MORAL DILEMA / SHOULD I GET PREGNANT? Isolated & in pain desperately need advice

[redclover]

I'm new to this so hope I get it right as this is my first post. I've heard a lot about Mumsnet predominantly on Radio 4's Woman's hour & other press.

I am not a mother & I'm not pregnant. I have a massive decision to make & I feel very isolated & overwhelmed by the magnitude of it.

I have a medical condition called Complex Regional Pain Syndrome / Reflex Sympathetic Dystrophy - in brief I have been in constant pain for 7 years following a road traffic accident. Previously a high-flyer I have had to stop work (now I volunteer as a Princes Trust mentor helping young people leaving the care system & with local social services helping abused & neglected children).

I have to practice pain management techniques e.g. pacing in all that I do & have to take strong medication to help reduce the pain. I have had 2 unsuccessful back operations, have attended 2 pain management programmes, done extensive one-to-one work with a Consultant Psychologist (predominantly CBT), & practice relaxation & stretching techniques everyday plus healthy eating & no alchol.

Unfortuantely I am still in significant pain. However I have battled severe depression & physical injury to claim more control of my life & to make a positive contribution to life. Don't get me wrong, things are hard but I do still laugh & cry like everyone else & my life is not without meaning.

I am now 34 & have been married for a year (we've been together for 10+). Our relationship is strong & has weathered very tough times due to CRPS & life..., he is wonderful despite finding my pain upsetting & frustrating to deal with.

We are now considering whether to start a family. I think that were I well there's a good chance we would have already done so (who know's).

This is a major decision as my pain medication would have to be stopped due significantly increased risks to the baby e.g. one medication I take is know to cause death to the baby in the third trimester.

In the past when I have had to come off of a medication or have had an ineffective medication / significant increase in pain I have become suicidal as the pain becomes unbearable - thus I know I can not manage with no medication at all.

I have discussed the issue with my consultant & he has advised me to go all out to improve my fitness as much as I possibly can before trying to get pregnant & to stop all medications. BUT he recognises that I will need pain relief to which there is only one solution...

That is that I continue to take morphine if necessary (I have been on constant morphine for 3+ years).

The problem with this is that the baby will be born morphine dependant - which make me feel sick to my stomach. This is treatable & it should be noted that there is a distinct difference between 'dependent' & 'addicted'.

There is VERY LITTLE information available about women with my condition having babies, they are usually older women (men too). There is a case study on associatedcontent.com & other bits & pieces BUT even the British Pain Society has nothing!

As a result I feel not only horribly guilty for contemplating giving birth to a morphine dependent child but also horribly isolated. In addition I've asked my GP & family planning nurse if they are aware of extra support I can fall back on if I get pregnant & they said there is none. If anyone reading this has had or is having the same issues I would love to hear from you. If anyone knows who I can access support & information that would be wonderful too.

Please try not to pass moral judgment on me without consideration of all of the facts. There is no long-term negative effect to babies born morphine dependent, although they are sometimes of a lower birth weight. The treatment to end their dependancy involves neonatal morphine being administered 4 times a day for approximately 12 to 21 days. Not all babies will experience withdrawal symptoms & breastfeeding is not at issue - i.e. it is safe.

There is a chance that giving birth could cause my condition to spread / worsen BUT this is manageable with a good birth plan & team but I don't know how to go about putting this into place - ideas would be very gratefully received.

I am aware that a child with a sick parent might have issues when growing-up but I feel I have a lot to offer & that I would be a good mother & that I would strive to ensure my child was affected as little as possible & that they have a rich life full of opportunities. Advice on strategies & things I should be considering would be very gratefully received.

All in all I feel confused & overwhelmed - I have noone to talk to & don't know anyone who has experienced this. I feel guilty for contemplating this & I know the time whilst trying to get pregnant & being pregnant will be very difficult if I can only take morphine. I am terribly dissapointed that there are no sources of support & very little information available & I hope that Mumsnet can help & be a much needed lifeline.

Many thanks for reading.

God, that's a tough one to have to face up to, but personally I don't think it's a question of morality. I don't pretend to know anything like enough to really understand - long-term effects, the difficulty of the process itself etc - but as you say, a morphine dependency can be addressed.

I do think that you need to keep in mnd that not only do you have a lot to offer as a mother, but that your husband will no doubt have much to offer as a father.

How mave the medical professionals responded to you? Has it been presented to you as a moral dilemma?

