All’s Well
It’s thirty-three degrees on the day Jacqueline and I go to Kew Gardens. I’m not sure what that is in Fahrenheit, but even Robert agrees that’s hot. So is our apartment; at least the District Line has AC.
We’re both determined to do the gardens thoroughly: Jacqueline has a map of specific tree specimens she wants to visit, and I am a compulsive completionist. So we’re there at 10, when it opens, sunglasses on, parasol up, sunscreen applied.
The gardens are extensive. Glasshouses range from palm to rainforest to desert to alpine to temperate (with appropriate climates for each). One is just for water lilies. There’s a bamboo forest, a canopy walk, a botanical confusion of trees from all around the world scattered through the park. With so much there to see, I have to remind myself to check in with my body: is this heat okay?
Although we take breaks in the shade, I’m googling “overheating pregnancy” “pregnancy cramps” and the like by teatime. In the tiny bathroom of the no-AC historic teahouse, I strip and try to cool my body with damp paper towels. It’s somewhat effective. Or at least, I’m less sticky after.
Based on my search results, I would have to be sustaining a temperature of 39C/102F to be causing baby any harm from heat, and even then, that’s mostly in the first trimester. Dehydration can cause mild cramping (I have some in my lower left abdomen), but I’m pretty on top of the water bottle refills. Jacqueline ensures I’m supplied with ice water by our short-staffed teahouse servers.
Back in the gardens, we discover air conditioned art galleries — worth the visit just for the cooling effect, but actually quite beautiful and provocative: Marianne North’s gallery, in particular, is an overwhelming flood of beauty. The artist was a solo-traveling woman in the 1850s so fascinated with botany that she went from Borneo to Australia to California and more just to paint the plants in highly accurate full color.
We linger at Kew until the afternoon cools into evening. Little drops of water start to fall and cool our shoulders. It’s late when we get back, but we feast on hot-day bean salad, rehydrate with coconut water. I feel okay. But I’m attentive: is the fetus moving a little less than usual?
There is a lot that is confusing in pregnancy. Sensations are changing all the time, and it’s hard to tell what’s worrisome. Some parts of the internet advise the use of a kick counter: supposedly, ten kicks every two hours at this stage mean the fetus is healthy. Other sites say every baby is different, but they’ll have wake/sleep cycles you’ll notice.
I notice when the fetus is awake, but when it’s an active day, it’s less obvious. Kicks can be subtle. There is a set pattern by now in theory, but not really in practice.
What’s uncontroversial is that from now through delivery, the baby should keep kicking, as much or more, every day. When stillbirths happen, the websites say, the mother has usually noticed a change in fetal movement. Even if it’s just weaker. It’s often the only symptom of a host of problems that could be life-threatening. The NHS has been very clear on this point: if I’m worried, I should come in.
So a bit after ten, I’m lying in bed, lights out, poking my belly. Usually, it moves if I lay on my back. Or if I roll over in bed. Right? It’s moving, I think. But it’s not usually so subtle.
Robert has been working late nights since last week and through the weekend, so I video call him at the office to ask.
“How much does the baby usually kick at this hour? It’s usually pretty active, right?”
His face goes immediately serious. “You should go to the hospital. I’ll meet you there.”
Jacqueline, theoretically abed on the couch downstairs, is instantly ready to come with me. I call the NHS maternal help line on the handout from the Royal London Hospital (good thing I got set up with them last week).
“What is the issue?”
“I’m concerned about reduced fetal movement.”
“How many weeks are you?”
“Twenty-eight.”
“Come in now. Urgently. Sixth floor. Bring your NHS maternity notes book. Call the high-risk maternity triage line on the way, but come in even if they don’t answer.”
We speed walk the fifteen minutes to the tube — luckily, my body is doing well: I feel rested, my joints work properly.
“It’s most likely fine,” I inform Jacqueline as we walk, “but just so you know. Best case, it’s nothing and they send me back home. Worst case, I think, is an emergency C section. There’s a 90% chance it will survive at this gestational age. I don’t think there are a lot of likely options in between.”
Jacqueline nods, carrying my backpack and speed walking along with me. “But it’s probably fine.”
It’s three stops to emerge at Whitechapel: a sidewalk scene that makes the both of us suddenly very conscious of being female, having exposed shoulders at night. But we don’t linger long in the cigarette smoke and male gazes. It’s only a half block across the street to the hospital.
The doors are locked, but we catch the door behind a family in Orthodox Jewish dress and whisk up the lift to the sixth floor.
It’s dead empty.
In the silent corridor, we read the directional signs: pediatric x, y, and z, and the labor and delivery ward.
“So…” I turn to Jacqueline, “Labor and delivery, I guess?”
Neither of us loves this option; it feels a bit leading in the circumstances. But we don’t have a child in need of pediatric care, so labor and delivery it is.
In the hallway, we finally spot another person: a nurse with her arms full.
“Sorry,” I accost her, “but do you know where we should be going if I’m getting fetal movement checked?” She points us onward to the labor ward. Jacqueline and I exchange glances.
We buzz in through a locked door, through an empty reception, another set of swinging doors. Finally, there are people: a staffed reception desk and a few pregnant women in hijabs sitting anxiously on chairs. The labor ward, it appears, is active.
The reception desk takes my NHS-issue purple book of maternity notes and hands me a pee cup. Someone comes to take my blood pressure and temperature while Jacqueline texts directions to Robert: the labor ward, she clarifies, but Kelsey is not in labor.
Now that we’re taking appropriate action, I’m not really nervous. Whatever happens will happen; the hard part was deciding whether or not to pay attention to the maybe-symptoms. Jacqueline and I solve most of the Monday crossword on her phone. Robert arrives.
Soon, he and I are invited to a hospital room, where a kind midwife introduces herself and asks what’s brought me in.
It’s pretty straightforward. At this gestational stage, she finds the baby’s heart rate with the Doppler and listens for a full minute to ensure it’s not dropping. It’s not.
She also gently presses my belly where it’s been cramping. “No pain?”
Slightly tender, but no pain.
“You would probably jump when I pressed, if it was a problem.” It’s probably just round ligament pain: normal at this phase.
“The Doppler usually wakes them up,” she smiles. “It makes a whooshing sound in the womb. So the fetus might move more while I’m doing your writeup.
“As a midwife, I’m authorized to release you if you’re happy with the fetal movements at that point. Or if you prefer, we can get a doctor to have a look.”
Back in the waiting room, we have time to finish the Monday crossword, and for Jacqueline to be kicked out — I’m only allowed one companion in the triage room. They’re waiting for my urine sample to process. Robert and I sit together in the late-night waiting room, tired but calm.
I don’t think I’ve ever had an emergency room visit in the States that cost less than a few hundred dollars out of pocket — regardless of my insurance. But of course, this is the NHS. The only cost to us is a little sleep.
I expect that the consequences of inaction are dire in a small percentage of cases with these symptoms: a certain bill for a likely non-event. Back in the US, I would probably not have gone in; I’m too used to that math.
But here? It’s a no-brainer. The fetus is fine. We can feel sure about it. They encourage us to come in again if I feel the same symptoms. They want to make clear: we did the right thing.
When the midwife returns, she double checks that I’m happy with the fetal movements. It’s kicking now. So she releases me, and the three of us wind though the empty hospital and out to the street. It’s still warm on the Tube, and beneath the streetlights of East London. By just after midnight, we’re safely home.
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