This is going to be a long one. I’m not going to apologise for that as there is a lot to tell, in the hope that this may resonate and help someone out there, or someone who is trying to help someone out there.

Two years ago I wrote a blog for this site whilst 20 weeks into my second ongoing pregnancy. I skimmed over the truth of what was happening to me behind closed doors and only dared to hint at the ‘low mood’ that had developed during my first ongoing pregnancy. Today, it is becoming so much more commonplace to discuss mental health, sometimes it even seems like a bang on trend topic. Which is doing wonders for reducing the stigma and empowering sufferers to come forward and get help but I still feel there is a long way to go from encouraging the conversation to knowing how to help and how to survive mental health disease and how to recover in the best possible way, for the longest possible time. For me, learning that whilst it definitely didn’t feel good to talk, it was okay to talk and it was the right thing to do to talk, has been crucial in triggering recovery.

I had been with my husband for 7 years before deciding that maybe it was time to give it a go…the baby thing. I got pregnant very quickly. I miscarried very quickly. I thought I was alright but I really wasn’t. I was lucky enough to get pregnant again soon afterwards. I started to bleed around 6 weeks into pregnancy. There were many fraught trips to the Early Pregnancy Unit, each time that little heart beat was still there, each time my anxiety levels got a little higher. We made it to 12 weeks…I should have been elated but I was terrified. I didn’t dare tell anyone though…how could I be in such a mess after 1 miscarriage, when I had a friend who was enduring her 5^th? How could I admit that I was struggling at work when I had only been in the job a year, was ferociously stubborn and independent and determined not to be encumbered by pregnancy?  At 18 weeks I was going insane with worry, no longer stricken with morning sickness and too early to feel any foetal movement, I didn’t feel pregnant at all. I couldn’t sleep, I was constantly agitated and then permanently fearful that my state would somehow kill the baby.

I asked my husband to make me a midwife appointment, hoping for reassurance. It was a disaster. To quote the midwife, “Well my dear, if you are this worried now, how on earth will you manage when it is actually born?” she said. I felt utterly humiliated. She asked if I thought I should have CBT. CBT? What the hell was that? Behavioural therapy? Sounds freaky. No thanks. I left the appointment firmly resolved to keep my thoughts to myself in future.

I continued my lonely battle against anxiety, throwing in a wonderful dose of SPD and stressful situations at home due to a father who was undergoing his own health crisis and a husband who was due to start a new job, travelling all over the country, just 2 weeks after my baby’s due date. Oh and we had a 9 month old, insanely difficult, puppy. I was not happy. I was not talking. As the story inevitably goes, I went into labour. Suffice to say that it was traumatic. It took 2 surgeons to pull my very stuck, very big baby son out. He was black and blue and they thought they had broken his arm. I felt absolutely nothing on holding him for the first time…except revulsion at his size and complete, numbing fear. My husband was kicked out just 2 hours after I had given birth. On the postnatal ward I called for help but the midwife told me they were too busy and I would have to manage. I could barely lift my baby without searing pain. I was transferred to the local community hospital the next morning and suddenly fell head over heels in love with my new son. But he wouldn’t stop screaming. He didn’t stop for about a year. I’m not joking. He refluxed and screamed and fed and didn’t sleep and repeated this cycle endlessly. I developed infectious mastitis when he was 10 days old and was fairly delirious for 2 days. My husband returned to work and my Mum drove across the country to help. The dog went nuts. I went nuts.

I felt like everyone was trying to take my baby away from me. I felt like no one trusted me with him and even worse, I was terrified that if I did let someone look after him so that I could rest, either they would be better with him than I was, in which case, I should clearly do the selfless act of leaving him to their better care, or what if his screaming alienated them and they disliked or hurt him. Nope, stuff sleep, I was better off staying on red alert at all times. My husband tried to give him a bottle to give me a break. All I could hear through the thin plaster walls of our home was howling and screaming. It was more than I could bear. Breast feeding was the only thing that I could do for him so let me do it. Stuff sleep. He wouldn’t take a dummy either. I started to avoid going out in public as I was so ashamed of breast feeding and so ashamed of the screaming baby that didn’t have a dummy. I was petrified of pushing a pram. How could I tell anyone this? My health visitor called the perinatal mental health team. They came to my house…I was horrified. Why was team strait jacket coming to see me? What had I done wrong? What would people think? They asked me how I felt about my son. I adored him. I really did. They said there was nothing wrong with me other than sleep deprivation. I was so relieved but inwardly so confused. Why couldn’t they see why I couldn’t sleep? That I used to sit by the moses basket as soon as he was asleep, desperately checking for signs of breathing. That, when he did finally fall asleep after yet another colic episode, I couldn’t fall asleep as I knew he would be awake again within hours. I begged my husband to hit me so that I would be knocked out and could finally sleep. I tried head butting the wall. Days and nights blurred into one long nightmare. When I woke up in the mornings I felt so much gratitude that he was still alive and hadn’t succumbed to cot death but then this awful creeping dread at the day ahead would wash over me. I couldn’t stop crying. The dog destroyed the house. The baby destroyed my sleep. The situation eroded my relationship with my husband.

At my 8 week check my GP was astute enough to ignore my protestations of ‘fineness.’ She offered me medication. I refused. I started going to birth trauma counselling sessions but didn’t dare admit to the ‘other’ feelings that were happening. I became convinced that because my son screamed all the time, if I didn’t get it ‘right’, if I didn’t look after him properly, he would grow up to become a mass murderer, all because I hadn’t helped him when he was a baby. Clutching at straws, my husband took me to see some friends, one of whom was pregnant and one of whom had a baby. I tried to jump out of the car on the way there, not because I wanted to kill myself but because I couldn’t bear them seeing how useless I was. I shouldn’t have become a Mum.

I got dragged back to the GP and began a long battle with medication. I eventually took it…that first day will forever be imprinted on my memory…I was so stricken with the side effects of nausea and dizziness, that in trying to walk the dog and push the pram, I dropped the pram in a ditch to avoid an oncoming car and upended it. The driver yelled at me. I felt so very low and so very useless. I hated myself for taking medication. I took it at the lowest prescribed dose for 3 months and then went back to work and halved the tablets again. I took myself off the drugs completely a few months beyond that, just weeks before having major surgery to correct the damage sustained during that traumatic delivery, all because I needed to prove to myself that I was still a capable human being who could get through stressful events without the (homeopathic) dose of anti-depressants that I had been taking. I told no one at work. I spent 18 months hating myself. My family knew about the initial postnatal depression but not about its lingering effects. Not about how it haunted me daily, nor about how I spent most days constantly worrying what my emotions had done to my son, my marriage, myself.

Then we had a Christmas holiday where everyone was on form, even my son was screaming less and sleeping more. In a rare moment of stress free tranquillity, I decided that another baby would be so welcome. I got pregnant again very quickly. Just shy of 12 weeks I had a small bleed. My husband was away and so a friend took me for the scan. I still feel sick thinking about it. The baby was dead and had died a few weeks earlier. I felt so tricked by my body. I was held together over the next 6 months by the perseverance of my GP and regular counselling sessions. After months tainted by physical illness and misery, I got pregnant again. The bleeding thing happened again but this one hung on in there. By 16 weeks I was a nervous wreck but didn’t dare phone the perinatal mental health team for some crazy superstitious fear that the more people I told, the more likely a miscarriage would be. By 21 weeks I was having surgery to remove a rapidly growing breast tumour, followed by a repeat operation 2 weeks later. By 28 weeks, I’d had the all clear from the breast team and the baby was growing well. I was so fine that I finally booked an assessment with the perinatal mental health team. I told myself I was making the appointment to keep my health visitor and GP and husband happy. Looking back, I think I was on an adrenaline overdrive. The crazier life outside of the pregnancy got, the more I felt proud of myself for coping with it all. I agreed to regular contact with a mental health nurse (how embarrassing, I had a mental health nurse!), to regular GP reviews but no, definitely not to anti-depressants.

