"Nothing could have prepared me" - Rachael's story #FullTermFeelings


Rachael's son Tristan was born at 39+2 weeks at a midwife-led freestanding birth unit. As soon as he was born, he was whisked away to NICU where he was diagnosed with meconium aspiration syndrome, grade two HIE and suspected sepsis.

Tristan is my second-born son, born at full term, at 39+2 weeks. This is his story – my little tornado, who made his speedy and dramatic entrance to the world on 18 March 2023 at a midwife-led freestanding birth unit, where there were no doctors.

Towards the end of labour, when his arrival was imminent, he was getting a little distressed and the attitude of the midwives changed once he started crowning. He was covered in poo - thick, black, sticky meconium.

Tristan came out at 11:17 am, followed by the remains of the amniotic fluid, which was brown and black sludge. No one could have predicted that this would happen as my waters before this were clear. When he was born, he didn’t make a sound. He was purple, blue, lifeless, floppy. Immediate newborn resuscitation commenced and 999 was called.

He had aspirated on the poo filling his lungs with the black tar meconium, blocking them so his brain was deprived of oxygen for an unknown length of time. Poo being where it shouldn’t be caused an enormous infection. Minutes old and the 999 call was harrowing, when the operator asked, “How old? Is he breathing?” I said, “No, no and no! Just send help now!”

The ambulance arrived, and then blue lights and sirens whisked him away. He was transferred to neonatal intensive care at Arrowe Park Hospital and diagnosed with meconium aspiration syndrome, grade two HIE and suspected sepsis.

Tristan took so long to stabilise that he went into complete respiratory failure within an hour of birth, so they placed him on a ventilator and then an oscillator due to ongoing hypoxia.

When tissues and organs go without oxygen for so long it can become fatal. The words, “He’s dying” were never said to me but I could see it in the doctor's eyes when they said, “He’s very, very sick.” He disappeared in an incubator to be placed on whole body cooling or therapeutic hypothermia.

As a mother, nothing could have prepared me for the first time I saw him - the wires, the tubes, the shaking of his body from the oscillator, the colour of him, the cold-to-touch feeling. A NICU nurse had to guide my hand as I was shaking that much.

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The neonatologist in charge of the shift when Tristan arrived had worked well over finishing time, and when he came to my room on the maternity ward I nearly vomited thinking it was the worst news.

It wasn’t great though; they had attempted to change the settings on Tristan’s ventilation but he had seizures. They had tried almost everything. He was not getting any better, but he was alive. So that meant he had a chance.

Alder Hey Hospital was our last chance, as only one out of six places in the country that could provide ECMO treatment (Extracorporeal Membrane Oxygenation). The quicker he could get there the better, and so Tristan travelled again by blue lights at 12 hours old. The difficulty was working out how he could go on ECMO whilst on WBC because the process of the blood leaving his body needed to be oxygenated and delivered back in at the same temperature needed.

There was no other option - either the emergency life support would work or it wouldn't. My tiny new baby had his lungs and heart working via machines out of his body. The many cannulas, lines and medicines kept him sedated and unaware - he could feel no pain and no movement.

Tristan needed ECMO for seven days, and we were then sent back to Arrowe Park where we stayed for two months. We only came across two other full term babies in that time, as transfers in from other areas. He held the record for the largest baby on the ward at 8lb 6oz.

During our neonatal stay, we battled an unsafe swallow and NG tube feeding, but Tristan never had one drop of formula - it was all breast milk. From being completely ventilated down to hi-flow oxygen then down again to low flow and eventually in air. We had to wait for him to be off high flow to be able to get MRI scans to assess the damage to his brain.

He has since gone from strength to strength and is now an absolutely thriving ten-month-old. He does not currently take any regular medication at all, and we do have additional support still in place like physiotherapy and such but he is still hitting the milestones. You would not believe it was the same child.

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