MAKING A MEAL OUT OF IT

COOKING FOR BABIES WHEN YOU CAN'T STAND COOKING

Chilli-ish con carne

Remember that daytime TV programme, 'Can't Cook, Won't Cook'? It suggested people avoided the kitchen for one of these two reasons only. Well I've discovered that there is a third category: HATE COOK.

I really dislike cooking. There, I said it. I can cook, I do cook (because I have to) but I really don't enjoy it at all. I find it boring, messy, and it involves way too much standing up for my liking. Yet despite my disdain for cooking, these days I seem to spend most of my day either planning it, buying stuff for it, doing it, feeding the results of it to Elliott (or myself), and tidying up after it.

I've written previously about how weaning was a stress point in my motherhood journey so far, and a few months down the line nothing really changed, and it's still the thing I've struggled with the most. We kind of found a rhythm, doing a big batch cook on the weekends and feeding the results to Elliott throughout the following week, but one afternoon I made the mistake of reading the "stage three" chapter of Annabel Karmel's baby and toddler meal planner book. It seemed to suggest my baby should be eating full-on meals by now, with freshly prepared pancakes for breakfast, lovingly crafted fish lollipops for lunch and a roast dinner with all the trimmings for tea.

Suddenly I felt stupid for still having bags of vegetable puree cubes in the freezer and for continuing to spoon-feed 75% of his food. I have to be honest, I had a bit of a moment. The moment was enhanced by my attempt that evening to bake a batch of vegetable muffins which went horribly wrong and ended up looking - and tasting - like baked, burnt vomit.

I'm well aware that there are loads of great websites and recipe books out there with some lovely meal ideas, but they all seem to presume that the person reading them enjoys cooking and baking. Not enjoying these things feels strangely risqué, especially as a "mother". But just because I now have a dependant doesn't mean I'm going to suddenly enjoy something that I've always found to be a chore.

Thankfully my wobbles over weaning have now mostly passed and I'm much more relaxed about what I feed Elliott. That's not to say I've suddenly begun to enjoy cooking, but I took a step back and realised that he does have a nutritious and varied diet, even though I do take lots of shortcuts when it comes to cooking from scratch. He also has a massive appetite and is generally a brilliant eater, and for that I'm really thankful. I also realised that just because the food I prepare for him doesn't necessarily exist as a traditional recipe, or have a name attached to it, it is still a proper "meal".

More often than not Elliott eats what my husband and I ate the night before, and by cooking just a little bit extra, minus the salt (and most of the chilli...), and putting it in the fridge overnight, the following day's meals are pretty straightforward to prepare. The current development is his wholehearted, raspberry-blowing rejection of any kind of attempt to spoon-feed him, so onto the highchair tray the food now goes. I can't even begin to describe the mess...

If you're also in the "I want my baby to eat well but without the faff" camp, here are some tricks and shortcuts I've learnt along the way that you may also find useful:

Cheese
Grated cheese is a quick and simple finger food for babies, and something they can get stuck into while you prepare the remainder of the meal. It does have a bit of salt in it, but a little cheese goes a long way and it's nice and nutritious.

Cream cheese
A dollop of full fat cream cheese is a great way to add a twist (and important calories!) to any bowl of mushed food, with the added bonus that it also cools down something that has been in the microwave for too long. Which, in my case, happens often.

Baby rice
This seems to be unpopular among some circles but in the earlier stages of weaning I actually found it really handy as a puree thickener or just to bulk up a puree if I was concerned it wouldn't be filling enough.

Full fat natural yoghurt
Baby yoghurts are all well and good, but my son loves plain natural or Greek yoghurt just as much. You can stir fruit puree into it for a bit of sweetness if you prefer. It's also good dolloped on top of meals for some creaminess. And has the same cooling benefits as cream cheese. Multiple uses!

Sweet potatoes
Most babies love them, but to save peeling and chopping before cooking, I just whack a couple of washed ones in the oven (skin pricked) for around 40 minutes whenever I'm using the oven for something else. You can keep them in the fridge for a couple of days in their skins and scoop out the soft flesh as and when needed.

Potatoes
As above really!

Frozen peas
Unlike other frozen veg, peas can be re-frozen once cooked. They make great finger food to help with pincer development and babies love the naturally sweet flavour. For a quick and easy puree in the early stages of weaning you can whizz up some cooked peas with a tin of unsalted sweetcorn and a bit of butter. It tastes lush.

Weetabix
Weetabix, whole milk and mashed banana warmed up in the microwave and all mushed together is a really simple and nutritious breakfast. Babies like it, too. Arf.

Chicken
We've got into the semi-regular habit of slow-cooking a chicken on a Sunday (bung a whole chicken in a slow cooker smeared in unsalted butter with some chopped carrots and onions dotted around on low for about six hours) and then using the juicy meat in meals - for us and Elliott - over the next couple of days. If you want to go the whole hog you could even create a baby-friendly chicken stock from the liquid leftover in the slow cooker. Or you could just buy these stock cubes from Boots.

Salmon
If you've had salmon the night before, save a chunk of it in the fridge overnight and flake it up as part of your baby's lunch or tea the next day.