My daughter was delivered via elective caesarean section. It wasn’t straightforward but that’s another story. I knew within days that I wasn’t doing so well. But to succumb to perinatal depression a second time…nope. The pressure was overwhelming. I had to hide it from my parents, my husband, my friends, my colleagues and definitely from the health professionals. How dare I be depressed when the baby I was desperate for had arrived safely? I hid my phone so that I couldn’t be tempted to call anyone for heIp.

Fortunately, I had a very savvy mental health nurse and a GP who knew me and all my tricks well. And friends who never ever stopped calling. It was different this time. I didn’t feel terrified of going out in public with a baby. This one screamed less and attracted attention for all the ‘right’ reasons. I didn’t have the anxiety but I did have this overwhelming depression. I could easily slide through the day but nothing registered. I just didn’t care about anything surrounding me, apart from my two little people. I would cry first thing in the morning and last thing at night, when no could see. I would choke back tears whilst trying to read my son his bedtime story. I was physically ill all the time. I lost my appetite. I lost so much weight and hated seeing myself. I wanted to eat and eat but I felt so sick the whole time that swallowing just invoked retching. I wanted someone to put me in hospital and take care of me so that I didn’t have to do it all anymore and so I didn’t have to feel guilty that I couldn’t manage my own children. I just wasn’t prepared to go in a mental hospital. That very word, mental. What did that make me? My self-confidence crumbled and social occasions triggered inward panic.

And then my daughter developed reflux and sleep stopped and more screaming started. “Do you think about suicide?” professionals asked me. I didn’t think about anything, other than what I couldn’t do, I couldn’t be a mum. I spent a year intermittently plotting my departure, researching houses that I could afford to rent alone, anything to release my children from their crazy, utterly inept mother. I was in turmoil because I didn’t want to leave them, couldn’t bear to leave them but felt that I was being so selfish. I finally broke down in front of my husband when my daughter was 8 months old and admitted that I had dropped our son off at nursery and told him that I would be leaving the family later that day. It was an awful thing to say and I can never take it back. I can only keep trying to repair any damage done.

My mental health care got stepped up a level. I slowly increased the low dose of anti-depressants that I had begrudgingly agreed to start taking some months before and began psychology appointments. I went back to work. I started to talk. I’m slowly recovering. A year on from that fateful day of breaking down, I have mostly good days. We generally have a happy household. I still take the drugs. I still do so begrudgingly but accepting now that it is the thing that I can and must do.  Along the way I have hugely benefitted from healthcare, friends, peer support and lately, involvement in developing perinatal mental health services. This long story is but a nutshell of the grief I have felt; the fear, loneliness, humiliation and oh so much shame. I hadn’t managed like everyone else had. “Tell me what you want?” the nurse used to ask me. How, how could I possibly answer that? I had no idea what I wanted. I couldn’t even read a book, think what to put in the shopping trolley, let alone think what I needed to get better. Nothing made sense and through it all, I had to keep hiding, hiding, hiding. So, if you meet someone like me, or someone who might be like me…what would I suggest? Be patient. Have the kindness and patience of a saint. It can be very painful to open up and impossible to see how talking can help. Impossible to believe that your babies won’t be taken away from you, that you won’t be branded with some mark of disrepute. That you won’t be forever gossiped about and that you won’t be forever defined by mental illness.

I feel like I lost the first four years of my son’s life. I know that it will be different now with my daughter. The tide is turning against mental illness. As a society we are so much less judgemental, so much more caring. I have met some amazing survivors of perinatal depression over the past year. They have given me hope. They have given me strength. If you’ve read this far, thank you. I hope this helps in some way.

Sarah*

Vicki, Lucy and the MumsVet Team.

If you have been affected by this story (or are struggling with anything) and need to talk Vetlife provides free, confidential support for the veterinary community 24 hours a day. Call on 0303 040 2551 or email via www.vetlife.org.uk

RESOURCES

If you would like further information or support, or if you have been affected by this story then have a look at this brilliant website

https://www.mind.org.uk/information-support/types-of-mental-health-problems/postnatal-depression-and-perinatal-mental-health/?gclid=EAIaIQobChMI5ru4nPXU3gIVz5ztCh2TmgmAEAAYASAAEgLOJ_D_BwE&gclsrc=aw.ds#.W-yfby-cZ8c

Postnatal depression and perinatal mental health | Mind, the mental health charity - help for mental health problems

This website explains postnatal depression, including possible causes and how you can access treatment and support. Includes tips for helping yourself, and guidance for friends and family and colleagues.

This brilliant video was made by the Devon Partnership NHS Trust. You may think you are not/won’t be affected by this but listen to these brave women’s stories –it’s a story about six women who found hope and found each other.

Head Up, Heart Strong from Devon Partnership NHS Trust on Vimeo.

Home - The Blurt Foundation

A gigantic hug in a box; packed full of products to nourish, inspire and encourage self-care.

www.blurtitout.org

Don’t forget that help is available specifically for Vets with the free and confidential advice and support resource Vetlife 03030402551 which is available 24/7. For more information

https://www.vetlife.org.uk/

Independent, confidential and free help for everyone in the veterinary community including veterinary nurses and students. Our charity provides a 24/7 phone and email helpline; professional mental health support; financial assistance; information and resources.

0303 040 2551

https://www.vetmindmatters.org

The Mind Matters Initiative (MMI) aims to improve the mental health and wellbeing of those in the veterinary team, including students, veterinary nurses, veterinary surgeons and practice managers. MMI was launched in 2015 and is funded and run by the Royal College of Veterinary Surgeons (RCVS) , the regulatory body for veterinary surgeons and veterinary nurses in the UK

I’d worried about struggling to get pregnant having not started trying for a family until I was in my 30s, but getting pregnant came very easy for me.  Working in large animal ambulatory practice I was very aware of the risks my physical role could bring so work was informed before I had even sought medical maternity care to allow adequate health and safety planning.  Straight away management made plans for my cover with a hint of annoyance we had to wait until the OK was given from my 12 week scan to get the role advertised.  I can understand now why many might avoid telling management until as late as possible as I missed being seen as an important part of team as I was increasingly being made replaceable.

My 12 week scan was fine with extremely low screening results and my midwife checks indicated a straightforward pregancy.  I was exhausted and having to reduce how many calls per day I did out in the heat of summer but there was little sickness and I couldn’t complain given how bad I’d seen friends and colleagues struggle through the first trimester.  After 12 weeks people told me the exhaustion would improve, it never did.  From around 16 weeks people told me I should be clearly feeling baby, it still just felt like gas floating around.  But I had an anterior placenta so movement was less likely to be felt and my midwife could hear kicks on the Doppler so we weren’t worried.  We booked a holiday when I was at 19 weeks and planned the 20 week scan on our return, I shed a tear when someone offered me a bus seat whilst we were away because I realised how obvious the new life inside me was becoming.  All anyone could ask us was ‘will you find out the gender?’, my reply was always the same, ‘no, all I want to know is it’s healthy’.  When people talked about birth plans I’d say ‘my plan is for me to have a healthy baby in my arms at the end of it’.

