'My fears I couldn't have a baby'

By Jane Elliott
BBC News Online health reporter

When doctors told Marcia Stevenson she would need a hysterectomy at the age of 40, she faced a worrying dilemma.

Marcia's uterus had numerous fibroids in it

She was told her uterus was filled with numerous fibroids and that, unless she had the womb removed, the terrific pain she was suffering could increase.

But she wanted a family, and knew that this would be impossible after the operation.

"The fact that I was going to have a hysterectomy at the age of 40 was so devastating. My partner had previously wanted to try for a baby, but I wanted to wait."

Agony

Doctors agreed to delay her operation while she and her partner tried for their baby, but warned that the fibroids might make conception difficult and that, even if she did get pregnant, she might face nine months in agony.

Marcia duly became pregnant - and discovered that the doctor was right about the pain.

Each month, as the baby grew, it had to compete with the fibroids for room in Marcia's uterus, causing her indescribable pain that left her hospitalised for much of the pregnancy.

The fact that I was going to have a hysterectomy at the age of 40 was so devastating Marcia Stevenson

One year on, Marcia now has a healthy little boy called Alasdair John Stephenson-Kear.

Holding him, she feels the pain has all been worthwhile. But she says she would not go through it again.

"It was definitely worth it, but I would probably not be so lucky again and I could not go through those pain levels again."

Marcia, who lives with her partner John in Hampshire, said she had been aware that fibroids ran in her family, but thought she had escaped the family "curse".

She always wanted children, but was keen to delay this until she was about 42.

"Then one day I found a lump in my tummy. Previously I had lost a bit of weight, but now I was starting to feel a little bit chubby and in January last year I went to see the doctor.

"He said I had a fibroid and they found one which was the size of a grapefruit. It looked as if I was 16 weeks pregnant."

A scan showed that the uterus was so full of fibroids that it looked as if it was a "basket of fruit."

"The consultant said that if I wanted to try for a family I would need to try now.

"She advised us to get an ovulation kit and said that if I wasn't pregnant by August I should come back."

Luckily, within a couple of cycles Marcia was pregnant.

Fraught

But even though she got pregnant quickly, her pregnancy was fraught.

At five weeks she was admitted to hospital in pain.

An ultrasound at seven weeks showed the gestational sac was already competing for space with the fibroids.

And at 12 weeks, after her nuchal fold scan (to assess whether the baby was likely to have Down Syndrome), she fainted.

Doctors told her the baby was starving the fibroids of blood, and this was causing her to be unwell.

The baby was developing well, but doctors warned Marcia at a very early stage that she was likely to need a Caesarean and hysterectomy at the same time.

"At 13-14 weeks I started having very bad abdominal pains so I went to my GP and he gave me painkillers.

"As the fibroids were being starved of blood they were dying, and that was causing my pain. All the blood was going from them to the baby."

They can cause heavy periods, pressure symptoms on the bladder, bowel or back, and occasionally can reduce fertility Dr Katrina Erskine

Over the next few months she spent much time being admitted to hospital for pain relief, but reassuringly the baby seemed to be thriving and at 20 weeks a scan confirmed that she was carrying a little boy.

At 26 weeks, the pain became almost unbearable and doctors discovered that the largest of her fibroids was pressing on her cervix and threatening to cause her to deliver early.

Marcia was told that each day the baby could be kept in her womb would increase his chances of survival, and she was given drugs to mature the baby's lungs.

At 28 weeks doctors said the birth was imminent, but she managed to hold off until 34 weeks and Alasdair was delivered at a healthy 5lbs 3oz - just six weeks early.

Marcia must now wait to see whether she needs a hysterectomy but says she is hoping to delay this until Alasdair is a little older.

Fibroids

Katrina Erskine, an obstetrician and gynaecologist, said fibroids were very common, occurring in approximately one woman in three and were particularly common among black women.

We were fortunate to be blessed with Alasdair Marcia Stevenson

"They are benign tumours (not cancerous) and consist of muscle.

"They often do not cause any symptoms, and do not need any treatment.

"It is not clear why they are more common in Afro-Caribbean women. They cannot be avoided.

"They can cause heavy periods, pressure symptoms on the bladder, bowel or back, and occasionally can reduce fertility.

"They may be removed surgically, but may grow back again.

"If they are growing inside the uterine cavity, they can lead to infertility or miscarriage.

"During pregnancy they can become painful as they can grow bigger, outgrowing their blood supply, and occasionally they can cause difficulties at the time of delivery as they may obstruct the baby's exit route.

"Finally, there is a small increased risk of heavy bleeding after the baby is born as the fibroids may prevent the uterus contracting well."

But she stressed: "If you have fibroids, there are lots of things that can be done - lots of very good treatment."

Marcia said that, despite all the odds stacked against women with fibroids, they should never give up hope.

"All I can say is that you have to have hope, and believe in that hope.

"That's what my partner and I did, and we were fortunate to be blessed with Alasdair."