TV sports presenter Amanda Davies had enjoyed an uncomplicated pregnancy – but it became a slowly unfolding nightmare when, alarmingly, two months before her due date her waters broke while she was live on air.
‘It was the BBC World sports shift, which is notoriously quiet,’ says the daughter of former Football Association chief executive David Davies. ‘I had not felt right for days but couldn’t put my finger on it. A friend who was six weeks ahead of me in pregnancy had said it was normal to feel a little damp, but I started to Google my symptoms, which was probably a terrible idea,’ says the 33-year-old, who has just moved from the BBC to CNN.
During pregnancy, a sac filled with a liquid known as amniotic fluid surrounds the growing foetus. Towards the end of gestation, the amount of collagen, a tough fibrous protein, decreases in the chorion, the outer layer of the sac. As the collagen decreases, the bag of waters will break.
For the majority of women, this will occur spontaneously during labour. However, in about eight to ten per cent of women who deliver early, the waters will break before the onset of labour (premature rupture of membranes) and this can also happen partially.
‘It’s known as a hind water leak,’ says consultant obstetrician and gynaecologist Clive Spence Jones. ‘It means that a small hole appears somewhere in the sac, away from the cervix. We don’t really know why it happens, but a lot of research is being done on the subject. Often these women can go on for days or weeks before delivering.’
Amanda says: ‘Some mothers online referred to this as “having sprung a leak”. I decided, to be on the safe side, to call the hospital. They said I should come in, so once I had finished my shift I turned up in full studio make-up, expecting to be sent home. But, after I was examined, the doctors decided to admit me for monitoring, explaining that my baby could be born early.
‘Sam, my husband, was working in Cyprus, so I called him – I wasn’t worried or upset at that point, and he didn’t come back for another two days.’
For seven days, nothing happened. Then, on May 25, 2009, Amanda went into labour.
‘At first I was relaxed, or as relaxed as you can be when you’re having a baby nine weeks early. We’d had time to prepare ourselves for what was going to happen. I’d been taking hypno-birthing classes and was planning on no pain relief. I had my music playing.
‘Then, a few hours in, the baby’s heart rate dropped and suddenly the doctors rushed in and told me they had to get her out straight away. There was no time for pain relief and I don’t remember anything but a feeling of panic.’
The obstetrician performed an episiotomy and forceps delivery – the baby weighed just 3 lb 10oz and wasn’t breathing. Amanda says: ‘The cord was wrapped around her neck, and when we caught a glimpse of her through the crowd of doctors and nurses she looked as if she’d gone ten rounds with Mike Tyson.
‘I was terrified. My husband and I were speechless – it’s not how you envisage seeing your newborn baby. People kept telling us, “It’s going to be OK,” but it’s hard to believe.
‘You just have to trust they are doing everything they can. And then, about five minutes after I’d given birth, a doctor said I needed emergency treatment.’
After baby Molly was successfully resuscitated, she was taken to neonatal intensive care, where she remained for six weeks.
Amanda was cared for in the adult intensive care ward after suffering from heavy bleeding.
‘It was before I was wheeled away that a paediatric doctor asked if I would like Molly to receive breast milk, that they had a milk bank and that it was what they recommended,’ she says. ‘It hadn’t crossed my mind – in the whole build-up to having a premature baby, you don’t think about how you are going to feed it. We asked if there were any risks and they said no. So we agreed.’
Research has shown that breast milk is the best nourishment for babies and that it is highly beneficial to their health in the short, medium and long-term, particularly for sick or premature infants.
The Department of Health recommends women breastfeed exclusively for six months and continue after that as part of a balanced diet.
Breast milk contains a complete spectrum of nutrients, alongside hormones and immune-system compounds which are not in formula milk. Giving premature babies breast milk protects them against infections and helps development, and they are much less likely to develop a common, life-threatening gut infection called necrotising enterocolitis.
The process that leads to natural milk production begins when a baby is born, but if labour is premature it can take three to four days before a woman is able to make enough. This can be longer if the birth is very early, or the mother is unwell.
Many neonatal units recommend donor milk be offered in cases where women either can’t feed due to illness, as in Amanda’s case, or for those who give birth prematurely and are not yet producing their own breast milk. Milk banking at Queen Charlotte’s & Chelsea Hospital, London, where by chance Amanda gave birth, was initiated in the Thirties by a matron to help provide breast milk to a woman who had delivered quads and couldn’t keep up with the demands of her four hungry babies.
Today, new mothers can choose to donate their breast milk to a dedicated milk bank – there are 18 in the UK. Donors are mothers who are making more than their baby needs, expressing the milk and would otherwise be throwing it away.
Volunteers are screened for diseases, the milk is tested and heat-treated to remove harmful bacteria or viruses, and then frozen so it can be used on request. Unlike some blood products, milk is not pooled and babies will often receive milk from only one donor. The process is confidential, but banks keep records of donors and who their milk goes to.
Milk bank manager Gillian Weaver has worked at the Queen Charlotte for more than 20 years. She says: ‘Most babies will need donor milk for only a few days while the mother establishes her own supply, but in cases where the mother is ill this can take longer. The nutritional value of the milk is affected slightly by the heat processing, but it has to be done that way for safety reasons. Supply is not usually a problem, although we always need donors.’
However, advocates claim there is a lack of awareness, principally among obstetricians and midwives – and concerns about HIV and other diseases transmittable via breast milk meant breastfeeding fell out of favour in the Eighties. In answer to this, NICE, the National Institute for Health and Clinical Excellence, has produced official safety guidance.
–Daily Mail, London