The first 20 week scan was disappointing; baby was sat in frank breach deep in my pelvis with a hand over its face and the other over its chest.  We couldn’t see the entire spine, facial features, heart, or digits.  They got me to go to the loo and move around, all we got was some finger and foot wriggles.  They booked us in again a few days later in the hope our little one had moved, all that did was one hand but that was enough to get the information needed.  They found a cleft lip the hand had hidden and all of a sudden things changed; the missing features of the heart weren’t obscured, they were missing; the slight renal dilation was now significant; the fact baby was still sat in an awkward position likely meant it has poor muscle tone.  We were booked into a foetal medicine specialist; my medical brain already knew where this was going.  An amniocentesis confirmed everyone’s suspicions, a lethal chromosomal abnormality was present, my baby would never survive beyond my body and most probably would die before 40 weeks.

To me there was no choice, my baby was already dying but I could choose at what point to let it take its wings and fly free.  So often in my job I’d discussed end of life decisions around when to intervene; now I was making those choices in the most unimaginable situation and relying on my medical education to reassure me of my decision.  If baby survived pregnancy and labour (which was unlikely), it was to be born into a world of tubes, intensive care and painful procedures all for a less than 5% chance of survival beyond 1 year.  I could not do that to my child.  As my midwife said, in some ways we were lucky with our diagnosis because without severity of disorder our child had there would be decisions to be made about so many unknowns with no idea about how much trauma you’re baby would go through or whether it would be worth it.  There is still much judgement around deciding to terminate for medical reasons, truth is it is the most painful decision a parent can make made purely on love.  

Until the confirmation came through I remained working.  At home there was a room with a cot and too much time to myself.  All of my colleagues knew about my pregnancy and that I was due my 20 week scan; some of my client’s knew I was pregnant, many had guessed by my changing shape and avoidance of x-rays; local vet groups I was part of knew because work was advertising for an extra vet and gossip around reasons spreads.  I remember before the foetal medicine appointment trying to politely get through a consult under the client’s continual questioning and excitement about my pregnancy whilst wanting to scream my baby was sick and might not survive.  The day after my second scan one of our support team asked me how it went, I broke down in tears then felt awful for making her feel so bad about asking.  I was glad she asked, without it I don’t know when or how I’d have told everyone.  The day the midwife rang with the news a colleague took me home and I didn’t go back until everything was over.  Until our delivery only close family and my management knew what was coming, I regret now not letting all my friends and colleagues know we were terminating as it was such a lonely time and their support would have been much appreciated but the fear of being judged was too great.

I was medically induced at 23 weeks and after 12 hours of labour delivered my son stillborn into a world not ready for him.  Our team of midwives were fantastic and we were lucky to deliver in the peace of a private room on the maternity ward.  I wish I’d used the time between our diagnosis and induction to understand birthing better as before mid-pregnancy there is little opportunity to discuss the stages of labour with your midwife and ignorantly I thought my veterinary obstetrical training gave me enough information.  I had managed to research how to memorialise our son in advance though so when they asked me if I wanted photographs or prints and casts I was ready and, although I hated my son’s body being taken from my sight for this, we were so thankful when I received the little mementos I can keep forever.

After we returned home we started telling our friends what had happened.  The support was incredible.  We never hid from why we had lost our very much wanted son and what had been wrong with him.  One friend asked me if she could come with me to visit him and another who lived far away asked me for photos.  I worried people would see his abnormalities but instead they saw what I did, my frail little baby boy lying so peaceful.  My medical mind was fascinated by how his body had survived with so many problems yet all my eyes saw were love for a perfect son.  He may not have lived within our world, but he broke hearts as we learnt to open our doors and share him with friends and family saying his name, reading him stories, and bringing him gifts to take on his final journey.  I learnt in that week all I’d been taught about grief was wrong and all you need to do is follow your heart and do what feels right.

The week following the cremation I returned to work part-time, I was entitled to maternity leave but an empty house and no sleepless nights made it feel unnecessary.  I needed to be with people, to share my story, and have things to occupy my mind.  In general work colleagues were amazing, a care pack when I was off, caution around over-working me on my return, and even a gift to mark my son’s due date. My employers chose how they wanted to let people know.  The big birth announcement was avoided; I’d been through labour and had a baby, why couldn’t I have a big announcement, I was still a proud mother?  They selected who they thought I’d appreciate being told; when I turned up at properties I had no idea who knew what, welcome questions around why I’d been on extended leave and come back earlier than expected, why was I part-time, or just the general ‘haven’t seen you for a while, much been going on?’.  The best was a few months after when I got the ‘didn’t you just have a baby?’.  My anger wasn’t at the clients, for them I only felt sympathy for being unnecessarily dropped in such an awkward position.  I, the grieving mother, was the one feeling guilty.  I’d openly shared my story, I’d told my work they were welcome to too, it is just sad my management did not do the most obvious thing, ask me how I’d like them to handle the situation.  My advice to any employer wondering how to manage their employee’s grief is talk to them, ask them how long they would like away before you plan to discuss coming back to work rather than presume, ask whether they want you to tell people and how – the worst that will happen is them tell you they don’t know yet.

When I share my story in several circles, I found it to be sadly not that rare.  I heard of so many losses and heartaches, so many that no one else knew about; so many who lie when asked about starting a family, or if they had children, so many who had kept their grief inside being suffocated by its weight, so many trying to cope alone because how do you tell people about your loss who didn’t know you were pregnant?  We take for granted every embryo we know about will turn into a little healthy human, but it doesn’t and our denial of that doesn’t help those is happens to; our insistence that no one must know about a pregnancy until a healthy 12 week scan fuels the fires of ignorance and perception early loss is something insignificant.  We get obsessed with maternity leave, gender reveals, and baby showers but we never consider bereavement leave, abnormal scans, or funerals that sadly become life for the parents of 1 in 200 stillbirths in the UK despite working in an industry that deals with mammalian foetal losses daily.  It is time to talk and acknowledge the angels belonging to 1 in 10 women affected by loss occurring in 1 of 4 pregnancies.  If you are mother to an angel, please take comfort in knowing you are not alone, your heartache is understood, and your motherhood journey is one worth sharing alongside any tale of pregnancy and birth.

If you would like further information or support, or if you have been affected by this story then have a look at this brilliant website https://babyloss-awareness.org/

Sands (Stillbirth and neonatal death charity) are a terrific charity involved in the 16th Baby Loss Awareness week and they also have very helpful information here https://www.sands.org.uk/

At around there same time I got married, my husband is also a vet, and soon enough baby number one was on the way. I spent most of the first part of the pregnancy a drooling vomiting exhausted mess, and most of the latter part crippled by SPD. I could just about get through a day, with a few dashes to the toilet, but by the time I got home at 7, I had hit the wall. I was incredibly fortunate, in that my husband was able to help me with my OOH. If my pager went off right in the middle of the night despite being a cow vet, he regularly trundled off to sort it out for me - possibly the one and only advantage of a vet-vet marriage! The practice were great and although my small animal skills were probably a little scratchy, I had kept them up and was able to do mainly small animal work towards the end of my pregnancy. Just to be clear, working as as small animal vet when pregnant is different to equine work, but I wouldn't necessarily say any easier. Seeing a new case every 10 minutes for much of the day is exhausting, most of the day is spent standing, and you are up and down on and off the floor like a yoyo- hard work with a beach ball sized belly!

