UAE-based mum: ‘Pre-term labour left me feeling so lonely’

That feeling of abject loneliness still haunts her; sudden scares that are triggered by a smell or thought. It ebbs a little though, each time she holds her baby, little seven-month-old Amelia, or watches her smile and gurgle.

Harriet Cobb’s pregnancy was a relatively easy one, says the Briton. Barring some morning sickness it was all going well – so well in fact that when she was 33 weeks along, the Dubai-based 35-year-old took a trip to the neighbouring emirate Abu Dhabi for the weekend. “We were just like around the pool. And I'd been feeling a little bit uncomfortable. And I started googling Braxton Hicks, which is sort of false contractions that you can get any time in like the third trimester. But I was feeling really uncomfortable. I was trying to do some breaststroke in the swimming pool. And then I decided I was going to go for a walk, because I just felt so full. But I went to the bathroom just before I went for a walk, and then my water broke.

“It was kind of like something in the movies, because like it just gushed all over the floor,” she recalls. And so began the surreal rush to her husband who drove them back to Dubai – and their birth hospital.

Because she was only 33 weeks pregnant – the usual period of gestation is 40 weeks - the doctors started her on a mix of medicine; to slow down her labour, to keep her hydrated, to help the little one develop quickly. “If they can get steroid injections before you give birth, there's a greater chance that when the baby is born that the lungs will be able to function properly,” Cobb explains.

But she was three centimetres dilated by the time they reached hospital and another four centimetres an hour later. “Everyone realised like the baby was coming,” she laughs. Three hours from the time she checked in, she had given birth. “It was a good labour. I didn't want to be induced and didn't want any forms of intervention and I didn't need any stitches. So that was really great,” she says.

Cobb recalls being happy – and in shock. “I didn't message any family or anything when I was on the way to the hospital, because I just didn't want anyone to worry. I remember a couple of hours later, we Skyped my mom from the hospital. And she was like, ‘Oh, something happened to you, you are in hospital’. And I was like, ‘Well, actually, you've got a granddaughter’. So it's obviously a massive, massive shock for everyone. And it really took quite a few days for it to just sink in,” she says.

But a sense of agitation endured – Amelia was put on her chest for a minute, then swept off to the neonatal care unit (NICU), where she was checked by paediatricians to ensure she was doing well. While she would see Amelia a few hours later, she couldn’t hold the tiny infant in her arms.

That first night was spent in hospital – a midwife would come in and collect some colostrum for the baby. But the anxiety that would sneak in on her started soon after. “I think on about day two, I had a talk with my husband and I thought it'd be a good idea for him to go home and have a shower and collect a few more bits and pieces. And actually, I had to call him and say, like, get back really quickly, because, let me know, I was getting really engorged, I didn't quite know how to deal with it. And I think one of the midwives came in and I was quite upset, because I didn't know what to do. And my body felt so different from how I expected it to.”

“Now when I reflect on it, I went into a little bit of autopilot. Like, I knew no different. I do feel like I had been very prepared for the fact that you can write a birth plan. And it might not go as you want. But I think for the actual baby arriving early, like nobody had prepared me for that. I had no idea what to expect, you know. I didn't get to hold my baby for as long as I wanted - you hear a lot about how important it is to have skin to skin contact straight away. That wasn't possible. You know, we hadn't got as far as deciding whether or not we wanted to do stem cell collection or things like that, or if we hadn't had time to think about because I was only 33 weeks pregnant. And you know, nobody prepares you for the fact that your baby will be won't be with you after it's after it's arrived.”

Dr Waleed Ahmed, Consultant Psychiatrist at Priory Wellbeing Centre Abu Dhabi, says it’s important to take cognisance of the fact that both body and mind of a pre-term birth mum have undergone a trauma.

"Pre-term births, by their nature don’t mentally prepare new parents, especially if there are birth complications, medical complications in the new-born and the mother. Therefore, looking after the parent’s mental health by providing appropriate psycho-social support, identifying, and addressing existing mental health concerns in parents will help mitigate or alleviate the symptoms. Where appropriate, evidence-based trauma focussed psychological interventions like cognitive behavioral therapy and in some cases, medications may be required after a comprehensive evaluation," he explains.