I dont have any experience I'm afriad but have no doubt you'd make a great mum and that youll make the right decision in the end. I'm more concerned about the effect that the pregnancy will have on you rather than the baby. It would probably take at least a couple of months to get pregnant so you'd be looking at a year of almost unbearable pain before the baby even arrives, which must surely take a massive tole. Have you ruled out using a surrogate or adoption?

Oh that's a difficult situation to be in, you poor thing. No moral judgements from me, I think you are very brave. If there are no long-term effects of neonatal morphine dependency and you are keen to start a family then I think you'll just need to find out as much as possible about it and come to terms with it. That sounds harsh and I don't mean it that way but there's not a lot anyone can say to change the problem unless any experts can suggest a different painkiller?

As for the pain, only you can know whether you will be able to cope with just morphine for what could easily be a year or more. Will you have to wait any length of time to clear the other drugs from your system before ttc? I only ask because my sister has MS and she had to come off some of her pain medication for at least 3 months before ttc.

Will you be able to control the pain with medication as soon as the baby is born? Or will it take some time to get it under control?

When you do conceive then I'm sure you will be referred to consultant-led care immediately so you will be able to come up with a birth plan to prevent your conditioning worsening so try not to worry about that aspect.

I'm sorry, I haven't been able to be more helpful. It sounds like a very difficult decision to make and that is really not helped by your medical support team being unable to give you any answers.

You might want to try posting this on the "parents with disabilities" board if you haven't already. There are people with lots of different disabilities on there and they may be able to offer more practical advice.

Z x

Thanks kitcat1977, theperfectbaguette & ziggyf, having your responses is wonderful - it is a massive help to know that I can at last speak about this & that I'm not alone.

Until now I have felt unable to talk to friends or family as I've been scared that they might not understand or will judge me negatively, I've also felt that it is unfair to burden my husband with all that is going on in my head as it's hard for him too. Plus I've been too emotional to talk about it at times - reading your responses brought a tear to my eyes, I really am very grateful for your support & am quite overwhelmed by your kind & non-judgemental words, thank you.

In answer to your points kitcat1977 you are right that the role my husband will play as a father is very important - I'm sure he will be wonderful & very hands-on which will help me hugely. I have to admit that at the very back of my mind I have had a small lingering worry that if it is too difficult for me to have a baby he might in the future decide that he wants one enough to leave me & find someone else. Hand-on-heart I don't think he will have considered this for a second, but I can't help considering it.

As for the medical professionals I've spoken to they've all tended to look pretty grave & say that it's not impossible but there are BIG implications, one is that women with CRPS are at a higher risk of depression both pre & post natal. My pain consultant said that he realises that considering having a morphine dependent baby is something which causes feelings of guilt & anxiety. In conclusion they all seem to say that if I REALLY want to do it I can - but there is no easy answer or way forward. What I'd like is for someone who knows what they're talking about to sit down with me & help me work out how to do it in the best way possible - or to be honest & tell me if it's not going to work.

theperfectbaguette raises 2 crucial questions basically will I be able to cope with a minimum of a year of terrible pain & have we considered using a surrogate or adopting. The truth is I don't know the answer to the first & no-one has helped me to get my head around it. Re surrogacy & adoption we haven't ruled them out & should probably do more research - thank you for raising it, I will do some research as I have always felt that I would like to foster so maybe adoption is a way forward although my husband has said he doesn't want to foster he might be more open to adoption.

Ziggyf - you raise some really crucial questions which I definitely need to get answered as soon as I can find someone to answer them. There will have to be time built in to get the drugs out of my system & I don't know how long. I fear it could take a while to settle my pain after too.

I'm definitely encouraged to hear that I'll get referred to consultant-led care immediately - will this be automatic or is it something I'll have to request? Do you know how much support they'll give & what they might cover? Also thanks loads for the "parents with disabilities" suggestion, I will post on there straight away.

Thank you all so much x

Mistake - I've posted twice by mistake. Sorry, it's my first time! The duplicate is at

www.mumsnet.com/Talk/pregnancy/895239-Moral-Dilema-Chronic-Pain-amp-Pregnancy-Advice-Desp erately-Needed

x

I've cut and pased over my earlier response and your reponse to it because you've ended up with these 2 threads - easily done.

So as i was saying..

I just wanted to reply to your post even though our situations are not exactly the same. I have multiple medical conditions and cannot stop taking some of my medication (alternative is likely death!) even though there is an increased risk of foetal harm. My DP and I are in the early stages of planning pregnancy. It is hard, isn't it? You just want the best for your baby and it feels bad not to have control of that.