Balls
I kind of stumbled across the realisation that if you combine a load of ingredients you have lying around in a bowl and roll into balls it's a simple way to enable your baby to feed themselves with slightly less mess. A quick example: If you're having rice with your own tea that night, cook a bit more than normal and prepare it a bit early. Mash in a few teaspoons of cooked rice with the flesh of half a cooked sweet potato, flaked salmon (from a tin is fine, but watch out for boney bits - they're fine to eat but maybe not for a young baby), some herbs if you're feeling fancy, and any other cooked veg bits you might have leftover from your meal the night before. Heat the mixture briefly in the microwave and roll into grabbable balls for a yummy meal they can feed themselves. This would work equally well with any other meat or fish, and I guess frying the balls off in a bit of unsalted butter might make them even tastier if you can be arsed. If your baby doesn't eat them invite your mum friends round and serve them as canapes.

Do you have any lazy arse "recipes" to share? Please do!

THE HOME PLATE

HOW WEANING CHANGES EVERYTHING

Breakfast. Help.

Oh how I dreaded sleepovers. Too much talking and giggling and not enough sleep for my liking. And how I missed my own bed at home! In fact, it was home that I missed more than anything. I literally used to get homesick on school trips and would count down the days until I'd be back in the place where I was most relaxed and comfortable. I loved being at home, loved going home, and - as I got older - always preferred a night in to a night out. I don't take for granted how lucky I was - and still am - that 'home' is a place where I enjoy spending time and feel at ease; a luxury that many people aren't fortunate enough to experience.

So when I was pregnant I imagined I'd be quite happy to spend most of my days at home with our new baby and, indeed, for the first few weeks or so I barely left the house as I recovered after an extended hospital stay, established breastfeeding, bulk-watched Homes Under The Hammer (I eventually came to terms with the sudden appearance of Dion Dublin as a third presenter) and generally got into the swing of things.

However, after a couple of months a pattern emerged. On the days we did go out, Elliott was chirpy, slept regularly and was generally easier to look after. And on the days we spent at home he was more irritable, difficult to settle after feeds and - quite evidently - bored. Going out became the new staying in. Once I worked out a system for getting everything ready in the buggy the night before, it was actually easier to go out; the day passed more quickly, Elliott would be getting lots of fresh air and seeing lots of new people and new surroundings, I'd be getting exercise and some much-needed adult company. It was win-win.

On the average weekday we'd be out of the house between around 10am and 3pm every day, hanging out with the lovely group of mums and babies we'd met through NCT antenatal classes. We'd go swimming or to a baby class (always followed by coffee and something to eat), attend the baby cinema screenings en masse, have a cheeky prosecco or two down the local pub at 3pm in the afternoon while the babies slept in their prams. Elliott and I would make the occasional trip into central London to meet non-baby friends during their lunchbreaks and he would happily sit in his buggy or on our laps while we nattered away. The days and weeks passed by in a happy blur of coffee, croissants, laughter and discussions about politics, poo and sleep (or lack thereof). Always a winning combination. There was always someone to see and somewhere to go and it was everything I'd hoped maternity leave would be, and more.

And then weaning happened. From the outset (at about five and a half months), Elliott loved solid food, which was - of-course - fantastic. Everything we gave him, albeit in puree form, he demolished, and it wasn't long until he was happily chomping his way through three mushy meals a day, and getting to grips with finger foods as well. And thus my little system for getting out of the house by a certain time pretty much went out the window.

You see, weaning's a messy and involved business. Firstly, the mess. No matter how careful you are, the food gets everywhere. On their clothes, your clothes, the floor, the walls, all over their face. Bibs, you say? Ha. Slimy purees laugh in the face of bibs. They set their sights on your baby's hidden neck creases (and freshly washed vest), and they always reach their destination. Of-course the mess is all part of it, and you just have to let it happen as your baby learns about food and how to (sort-of) feed themselves, but it also means you have a mountain of food-stained laundry to do, a never-ending pile of washing up and a very sticky and increasingly wriggly baby who hates having their face wiped.

Secondly, the cooking. Suddenly you're responsible for producing a nourishing supply of food that doesn't magically appear from your boobs. In the beginning I just couldn't get into any kind of routine for preparing it and would end up cobbling something together for each meal based on what we had in the cupboards. Which wasn't much. "Feed your baby food from your own plate!" is the advice frequently given by people with the best of intentions, but when you're having ready meals or takeaways every night it quickly brings into focus how terrible your diet is. We're in the process of getting more organised on this front in terms of batch cooking beyond steaming a pile of vegetables each weekend for Elliott, but we're still not quite there.

None of this is massively compatible with getting out and about. Not that it's stopped me - that's what Ella's Kitchen pouches are for - but trying to find somewhere for lunch that will accommodate anything up to eight adults, eight babies, eight buggies, and multiple high chairs is no mean feat. You try your best to mop up the floor, the table and the high chairs as you go along, but baby wipes will only do so much. And you somehow have to find an opportunity to feed yourself in amongst it all. Some places are great, but in others in can be a bit of an ordeal. Truth be told it's easier to feed your baby solid food in your own surroundings. Well, it is for me, anyway.

So we're gradually spending more time at home again. Elliott gets to have lots of time on the floor roaming around, just on the cusp of crawling at eight months. He's getting better at napping in his cot rather than in the pram or sling (face down, bum up), and I'm re-establishing my relationship with Homes Under the Hammer and learning how to prepare my own lunch again. None of which are negative things. I like home. I just wish all the surfaces were a bit less sticky. And that there was a nice bearded chap in the corner handing me flat whites all morning.

IN A FLAP OVER NAPS

WHY PARENTS OBSESS OVER SNOOZES

Eb in his beloved Cocoon-A-Baby, before he grew out of it (SOB!)

