Positive induced hospital birth with low Papp-A
Jade was told she had low Papp-A in her pregnancy, and kindly shares her pregnancy and birth story here.
My pregnancy
The first time I heard of low PAPP-A was when I received a photocopied leaflet through the post saying I had it, along with a consultant appointment for when I was 28 weeks pregnant and scans for every four weeks from then onwards. This has unfortunately reached me before my 16 week midwife appointment so it was a bit of a shock as I didn’t even know I had been tested for it. I told my community midwife and she told me not to worry, that there wasn’t much research around it and MOST people were absolutely fine.
I put this out my mind and looked forward to seeing baby again at the scan. 28 weeks came and everything was fine, baby was showing as 35th centile.
I went for my 32 week scan on my own, assuming again everything would be fine. The radiographer took a long long time and kept redoing the measurements and I just knew something wasn’t “right”. When I got to see the consultant after the scan he told me that the baby’s growth had slowed and was now around the 10th centile. They told me I would most likely have to be induced somewhere between 37 and 39 weeks, and scheduled a scan for another 2 weeks time. This time my husband came with me and we were told the growth had slowed even further and was now below the 3rd centile. They scheduled another growth scan in 2 weeks time along with CTG monitoring once a week and a Doppler scan to check the placenta blood flow and fluid a week later. This was repeated until I was 36 weeks, when it was decided that the best thing to do was to induce me at 37 weeks. I was really upset, and had initially wanted to push back on induction but by this point I was seeing a midwife or having a scan 3 times a week and my anxiety was through the roof. Following an episode in hospital after I was convinced I hadn’t felt the baby move, I was offered induction at 37+1, and accepted.
The Birth
The induction itself was SO much better than I expected it to be. The midwife listened to me and looked at my birth plan and gave me realistic expectations on what I could still go with and what wouldn’t be possible. I was induced at 5pm and by midnight was having contractions and my waters broke at 1.30am.
I had to unfortunately be monitored constantly as the baby’s heart rate kept dipping when I had contractions so couldn’t move around. I had hoped to manage labour without opiates or an epidural and luckily I made it all the way to the last hour of contractions just using my breath and had gas and air for the last hour.
When it was time to push I was on my back with my feet in stirrups which I also had not wanted but didn’t feel I could say no. I’d felt immense pressure when I went to the loo just before I was examined to say I was ready to push and looking back wish I’d been more assertive and asked to be more upright for the birth itself. A clip was placed on the baby’s head to continue to monitor the heart rate and just over an hour later our beautiful, tiny 4lb 8oz baby boy was born at 12.04pm, small but perfectly healthy, and in the end was below all the centiles at around 0.2.
I is now almost one and still not on the weight charts but following his own curve, is developing as he should be and is healthy and happy.
Thank you so much to Jade for sharing her birth story with us - showing that birth can be positive even if complications do develop in pregnancy.