From your POV I would say there are lots of positives:
consultant isn't saying don't do it.
morphine dependency in babies is a relatively commonly encountered condition, usually in Mums who are not in good health/well nourished and outcomes are OK, hospitals are used to it.
pregnancy doesn't last forever, maybe you could get extra support from a pain management service as you gear up (sorry if that is a rubbish idea).

I have also been told that as a risky pregnany person there is a lot of support out there, including weekly multi-disciplinary appts and regular checks, so you are unlikely to feel unsupported.

Good luck.

and you answered

mrschigur I really feel for you & wish you all the best. You are right that to not have control is frightening, especially when there could be harm to your baby.

I am encouraged that you say there are multi-disciplinary appts & check-up's available. Do you know how I would access these as I keep being told that there is nothing (by my GP, FP nurse & consultant), I do appreciate that they aren't specialist in pregnancy so won't necessarily have all the answers; any advice you can give me on what I need to do & who I need to talk to would be great. Thanks.

As far as accessing extra help goes, I think the best thing to do woud be to speak again to your consultant or any support staff in clinic.

Because my main problems are probably more common (diabetes and epilepsy) the procedures are better set up, but what I have been told happens is that as soon as I get pregnant I would get allocated an obstetrician specialising in high-risk pregnancy and the appts etc would be arranged along with my neuro and diabetes consultants (and others, but you don't need my entire life story right now!). So I would ask your consultant if you could get a referral to obstetrics as soon as pregnany is confirmed (or moot the idea of even going for pre-conception advice?).

Also the importance of high dose folic acid has been emphasised to me(5mcg - more than the standard shop dose). I understand this applies to most women taking medication in pregnancy. Worth asking about anyway.

Hello there - I just wanted to add one more thing to the advice above: you mentioned that you're aware children of a parent with long-term illness may have issues as they grow up and later.

My DH was born to a mother with an auto-immune disease that has seen her in constant pain for 40 years, and put her through almost 20 operations. He is an only child. the only discernable effect on him is that he is an unusually patient, compassionate, loving and caring man. He has never once felt he missed out on things other mothers could do, nor was his childhood one ounce less happy or secure than that of his friends (well, more, I'd say!).

As I think one or two others have said, the question is more about the effect on you & your health than that of your child, because it seems to me you've got an enormous amount of courage and thoughtfulness and affection, and all those qualities would make you as good a mother as any of us would hope to be.

Good luck with whatever you decide- hope you can stay on here and keep us posted.

sorry if i'm completely idiotic, but pain is a very complex and strange thing isn't it? not fully understood by science?

pregnancy changes so so much about ourselves physiologically: allergies present that weren't there before or disappear/headaches are more or less frequent or disappear altogether, there are countless ways in which our bodies sort of shift..

is it in any way possible that pregnancy might result in a lessening of your pain???

fwiw, i too believe this isn't a moral decision. you need to work out if you want this badly enough to step into the unknown.

yes i agree...have you tried acupuncture? they can perform major surgery without anaesthetic with the use of acupuncture...

Try yoga to strengthen your back and improve your overall fitness and flexibility... and if you really want a child, just be mentally prepared for the hardships during pregnancy, and go for it.

Hi redclover

I just wanted to thank you for sharing your question with us and please do update us on how you are feeling if it helps.

You are a truly amazing person.

I know nothing about the situation you describe but wanted to agree with theperfectbaguette that I would be concerned about your health and pain. I wonder if it is worth talking about adoption and also about using a surrogate, either with your own eggs or with donor eggs, if this would be an option. There are obviously all kinds of issues to think about but I feel sure whatever you do you would make an excellent mother. (I have a daughter and am awaiting fertility treatment with donor eggs.)

I had a Google around and found a couple of sites which you may well be aware of. I feel sure many helpful sites many be in the USA and so you may find some support via the Internet. Thinsg may be different but you may find something useful there. They do seem to have more information out there about medical things (just a bigger population than ours I guess) so if helpful, they are at
www.dailystrength.org/c/Reflex-Sympathetic-Dystrophy/support-group
www.rsds.org/index2.html
I expect you already know about these or if this these are the wrong condition, my apologies. I don?t know if this will deal with issues about pregnancy but who knows!

Apologies if this is no use.

I am thinking of you and I am very impressed by your great courage.

Just in reference to what sophable said - for what it's worth, when my mother in law was expecting my husband, it was the only time in her life she has been free from pain. I know these anecdotes aren't necessarily helpful because everyone's circumstances are so different, but they do offer hope, I think.