Fortunately, the baby was doing well. “Amelia was 2.3 kg when she was born. So for 33 weeks, it was quite a good weight for her to be and she needed to be on oxygen for only for two days. Initially they were feeding her through a tube to her stomach through her mouth. And she was having some of the colostrum that I was able to express. And then within a few days, they were able to move the tube from her mouth to through her nose.”

But for the mum, the blow of not having her baby with her was about to get worse; she would be discharged and have to go home alone three days on… with no baby in arms. “I managed to speak to another woman and other mums in NICU who told me, ‘Yes, it will be horrible. And you will cry the whole way home. But you'll get up the next day and come back.’ She was right. We went home that night and the next morning I got up and I drove myself back to the hospital. And there was really no like no time to think about my own recovery,” she says.

She tells of support that came from a fellow NICU mum. “She really helped me …because I really didn’t think anyone understood me; you feel like your husband doesn’t understand because it’s such a maternal thing not being able to have your baby with you and feelings that you have – you blame yourself for your baby arriving early and you blame yourself for your baby being in NICU and she had reflux, and I couldn’t comfort her. I feel like because I wasn’t able to hold her in the beginning that it was my fault. And Megan was amazing because she gave me [positive] recorded Ted Talks every morning and told me that it was really unfair and I shouldn’t be going through this, told me that I was doing an amazing job and that I was amazing for getting myself up in the morning and driving myself to the hospital every day and sometimes twice a day – because some days I’d go home and have a nap and go back,” she explains.

Having a supportive husband was important, she says, but adds that she felt at sea without the comfort of her mum – who couldn’t fly down from the UK owing to COVID-19 – and without being able to talk to her friends. “It was difficult to even explain how I was feeling,” she says. The Facebook group Small and Mighty Babies helped – as did Meghan’s understanding.

it’s quite difficult to be around people that have had full-term babies and are worried about things that you haven’t even had a chance to worry about, explains Cobb, recalling a difficult incident. “A woman looked at Amelia and asked, ‘How old is she?’ and I’d answer. And she looked at her baby and my baby and was like but my baby is that age and then I had to explain Amelia was premature…they force you to explain things that you’ve not dealt with yet.”

Amelia would recover from two bouts of jaundice before she was strong enough to go home five weeks later.

Cobb was at the hospital every day at 9am. “I realised that if I got there for 9am, when the doctors went around, and they would have the paediatricians and the student doctors, and they would discuss each of the babies. And I found that being there for that made me feel better, because then I would hear how much weight she's put on, how much milk she's had today. I found that I needed to be there,” she says.

When Amelia came home, there was no one other than the Cobb couple doing the monitoring, trying to ensure the baby drank enough milk, slept enough, etc. ”When she came home, that initial months of her being home is a complete and utter blur,” she says.

When they were well enough, the Cobbs headed to the UK for some respite. But first there’d be another health scare. Amelia contracted respiratory syncytial (RSV), a respiratory virus. Cobb recalls “That was quite a horrific experience. Because, they sent out an ambulance and a paramedic to the house. And Amelia’s temperature had spiked up to 40 [normal temperature is 37 degrees Celsius]. And so we had to go to the hospital in the ambulance. And it was one of the most awful things because she was only three months old. They connected all of the wires back onto her chest and then a little oxygen monitor on her foot and put her back in an incubator when we got to the hospital. And it was just awful, because it felt like we were back in NICU.”

It made Cobb realise that she hadn’t had a chance to process what she’d been through. “It's only recently that I'm starting to give myself time. I needed to go back to my doctor and ask her my fault that she was born prematurely,” says Cobb.

“I have started to have some therapy because aside from the fact that I was tormenting myself for the beginning, where I didn’t feel like I spent enough time looking and holding my baby, because I was expressing milk and running back and forth from the hospital; it left me with a lot of post-natal anxiety that just intruded on me being able to make decisions, plans and worry a lot and that wasn’t something that I did before. When you become a mum you become a different person; you have to evolve into the role and I may not be the same person I was before, and I know that one of the things that I’m finding really hard is making decisions, being able to plan things – I find that overwhelming,” she explains.

Then she coos – Amelia is awake and gurgling right next to her and she says, “Amelia is lovely and we have her – that’s what I’m focusing on right now.”

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