What to Expect – TFMR

Before November last year, I’d never even heard of a termination for medical reasons (TFMR). Unfortunately, I was about to get pretty familiar with the term. As you’ll have already read, our story did not have a happy ending second time round.
We’d had doctor appointments and scans, seen specialists, had amazing care and been told how unusual our case was (the geneticist and a few other doctors said they couldn’t recall this problem having been diagnosed so early in this country before). And we’d made our – admittedly painful – decision. A termination for medical reasons was the only way forward, based on the information we’d been given. And although I had a vague idea that this meant ‘labour’ at this stage, I had no point of reference for how this might play out.
Because of this, I wanted to update the website with a timeline of sorts of our experience. Of course, yours might not be the same, and your hospital might have different facilities/ways of supporting you through this. But hopefully, if someone is looking for a bit of help or information, this might be useful.

Two Days Before The Induction

We went into the hospital for a meeting with the screening midwife, so she could explain exactly what was going to happen. This was one of the hardest parts for me because it made it real. This was actually happening, and it was happening to us.

It’s a strange thing when you’re faced with something that seems so completely horrifying you’d do anything not to have to go through with it, but at the same time you know there’s no other option so you just well, have to. That’s exactly how I felt.

I had some real fears about the procedure, and certain things that were causing me a great deal of anxiety. As a real practical planner I like to have everything laid out in my head so I know what I need to cope with, what I might be facing. And in this scenario, there were so many unknowns I just didn’t know where to begin with trying to get my head around it.

I’m not going to share the details of my own anxieties and concerns here, firstly because they were specific to our case and secondly, because they are probably irrelevant – as I’ve said many times before, everyone is different and every case will be different. But what I will say is if you have ANY concerns or specific anxieties at all, do make sure you share them with the midwife at this point. In our experience, they are so helpful and reassuring and it made a horrible experience a lot easier.

There was one point where one of my questions set me off, and I couldn’t stop crying for about half an hour. The screening midwife was so patient and reassuring, and somehow made everything seem like it was going to be okay. When I finally managed to get myself together, I struggled to ask some of my other questions but between the midwife and my husband, they managed to go over everything in as much detail as I needed.

You have different options when you’re set to be induced for a termination for medical reasons. You can see and hold the baby, have footprints and handprints and photos taken. You can spend time with them, hold a funeral for them, and put a few personal items in with them too. Again, I’m not going to share our decisions about this, because although I want to be candid and help people going through the same thing where I can, it’s a hugely personal thing. All I can say is, do what feels right to you.

The screening midwife explained that I would be given two sets of tablets, two days before I was taken in for the induction, which prime the cervix and prepare the body for labour. These can sometimes make you feel quite sick, so after I’d taken them, I stayed for half an hour to make sure I wasn’t suffering any ill-effects.

By the time we left that room, I felt like I could cope with whatever was coming.

The Induction

We went into hospital for 1pm on a Saturday. We were greeted discretely by a midwife who took us to a private room. We were told we’d have a separate room away from the maternity ward, but I wasn’t expecting it to feel so homely. It was like a little suite with a kitchenette, sofa, TV, double bed, hospital bed and bathroom.

Little touches such as a matching colour scheme, pictures on the walls and tea and biscuits made it feel less clinical, and therefore made everything feel a bit less daunting.

Our midwife chatted to us about our decisions and made sure we had been fully informed about what to expect. We had to fill out a fair bit of paper work – this is something to prepare yourself for – and sign off on things such as funeral arrangements and a post mortem. I didn’t realise we would have to do this beforehand (and some other paperwork the morning after), so it’s worth bearing this in mind, as it can be a bit of a unpleasant surprise and something extra you didn’t realise you’d have to be dealing with.

The midwife said we could get things underway whenever we were ready. This was one element I was profoundly grateful for – whether it was deciding when to come in for the induction, or when to get it going, I never felt pushed or rushed, it felt like it was completely our decision and they would work around us. In a situation like this where you don’t have much control over what’s going to happen, things like this make all the difference. I decided to get started as soon as possible – I just wanted to get it over with at this point. I was given pessaries to start induction but she explained that it sometimes takes a few rounds to work (after the initial round you just have tablets to take every few hours). You can only have so many tablets in a 12 hour period, so if it didn’t work, she warned us that we’d have to wait 12 hours then try again. I hadn’t considered this, and just hoped against hope this wouldn’t be the case. I just couldn’t imagine how I’d feel if it dragged on for that long.