It was at this point it dawned on me the benefit of having more that one string to my bow. Once my little boy arrived I took 9 months maternity leave before going back to work for 3 days a week. I fairly quickly discovered that having a small child with 2 parents working totally unpredictable hours, me working a 1 in 3 OOH rota and my husband working a 1 in 4 OOH rota was a logistical nightmare. Nursery was 25 minutes from the practice with a strict 6pm sharp pick up time - no being late! It doesn't need explaining on here that due to the nature of our work we never know what time we would be finished. From 3pm onwards each day I spent most of my time praying that I wouldn't be sent out to a colic an hour in the wrong direction, knowing that my husband would likely be stuck in a field somewhere calving a cow. The day usually finished with a break neck speed dash through the lanes to pull in to nursery at 6pm on the dot, tyres smoking! My husband managed to keep the nursery girls sweet with his regular videos of draining litres of pus off some revolting abscess or pictures of malformed foetuses that seemed to fascinate them all! We could have made our lives much easier by having a nanny at home, but we valued the socialisation our little boy was getting at nursery, he was happy there and we chose not to move him. A few months after returning to work, I was preparing a yearling TB to be anaesthetised. He was sedated, I had just arranged his legs as I wanted them and as I walked away from him, he totally unexpectedly let fly at the back end with both legs - a proper double barrel and got me square in the back . I dislocated my shoulder and fractured my scapular. When I was seen to in the hospital I remember the doctor commenting how lucky I had been that I hadn't been kicked 10 cm across or 10cm higher, as if it had got me on the spine or head with that force I would likely have been paralysed or killed. I was totally useless for 6 weeks, I couldn't drive, couldn't lift my little boy or out of his cot, really could not use my left arm at all. I had all sorts of weird neurological things going on with my left arm and still 6 years later get a lot of pins and needles. One of the things that stayed with me from the incident was the reaction of the owners. When they picked the horse up, someone mentioned what had happened, and all they said was ‘oh well, she must have been standing in the wrong place’. Not even a hint of concern. At the time I was really angry about this - fair enough I was in the wrong place, but I was an experienced and careful vet, doing my best for their horse, and it made me realise that we put ourselves in danger everyday doing what we do and at the end of the day if I get hurt, its me and my family who have to live with it. This started me questioning - is it really worth it? Having children had also increased my sense of mortality and in general I was much more cautious than I had used to be. Once I got back to work, I was unable do much equine work for a while as every time I picked up a leg, my shoulder popped out. Again I was fortunate in that I was able to do my small animal work instead. It’s probably obvious where this is going, and yes despite all my training and my Certificate in Equine Practice, I decided to cross to the dark side and become a small animal vet. Since my accident I had totally lost my confidence working around horses, and had no desire to spend my days sticking needles in horses legs all day any more. 

After a couple of years I was pregnant with baby number 2. A few days after the after the birth of my second son, I noticed a lump in my throat and within a few months had been diagnosed with thyroid cancer and had undergone a hemithyroidectomy. The pathology of the carcinoma was unusual and at the time there were a lot of questions about the amount of radiation I had been exposed to. I will always wonder if the radiation we are exposed to through our work in equine practice (radiography and bone scan) played a part, but I will never know for sure. As if this wasn't traumatic enough, during the surgery, I sustained damage to my recurrent laryngeal nerve. I woke up unable to speak, cough and only being able to swallow with difficulty. This was probably the most terrifying part of the whole ordeal. I was lucky, and made a slow recovery, eventually regaining pretty much normal function. This time I had a year off before returning to work 3 days a week, doing 1 in 4 on call. I was lucky, working with a very supportive colleague and an understanding boss allowing me to finish consulting half an hour early so I could do the nursery pick up, and on a night when I didn't have to do this, I would stay so my colleague could leave a bit early. This worked most of the time, but was not without the stress of spending most of the day wondering if I would get away on time and having a small fit every time the receptionists booked a PTS in as my last appointment. We made it work for 4 years, It was hard but I was proud that I had managed to stay in practice and gain my certificate in Small Animal Medicine while juggling 2 small children in a 2 vet family. On several occasions the kids were collected from nursery, exhausted and grotty having been there from 8 until 6, then taken off to do a calving or a milk fever or such like. Or they had to sit for half an hour in the nursery car park while I made calls to owners. Many owners were told the fate of their beloved pets with Paddington Bear or Percy’s Park playing away in the background!  After 4 years of this, and once my oldest had started school, I got to the point where I knew something was going to have to give. I started to look for something I could do that offered more regular hours and would mean that my main hobby wasn’t pouring over OOH rotas, trying to work out all the various complicated swaps we needed to do. Something that didn't mean my long suffering mother in law had to make a 9 hour train journey from Cornwall practically every 4th weekend to look after our children while we were on call, and that meant I could have more of a relationship with my husband than just trying to work out who was picking up from nursery!

Since making the decision to stop, life has changed considerably. I am currently lecturing on a vet nursing course and doing some work with the RCVS as well as doing a bit of locum work.  This has vastly improved our work life balance, and I don't feel constantly exhausted. I found it very difficult at first leaving clinical practice, as it had defined who I was for so many years. I hope that at some point I will get back to doing some clinical work, although as I get used to being out of the clinical world, I realise there are an awful lot of things about it that I do not miss! 

I’m not sure I have any very useful tips for anyone…I do think we all put so much pressure on ourselves to juggle work, be there for our kids, read our journals, cook healthy food, keep the house tidy etc. I think one thing I have learned is that maybe we can’t actually do it all, all of the time, and we shouldn't feel bad in admitting that. There is nothing wrong with taking some time out, or stepping away from practice for a while if you need to.

My many career changes around my children have been really tough decisions each time, but have also made me realise that our careers don't have to follow the path we presumed they would when we graduated. Life's demands change and we can adapt and do other things if we start looking for them. We sometimes have to make sacrifices, and do what we can do rather than what we really want to do, but I guess its all worth it for those crazy little people!

So as “reflection” is the buzz word in our CPD requirements these days- here are some thoughts, hints and tips on living your dream (being a parent and a vet). 

Firstly remember that you are living your dream- whatever the vet career throws at us- we chose it, and how much worse would it be to have not got in to vet school on results day- Hold on to that thought.

Next- there is never a totally right time to be pregnant- it will always be a complicated mix of emotions for employer and employee. Don’t be totally surprised if the smile that greets your big announcement looks a trifle strained.

There are many excellent resources on all the risks of being a pregnant vet, ranging from the official website to webinars by BEVA, the practice Health and Safety and COSHH assessments- so I won’t repeat this information, but offer a more personal view of how it worked for me.

1- Versatility.   Although your long term career plan may be to be an equine surgeon, be adaptable. My practice kindly took me off equine work altogether relatively early as they had no experience of pregnancy in vets (only of the senior partners’ wives). Although I minded a bit, it was only for a relatively short time compared with the length of my career.
2- Small animal work- see above. I moved over to the small animal department for a while and was very grateful that I already had mixed animal experience and could slip into the basic operating list and basic consults. Although the tendency is for early specialisation, I really advocate the broad brush approach early on either in EMS, voluntary work or first job– small animal work can provide good surgical experience and more opportunities to work into late pregnancy.
3- Take on new challenges- It might be frowned on these days, but stepping into Vet nurse training provided another way to be useful, and has led to a continued interest and qualification in teaching many years later.
4- Learning- this time forced me to complete my certificate in equine practice, as there was a rather obvious deadline looming. 
5- Step back- in “my day” you had 3 months total maternity leave, including the bit before- so you had to leave a very young baby. That was hard and I was grateful to be offered the opportunity to come off the equine night rota for a while. Financially it was terrible, but at least I slept and was there in the night for my wakeful baby.

