BY PETRE WILLIAMS-RAYNOR Career & Education editor firstname.lastname@example.org
UP to 28 weeks, Kristina Wellington was experiencing a textbook pregnancy, but then, with a deadly blow, pre-eclampsia (PE) struck.
The condition — which typically presents as high blood pressure with protein in the urine, suggesting a kidney in trouble, as well as the retention of fluids — is written about in most, if not all, books on pregnancy. Yet, its diagnosis never fails to shock pregnant women, bringing them face to face with their own mortality and that of their unborn child.
Wellington, 21, was no exception.
The news of her PE, also known as toxemia, came when she went in for her check-up, just 12 weeks shy of her due date.
"As I waited to be seen, one of the nurses called me and said let me do your thing. She said my pressure was high, she is going to check it again and that I should go and do my urine test. After, I went back to the nurse and she told another one to check it. They said it was high and they kind of rushed me in to see the doctor," the Seaview Gardens resident recalled.
"She [the doctor] asked me if I was having any headaches and I told her no. She took my fundal height and she said it was a little lower than it should be based on my gestational age. She did a urine test and after, she told me that I would be admitted to hospital because I was showing signs of pre-eclampsia. They hooked me to the IV and I called my boyfriend and told him what was happening. He said he was on his way there."
A pain in her neck and swollen feet some days before were the only signs, prior to having her blood pressure checked, that perhaps all was not well.
"I [had] realised that my feet were swelling and they weren't going down like they used to, but I naturally have poor circulation so I thought nothing of it," Wellington said. "So it was from a perfectly normal weekend to being admitted to hospital."
But even after being admitted, Wellington did not realise what she was in for.
"Basically I didn't know what was going on. They dropped me upstairs really and explained to me they would have to keep me for a few days to observe," she said.
Wellington — who was having her first child — was immediately put on medication to control her blood pressure, which had reached a high of 120/100, and to prevent seizures.
Blood tests later revealed her blood platelets — necessary for her blood to clot — were low.
The days turned into a week up to which point Wellington still felt fine.
"I personally felt alright. I wanted to go home. There was nothing wrong with me... I was feeling the baby inside of me like she used to," she said. "Apart from my swelling and apart from them telling me I had high blood pressure and low platelets, I felt fine. So it was really them trying to tell me I am sick and me feeling alright and wanting to go to my yard. After the first week, I was like I don't need to be here."
But she needed to be there and she wouldn't leave until her child was delivered — delivery being the only way to cure a woman of pre-eclampsia, which research has shown oftentimes occurs in first-time pregnancies and in women younger than 20 years old and those over 35.
In the end, Wellington stayed three weeks at the University Hospital of the West Indies — where she said the nurses and doctors were professional and attentive to her — taking her to 31 weeks into her pregnancy.
It was three weeks of stress; 21 days of being at once hopeful and yet dreading the outcome. Among other things, Wellington had discovered over the period that her baby — whom she and her spouse had named Zarina, meaning 'golden' — was not receiving the needed nutrients to fuel her development.
"They had done an ultrasound and said she was not growing as she should. From then the heavy praying started. I was like 'God, let this baby grow'. I started to eat... I started to put in extra eating; I thought probably that would help," she told the Sunday Observer.
A couple of days shy of the three-week mark, Wellington developed diarrhoea, which she theorises may have been due to eating some fruits before having washed them.
"Everything just got bad from that point on. The day before she [the baby] came, I went to sleep. I had a little back pain. Throughout my whole sleep, I was having this horrible back pain; I thought it was my bladder," she said.
Wellington also had another bout of diarrhoea. At around four o'clock the next day, the nurses on the ward came to check for her child's heartbeat and had difficulty finding it.
Later, Wellington said, "I felt this urge to use the bathroom".
"That's when I got pain and felt a warm rush; I told the nurse that I feel like peeping on myself. When I looked, I saw it was blood and that was when I started to panic," she recalled, clearly pained by the memory. "The nurses told me to lie down. They took off my underwear and put on a sanitary napkin. I just started praying."
She was then rushed to the Labour Ward and telephoned her spouse on the way.
It was while on the ward that they picked up her child's heartbeat, ahead of the delivery.
"There was nothing to explain how good I felt because I was so worried that something had gone extremely wrong. But they found the heartbeat and it was just a big relief. They had to keep me strapped up. They said I was four centimetres dilated so I was going through labour and didn't even know it," Wellington said.
She was subsequently told to begin pushing but opted not to, based on what she had been told a day earlier by a doctor.
"The doctor had done another ultrasound and told me the baby was breached. So I told the nurse I can't push. She was saying why and I told her because the baby is breached. She told me she felt the head, but went for the portable machine to check and realised that it was breached. She started calling for the surgeons and so forth," Wellington said.
A Cesarean section was performed. She awoke to news from her spouse that her little Zarina was alive, albeit small at just over two pounds, and on the Nursery Intensive Care Unit (NICU) where she was being cared for. Given her grogginess and weakness, Wellington was not, however, able to visit her.
"The next day came and that was the beginning of the worst part of everything. They said they had her on a ventilator, but she is not breathing so well [and] she has an infection," said the past student of Merl Grove High School and the College of Agriculture, Science and Education from where she holds an associate degree in general agriculture.
"She [a female doctor] came to me and said something is really wrong with the baby and we might have to do a blood transfusion. They said she had jaundice. That's when I lost it. I didn't know what to do. I borrowed a nurse's phone and called my boyfriend. He told me he would be there shortly," she added.
Round about that time, Wellington was to do an x-ray and went to get that done. She and her spouse later went and saw the baby.
