't believe it.
0:56:34 > 0:56:39After all the planning, no early epidural, no breaking the waters,
0:56:39 > 0:56:44it all happened very naturally and all very quickly,
0:56:44 > 0:56:45which is good.
0:56:45 > 0:56:48And her heart has managed OK.
0:56:48 > 0:56:50Oh, I'm so proud of Carly,
0:56:50 > 0:56:52I am so, so... Ah, but you missed it.
0:56:52 > 0:56:55I missed it, I'm going to shoot myself in the foot,
0:56:55 > 0:56:57in the head, everywhere.
0:56:57 > 0:56:59So if you have another baby now, don't leave her.
0:56:59 > 0:57:01No, no more. We're going to call a last one now.
0:57:01 > 0:57:05She's gorgeous, Carly. Well done. Congratulations.
0:57:08 > 0:57:09Carly and baby Amelia
0:57:09 > 0:57:13will both spend the next two days on the maternity unit,
0:57:13 > 0:57:16being observed by the cardiologists and the midwives.
0:57:18 > 0:57:20This is it now, this is it.
0:57:20 > 0:57:24After 48 hours in coronary care,
0:57:24 > 0:57:27Alison is well enough to be reunited with her baby.
0:57:31 > 0:57:33And your daughter. Yeah.
0:57:33 > 0:57:35Not to be parted again, eh?
0:57:35 > 0:57:38Hello, my darling! Thank you.
0:57:38 > 0:57:41Oh!
0:57:41 > 0:57:43Oh, my baby, oh!
0:57:43 > 0:57:46It seems like I haven't seen you for ages.
0:57:46 > 0:57:47Oh, my sweet darling.
0:57:47 > 0:57:51In a few days, Alison will be allowed to go home with her family...
0:57:51 > 0:57:55to return for a heart operation in three months' time.
0:57:56 > 0:57:58So is she behaving? No...
0:57:58 > 0:58:0148 hours after the birth,
0:58:01 > 0:58:04Carly is also free to go home with baby Amelia.
0:58:04 > 0:58:05She's so sweet, isn't she?
0:58:05 > 0:58:09So is there going to be no more now? No, she's the last one, she is.
0:58:09 > 0:58:12Good. OK, take care, all the very best.
0:58:12 > 0:58:13All right, bye-bye.
0:58:13 > 0:58:17Carly will only need a heart check-up in six months' time.
0:58:46 > 0:58:50Subtitles by Red Bee Media Ltd