Prematurity isn't generally covered in antenatal classes, nor in the myriad books available on pregnancy and childbirth, so when a baby makes an unscheduled appearance, an expectant mother couldn't be worse prepared. The trouble is, her hospital may not be able to cope with her either. Britain has the highest rate of premature birth in Europe, and it's rising.
Already, more babies die as a result of early birth than any other cause and, according to Bliss, the premature baby charity, the government is failing to implement its three-year plan to improve neonatal provision. In particular, where 70 new special care cots were promised, only 30 have been created. The standard of care a baby gets is good, but there are simply not enough places in special care units.
Not only did my baby decide upon an early arrival, but he was born away from home. This presented more problems than I would have thought possible. Anxious for the antibiotics I knew I needed when my waters broke in a hotel bedroom, we headed for the nearest hospital. They were reassuring and efficient, but they were worried: at 35 weeks gestation, my son might need a cot in a special care baby unit, and they had none spare.
The friendly doctor went off for "five minutes" to see if she could find a cot for us in a hospital nearby. An hour later she returned. She had rung every hospital within a 50-mile radius, but none was able or willing to take me apart from one, which had grudgingly agreed to accept me "if no one else will". A further hour and many contractions later, and I was in an ambulance with a midwife, heading off across the country to the grudging hospital. My worried husband followed in the car.
The adventure did not end there. Joseph's birth was relatively smooth, but he did need special care. Now I was the problem. While my baby lay with a drip in his arm under a glowing blue light and took ages to put any weight on, I was taking up a hospital bed. They couldn't send me home - it was too far. And they couldn't pack me off to a local bed and breakfast - I was establishing breastfeeding and needed to be on hand through the night.
Initially, I thought that the regular inquiries after the progress of my son from the nurses on the maternity ward were a wonderful sign that they cared. But after one particularly officious woman revealed that they didn't know when they might need my room for someone else, I began to suspect the inquirers' motives. I wasn't ill, so why did I need a bed, seemed to be the administration's train of thought.
The nurses in the special care unit were very supportive and spent hours trying to find us a London hospital, but they were in a quandary. Joseph wasn't ill enough to be accepted by the hospital where I had my antenatal care (or anywhere else, apparently), but he wasn't well enough to go home. The special care ward of one hospital would agree to take us, we would start to pack, then a consultant would ring to say that there was no way his hospital would accept us, and we would unpack. It was a horrible time.
After much cajoling, however, one hospital close to home did give in, and we were both transferred. No longer under threat of eviction and separation from my baby, I relaxed. My husband, who had been alternately commuting between home and hospital and sleeping on an armchair in my hospital room, finally got a good night's sleep. I finally got the hang of breastfeeding, and Joseph finally got the hang of putting on weight. We were home six days later.
Joseph's story isn't unusual for a premature baby. In fact, it is relatively rosy. Some women who find themselves shipped miles from home to the only special care cot available are sent home before their babies are ready. They can end up making an 80-mile round trip to see their offspring every day, bottles of expressed milk in their bags. But my experience underlines some of the hidden traumas of prematurity. I didn't realise how much I had been affected until I found myself, three months after the birth, ringing Bliss and leaving a tremulous message on their helpline, desperate to talk to someone.
Without a significant increase in the number of cots available for premature and sick babies, women will continue to find that an already stressful situation is made even worse by the simple logistics of where they can give birth. And we are a pretty important part of the equation. A mother who is in shock, who feels anxious and insecure, could face problems bonding with her baby and providing the breastmilk that is so vital for the premature. Giving a baby the best care possible is paramount, but mothers need support too.