"She was so tiny. She was under the blue light. I was there talking to her. I felt then I should have touched her," the mother said.
But she didn't.
"That was the worst mistake I ever made. I never got to touch her, not when she was alive," she said tearfully.
Meanwhile, they opted to do a blood transfusion on the baby, based on the medical advice given to them.
"I wanted to see her before they did the procedure; the nurse said she would take me. Right when I was about to go, the same doctor came. The first thing I said to her was 'you look like you are coming to give me some good news' and I was smiling. But by the look at her face, I knew; I started to cry same time," Wellington said.
"She said things weren't looking so good. She told me she thought I should wait; 'I think you need to have somebody with you'. I am hoping at that point that things are going to get better by the time we get down there," she added, fresh tears running down her cheeks at the memory.
They wouldn't be.
"When I got there, everybody was coming out of the room and I was just like 'This is not happening'. That was my reaction; 'this is not happening'. Trust me, I lost it. The only thing I remember is getting out of the wheelchair and I had her in my hands. I was there for hours, hoping she would just open her eyes and look at me," she said.
Wellington took the time to call her boyfriend, impressing upon him the urgency of getting to the hospital immediately.
"I didn't want to tell him over the phone, but I told him she didn't make it. He was there in 15 minutes and usually it takes him 20 to 25 minutes," she said. "And it was like a signal went off in everybody's head at the same time. My father called and he's crying. My mother called and she's in Africa and she started crying."
All the while, Wellington held her child in her arms.
"I didn't want to let go," she told the Sunday Observer. "They kept asking me if I am ready and I told them no. I went there after five and I was there until after 7."
Wellington would later return to the ward where mothers who have given birth are admitted, and there, she nearly lost her mind.
"It was awful. I had to see all those babies and I cried that whole night," she said. "They (at NICU) gave me her footprint and her hand print and her hair and everything. My family was there... and I mean, the crying. Trust me, it was just pure awfulness; everybody felt it."
"I told the doctor I needed to go home, I felt like I was going to go crazy. I needed the comfort of home. I was actually considering checking myself out; the environment was just not for me any more. I always tell myself that I am crazy, but it was the first time I actually felt I was going to go crazy," she said further.
Wellington was eventually moved to another ward and subsequently discharged with a course of blood pressure medication. This is because hypertension stays with some women who have had PE, at least for a little while after delivery. For others, it stays permanently as they develop essential hypertension -- on top of becoming predisposed to developing blood clots and heart disease.
It's been just about three months since she lost her baby and every day is a struggle.
"Every day I try to block out the memories. I try to sink myself into work; it doesn't work all the time, but I try," said Wellington, who works as a livestock attendant with Newport Genetics in Old Harbour.
"I don't show it [the tears]; I probably go into the bathroom or hold it in until I get home. But some days I literally break down," she said sadly.
Wellington doesn't know if she will ever be able to hold a child in her arms again.
"Probably it is my psyche or something, but I don't think I will be able to hold another child for a while. You go through that thing where you don't want to blame God, and it is hard for me sometimes not to yell at Him," she said.
"It is unfair. You see other people and their kids and all of your plans, you just know it is not going to happen. Everybody says 'Oh, you are young, you can try again', and 'God knows best' — which is the most common thing I have heard," Wellington added.
But that is cold comfort to a woman who has lost a child. She still grapples with feelings of guilt, though she understands, intellectually, that there is nothing she could have done to prevent PE — for which there is no known cause — from affecting her.
"When you look at it, you always say I must have done something wrong. Since then, I have read over all these things, and I think I must have done something wrong. The weekend before, I went to the hairdresser and spent hours. And I think that must have triggered it," she said. "The doctor says there is no real thing that causes it, but you must have done something to have it reach that point. It is human instinct to find some reasons..."
To help her cope, Wellington has resorted to writing.
"Personally, I totally avoid the whole counselling thing. I would rather write my feelings down," she said.
As for having another child, Wellington said it may be a long while yet.
"I can't tell you a time frame [although] it is something I would definitely like to do again," she said.
She is reluctant because having another child will not replace her first.
"I already named her [and] I know that if you go you aren't going to get her, you are going to get someone else. So eventually [I may have another baby] -- some billions of years in the future," Wellington said chuckling. "I mean, I do want to, but not any time soon. I don't know; it is at the point where you don't want to let her think that you forget her or you are going to replace her or anything like that."
As part of her coping strategy, Wellington also talks to her little girl.
"I know I am a little crazy, but I talk to her. I tell her, 'You will always be my first child and you will have a little brother or sister'. I mean, honestly, I am still at the point were I say to God, 'Just wake me up from the nightmare'," she reflected.
"It's like my brain is not processing that this is real. Sometimes I go to bed hoping that I will wake up and it's a day before the check-up. I know it is unfortunately not going to happen, but that's just how I feel sometimes," Wellington added.
Still, she holds fast to the memories of her lost child.
"When she was inside me, she was like my best friend. There was no time that I wasn't feeling good that she didn't wriggle or do something to make me feel better. I would always say this little girl is like my godsend. I would talk to her; and she would just wriggle as though saying 'Forget that'," she said.
Wellington also cherishes the few images she got of her little one following her birth.
"I have her picture on my screensaver and every night we have our talks and I pray to God to keep her safe. Sometimes I tell him to give her back to me and I will take care of her. You know within yourself that as much as you want it, you can't have it, but you still ask."
Her advice to other pregnant mums: "Enjoy every moment of it; unfortunately, if it ends like my situation, that is all you will have — the movement and talking and the ultrasound and everything."