I suffer from recurrent kidney stones, which are incredibly painful (though touch wood I haven't had one for a year!!).

They were triggered by pregnancy in the first place and after my 2nd child I was advided to have no more kids - but I fell pregnant with dd2 (dc3).

I spent the entire pregnancy taking daily pethedine or diamorphine uner intense medical supervision, the pain team, anesthetists, paeditricians and was eventually transferred to a much larger hospital for the birth who would be able to deal with any dependency issues when she was born.

Obviously I wasn't allowed any anti-inflammatory medication (which is first line for renal colic) as it can affect the formation of the baby's circulation. Coedine is worse for babies than morphine, more addictive and harder to get off, apparantly.

I spent a lot of time in hospital on PCA (PAtient Controlled Analgesia) which reduced the amount of opiates I had to take.

One of the things that helped me the most was the lovely anaesthetist explaining to me that the stress hormones which are produced when you are in pain can actually affect the baby's development, causing growth restriction. Also, the babies who seem to be badly affected by maternal opiate addiction are actually affected by other things - use of alcohol, poor nutrition, smoking etc.

I was advised to breastfeed (which I did anyway) in order to help my daughter adjust to life without the medication, and that seemed to help. I was told that any opiate injections should be given below the waist as then the morphine is processed in the liver before it reaches the placenta. Effective regular pain releif is better than large doses - so better to take a little on a regular schedule than wait for the pain to get bad and then try to "get on top" of it.

Dd2 was assessed at birth by a paed and was fine on examination. She never needed to go to special care, we were discharged after 4 days, and she is not in the slightest bit affected by her unusual gestation - she's now a lively, cheeky, intelligent and very loving 6 year old.

There's no moral judgement about it - you have to do what you have to do! I would no personally have gone out to deliberately get pg - but I already had 2 children. It was very hard work after the birth as I continued to be in pain for 2 years, and I actually got very depressed, but that could happen to anyone.

Feel free to send me a private message if you want to chat about it more.

All the best!

hi

i agree with what others have said. this isnt necessarily a moral decision. it is a personal, individual decision that needs to be looked at from a point of view considering your health and how you will cope without the painkillers.

is your pain mainly in your back? or is it elsewhere aswell??

my mum suffered from chronic pain following an op to remove her lymph node due to stage 2 breast cancer. now i know this isnt the same but chronic pain is just that, no matter where it is. she was finding it very hard to cope with the pain and was becomming dependent on opiate meds. she was referred to a pain speciallist called Austin Leach who was able to do a clinical trial for a device to be fitted to her spinal cord called an Electro-Nerve Stimulator. i dont know if this works for spinal injuries but it was severe nerve damage in her arm and upper right side of her chest that caused my mums pain and this ENS has pretty much cured all pain she was experiencing. worth a look i think. this would maybe help you cope better with the pain, if not get rid of it altogether.

i will try and find a link to the site for it as i did a case study for this while i was in uni studying to be a nurse and there is info out there on it

this is the device and the study is about angina but is is used more widely than for heart problems. as i said my mums pain was caused by nerve damage following a botched cancer treatment op so that proves my point i guess

FWIW i think that as pregnancy changes so much including bloodflow in your body, you may find that your pain all but disappears with any luck

Hello

I was overwhelmed before - I feel blown-away now by all of your help, advice & very kind words. Thanks so much it really means the world to me & for the first time in a while I feel like the melancholy is lifting.

I didn't expect it but I've begun to look at things in a different way & to see that the bigger issue is the conception & pregnancy itself & what it will do to my body/pain.

Thanks for getting back to me mrschigur asking for a referral to obstetrics as soon as pregnany is confirmed (or for pre-conception advice) is an excellent idea - thank you. I will definitely look into high dose folic acid too.

LunaticFringe thank you for sharing your experience, it's true that it's never easy. When I read about your situation I just feel full of empathy & don't jump to any negative conclusions/judgements. I haven't looked into alternatives e.g. acupuncture but will do. Good luck with everything, let me know how it's going if you get the chance.

Eadwacer you are right that if approached the right way a child whoose parent has a medical condition could benefit from the life experience - your DH sounds lovely. Thanks for helping me see the other side & for your very kind words.

The thought of going into remission is wonderful - thanks for suggesting it sophable, it isn't idiotic at all, apparently there is a slim/very outside chance of remission, from what I've read it is something to do with a huge boost of progesterone & other hormones. You and Eadwacer are right that it's good to have hope. It does come down to stepping into the unknown...

