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scar pregnancy
When former shop assistant Haley Malton, 34, and her decorator husband Axl, 30, discovered they were expecting, they were thrilled – hoping it was third time lucky after suffering two miscarriages as they tried for child number three.
But, unsure of her dates, she was sent for a scan by their GP in December 2016, which was to turn her life, and those of her daughters Annie, 13, and Lola, six, upside down.
Haley, of Harrogate, North Yorkshire, England, was diagnosed with a caesarean scar ectopic pregnancy, which, according to the NHS, is potentially life threatening and happens when a fertilized egg implants itself on a previous c-section scar.
Now proud mom to Lilly Dot, aged two, her miracle child, Haley said:
"We were taken into the same scan room where I found out I'd lost my other babies, so it was quite a difficult room to be in."
"They took the scanner off me, passed me a box of tissues, said they were sorry and left us in the room thinking we had lost another one."
It was five long hours before the couple saw a specialist, who delivered the bombshell news that Haley was six weeks pregnant – but the embryo had attached itself to the site of an old caesarean scar, low down in her womb.
"The doctor said these pregnancies usually sort themselves out and I would probably miscarry, but there would be heavy bleeding, so she recommended that I terminated the pregnancy straight away," she said.
"It was so shocking. I didn't know what was going on. I just happened to glance at the notes on her desk, where it said there was a heartbeat present, so I asked if it was possible to continue with the pregnancy. I couldn't bear the thought of losing another baby."
"The doctor said they couldn't force me to terminate, but if it hemorrhaged, I would be in serious trouble," she continued.
"We decided to go home and wait for another specialist appointment. I Googled like crazy, but there's just no information out there. And in every case I did find, they had either terminated or lost the pregnancy."
When she was 11 weeks pregnant, Haley and Axl saw a more senior specialist who again advised that terminating the pregnancy was the best option.
"I don't know if it would have been the same if I hadn't had my miscarriages, but I just couldn't bring myself to terminate a life that I wanted so much," she said. "My husband wanted this baby too, so we decided to carry on and wait and see."
Haley had weekly scans and MRIs, which showed the baby was growing down towards her cervix, making it more dangerous than if it was growing upwards, as it put her at risk of a hemorrhage.
Doctors also told her that the womb scar from the previous c-section now had a 2cm rip in it – caused by the placenta pushing through and the growing baby pushing down, meaning she was slowly rupturing.
"The placenta is like a parasite," Haley explained. "It needs to keep the baby alive and so will grab at any organ for blood. I was lucky it was a slow rupture and that it didn't rip suddenly.
"It wasn't really painful, it was just uncomfortable. It felt like I was desperate for the toilet all the time."
But Haley dreaded her hospital appointments, as at every one doctors begged her to terminate.
"They said I was crazy and told me if their wives or children had this pregnancy, they would make them terminate," she said.
In the end, she felt so isolated by her weekly trips to the hospital that she booked a private scan, so she could have at least one experience of having a 'happy' pregnancy.
"Those radiographers didn't know what was happening, they just showed me 3D images of my baby and congratulated us," she said. "It was nice to be normal for a minute. And we also learned we were having a girl."
Waiting for enough weeks to pass for the baby to be viable, Haley endured some very dark days.
"I spent some days in bed just crying and Googling, but on other days I felt normal," she said. "The pregnancy didn't feel wrong, but I don't think I fully took in what was happening. It was just too unbelievable."
"I couldn't enjoy the pregnancy, as it was too different to my others. I couldn't buy anything or watch TV shows about babies."
At 18 weeks, Haley was sent to see the fetal medicine specialist at a hospital in Leeds, by which point her placenta had pushed through the scar and was growing around other organs.
"The specialist sat me down and said, 'This is it, you need to terminate. The placenta has engulfed your bowel and your bladder and is now surrounding your kidneys. We don't think you can survive this,'" she recalled.
"We'll book you in for surgery in a week's time. There's nothing else we can do, so I will give you five minutes with your husband to decide."
Haley admits Axl was now sick with terror at the thought of losing her.
"He said he thought maybe we should not continue with the pregnancy, but I went against his wishes," she continued. "We talked on the way home and he finally agreed we should go ahead."
"The surgery at that point would have been just as life threatening as if I had got to the end of the pregnancy, so I thought, 'I'm risking my life already now, why not see if we can get a bit further.?'"
Once home, Haley put herself on strict bed rest to stop the risk of a blood vessel bursting in the placenta.
"The placenta, when it escapes, becomes really vascular," she explained. "It splits and spreads out and has massive veins, so if you burst one of those you will hemorrhage and be in real trouble."