Fast forward to future pregnancies and a different job ,  here there wasn’t the option of not doing equine work, so potentially a more complicated situation, and in some ways more negative attitudes to confront at first. It was odd that some people regarded having a “bump” as little more risky than having a beer belly!!  In this case some more firm self protection was needed, and here is where knowing your rights and responsibilities was very helpful. Some of the measures to improve the life of the pregnant vet that I initiated have certainly helped future employees, for which I am mildly proud.

A final rather late pregnancy when they all though I had stopped breeding, was a lot easier on everyone, largely because all of us no longer felt the need to be heroic or prove ourselves- vet or manager. So here is my final reflection on enjoying being a vet/mum.

6- Move sideways. Up is not the only direction in the workplace, and there are lots of interesting opportunities if you turn your head. Completing my own Masters degree part –time (distance- learning) age 45 was nice. 

7- Teenagers need just as much care as babies, but in a different way- Be under no illusion that you are going to magically find things easier quickly- accept that there is a new normal in your life and find a way to enjoy it.

To end on a cheery note- as you get older memory fades, and I really cannot remember most of the bad bits of the early days- and as we only took photographs of the good bits (pre facebook, pre Whats App), they paint a rosy picture! 

One day you wake up and realise you are 38, or 39, or 40. You spent years building your career and kept saying to yourself “It’s not the right time. The practice is short staffed/I may become a partner/my practice doesn’t tolerate part time/I’m building my caseload…” but then you look up and you’re tipping 40. I did just that and at 38 started that long road to try to start a family.

To already stack to odds against me, I had never had a normal cycle so the doctors tried Clomid which makes you ovulate. This does work for a lot of people and can help you make a schedule… but getting pregnant and reading the train timetable are slightly at romantic odds so this won’t work for everyone.

We then tried IVF using my own eggs. Injecting myself with drugs was fine, with no side effects, but some people have a horrendous aversion or terrible side effects and the process stops there. The basic process is injectable drugs to make you develop the most eggs for harvesting, which is then done under a short GA. The eggs and sperm head off the to lab and within a couple of days you get a phone call about how many embryos look healthy. Try not to take this phone call in your practice’s reception. 

Then you head back in for implantation and PLEASE NOTE: DO NOT head straight back to work just because you have a case booked in that someone said was urgent. Relatively speaking, nothing is that urgent, and if it is, you have colleagues. In fact, try to go somewhere quiet for a few days and make up an excuse to do so if you have to do so.

And then you stock up on pregnancy tests in Sainsburys and wait until 14 days… and then you are at work and get your period. And know it didn’t work. And you think how much money you spent on this… and then reception calls you for a phone call to take, while you try not to cry in public. (NOTE: Don’t lose ALL hope if this happens as sometimes small bleeds happen after a week, so called “Implantation bleeds”, which scare the bejesus out of you for days…..) 

And the nurse says “wait three cycles before you try again” and you think “time is ticking, and passing me by”. So you do cycle number two, have great hopes when they harvest 18 eggs and get six embryos…. But then the same things happen. More tears and you are not getting any younger. And this time a sac develops but no foetus so your body thinks you are pregnant but you aren’t. What a dilemma. And then you need surgery to scrape everything out and know that that surgery increases the risk of scarring and decreases the likelihood of conception. But what can you do?

I then went on a holiday with my husband and came back pregnant. Jubilation! So we trundled off the 12 weeks scan, happily oblivious to what was to come. At twelve weeks or so they do a basic scan and also a nuchal ligament translucency test which is a test for Downs Syndrome. What I didn’t realise at the time was that this test is combined with blood tests for a final odds ratio of Downs Syndrome. But on that day the ultrasonographer said he didn’t like what he saw, and we didn’t realise at the time that this meant very significant abnormalities and a non-viable baby. We were completely blindsided by this… and two weeks later lost the baby.

For the next month I felt very ill. I assumed it was the emotional and physical trauma of the situation until one morning I couldn’t get out of bed and was taken to the hospital. I was given antibiotics and sent home…weeks later I was back in the hospital and saw a very straight forward consultant who said I needed hysteroscopy. A large piece of retained placenta was removed and I was well again very quickly. But still not pregnant and getting older. 

I was now in my 40s. We had spent thousands of pounds on IVF. This doesn’t even open the discussion about a wife who is keen on children, and husband who is not…or the reverse. We met with the consultant who said that at my age the likelihood of conceiving was 16%. What they don’t tell you is that is the chance of getting pregnant, and not carrying the baby to term. That was about 6%. But we had an open minded progressive consultant who said the best option was egg donation.

Egg donation means eggs from another female, usually much younger. The age of the eggs is the rate limiting step so younger eggs have a much better chance. In the UK, regulations dictate that an woman who donates eggs must have had all the family she intends to have, which usually puts them in their late 30s. The wait can be up to two years. Other countries have stringent egg donation programs along with genetic and psychological testing of the donors. In some countries there is a very altruistic society and these young women donate eggs in their 20s for no remuneration other than expenses. 

The first cycle involves flights, back and forth, sperm donation, incubation, fretting in a hotel room, implantation, and home again. And BAM, same again, Pregnant with no baby. So surgery again and I was becoming more despondent by the day but trying to keep it together at work. 
Egg donation cycle two. Same again but this time I flew to see relatives within days of implantation and I do think this made a difference. Not going to work, not trying to keep the show on the road… 

But then at eight days, bleeding. I remember having a dear friend to dinner and I couldn’t keep my mind on the conversation. What if this didn’t work? Would my husband said we had spent enough money? I had now had three surgeries, each of which decreased my potential fertility. This was truly the law of diminishing reproductive returns. I saw women with several children and wondered why I couldn’t have that too?
If there is an upside to bleeding, it’s that you get an early scan and then the amazingly good news that there was a tiny sac, with a tiny heartbeat, which we watched over the next nine months grow and grow and finally emerge as a gorgeous, precious long awaited gift. Which just gets better every day. 

So the moral of the story? Hang in there! You have options! I worried that I wouldn’t feel the child was mine with someone else’s eggs. It crossed my mind only once but I carted the child around for all those months and until I sat down to write this, haven’t thought of it since. This is MY child. (research since has shown that there is indeed transfer of genetic material from the mother who carries the baby, to the baby. Have to slot in EBM somewhere…)

So my advice? If you hit 35 and want a family but are not pregnant, get on with in. Your practice will NEVER take you aside and say “We are so grateful that you devoted yourself to us… and not to a family”… so give up hoping for that.

And having a child is simply THE BEST THING EVER!!

2. Tell the people who can help to make managing your daily life easier. I was surprised how much support I received from a practice that a small part of me was sure would be advertising for my replacement as soon as I told them. I cannot fault them and am sure the same approach will be taken next time around.

3. Take some time off. We have yet to discuss when we will go again, but whether I take holiday or unpaid leave I think I will take more time off in that two weeks between implantation and testing. Being away and relaxing will help your mental state.

