Hannah – two births, Vaginal Breech Birth, NICU Journey, and Raising Awareness About CMV in Pregnancy, infant loss

Hannah, a midwife working at Campbelltown Hospital and qualified lactation consultant, lives in the Southern Highlands with her husband David and three-year-old daughter Beatrix. Her journey to motherhood began after experiencing a miscarriage at 10 weeks, which she describes as happening “the best way for it to happen if it’s gonna happen” – allowing her body to naturally complete the process.

When she conceived again with Beatrix, Hannah felt remarkably confident about her pregnancy and birth. “I wasn’t really thinking, I was just doing,” she reflects on her approach to labour. Having worked with experienced midwives in the MGP (Midwifery Group Practice) programme, she felt well-prepared and chose private midwifery care with Geisha, wanting the continuity and home-based antenatal visits.

The Breech Discovery and Decision-Making Process

At 36 weeks, Hannah discovered that Beatrix was in a frank breech position – bottom down with legs flexed up beside her head. “I was one of those people testing like five days before you can test and just thinking I was pregnant every time,” she had said about her early pregnancy, but the breech presentation caught her completely off guard.

Hannah attempted an External Cephalic Version (ECV) at Campbelltown Hospital, describing the first attempt as feeling “like a Chinese burn almost” but ultimately unsuccessful. The obstetrician explained that he could move the baby to a certain point, but “she’s just springing back up.”

Faced with the choice between caesarean section or attempting vaginal breech birth, Hannah initially struggled with having to make a decision at all. “I really resented having to choose, like I thought I had really surrendered to the process of pregnancy and birth, and I just thought I didn’t have a choice.”

The Westmead Breech Clinic Experience

Hannah’s journey led her to the renowned Westmead Breech Clinic, which she describes as “like Willy Wonka land for midwives” due to their advanced facilities. Despite the two-hour drive from home and the challenges of navigating COVID-19 restrictions, she found the team incredibly supportive.

Dr. Pesh and the breach CMC Michelle Underwood provided comprehensive care, explaining that Hannah was “a great candidate for vaginal breach” with a normally-sized baby estimated at 2.7kg. The conditions for attempting vaginal breech birth included continuous CTG monitoring, staying upright and active, and avoiding the birth pool for the actual birth.

Labour and Birth at 39 Weeks

Hannah’s waters broke unexpectedly at 39+1 weeks at 6am. Initially thinking she had “wet myself for the first time this pregnancy,” she soon realised labour was beginning. The drive to Westmead was comfortable as contractions hadn’t started, but labour progressed rapidly once established.

“I had my very first contraction at midday and then at about three o’clock they were like, we might call your midwife in,” Hannah recalls. By 5:30pm she was 5cm dilated, and labour accelerated from there. She found comfort in the bathroom, managing nausea with peppermint oil and craving ice throughout labour.

The birth itself was swift once pushing began. “Her bottom was like, already on view,” David observed, and Hannah birthed Beatrix in an upright kneeling position at 10:29pm.

NICU Journey and HIE Diagnosis

Beatrix was born with poor Apgar scores of 1, 1, and 2, requiring several minutes of CPR. She was diagnosed with HIE (Hypoxic Ischemic Encephalopathy) – oxygen deprivation at birth – and required cooling therapy in the NICU for 72 hours.

“I’ll never forget the feeling when she had that brain MRI and it was normal,” Hannah shares about the relief of discovering no lasting brain damage. The two-week NICU stay included treatment for suspected meningitis, but Beatrix has since shown no lasting effects from her difficult start.

Breastfeeding Challenges and Oversupply

Despite the NICU stay, Hannah successfully established breastfeeding with strong support from the Westmead team. However, she experienced significant challenges with oversupply, leading to mastitis five times in the first six months. “I have never been so unwell as having mastitis,” she reflects, noting that despite the smooth breastfeeding journey, she “didn’t sort of love it like I thought I would.”

Second Pregnancy and Alby’s Arrival

Hannah’s second pregnancy with Albie was planned and progressed smoothly, though she developed vulval varicosity – a painful condition she managed with compression garments and ice packs. Due to her previous experience, she chose MGP care at Campbelltown Hospital rather than attempting homebirth again.

Albie arrived at 37+5 weeks after another rapid labour – less than two hours from waters breaking to birth. “The sorest part of my body was my bottom, I think from trying to hold him in from being born on the road,” Hannah recalls of the urgent drive to hospital.

The CMV Diagnosis and Its Devastating Impact

Initially, Albie appeared healthy with good Apgar scores and successful early breastfeeding. However, at two weeks old, during routine surgery for a suspected testicular issue, a paediatrician suggested CMV screening – a suggestion Hannah initially resented.

The positive CMV result led to devastating diagnoses: left-sided hearing loss, vision impairment, and most critically, lissencephaly – a life-limiting neurological condition where the brain remains smooth rather than developing normal folds. “From that point, our world was flipped upside down,” Hannah explains.

Understanding CMV and Its Prevention

Hannah has become passionate about CMV awareness, explaining that it’s “the biggest preventable cause of disability, infectious cause of disability in newborns.” She contracted CMV at approximately seven weeks pregnant, likely when she was unwell and chose not to attend a social event.

“The heartbreaking thing is that it’s preventable,” Hannah emphasises. Simple measures like careful hand hygiene, not sharing food or drinks with toddlers, and avoiding contact with saliva can significantly reduce transmission risk. She advocates for routine CMV screening in early pregnancy, similar to protocols now implemented in Europe.

Life with Albie and Support Systems

Albie’s condition included cerebral palsy and dystonia – involuntary muscle spasms that caused significant distress. “It’s sort of like experiencing a cramp that he can’t control,” Hannah explains. The family accessed extensive support through NDIS, the Cerebral Palsy Alliance, and Bear Cottage – NSW’s only children’s hospice.

Hannah openly discusses her mental health challenges, starting fluoxetine to help manage the daily emotional toll. “I didn’t sort of feel particularly anxious or depressed… but I think, you know, Dave and I have a really supportive relationship and we were very well supported.”

Tragically, Albie passed away at home at 17 months old. “Both of my children marched to the beat of their own drum,” Hannah reflects, noting that he chose to die at home surrounded by family rather than in hospital. The palliative care team commented, “no wonder he chose here. It’s such a beautiful place.”

Hannah describes the ongoing grief, particularly watching three-year-old Beatrix navigate the loss. “In the bath the other night she was saying… ‘it’s just me in the bath now.’ And that just undid me,” she shares, highlighting the “emotional whiplash” of parenting through grief.

Advocacy and Moving Forward

Hannah is now working with researchers from the Cerebral Palsy Alliance and University of Sydney to update Australian guidelines for CMV screening, hoping to align with European protocols. Her message to healthcare providers is simple: “wash with care, kiss with care, don’t share.”

For women planning pregnancy, Hannah recommends asking GPs to add CMV screening to routine antenatal bloods, particularly in the first trimester when antiviral treatment can be most effective.

This episode serves as both a tribute to Albie’s short but meaningful life and a call to action for better CMV awareness and prevention in pregnancy care.

If you’ve been affected by any of the issues discussed in this episode, support is available through the Gidget Foundation, Bear Cottage, and the Cerebral Palsy Alliance. For more information about CMV in pregnancy, speak with your GP about screening options.