Sudden unexpected disablement

In a second article, Kim describes how she has been able to use the insights gained to help other mothers in her role as an epilepsy specialist midwife.

My journey started on 25 May 1984 when I was involved in a tragic accident in Derby in the Kimberley Ranges, Western Australia. I sustained multiple injuries including a fractured spine. My hopes and dreams were as shattered as my ankle and spine; my zest for life dispersed in the red dust that blankets the inner core of this arid continent.

Sudden, unexpected disablement

I had lived the dream to work as a midwife and nurse with the indigenous people of Australia for 16 action-packed weeks, so the words from my obstetric colleague “Derby is a special place where people meet their destiny” set in stone my new identity: incomplete, lumbar two paraplegic. The extreme pain and life-changing experience associated with this sudden disablement was matched 15 weeks later by my first encounter with a wheelchair. I detested it more than the tilt table used to prepare me for the achievement of sitting in the wheelchair.

I encountered all the emotions one experiences with bereavement and internment; a prisoner trapped inside a body that no longer responded to the commands of its intricate nervous system. I experienced no vision of a miracle — just a realisation that life as I had known it had changed for ever.

My battle with this encounter went on to mould my professional and personal life, fuelled by relentless determination. Not only did I learn to walk and even ski again against all odds, I returned to my beloved career, continued to travel and married Philip before becoming the proud mother of our two wonderful children, Christopher and Victoria.

Fears and expectations of future parenthood

Twelve weeks after my accident my periods returned. Was this an indication that I would still be able to mother a child? My shattered self-image precluded me from believing any man would ever find me attractive again, so I mourned for all the lost possibilities and potentiality of marrying and becoming a mother. This was made even more difficult by the fact that my twin sister had given birth to her second child on the day of my accident; my younger sister married six weeks later.

The amazing factor about our bodies is their ability to physically heal beyond expectation but our mental health is far more fragile. Coming to terms with the experience of disability when it’s so sudden and unexpected stirs emotions unfamiliar including disbelief, fear, bitterness, indescribable sadness and emptiness. Regaining my sense of self-belief took two years and that is when I regained my sense of identity.

Meeting Philip in 1986 was a milestone. Philip found me both sexy and desirable; he even loved my scarred back and crooked foot. He laughed at my attempts to run and still does. What I love about him most is that he has taught me to love myself again and knows instinctively to listen rather than question.

Following our marriage we emigrated to Australia, but after conception I knew I would have to return to the UK, as there was only one person in the world I trusted to deliver my baby — Pippa. As an obstetrician, she had supported me as a student and newly qualified midwife and prepared me for working in the Outback. Along with family and midwifery colleagues from Southampton, she was a source of great comfort following my accident.

Pregnancy joys and concerns

To be pregnant was a miracle and I marvelled at my developing body. The fears, however, of the toll to my back and bladder were a constant concern. Would pregnancy render me incontinent because of having to strain to pass urine as a result of now having an impaired nerve supply to my bladder? This did not prove to be a problem, and despite two pregnancies, I remained free from urine infection and stress incontinence.

My pregnant uterus and the relaxation of my muscles caused by progesterone did not cause excessive strain to my reconstructed spine and I remained active throughout. My darling son did protest though when I ‘belly boarded’ in the Hawaiian surf at 28 weeks’ gestation!

I had no preconceived ideas about delivering a baby vaginally but a caesarean section would have to be performed under general anaesthetic. I am fused from lumbar one to lumbar three with bone grafts from my hip and ribs — a scaffolding effect. Despite this, an obstetric anaesthetist still tried to convince me that an epidural would be the safest option. Having encountered spinal injury and sensory loss I felt that there was no way I would ever have coped with the temporary physical and sensory loss of an epidural, and my neurosurgeon recommended that I should never go for this option.

Despite concern about the potential risks I was taking, my beautiful son Christopher was born safely by caesarean section under general anaesthetic. Two years later, I returned for the delivery of my vivacious daughter, Victoria. My dear midwife friend Kay was there to share that wonderful moment of meeting our babies for the first time.

Hidden memories

The worst experience for both births was having a catheter in situ as it brought back terrible memories. After my accident I was in acute renal failure, placed on strict fluid restriction and catheterised every two then four hours for the first three months. I felt violated, being the only female ’guinea pig’ for students to practice their catheterisation technique; when they mastered this I became an object to conduct their practical assessment examination. I provided this facility for every student in the hospital without ever being asked for my consent. When I did protest, my voice went unheard to the masked, gloved and gowned figures.

Empowerment is a great thing and the skills I have as a midwife and nurse solved this matter after both my deliveries by me removing my own catheter, much to everyone’s surprise. My next fear was of straining to pass urine having a caesarean section wound but this did not prove to be a problem.

Becoming a parent is a privilege, a gift from God. For me it proved that despite massive injuries I was indeed capable of childbearing. My message to other women with any type of disability is to be aware of their physical and psychological needs. Make sure you have a voice when it comes to making important decisions. Intimate examinations should only be performed with your consent and after careful explanation. Use contact with professionals as an opportunity to increase their knowledge about your condition; you, after all, are the expert.

First published DPPI Journal, Issue 66: Summer 2009