Yoga is a great idea sunagel188, I did used to do it prior to the CRPS, is there a particular type you could recommend, not having to hold poses for too long would be good. Thank you for suggesting it. You are also right about the hardships, I guess that's why I really need to get a good support network around me.

Thanks Italiangreyhound for your lovely words. I haven't looked at the links you've given to me before but will do now, thanks for finding them, I think you're probably right about American sites so will go on the hunt for info again. You & theperfectbaguette are right about considering other options, I don't know why but we've not really considered a surrogate or adoption & we should. Are there any sources of information that you would recommend? I wish you all the luck in the world with your fertility treatment - I don't want to pry but would be really interested to know more about it & how you are getting along. Thanks again.

It sounds like you've had a very tough time weegiemum, I really hope things have settled now. It's so encouraging to hear that you had such good medical supervision - did it kick in automatically or did you have to ask to be referred? How much of the pregnancy did you spend in hospital? It's very interesting to learn that the stress hormones can be worse but it does make sense - helps with perspective! It also makes sense re taking a regular dose of morphine as I know how hard it is to try & bring my pain levels back down once they rise. What you say about other issues affecting dependent babies makes perfect sense - it's great to hear that your daughter didn't have to go into special care. I also feel relieved that breastfeeding is advisable. Thanks loads for sharing your experience with me.

The ENS sound amazing & I'm so happy it's helped your mum PandaEis - living in constant pain sucks & it's wonderful to hear of people beating it. My consultant has said that the ENS won't help me - following 2 failed ops! However I've not had a 2nd opinion, although in fairness I have read that after 5 years most interventions aren't very effective - my pain is in my upper back, neck, chest & shoulders though so maybe there is hope... I'll definitely look at the study, thank you. Fingers crossed that it will trigger remission! I hope your mum is back to good health.

I feel so fortunate that so many of you have taken the time to help me. I feel lifted & much less isolated. I can see that it's a big decision / a lot to take on board but it feels great that with your help I am now starting to get my head around how to prepare & what I need to consider.

I also feel liberated from thinking that by considering taking morphine throughout pregnancy I was being very selfish.

It feels really positive to be putting together a list of things to do, any more suggestions would be very gratefully recieved.

Thank you all so much x

Dear redclover, I hope you will keep us posted on your decisions: I've thought about you ever since reading your first post, and will continue to do so. . . xx

Hi Eadwacer thank you so much for all your help, advice & support - I'll try to update as & when there are developments (no telling when that might be with the NHS...). Thanks again. Take care x

reclover - if you are looking for advice and support regarding surrogates and/or donor eggs then Fertility Friends might be a good place to start - www.fertilityfriends.co.uk/forum/index.php

Hope that helps,
Z xx

Hi redclover

Thanks for your kind words. My own situation is just that we had our dd and then could not conceive with my own eggs so went on the waiting list for donor eggs. I hope it will all happen soon.

The reason I thought a surrogate might be useful for you is that you could have a baby (if it works) with your hubby's sperm and your own eggs, or donor eggs if that was better for any reason. You would not need to have the pregnancy yourself and go through the pain management situation. I must say I have no experience of surrogacy myself so I really can't advise. I did Google around and found sites about it. It would need to be something to talk about with dh and look into and it is not cheap.

I Googled around and found this website www.surrogacyuk.org/
I MUST STRESS I do not know anything about the website or surrogacy, it is just a suggestion. I can't advise, I just hope you will find the pathway that is right for you.

As far as adoption goes I have no idea how that works. We looked into it a lot but because my dd was only little we were not eligible to go for it. We may look into it again if treatment fails, we may hopefully now be able to pursue it as dd is 5.

I think having a baby is a wonderful thing but you must put your health first as well.

I wonder with some conditions (perhaps like endometriosis) if the person can experience a change for the better after pregnancy. Maybe this could be the case for you! But maybe could be the other way so you just need as much medical help as possible to make the right decision.

Hopefully all the combined opinions/advice/ideas here and the medical advice you can get for your specific situation will just help to point you in the right direction. You can decide with dh what is best for you guys as a couple. Whatever happens I wish you all the very best, God Bless

redclover - I like hatha yoga as it does give you some time to get into the poses and become comfortable in them. You can keep in them as long or short as you like, most yoga classes allow you to do as much or as little as you need. Don't get daunted by the students wh've been doing it longer who can do complex poses, just get on with your own practice and simply focus on improving your poses without being competitive (and that's not easy!). The improvement will come naturally. You could also try Bikram yoga (or hot yoga)... it's done in a heated room so while the poses tend to be easier for the muscles as it's warm, you do get quite a workout.