Two hours after the pessaries

Initially I felt fine. I started getting a few cramps but nothing too painful. Unfortunately, I had a reaction to the pessaries and started getting a temperature. They were worried about the possibility of infection so I had to have antibiotics when it didn’t drop, and they took bloods to check.

The cramps started getting more intense and, after the second round of tablets, I started feeling a bit sick. This is apparently completely normal, and they assured me I could have some anti-sickness medication if it got any worse.

After the third round of tablets

We’d passed the time watching some DVDs we’d brought from home, reading books and listening to podcasts but it was the kind of  watching/reading/listening where you’re not really paying attention.

By the third round of tablets, the cramps had kicked up in intensity and I was starting to feel really really sick. I was given anti-sickness medication but, ridiculously, this also made me sick. I was then offered a Morphine drip as a pain relief option. I wasn’t sure whether to take it as the pain wasn’t that bad at the time, but the midwife suggested I get it set up, as it can take a while, and I didn’t have to use it unless I needed it.

I was glad I took her advice.

I’d had no time to prepare for labour, hadn’t been to any classes, didn’t really know anything about it at all. And I wasn’t going into it in a positive frame of mind – I knew there wasn’t going to be a happy outcome this time. I tried to think of it as a medical procedure to make it easier to bear, but it was difficult. I started being sick, which the midwife said was a good sign, and amazingly managed to sleep for a bit (I don’t think my husband did, although he tried). The midwife had to come in and keep checking my temperature every half an hour or so but I was so tired, I barely even noticed.

The cramps crept up in intensity, until no matter which position I lay in, I couldn’t get comfortable. The pain became all encompassing just before my waters broke, then subsided completely. I think at this point it was actually worse for my husband, because I was so absorbed in the pain and focusing on what was happening, I’d almost forgotten why it was happening – it became a very abstract thing, and I was so focused, I couldn’t worry or be upset. He just had to sit by and watch, and try to comfort and reassure me when I needed it.

The rest is a bit of a morphine-induced blur, but a couple of hours after my waters broke, I delivered and it was all over. I was so exhausted and relieved, I didn’t even cry. I just wanted to climb into bed and sleep for a week, but I could barely stand up and there was a lot of blood loss (not dangerously so, I just hadn’t realised I would lose so much). I still felt very sick.

As I’ve said before, I’m not going to share our decisions or how we spent our time immediately after/what our reactions were. To be honest, those are moments I don’t really want to relive or think about, but also they don’t need to be shared.

Afterwards, the midwife cleaned me up and helped me into bed, and I was out like a light. I wouldn’t have thought I’d be able to sleep but I was so exhausted I could barely string a sentence together.

It was 17 hours since we’d arrived.

The Day After 

I woke up the next day feeling battered, sick and empty. I just wanted to get out of the hospital as quickly as I could. But there was also an element of relief that the physical part was over and gratitude to the staff who had been amazing, supporting both of us the whole way through.

Staff came in to check on us, there was more paperwork to be signed and I was given more anti-sickness medication as I couldn’t stand up without feeling nauseated. We were offered breakfast, but I couldn’t eat anything.

We were assured that we could stay as long as we liked once I’d been given the all-clear to go home. Because of my temperature the previous day, I was given two sets of antibiotics, one that had to be administered via a drip before we left.

If you don’t have any offered to you, make sure you ask a nurse or doctor for medication to suppress your milk – another small thing that might make it a little easier. I definitely did not want to have any reminders of what was not to be, if I could help it. This was the last thing I was given before I was discharged.

We left as soon as we were allowed, and it was such a relief to get home, to familiar surroundings, away from a hospital environment, despite the brilliant care and comfortable room we’d been given.

It’s a strange thing to be thankful for any part of an experience like this, but I want to take the opportunity to highlight how wonderful all the staff were at Broomfield Hospital. Although they were just doing their job – which to me, makes it even more amazing that they can deal with these things on a sadly regular basis – I cannot put into words how much it helped to have people by your side throughout who didn’t judge, didn’t put any pressure on us, respected our decisions and simply made it known that they’d be there, getting us through it and making it as easy for us as they could.

If you’re about to undergo a termination for medical reasons, I’ve put together a list of things that you might want to take to hospital here.