Weeks later, now 22 weeks pregnant, Haley and Axl were on the sofa watching television when she suddenly hemorrhaged.
"I was bleeding out," she recalled. Haley was rushed first to hospital in Harrogate and then on to Leeds, where the doctors had the specialist equipment needed to save her from bleeding to death.
"I thought, 'This is it. I've got as far as I can go,'" she said. "I was scared. I thought this might be it for me and for the baby."
By the time Haley reached the hospital in Leeds, the hemorrhaging had stopped.
She spent the rest of that night passing golf ball-sized clots and the doctors told her she would now have to stay in the hospital until the baby was delivered.
She had one more hemorrhage between 23 and 24 weeks, which prompted a late-night visit from the neonatal team, asking how much intervention she wanted if the baby was born there and then.
"I told them, 'If she comes out with a bit of fight in her, help her, but if you think there's no hope, don't make her suffer,'" Haley recalled.
Then, a few days later, another doctor came to talk to her at the end of his shift.
"It was quite late at night," she said. "He sat on the armchair in my room, put his head in his hands and told me the surgeons were scared they might not be able to save me."
It was decided surgery would take place once the pregnancy reached 27 weeks, to give the baby the best chance of survival.
But the day before the planned operation, Haley experienced a blinding pain in her ribs and collapsed. Unable to breathe, she was given morphine for the pain.
And when she woke up in the early hours of the day the surgery had been planned, she said she was in excruciating agony.
"I can't describe the pain," she said. "It was like I was being torn apart from the inside."
Meanwhile, poor Axl, who had spent that night with his wife, had no idea as she was rushed away if he would ever see her again or meet their baby.
"We are such a close and totally in love couple, he must have felt so lost and broken," she said. "He told me he was devastated and frightened to death, as they rushed me out of the room."
Haley was in surgery for six hours, during which time baby Lilly Dot was born and whisked to the neonatal intensive care unit.
After that, surgeons set to work to remove the sprawling placenta and repairing the damage to Haley's organs.
She also had a hysterectomy and her cervix was removed. Her bladder and bowel were damaged but left intact.
"I remember waking up feeling really groggy when it was all over and apparently all I did was ask if the baby was alive," she said. "When they told me she was, I went back to sleep."
Haley's unbearable pain had been caused as some of her placenta shearing away. On top of that, her womb had filled with blood, which Lilly Dot had swallowed, triggering a stroke.
"The doctors told me we were both lucky to be alive," she said. "Lilly Dot is definitely a miracle, because they told me when she came out, she actually squeaked, so they knew to fight for her."
It was four days before Haley was well enough to see her remarkable daughter for herself.
"It was scary," she said. "She was so small she was the size of a Mars bar. Her skin was sticky because she was so premature and her eyes were sealed shut. But we were so bonded. I was crying and thinking, 'We've done it.'"
Haley discharged herself after the doctors came to talk to her about Lilly Dot's stroke and the consequences.
"They told me she would have no quality of life. It was devastating and I just thought, 'What have I done?'" she said. "I went against everyone's wishes and now I could have ruined her life."
Lilly Dot, who has chronic lung disease and mild cerebral palsy – movement disorders – stayed in hospital for 89 days and Haley, despite the pain of her own recovery, traveled over 30 miles from Harrogate to Leeds and back to spend every day with her.
Once she came home, the baby could not leave the house for the first year of her life in case she became sick. After being told she would be mute, the family also began to learn sign language.
But on her second birthday in May 2019, Lilly Dot shocked Haley, who is now her full-time carer, by saying, 'Hi Mummy.'"
"She's doing amazingly now and hasn't shut up since then," laughed Haley. "She has braces on her legs and walks with a little walker, but mentally she's all there and ahead of the game."
"She's full of life and before the lockdown was going to nursery two mornings a week, which she loved."
"The family is complete now and I am so happy. I would do it all a hundred times over because it was just so worth it. I can't imagine not having Lilly Dot in my life, she's just so special."
After her own harrowing experience, Haley is now keen to make other expectant moms aware of the risk of having unnecessary C-sections, which leave scar tissue in the womb, increasing the risk of a scar ectopic pregnancy.
She had a C-section with both older daughters, but believes the surgery could have been avoided.
"They were both totally unnecessary," she said. "The reason for the first one was failure to progress."
"They said I was too tired, but I was already 10 cm dilated and if someone had just kept me going I wouldn't have needed one," she concluded.
"The second one, I was planning a natural birth, but I got sciatica, so was told that, having had one C-section, I may as well have another."
"I couldn't be more grateful to have Lilly Dot, but I honestly believe that if I hadn't had those C-sections, there wouldn't have been a scar for the embryo to implant itself on."