I'll put my hands up here. Before having a baby I couldn't for the life of me understand why parents got so worked up over their baby's naps. Granted, little Elliott has always enjoyed his sleep and early on established a bit of a reputation as the baby who always seemed to be in the land of nod, but I always figured that if a baby needed to sleep it would sleep. And if it didn't sleep, it would make up for it later on in the day.

And then it happened. About three and a half months in, Elliott missed out on what had apparently become one of his regular daytime slumbers (I hadn't been keeping track, which seems preposterous looking back on it) and, that evening, ALL HELL BROKE LOOSE. What I hadn't realised until two hours into a marathon screaming session is that babies tire VERY QUICKLY. One minute they're happy as larry giggling and playing, the next there's a shift in the atmosphere, they're rubbing their eyes and they want to be asleep. Like, immediately. And if they get too tired, it's actually MORE difficult for them to fall asleep as they get themselves so worked up about it.

The worst thing? Unless you have a magical super-baby with special powers, it's incredibly unlikely that they will even be able to fall asleep without help from mum and/or dad. It's bonkers. A young baby usually needs to be moving in some way in order to fall asleep, to replicate the sensation of being in the womb; a parent's rocking arms is the optimum place, if not then the buggy or a sling will (hopefully) suffice. As long as they're moving, nice and snuggly and can constantly touch or see you, so you're the last thing they clap their eyes on before they finally succumb to the zeds.

So now I'm that person who will resort to anything to ensure their baby gets the sleep they need during the day to make the other parts of the day less screamy. The person who frantically pushes the pram back and forth in a shopping centre while their friend has nipped to the post office. The person who walks up and down the same stretch of pavement absentmindedly "shushing" in the vague direction of the buggy. The person who sways or bounces on the spot with a baby strapped to them. The person who has begun to think seriously about whether or not to leave the house if a scheduled rendezvous suddenly clashes with a new nap time. The person who hopes that every nap reaches beyond the current standard of 35 minutes so I can actually get something done that doesn't involve sterilising an ever-growing arsenal of plastic paraphernalia, or continuing on my apparent mission to turn our spare room into a fully operational laundry (though, of-course, the longest naps inevitably take place at the precise time you need to be leaving the house).

It would be easy to turn this into an epic blog post about babies and sleep. But, frankly, every baby is different and what works for us (including white noise, dummies, a sling, a touch of controlled crying and - in the earlier months - a lifesaving thing called a Cocoon-A-Baby) might not work for everyone else. 

I guess, then, that this is more an explanation for my non-parenting friends about why I'm suddenly more flakey about meeting up, why I use the word "nap" a lot and - when I do make an appearance with the baby - why I appear to be expending a disproportionate amount of my energy reserves on getting Elliott to sleep. No, it's not the end of the world if a baby misses out on one of its daytime kips, but babies are a whole lot more pleasant for everyone to be around - and tend to sleep much better at night - if they get the sleep they need during the day.

Becoming increasingly flakey is actually really hard for me to come to turns with, since my reliability is such an inherent part of my personality. But being a parent, I now realise, is about sacrificing little bits of yourself to make the little human you've created the best possible little human they can be. Weaning is the current challenge as I'm having to sacrifice the very substantial bit of me that enjoys ready meals and takeaways. But that's a blog post for another time....

A LAZY PERSON'S GUIDE TO WASHABLE NAPPIES

INTRIGUED BY REUSABLE NAPPIES? READ ON...

Woodland bottom (this is a Bambino Mio nappy)

People always seem surprised when I tell them I'm a naturally lazy person because I always appear to be on the go. That's because I'm actually very good at disguising my laziness (think of it this way: to me, each "on the go" moment is simply a way to get to the the next opportunity to sit down more quickly). My family, however, they know the truth, since my slothful tendencies have been intact since birth. So when I told my mum I was considering using reusable nappies (also known as 'washable', 'cloth' or 'real' nappies) once my baby was born she was very surprised. Her scepticism, however, was based on visions of big towels that you had to fold and pin in place, much like the kind of nappies she used with me and my brother in the 1980s. She was doubtful that I could be arsed with it all, especially given that disposable nappies are so (ridiculously) cheap these days. What she didn't know - and what I didn't know until I saw pictures of friend's babies with fab, bright, billowy pants on their little bums while I was pregnant - is that washable nappies these days are in fact brilliantly designed and simple to use. Before I go on, an important disclaimer: I am not a washable nappy guru. I don't use them on a full- time basis and I doubt I ever will. I go through phases of using them a lot, and not using them at all. There are plenty of extremely knowledgeable people out there who know everything under the sun about cloth nappies and are incredibly passionate about it. My own nappy oracle is the wonderful Sarah from Nappy Geek, who lives down the road from me and is always on hand to provide a sensible solution to my latest practical query. Sarah - like many other nappy experts - also runs regular "nappucino" coffee mornings from her home in south London, during which she demos all the various types of nappies and answers all of your burning nappy questions. I attended one while I was still pregnant and on maternity leave and it was incredibly useful. I wish I could have 1% of Sarah's enthusiasm but, well, see above regarding my laziness, which prevents me from being hugely passionate about most things in life (with the exceptions of my family, hand dryers, puns, putting food in my belly and sitting down), but that's a blog post for another time and another blog which I'll undoubtedly never get around to writing because I'm too lazy. But I thought if I outlined some of the top level stuff for those of you whose interest is mildly piqued by the thought of washable nappies, but not piqued enough to look into it properly, that I may hopefully tip you over the edge so you can seek out your very own nappy guru - there is bound to be one round the corner from you. Why use them?