4. Try to believe the studies that say nothing you can do will make a difference. It is hard, but a person who has conceived naturally wouldn't know at this stage and therefore would make no alterations to their routine.

5. If the test is negative, don't rush back in. Overall from the initial tests to the negative pregnancy test we were thinking about IVF for 10 months, waiting for appointments, getting the relative bloods etc. When it didn't work, we just wanted our lives back for a bit. Your body is capable of turning round and going again but if you are not in a rush due to age or health concerns, have a break, it will be better for everyone in the long run.

6. There are positives in everything, I’ve been able to make some good contacts and set up a meeting to share knowledge between human and equine reproductive specialists.

And I hope that one day there will be a little update on the bottom of this article announcing the birth of a healthy baby!

The answer is not easy but somehow I manage! I would like to say, from the outset, that it is only possible because of the amazing support that I have at home. With a very easy-going husband, who runs his own business, so can be flexible in his working patterns, and is also a great dad. We also have amazing grandparent support on the doorstep! For me it means living a fair distance from work with the commute adding hours to my day but if we lived closer the support wouldn’t be there. I also find the journey home a good de-stress and while I do quite a lot of work at home in the evenings, to keep on top of things, I can separate home life from work life much more than I used to be able to. I have stopped carrying difficult cases etc around in my head. I think this a really important as part of a coping mechanism. Having children has really helped to put life in perspective, know where my priorities lie and what is truly important in life - or at least what is important to me! I don’t think it means I care less about the cases I can just manage the emotional side better and have a more pragmatic approach.

Having children has helped me have a much more realistic approach to life but still try to do the best job that I can. I don’t think I could drop any of the bits of life that I juggle, despite being encouraged to stop trying to be a perfectionist. I wouldn’t be happy to let go so I work 4 days a week and on-call and try and spend quality time with the family too. The children have never known anything different but it’s clear that they like it when I’m around a bit more. This is hard and I feel eternally guilty but I really wouldn’t be happy to stay at home and if I worked fewer days I wouldn’t be able to get everything done (sometime it’s hard enough in 4 days!). I do make sure that I make it to all the important things such sports days, concerts, shows and other school/nursery events and keep some holidays back to use for additional things, just in case.

I think things get harder as the children get older and with my youngest little girl starting school next year (can’t believe how quickly that has come round) I have realised that they need quite a lot of support through school. This is something I both want to and enjoy being involved in. I want to be part of them learning, discovering and developing and don’t want to leave it just to the teachers. Luckily I am part of, what is now, a more forward thinking practice that is looking seriously at staff well-being including work-life balance. I am also lucky that I have a fairly unique role within the practice, which enables a degree of flexibility.

My professional life has evolved over time and I now have a management role as well as the clinical work that I do. 15+ years ago I had no interest in management but now find this a new and interesting part of my role. I’ve never been one to sit still and finding new challenges along the way has ensured that I still enjoy what I do with 20 years down and probably another 20 to go (by the time the kids have been to Uni etc. etc!)

As part of my management role I am responsible for a team of people as well as ensuring high clinical standards, this is challenging and rewarding at the same time. Sometimes it feels like trying to wade through mud but when problems are solved, new initiatives come to fruition and seeing the practice evolving is hugely satisfying. Making people’s working life better is something I enjoy and think is absolutely necessary.

So why buy in? I spent a good deal of time thinking about this and the potential effect it might have on family life. At the end of the day I already commit a huge amount of my time to work and becoming a Director has given my a little bit more to show for it. Also, while I was listened to before, it has given me the confidence to push a bit more for the changes I would like to implement, hopefully for both the good of the practice as well as the people who work for us.

While this has been the right thing for me it’s obviously not the right thing for everyone. Being at home doesn’t suit me, maternity leave nearly sent me round the bend (but that’s another story) so while it feels like things aren’t well balanced at times I know that if I looked to change things too much I wouldn’t be happy. I think it’s really important as a parent (mum or dad) that you work out what it right for you and try not to feel guilty about the decisions you make, easier said than done! It may sound obvious but research has shown that a happy mum = happy children, whether you stay at home full time or work full time.

And at the end of the day there is always exercise to make me feel human again! The mug I got for Christmas says ‘I run because somehow exhausting myself is the most relaxing part of my day’ - so true!

My husband and I were both keen to start a family but were both worried about the associated stress and workload of my hectic on call rota and my different shift changes that occurred weekly. No other nurses in the hospital had children and due to the on call and unsociable out of hours I was worried about how child friendly the practice would be towards me being “the guinea pig”, so to speak. 

I found once I told my bosses not a lot changed, which was good as I didn't want to be treated differently, but I also found there wasn't really much support of tasks I should and shouldn't carry out. Dealing with dangerous horses was mainly one of my concerns and doing hind limb bandage changes is a large part of my job. I stopped doing these once I was about 7 1/2 months pregnant but was still happy to carry out hind limb bandage changes on sensible horses, in hind sight any horse can be unpredictable.

In the hospital our nursing tasks are so diverse, I felt safe in theatre and would get a spare member of staff to carry out fluoroscopy or x-ray for me. This was a little tricky out of hours! I did worry about the side effects of the isoflurane gas but was always careful and stayed away when the patients were disconnected from the anaesthetic circuit. Dealing with colicking horses out of hours was always challenging, as there would be minimal staff to help, and the Nurses responsibility to secure intravenous access. The long working hours on call over the weekend with just a few hours sleep would take its toll on me. 

I had a few close calls during my pregnancy, one was when I was dealing a mare who had been admitted for an exploratory laparotomy. I was securing an IV line and had just finished placing a long-term IV catheter in which the patient had stood perfectly. For no reason whatsoever the mare reared up and flipped over backwards blocking mine and my colleague’s exit from the stable. Luckily we were both unhurt but this could have been a very different story. 

Recovering patients post-anaesthesia with minimal ventilation in the recovery boxes was difficult to manage out of hours. My colleagues were great at helping with difficult horses and taking responsibility of x-rays for me. But the real difficulties for me were out of hours with emergency patients and isolation cases with minimal staff around. I soon found out that there were lots of drugs I shouldn't handle which we routinely gave to our patients. 

Working at a busy equine referral hospital meant all-nighters were common and being on your feet for 20 hours takes it's toll on the pregnant body. Knowing I was on call Friday to Monday I would get sleep in whenever I could. I decided to finish work at 36 weeks and did my last on call at 34 weeks. I had no idea what was expected of me or when I should stop on call, although I’m sure my body would have preferred sooner! I finished work on the Friday and went straight to a midwife appointment where I was sent straight to hospital with high blood pressure and protein in my urine. I was kept in overnight and sent home with blood pressure tablets to try and control it. This was unsuccessful and I was readmitted with pre-eclampsia the next day. I had severe swelling in my legs and abdominal oedema. I was induced at 36 weeks and 2 days. My little daughter didn't make an appearance until 5 days later but she was worth the wait.  Life was tricky to start with as she was a very colicky baby and was eventually diagnosed with dairy intolerance and associated reflux. 

Life did settle down and I started my negotiations for returning to work when my daughter was 7 months, as I knew this could be a lengthy process. I returned to work doing 2 days a week and then went up to 3 days a week after a month, always doing my part-time share of the out of hours rota. I found getting out of the house for a specific time hard to start with and juggling my shift changes with childcare. Luckily I have family around to help me when I’m unable to pick my little girl up or when I’m on call.