But try a few styles, and it also depends on what classes are close to you. It's not so much the type of yoga but the instructor that's important.

Good luck! I found it quite difficult making a decision to have a child but finally made the jump and went for it because it was the right thing to do for me. Hope it goes well for you!

redclover - you sound like an inspirational lady! I think it is brilliant that you volunteer with Princes Trust and Social Services.

There is just something about your post that made me want to try and share as many ideas as I can.

I think that you've come to the right place to get advice.

I lurk much more than I post but I've found the internet to be very useful to research all things PG/parenting. (I have one DS who is 2.3 years old.)

You definitely need expert advice re the use of your pain medication - the default advice can often be no meds during pregnancy. GPs and your hospital specialists won't be experts in this field as they are not obs/gyn or paeds.

Have you considered a private medical consultation with an expert - not sure how you'd go about finding one.

I think that if I was in your position I would have several strands of research on the go as follows:

Surrogacy

Have you seen the COTS website - here?

Adoption

There is an adoption section of Mumsnet - here.

I am wondering whether you would be unlikely to be offered a child for adoption due to concerns about your health.

Remaining child free

I am aware of various forums for people who have decided to be "child free by choice" or who are unable to conceive.

These are some places where I lurked before my DH agreed to TTC.

I think that it is worth considering this possibility and what would be positive about it and what life experiences it would allow (more volunteering/travel/time as a couple etc).

One child families

Obviously if you do go ahead to TTC then having one child may be easier to manage-
see the one child board - here - there are many positive experiences there.

I lurk as DH adament he wants no more DCs.

Conception

With regards to TTC - I would think that it would be of benefit to you if you could conceive ASAP after you came off your meds.

Therefore I would suggest that you get very familiar with the details of how your cycles work - i.e. temp taking/cervical mucas/
/ovulation tests.

I can recommend this
book - I used it and conceived first try!

I can also recommend the Zita West books she talks through health for fertility vitamins etc - I believe her consultations are higly recommended by many- may be good to get someone real life to discuss TTC with.

Accupunture which others have mentioned is good for fertility.

I did a Hypnobirthing course as I was really anxious about giving birth - I can really recommend it. I had a fast labour and relatively straight forward labour with gas and air for pushing stage.

Hypnotherapy in general may be of use to you in your relaxation programme - I have several downloads from here.

Other thoughts - What contraception are you currently on? If it is one which generally takes a while for full fertility to resume could you come off it and move to non-hormonal eg Condoms plus Diaphragm plus Charting.

Maybe your DH could have a sperm count test done to confirm all is OK with him before you proceed.

Could you maybe find out if you could use IVF or ICSI (don't know much about these) - I wonder if it would increase the chances in an individual cycle.

It may be worth finding out if you could use certain meds at the beginning of each cycle if you have confirmed you are not PG?

Thoughts about managing a baby

I'd recommend that you research Birth support - google doulas.

A part time nanny/au pair/ mother's help would be very helpful to you - could you afford for this - do you need to start budgeting?

Start to research breastfeeding - I wish I had done more before my DS is born. Basically because in this country
we are not surrounded by generations of breastfeeding women we have culturally lost a lot of the know how.

There are people on the breastfeeding board here on Mumsnet who are very clued up about where to find out about
what meds are ok for breastfeeding.

Routines for baby etc - not for everyone - and I agree that ideally biologically these are not "natural". And despite believing that on-demand breastfeeding/co-sleeping was best it wasn't possible for me so I eased my DS into a routine - and certainly a Nanny could help with this - I recommend that you look into both routines AND Attachment parenting.

As for managing a baby - I really believe that you can shape how a baby develops/increase concentration levels -
many of the ways of doing this are not "mainstream" and different to want most folk do (less plastic toys, less TV etc!!).

Generally Mumsnet won't be the best place for this info .

I'd like to recommend - this
book - Montessori from the start - and also have a look at Montessori infant and toddler
info and blogs. I really like some of the principals and I find the various activities really calm my DS.

My reason for posting this was so that you could be more confident of raising a child who fits in with your life and who would grow up to be able to occupy themselves happily when needed.

Good luck with everything and apologies for the masssive post.

Hi ziggyf

I will definitely look at Fertility Friends as I don't know anything about surrogacy & donor eggs. Thanks very much -again- I can't stress how much I appreciate it x