Babies get through thousands of nappies a year which means that, every single day, 3 million disposable nappies go to UK landfill. I don't know about you but that makes me feel pretty awful. There are also financial benefits - even though the up front cost seems like a lot at the time, in the long run you would actually save money by using washable nappies instead of disposable ones. Also, have you seen how fab they look? There are some amazing designs out there. Bear in mind that some UK councils offer incentive schemes - often cashback - to encourage people to use washable nappies - there's a list of participating councils on this website. Isn't it all a bit of a faff?

It's a bit more of a faff, but nowhere near as faffy as you think. In short, you put the nappy on (they mainly fasten with Velcro or adjustable poppers) the babies do their thing, you take the nappy off and put it in the wash and dry it before the next use. You don't need to soak the nappies before washing or anything cumbersome like that, you can simply put them in a mesh bag within a well-sealed bin and then chuck the mesh bag in the washing machine with the nappies still inside. How do they work?

There are various types and loads of different brands that I won't go into, and different styles work with different families and different babies (I'm a particular fan of the flat nappy which is simply a wad of super-absorbent material that you fold and stuff inside a waterproof wrap, and at the next nappy change you just stuff a new wad into the same wrap). But the principal for each is the same - absorbent material inside a waterproof cover. Some nappies have the absorbency built in (easier to use), and others have them separate (quicker to dry). The great thing about most washable nappies is that they expand with your growing baby, meaning that - in some cases - the same nappy can last from birth right up until the little one is potty trained. And this point is the key one for me - even if I'm not using them very much at one point in Elliott's babyhood, I can quickly switch back to them at another point. The way I see it is that part-time or occasional use of cloth nappies is still better for the environment. Right?! BUT WHAT ABOUT THE POO???

The thing I didn't realise until I went to the nappucino session is that you insert a liner - not unlike a slightly larger sheet of loo roll - between your baby's bum and the nappy. So when there's poo you can scoop it up and throw (or flush, depending on the liner) it away and hopefully be left with a non-soiled (albeit wet) nappy. But, let's be honest, not all poos are scoopable, especially in the early weeks, but once you get to know your baby's habits you could choose to be a bit tactical, e.g. use disposables until the poo has happened and switch to washables later in the day.

If your baby poos A LOT and you can't face the pooey washing you could consider waiting until their poos become more solid before you start using washable nappies. We've just started weaning and I imagine our washable nappy use will increase substantially in the coming weeks as the poos become more manageable (but more stinky!). I never thought I'd write the word 'poo' so much. Won't my baby's bum feel all wet and yucky?

They are surprisingly absorbent, and because the nappies themselves are adjustable you can ensure they are really snug to prevent leakage. Interestingly my parents swear that, because they used cloth nappies with me rather than nappies that keep babies' bums feeling falsely dry, I was easier to potty train because I wanted to get out of the damp nappies quicker. I have no idea whether this is true or not, but you can see the logic. Night time is a different matter, and we always use a disposable nappy to reduce the risk of a wet bum waking Elliott up. I believe this is quite common amongst washable nappy users. OK, I'm interested. How can I find out more?

Reading this superb guide by the aforementioned Nappy Geek (with whom I have no affiliation, honest!) is a good next step. You can then search for "washable nappies" and your local area online to find a local guru / supplier to find out more. I'm interested, but I'm even lazier than you...

I have good news. There are companies out there who provide a "nappy laundering service", collecting your dirty nappies and delivering fresh ones to your door, although it's obviously not as cost effective as doing it yourself. More details here. I remain unconvinced.

You can still do your bit for the environment by investing in some other washable baby items without going down the nappy route. We love our washable baby wipes, which are effectively a stack of super soft mini flannels. Because you can use them dry as well as wet they have tons of uses beyond cleaning your baby's bum (we dip ours in warm water with a little drop of baby wash, much nicer than cold wipes) - patting dry your baby's bum, washing them in the bath, cleaning mucky faces and hands, wiping runny noses etc etc. The best known brand is Cheeky Wipes but you can probably pick up a set from your local nappy supplier for a much lower price.

I mostly resisted the urge to whip these out of my bra and show everyone. Mostly.

I also love my washable breast pads. I don't know about anyone else, but I never got on with disposable ones as they invariably ended up as a sticky ball inside my bra and never stayed in place. Washable ones are much easier to move around, they don't lose their shape and, more importantly, they come in all manner of fun designs. My favourite ones have a brilliant Dalek print on them. BREAST-ERMINATE!

Happy washing!

PLACENTA ACCRETA - THE LOWDOWN

WHAT TO EXPECT WHEN YOUR PLACENTA GETS STUCK

Count the cannulas

Ah my pesky placenta. For some reason I always had a bee in my bonnet about the 'afterbirth'. My mum had suffered from a retained placenta, and it was the topic I was most interested in during my NCT antenatal classes. If they - and my hypnotherapy CD - were anything to go by, the placenta would simply slide out after childbirth (quickly with an injection, not so quickly without one) and that would be that. But there was always a niggle at the back of my mind about it

Well, that niggle was probably the sensation of my placenta clinging on to the muscular layer of my uterus for dear life, as - unbeknownst to me up until the moment it became apparent my placenta was going nowhere following the relatively straightforward birth of my son Elliott - I had a pretty bad case of placenta accreta.