I knew I didn't want to work full-time as I wanted to spend as much time as possible with my daughter while she was young. I did find it important to return to work as I felt it gave my weeks the structure I needed and made me appreciate the time I then got to spend with my daughter on my days off. Life as a working mum can be difficult but I have found it so rewarding! I think returning to work after having a baby changes how people see you in the work place and it has taken me a little while to regain my confidence. But I now feel like I have settled back into work as a working mum but at the same time I can't wait to get home to see my little girl! I wasn't really sure when the right time to stop on call was. Work left it up to me and there weren’t really any guidelines to follow. I’m glad I stopped when I did and next time I think I would do things slightly differently.

Dear future Au pair, 

Being an Au pair should only be a wonderful experience. 

This is going to be my second year being an au pair (and yes in the same family) and most of the people that I'm meeting or I have met during my experience think I'm crazy, but I always say the same: it is all about the family. 

Most of the au pairs do not stay more than six or twelve months because of the families. I have a lot of friends who were au pairs and I have heard and I'm hearing a lot of awful experiences. It is very hard to come here without anyone our side; you leave your family, your friends, your country, your house… everything and you land in a new country and you are alone and you are going to live in somebody's house that you have met on internet (sounds scary, doesn't it).

Most of the families forgot that we are human- we are not nannies, we are not cleaners, we are not chefs we are not gardeners and we are not slaves. It can be really hard to find a good family and not to find a family that thinks that having an au pair means a slave. 

I think it is important to cooperate with some light housework such as tidying the playroom, load the dishwasher, help tidy the kitchen… as another member of the family would. 
 
So, after that, it makes me feel very lucky to live with my host family; I like to call them My British family. Their children are my spoiled nephews and I will give my life for the best for them. They have helped me when I needed help most, they have dropped and picked me up every time I asked for because I cannot drive (yet!) and the buses here have a bad connection, they become a part of my family as well and that, let me tell you is wonderful. 

Faced with newborn twin boys, my husband and I were also faced with the need for impending child care as we both work. I went back to work part time after seven weeks and full time after three months (a whole other story) and my husband had (entirely understandable) second thoughts about being home daddy. So we considered an au pair. 

I should start by saying we have had nothing but wonderful experiences with au pairs. Our first au pair stayed for two years (over her initial six month plan) and our second au pair is closing in on two years and showing no signs of moving on (long may that continue!). 

What’s the up side? Having an au pair should be considered similar to having your younger sister or brother living with you. They must be considered part of the family- they eat with you, share your house, go on holiday with you (if you all choose to do this) and generally be included on all family outings. 

What doesn’t work, according to our au pair’s friends who have had bad experiences, are things like being told “You can’t come in the family sitting room between 5 and 6 because that’s time just for the family”, or parents who change their plans at the last minute but insist they told the au pair that they had asked them to babysit, or having the au pair get up at seven, get two unruly children up, fed and to school, clean the house, get the kids, cook for the family and get the kids to bed… that’s not an au pair, it’s indentured servitude.

Is there a downside? We haven’t seen one yet. I suppose you could argue that a child in childcare gets more socialisation early on. You could have a bad experience with an au pair who wasn’t a good fit, but that’s the risk of hiring anyone for any job. 

Physically what you need to supply for an au pair is their own room. Broadband is a big plus too! If you live in the sticks like us, an au pair with a driving license is a bonus but not crucial. I thought I would struggle with someone else living in the house but it was a great big non-deal and seemed very normal very quickly. 

The one thing which does make me uncomfortable about having an au pair is how little you actually pay them. The going rate is about £70 per week (we pay our more because there are two, and when you equate it to a childminder it’s still a very small amount)- but this is offset against providing food and accommodation (and all the other expenses that would be incurred by living in a flat with a roommate)… and a family. Many au pairs come to the UK to improve their English (although our first au pair was English!) so the security of a family is good for them. And we have found that it also reassures their parents to know we are “looking after them”. There are also Facebook groups of au pairs in different locations which has been a big help to our au pair for making friends, using the common ground as a starting point.

How do you find one? We used a site called aupairworld.com (there will be others but we were pleased with this one) which is German in origin and very professional. It has large sections on the legalities, what can reasonably be asked of an au pair, and many other FAQs. 

If you are interested in an au pair, you must be ready to move quickly! You can spend a few days chatting to a prospective au pair only to find she or he has accepted another position. It’s worth having a pre-written blurb about who you are, where you live and what you are looking for in an au pair and then you can just cut and paste this into emails. And if you find a good one, seal the deal as quickly as possible or the opportunity will have passed. Also make a written “contract”- not legally binding but a good reminder of what has been agreed between you and your au pair.

Our au pair is what makes our family life work so well. I worried briefly that the boys would prefer her over me sometimes, but you are always their parent and now when the boys are affectionate to Andrea, it makes me very happy. In fact, having such a great au pair makes me very happy!

The logistics involved making sure every child is where they have to be....on time.....and with the correct outfit and equipment is an organisational challenge and in my opinion impossible to do without help. Without a support system in place life is no joy!

For me the support system starts with my husband (who is perfectly happy to help as long as I specify exactly what needs doing) but also the children themselves. If you have (willing) family nearby, consider yourself very lucky. If not buy help in! We have had a series of au pairs over the years and with the exception of one crazy person who unfortunately I had to ask to leave after one week, we had a great experience with all of them. They not only helped with childcare they also enriched our family life by bringing their own experiences to the table.

It also helps to make friends with the parents of your children's friends. I was never part of the "in" crowd" of the mothers at school but there were a few other mothers that have helped me out, especially driving children to and from out -of school activities. What I want to know is why schools think it is ok to expect parents to pick children up in the middle of the day to drive them to some sports event and bring them back afterwards?!

I am a workaholic and I pretty sure if I did not have children I would never be home for dinner. I force myself to be home to have dinner with the whole family. No dinner in front of the telly in our house! We have a schedule that each family member is in charge of dinner on a certain day of the week. While they were younger I cooked with them, but nowadays my teenagers are very good cooks and even the little ones are getting there. I am not very good at playing kids’ games so with this system I can spend time with them while doing something I love (cooking) and we (usually) manage to get a meal on the table. 

I also have a cleaner who comes in twice week. This is worth every penny since I come home to a clean house and can do things I enjoy doing with the kids rather than getting stressed about the state of the house. At the beginning I had huge psychological issues with accepting help, paid or unpaid. After all my mother had coped with bringing up while working full time. I am pretty much over this.....although every now and then it does bug me.

I spend a lot of time going away to teach in different countries and I absolutely love it. The downside is that I do miss events that are important to my children and it has taken me a little while to recognise that the Sharing Assembly on Friday afternoon, which I find incredibly boring, is actually really important to my children. I now try to keep those dates free and have limited my trips abroad to once a month. Turning down invitations to speak is not easy for me, but I accept that the number of occasions the children want me there are finite and won't last forever.

I like to believe that my children are happy and responsible individuals who will grow into independent, confident and happy adults.