I had no knowledge of this medical term until many weeks after the birth when one of the local supervisor of midwives paid a visit to our home to talk to my husband and I about what happened to me - a service Lewisham and Greenwich Trust offers mums who've had a particularly tough time of it to help them come to terms with their experience. I knew my placenta had got stuck, and I knew that I'd lost a very large volume of blood, to the extent that I needed a transfusion, but I hadn't been aware of what caused all of this nasty stuff to occur.

I thought it might be helpful to outline the ins and outs of placenta accreta in case any other mums (and their partners) who are unfortunate enough to experience this decide to turn to the internet for advice and information, since when I did the same all I got were bog standard overviews, a technical Wikipedia page, various medical studies which are pretty impenetrable for sleep-deprived minds, and a load of articles about Kim Kardashian (she, too, suffered from this condition after the birth of her daughter). I never found anything written by someone who had experienced it first-hand and how the condition made them FEEL, which is what I desperately wanted to read to reassure myself that how I felt was normal and things would get better. So here goes (and apologies in advance for such a long post, but I want it to be as useful a resource as possible)...

THE FACTS

What is placenta accreta?

When you get pregnant, the placenta normally attaches itself to the outer layer of the uterine wall. With placenta accreta, the placenta attaches itself a little too deeply, into the muscle. This means that the placenta cannot naturally separate and requires intervention to remove it.

How common is it?

About 1 in 500 pregnant women encounter it, and it's becoming increasingly common in line with the rise in the number of caesarian deliveries. This is because placenta accreta occurs most often in women who've previously had a caesarian section because the scar tissue left behind is fertile ground for the condition. This also means that women who have had other types of uterine surgery, for example to remove fibroids, may also be at a higher risk. I, however, have never had any kind of procedure in that region, so I was particularly unlucky.

What's the difference between placenta accreta and a retained placenta?

Placenta accreta is one kind of retained placenta, albeit a rare one. More commonly, a retained placenta is when some or all of the placenta is left floating around inside the womb, and eventually it'll have nowhere to go but out (and may be accompanied by bleeding). With placenta accreta, it is impossible for the placenta to come away without some kind of intervention.

Is there any way to tell if I have placenta accreta once I'm pregnant?

There are a couple of scans available on the NHS which may be able to detect it (colour Doppler ultrasonography and MRI scanning, both of which have an accuracy rate of around 80%). However, not all UK hospitals have the relevant equipment to offer these, and in all likelihood you’d only be offered one if you’ve had placenta accreta in the past, or if you have a low-lying anterior placenta combined with a previous lower segment caesarian section (LSCS), as this would put you particularly at risk.

Should I have the injection to speed up the placenta delivery if I'm worried about my placenta getting stuck?

This is 100% a personal decision. Many women prefer to deliver the placenta physiologically (in other words, with no injection) to experience a totally natural childbirth. Fair play to them. I personally wanted the whole thing to be over and done with as quickly as possible, so opted for a managed afterbirth (the injection). I was informed by my consultant that, in hindsight, this was the right decision for me as otherwise it would have taken much longer for them to realise that there was a problem.

What are the complications?

In my case, because the placenta had partially detached, effectively leaving an open wound inside of me, I experienced very heavy blood loss (four litres in total, which is not unusual for the condition). Obviously major blood loss is extremely serious, but with the right medical care that we're fortunate enough to have access to in the UK, for free, this can be dealt with.

What if I don't want a blood transfusion?

Again, totally a personal decision. But if I had declined a blood transfusion I'm pretty sure I would have died. More information on blood transfusions is available here. It's worth noting that once you have a blood transfusion, you are not (currently) allowed to donate blood ever again. This is to reduce the (very small) risk of transmitting vCJD (more here). It’s worth noting that some hospitals offer a 'cell salvage' service to clean and recycle your own blood if a placenta accreta is suspected or diagnosed before delivery, or if a caesarean section is planned.

Can I stop placenta accreta from occurring again?

If only. The supervisor of midwives informed me that, if you've experienced placenta accreta in the past, medical studies have shown that you have a 6% chance of it happening again. This doesn't sound like much, but it medical terms that's apparently quite high, especially when you compare it to the 1 in 500 (0.2%) risk to the general pregnant population. Needless to say that anyone who's had placenta accreta before will automatically be classified as "high risk" in subsequent pregnancies.

If I’ve had placenta accreta in the past, I presume a planned a caesarian section would just be safer next time?

This is what I thought, but apparently not. After all, a c-section is a major operation, and heavy blood loss sustained whilst you are cut open for the procedure could prove to be more serious.

WHAT DOES IT FEEL LIKE TO HAVE PLACENTA ACCRETA?

It probably makes sense to break this down into sections, as you're likely to feel lots of things, physically and emotionally.

As it was happening...

Imagine you've run a marathon, and just after you cross the finish line you get run over by a lorry. That's basically how it feels. You've gone through the most physically demanding and painful hours of your life, and just when you think it's over and you finally get to see and hold your baby, your sense of euphoria is knocked out of you and there are numerous people quite literally rummaging inside your body (with, in my case, having had no pain relief beyond gas and air) in an attempt to pull something out of you. It's horrendous, there's no denying it.

I gave birth in a birth centre which is attached to a fantastic hospital with state-of-the-art emergency care, so I was able to receive the help I required relatively quickly. If this does happen away from such facilities, however, the midwife with you will know what to do in order to get you access to the care you need as quickly as possible. I remember being prepped for surgery, having to sign a consent form giving permission for the surgeon to perform a hysterectomy if necessary (a hysterectomy is the simplest way to treat the condition, though for obvious reasons they try and avoid this if they can).

I thankfully didn't see the blood, mainly because my eyes were closed for most of it, but I do recall the sound of them suctioning it, presumably so they could accurately measure my blood loss. I can't remember the pain, but I do remember being desperate for the the anaesthetic to take effect so it would all be over. I was scared for my life, and I must admit that - when they allowed my husband in the room just before I went under - I did truly wonder whether we'd ever see each other again.

The aftermath...

The next instant (when in fact it was hours later) I woke up in recovery surrounded by medical staff and my husband. The operation had been a success - they'd removed the placenta piece by piece and had inserted a balloon inside my womb to stop the bleeding - and I was going to be moved to the High Dependency Unit. Everyone is different, of-course, but I felt the following things after I woke up:

- Relief - I was alive.

- Intense thirst - I'd been intubated so my throat was very scratchy, and my body was also working on overdrive to replenish the blood it had lost.

- Delirium - I was on 100% oxygen via a mask, later a nose tube.

- Hunger - I hadn't eaten anything for almost 24 hours Goddamit!

- Fear - I was terrified of haemorrhaging again, so decided the best way of dealing with this was to talk nonsense nonstop for 12 hours to stop me from thinking about what had happened, and what could happen again.

- Pins and needles - my hands and arms were tingling for the entire night afterwards, I think potentially related to the anaesthetic.

- Exhaustion - once the adrenalin had worn off.

- Extremely hormonal - I kept waking up wailing, though I expect this is common for any new mum, with the key difference that my baby wasn't with me.

WHAT TO EXPECT WHILE IN HOSPITAL

First cuddle on the High Dependency Unit

Where is your baby in all of this?

It sounds odd, but - once I'd been told he was perfectly healthy - my baby was the thing I was the least worried about. I was lucky in that my parents were on hand to step in while my husband stayed by my side (needless to say a High Dependency Unit is not set-up for babies to take up residency, although he was allowed on the ward for sporadic visits), and they did bloody brilliantly in what must have been awful circumstances for them as well. They were given a private room in one of the maternity wards and cared for Elliott for the first two nights, while I focused on getting myself better so I could care for my baby as quickly as possible. So did you ever get the chance to bond with your new baby?

This is what I emotionally struggled with the most. Antenatally, so much emphasis had been placed on bonding via skin-to-skin contact in the initial hours that I felt that I had failed as a mother from the outset and I would never be able to make up for it. I had looked forward to giving birth so much and had presumed I would fall head over heels in love with my baby in the birth centre, so when I was whisked away from him it caught me totally off guard. It took me quite a while to come to terms with this and to realise that a very large number of new mothers feel the same, and - if you are separated in the beginning - skin-to-skin contact at any point in those early days and weeks does exactly the same job. Switching the internet off my phone when I finally did get home from hospital and spending a good 48 hours drinking in every glorious millimetre of my new baby also helped.

What is a High Dependency Unit (HDU) like?

HDU is the next level down from intensive care. Patients in HDU need round-the-clock monitoring and care, but they are conscious and can breathe unassisted. There are two patients for every nurse, and the nurses are there for you 24/7, and throughout the day a host of doctors, consultants and physiotherapists do their rounds. The care I received in HDU was incredible. I was more or less immobile for the first 36 hours or so, and had to be helped to even shift my weight on the bed. I was catheterised, had to be wheeled to the shower on a commode and helped with every bodily function imaginable. It would have been easy for me to have found all of this humiliating, but I was so thankful to be alive - and everyone was so sensitive and caring - that my overriding feeling during my three night stay on the ward was awe and gratitude.

What's going on 'down below'?

A lot. Firstly, it's all extremely swollen and tender. You may also be the proud owner of stitches if you suffered from any kind of perineal tear (second degree for me). I had a Bakri balloon inserted to stem the bleeding and help my womb to contract down to normal size. The balloon was gradually deflated over the course of a day before being removed (along with, in my case, about a mile of surgical wadding). I was terrified this extraction would be accompanied by blood loss but it was fine, if a little disconcerting. Speaking of which, bleeding after a vaginal delivery is perfectly normal, and the bleeding I experienced was no heavier than average and only lasted a couple of weeks, though I was constantly paranoid I would suddenly start haemorrhaging again. Finally, in all likelihood you'll have a catheter in. This ensures that your bladder doesn't get too full so your womb can contract and prevents further bleeding. It's also extremely handy in light of the fact that you'll be unlikely to be able to get out of bed for 24 hours or so. My catheter was removed just before I left HDU, and it was completely painless.

Where did you go after HDU?

I spent the remainder of my time in hospital on a maternity ward in a private room. The rooms had a chair in the corner which meant my husband could stay with me and our baby. There is no way I could have cared for Elliott without him. I required regular observing and medication, which often meant we were woken up in the middle of the night (or day) by a midwife / healthcare assistant / consultant coming in to the room - frustrating, but necessary, of-course. We encountered many wonderful people on the maternity ward, and lots of useful advice, but when the only place in the world you want to be is home it's very easy to feel an overriding sense of resentment that you're cooped up inside at the behest of someone else's timetable rather than enjoying the early days with your baby on your own terms.

What if I want to breastfeed my baby?

I've written separately about that here. But, in short, if you want to, it can be done. But it will require time, patience and a lot of support, which the hospital should be set-up to provide. Ask for help if it's not forthcoming, and don't beat yourself up if you turn to formula in the early days - I couldn't have established breastfeeding without it (and we still happily use it months down the line).