Having it all? Part 2: The child’s perspective 

Both my parents work full time jobs. There are days were one or both of them don’t come back till about 7 or 8 at night because my Mum is on clinics and my Dad has a lot of work left to do. However most days they both try to make back for 6 which means we get to all eat dinner at the same time and have a conversation about how our day was. My parents are very busy people and at least one of them will be gone for a couple of days each month to some conference somewhere in the world. Which has its pros and cons; a pro being that it is easier to throw house parties and clean up before they get home. A con is that there are some days in the year where I have sport awards night or on my birthday and my parents haven’t been able to make it because their plane was delayed or they were giving a talk in the US. It can be quite disruptive to certain things in my life which are important and I wish my parents could be there. However at all times I know that they enjoy what they do and they both love helping animals and helping others understand new things about how certain injuries can have a lasting effect on animals. I also know that there work benefits more than just their animal patients as they have both visited schools including my own school to teach younger people who are interested in a career in STEM (Science, Technology, Engineering, Maths). What I like about the fact that both my parents work full time is that it allows me to feel more independent and like I can accomplish certain things by working through it myself rather than having my parents give me all the answers. I feel more prepared for real life once I am eighteen and have left to go to university. Overall there are good and bad things about having two parents working full time but I wouldn’t have it any other way. 

I do get to spend amazing time with my kids- I see them grow, wonder at their progress and we laugh, play, bake, garden and bug hunt. Then I go to work- the kids go to preschool/nursery and develop as individuals and I get to be a professional again- treating horses, vetting etc. 

All very fabulous and sunny and perfect, except that’s not really how it works.  I spend at least half a day of ‘kiddie time’ trying to check up on cases seen at work, teeing up vettings, sorting out queries, checking lab results and asking colleagues to ring them or ringing them myself. This week my kids are getting a crash course in managing a strangles outbreak on a yard as I liaise with colleagues, labs and owners. The children now play ‘doing my paperwork’ at the kitchen table with me. I get tense and snappy trying to multitask. They go and bug hunt on their own, I can’t remember the last time I actually played with toys with them, we bake but sometimes it’s ‘spectator only' for the kids if I’ve a long ‘to do’ list . I also need to juggle childcare- what will I do over the school holidays? Grannies are great but have their limits and own lives- they are my kids! Kiddie time also involves organising childcare- that’s when they’re open, along with trips to the bank, shops, estate agents, doctors, dentists, garage etc. Kiddie time also covers doing the housework, as I’m part time so surely can clean my own house.

Part time clinical work is great, but you do have to sacrifice some degree of case continuity, you spend ages making good notes and filling in colleagues on cases. You rarely see an entire case through to the end and your revisits tend to fill your day and childcare, clubs etc. swallow your pay whole. You also are on the clock from the moment you leave the house to make that nursery pickup- no more cups of tea at the last client’s or chatting cases through and team bonding after a busy day, you’re out that door like a missile. You feel constantly guilty that you can’t do that late emergency call, or have to drop everything because you gave the kids too many blueberries yesterday and one has had successive loose nappies requiring an emergency collection from nursery- your non- kiddie owning colleagues get lumbered with all the extra.

However, after that more honest rant, I would not change my life- it’s utter chaos and there are days I drive straight past nursery thinking about cases, or spend 10 minutes in the nursery car park trying to sort problems out on the phone, but I think I’m saner than I would be otherwise, I definitely have more self respect and self value, and at work I can also go to the toilet without spectators! Kiddie time involves a lot of juggling and yes, I do drop the balls, but we get by, I think. I hope my kids are learning about real life- the need for work, money and how to clean?!

But no, we part timers do not have the grass greener, it’s just as green as the full timers, but just fertilized with a different sort of s**t! 

The partners in my practice were really supportive when I eventually told them about my ectopic pregnancy and indeed were quite cross that I hadn’t felt able to confide in them at the time. Certainly things have changed radically with the advent of more female partners in the practice, and particularly since those partners have had children. I imagine my own sub-conscious thoughts were aligned to previous practices where having children was seen as an inconvenience and part-time working meant less people to staff a busy on-call rota. In hindsight I perhaps shouldn’t have judged my employers from a preconceived view and given them more credit. 

So back to my original question – when is the right time to tell your employer that you are pregnant. In my case I was really reluctant to tell anyone until I was sure as possible that everything was going to plan. The only people who knew I was pregnant until I was nearly 20 weeks were my husband, parents and two best girl friends. I rationalized that I needed the support of these people if something went wrong but that I didn’t want the sympathy and awkwardness of other people knowing if the worst happened. I had certainly seen other friends and family dealing with the awkward situation of telling people that the pregnancy they had announced early (and awkwardly in one situation a scan picture via social media at 7 weeks) only for the worst to happen a short time later. Of course it is a very personal choice and multifactorial.

There must of course be a balance of costs and benefits. The potential complications of pregnancy in equine practice are huge and far-reaching. It can quickly become apparent that a team member is pregnant when they are reluctant to pick up the x-ray/sarcoid/dangerous horse call – and rightly so. I do believe that there is still bravado amongst equine vets that they are tough enough to get on with the job – does this apply equally to male and female vets? I have certainly put myself in dangerous situations (before pregnancy and motherhood I hasten to add) just to “prove that I was up to the job”. Perhaps this is something we should look at as a profession in addition to the individual’s perspective. We know that equine vets have an increased risk of serious injury as evidenced by the results of the BEVA Injury survey, but how many pregnant women are putting themselves, and their unborn child, at risk just doing their job. 

To be fair to employers, they cannot mitigate against risk if they aren’t aware of the pregnancy. I was lucky that I didn’t need to perform radiographs or apply sarcoid cream due to the nature of my job. When I did finally tell the partners, I cannot commend the entire team enough for their protective and proactive approach. We still didn’t tell the clients until quite late on – one client actually became quite cross that I was pregnant because she was quite particular about which vet she would have on the yard but that is another story – and they were all quite shocked when they realized I was so pregnant and still doing routine work. I must reiterate that it was my choice to keep doing routine work right until the week before my child was born but this will not be the case for everyone and decisions must be made on an individual basis rather than on tradition or expectation. 

Further guidance is available in our MumsVet guidance links or here at http://www.hse.gov.uk/mothers/law.htm

Either way, by 16 weeks I was slow to walk to put it mildly. I could also only sleep on my side, and only for 2 hours on each side, after that I was down to 30 minutes before needing to turn, or crawling round the bedroom on all 4s. Crawling was infinitely better than walking.
At this stage it became clear to me that continuing to do ambulatory equine work with my reduced ability to move was not safe for me or my (pretty non-existent) bump. Thankfully I had a very understanding boss and a job that had a non-ambulatory and latterly non-clinical aspect so was able to continue to work in a different capacity. 

In hindsight I would love to say that given the time again I wouldn’t have done the physical bits I did on call, but in reality there was no way of knowing it would go so bad, so quickly.  My second pregnancy- although 3 years before the advised time by the physios and midwives, was much less uneventful- thankfully as I had a toddler to chase.

My top tips would be:
1. Find an APPI physio- this kept me moving as much as possible and helped manage the pain
2. Seek help early if you have hip, pelvic or lower back pain- don’t be a hero- trust me, it’s not worth it!
3. There are many other jobs you can do at work- look for them- answer all the advice calls, write newsletters, organise client evenings, weed the drugs store, do all the practice standards protocols and paperwork, deal with the insurance forms, organise or plan staff training.
4. If you’re offered crutches take them and use them- they don’t offer them lightly and they really do help.
5. Don’t feel too disheartened- easy to say- it’s hell, but it will get better. 
6. It may take some time after the birth to get a lot better- I was at my lowest point with it 4 weeks after the birth of my daughter as I was still in pain and was petrified that I would never be able to work, or walk or run again- it takes time but you will. Rest and do your Pilates!