How long do you have to stay in hospital for?

I can only speak from my experience, but I was in hospital for eight nights. The team caring for me wanted to ensure there was no placenta left inside before discharging me, which required my womb to have sufficiently contracted down before performing an ultrasound scan. This scan was probably the most petrified I felt throughout the entire experience. It was almost a week since the birth when I had it, and I'd made so much physical progress in terms of being able to get out of bed and move around a bit. I feared that if I needed to go through the entire ordeal all over again I'd be back at square one. The scan did indeed reveal that there was still a blob of placenta left inside, and although in some cases this can be left alone to be absorbed, it was recommended that I had an additional operation under general anaesthetic to remove it. Fear not, though, if you do need this second procedure it's a completely different kettle of fish to the initial operation. It's a routine procedure as opposed to an emergency, so you won't wake up feeling as if you've just been in a massive accident. In fact, I felt brilliant (albeit still physically frail) the following day as a huge weight had been lifted off my mind, since I finally knew that all of my pesky placenta was gone and there was no longer a risk of haemorrhaging once I returned home.

AFTER HOSPITAL

Recovering at home

You must have been thrilled to go home finally?
You'd think. But despite feeling on top of the world the day before we went home, the next day was a different story entirely. Remember how you've run a marathon and then got knocked over on the finish line? Well, now imagine that you finally know that you're going to get through this, albeit with a long period of recovery ahead of you, but then someone hands you a screaming, hungry newborn baby, and it's partly up to you to keep that baby alive. All your body wants to do is sleep and recuperate, but you can't. And the realisation of this momentous responsibility suddenly dawned on me the day I was due to go home. I was a complete mess. I was physically and mentally exhausted and felt utterly hollow and bereft. I was also suffering from flashbacks of everything that had happened over the previous week and - when sleep finally did come - it was blighted by disturbing nightmares. I can honestly say that I've never felt less 'alive' than I did the day I got home with our new baby, which breaks my heart to this day.

How long did it take for you to feel 'normal' again?
With the exception of a few blips, I felt slightly better every day. I can't emphasise how important sleep was - an hour here, a couple of hours there - every time I woke up having banked a bit more slumber I felt a little stronger, and I could feel my personality and sense of humour rising up from somewhere deep inside. I spent the first 24 hours or so in bed, then the next day I'd venture downstairs to lie on the sofa, the next I'd sit on a dining room chair (with the help of a donut cushion), followed by stepping into the garden, walking the pram to the end of the road and so on and so forth. I was on a lot of medication to begin with (painkillers, antibiotics, iron, laxative), but within a week or so of returning home my iron levels were back to normal and we worked out a little system for both of us to get (just about) enough sleep to make it through the next 24 hours. After a couple of weeks we started to welcome visitors beyond immediate family, and my husband returned to work. I felt 100% better - physically and mentally - within about eight weeks. However, EVERYONE IS DIFFERENT.

Where can I get emotional support?

Do not be afraid to ask for help. I cannot emphasise this enough. I felt as if I had to prove myself as a mother and, for some reason, thought that letting people step in to care for my baby was 'cheating'. But this is not the case. You have been through a huge physical and emotional ordeal. Accept all the help you can get, but don’t expect professional help to present itself once you leave hospital. I quickly realised that if I wanted emotional support I had to be proactive and seek it out for myself. Hopefully the list below will give you a headstart:

- Immediate family - for the first two weeks we had immediate family on hand to take care of us, while we looked after Elliott. Let them cook, do the washing, get supplies from the shops - anything that needs doing beyond caring for your baby. If they offer to have responsibility for the baby for a night or two, even if it’s just in the next room, take it, and bank as much sleep as you can.

- Find women with similar experiences - I was put in touch with numerous women (via friends and a local Facebook group) who had encountered similar experiences when I posted an appeal for help. Their messages while I was still in hospital provided me with much-needed slices of hope that things would improve and - one day - I would feel like myself again.

- The NCT - I also called the NCT helpline and was referred to a lovely lady who had gone through a similar birth experience. We spoke (well, she spoke eloquently while I mumbled) on the phone one evening for around an hour and she gave me some fabulous tips for conserving energy once my husband returned to work. Hearing her children happily playing in the background whilst I was curled up in bed in a dark room was also strangely soothing. The NCT also offer breastfeeding counselling over the phone.

- Birth Trauma Association - I only learned about the BTA many weeks after I returned home, by which point I felt much stronger and in control - but they can also refer you to women who have experienced a similar birth.

- Supervisor of midwives - as previously mentioned, all Trusts have a supervisor of midwives team who are responsible for protecting women and their babies through ensuring midwifery standards are as high as they can be. Although they work closely with the midwives who provide the care, they report to a separate body and are therefore impartial to ensure they have the mother's best interests at heart. If you have any concerns or questions about the care you have received, ask to be referred to your local supervisory team.

- Healthcare professionals - if you continue to struggle emotionally following the birth, I'd advise you speak to your GP or health visitor for further advice. It is possible to suffer from post traumatic stress disorder (PTSD) after a difficult birth, and they will be able to refer you to sources of additional help.

But, hey, you got your baby at the end of it all, so all worth it, right?

Well, yes, of-course! Regardless of how tough a time a mother has when they give birth, the vast majority of attention naturally shifts to the baby once they arrive, and while your bundle of joy gives you a motivation like no other to get better, don’t underestimate - or let anyone else underestimate - what you went through to bring them into this world. Give yourself a break, ask for help (and, crucially, accept help when it's offered) and happy times will arrive sooner than you think. If you have any other additional questions about placenta accreta, or want to contact me about any element of this post, please feel free to do so. I would never want to go through it again, and of-course I wish things had been easier for us, but I can honestly say that I have never felt more thankful to be alive as a result of my experience, and so in awe of the NHS and the people in the world who I love the most.

Many thanks to the Lewisham and Greenwich Trust Supervisor of Midwives team for fact-checking this blog post.

WORTH THE WEIGHT

DEALING WITH A NEW BODY AFTER CHILDBIRTH

My signature face / body photo crop post-childbirth

They say your body is never the same after you have a baby. They're not wrong.

I expected my boobs to get bigger, I expected a few stretch marks and I expected a paunch. What I didn't expect was an extra two-and-half-stone to lug around, stretch marks EVERYWHERE (most strangely on my inner thighs?!), giant bingo wings and boobs that are literally six cup sizes up from my pre-pregnancy days.

Suddenly being a size 14-16 after never getting beyond a size 12 has been a shock to the system, and my poor knees and ankles, which were never great to begin with, are feeling the strain as they get used to the extra work.

I've never struggled with my weight and have never let my wobbly bits bother me. Before becoming a mum, if I put on the odd half a stone I'd stop eating quite so many bowls of cereal for a few weeks, swap to skimmed milk, walk up and down the escalators rather than stand, and the pounds would fall off. Well, up to the point where I couldn't resist cereal again. I was in good shape without being superfit and, most importantly of all, was healthy and happy.

That said, I've always had a huge appetite (you don't want to speak to me when I'm hangry) and being pregnant only made my growling stomach all the more insatiable. In the first few months of pregnancy I would get sudden bouts of ravenous hunger, meaning that it got to the point where I was having two breakfasts - one at home and one as soon as I got to the office - followed by a stodgy canteen lunch at noon, snacks throughout the afternoon followed by a big meal at teatime and cereal before bed (aka supper). If I didn't eat I felt sick, so I went with it and gave my body what it wanted.

I read somewhere that an increased appetite is more likely if you're expecting a boy, but it got to the point in my pregnancy where I continued this eating regime out of habit, rather than necessity. "Sod it, I'm pregnant, the extra biscuit or four won't make much difference." Well, turns out it probably did, and it's no wonder I've piled on the pounds.

A tough birth and a period of immobility after a prolonged hospital stay didn't help, and in the early weeks once I was back home I would happily munch my way through a packet of Hobnobs ("oats are good for breastfeeding!") and boxes of chocolate for comfort ("I need the happy pheromones!") while pinned to the sofa by a hungry baby.

Now - five months after giving birth - I'm having to make the biggest effort I've ever had to make to lose weight and get healthy again.

This isn't about what I look like, though I must admit it would be great to be able to get at least one pair of my pre-baby trousers beyond my mid-thighs, finally get to wear my wedding ring again and not look like my arms are bigger than my baby's torso. Instead, it's about ensuring that I'm fit, active and well so I can do all the things I want to do in order to be the kind of mum I want to be. I want to be able to chuck him in the air, and goodness knows I'm going to to need to be able to chase him round a park - and have him chase me - in the next year or so without feeling like I've just run a marathon.

So, over the next few months I'm setting myself a personal mission to lose the extra weight, get my legs, core and arms strong again and, most importantly of all, feel good about myself. It's been a tough old year for my body - and my mind - so I'm not going to be too hard on myself, but in a strange way I'm actually looking forward to the challenge, to prove to myself that I can do it. And this isn't just about being a mum, this is also about doing something for myself. I've got this.

Interested in postnatal fitness? Here are some ideas about how to ease your way into exercise after childbirth:

Wait at least six weeks
Firstly, and most importantly, don't do any strenuous exercise for at least six weeks and you've had the all-clear from your GP after your postnatal check.

Walk everywhere
You'll likely be discovering every nook and cranny of your local neighbourhood in the early months. We don't have a car so, instead of hopping on the bus or train for local jaunts, I've been walking as much as I can. Start slowly in the early weeks before building up to a Harold Bishop-style power walk. If you have a baby sling and can carry your baby, all the better for getting those muscles working.

Postnatal Pilates
I found a good local class which was great for the earlier months after birth, with a focus on relaxation, slowly building up core strength and help with the (very important) pelvic floor region. Some classes let you take your baby, but I actually found that my Saturday morning mum-only class gave me some much-needed 'me' time.

Mother and baby Pilates
I've also just started attending a weekly class which you can take your babies (under one) along to. The babies are fully involved in the class, and they even get to do a few stretches of their own. And yet another way to meet local mums.

Our local Buggyfit location

Buggyfit
I was lucky enough to win a series of classes in a local raffle, but there are sessions available nationwide. You go along with your baby in a buggy (no special jogging buggy needed) and take part in a group outdoor workout in a local park - come rain or shine - led by an instructor who is qualified for postnatal exercise (Corinda Slyfield taught my nearest class). It's good fun, and babies can get involved for lifting and arm exercises.

Spinning
Definitely one for a few months down the line given the likely sensitivity of the "down below" region, but I love spinning and have recently started going to Saturday morning classes. High energy, loud music, lots of sweating - it's a fab way to start the weekend and have a bit of fun baby-free time, and it feels great to do some exercise that doesn't have the word "baby" or "postnatal" attached to it.

Has your post-baby body come as a shock? Any other exercise tips? Feel free to let me know!