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He cannot speak because of problems with muscle development, although he has perfect hearing. The babies were weak, but gave no immediate cause for concern, but then at three days doctors discovered that Jack had suffered a brain haemorrhage some time after birth,probably due to the fragility of his blood vessels.This is not uncommon in premature babies and, initially, Jack seemed to be making good progress, but at two weeks he was diagnosed with water on the brain (hydrocephalus), as a consequence of the blocked and damaged blood vessels. I’d had a consultant’s appointment the week before and everything had been fine. In fact, I was more concerned about what he would do if I went to 42 weeks, when would he induce?”Unfortunately, there was no question of that. When the pain became so severe that she was in no doubt she was in labour, Julia was rushed to hospital in Hemel Hempstead “It was almost over,” she says. “I was seven centimetres dilated.” It certainly would have been all over if the doctors had not decided to arrest labour temporarily – though they knew they could not do this indefinitely – so that they could administer steroid drugs to help the babies’ lungs to mature and reduce the chances of breathing difficulties.Julia Suslak was then transferred to the Luton and Dunstable NHS Trust Hospital for the birth of the twins, with Anne weighing in at just 2lb 10oz, and Jack at 3lb 2oz.

“I knew that twin pregnancies often don’t go to 40 weeks, so from about week 35 I planned to be on the alert for symptoms.”She was just four days in to her maternity leave and 29 weeks pregnant when she experienced a small, thickish vaginal discharge, and developed some mild pains in her back. “It was exactly the kind of pain I’d had before when I ate something that disagreed with me Rather like indigestion,” Mrs Suslak says “I went to the hairdresser’s and walked around. I don’t smoke, I didn’t drink, and I made sure I wasn’t rushing around like I usually did. I’d planned to go on working to 36 weeks but I was getting so tired that I stopped at 29,” she says. She continued working as a product manager for a drugs company but “slowed down considerably”, and built regular rest periods into her day.”I was very careful.

Julia began to put on weight and apart from the fact that she felt very tired, all the medical signs were that this was a normal twin pregnancy. She suffered dreadfully from morning sickness, which persisted throughout the day for the first three months, and lost half a stone from her slight frame But at 14 weeks, the sickness stopped. It is as if it comes on by stealth, and the least we can do is be explicit about what a woman should watch out for.”Lucilla Poston, professor of foetal medicine at Guy’s and St Thomas’s Trust, which is pioneering research into the causes and prevention of premature labour, agrees. “We tell all our mothers-to-be to be alert for contractions, and lower abdominal pain. But often women don’t realise they are contracting; it may be just a mild, period-like pain.”Julia Suslak conceived early in 1992, a planned pregnancy which had delighted her and her husband, Nick. “I used to ask, ‘When will I know if I am in labour?’ and everyone said, ‘Oh, you can’t miss it.’ Well that is probably true at 35 weeks on, but earlier in pregnancy there are more subtle changes Premature labour is something of a mystery We just don’t know why it starts. The first National Pregnancy Week, which begins on 2 September, will focus on the problem, with an international conference at St Thomas’s Hospital in London.”Everything is geared towards a full-term, 40-week pregnancy,” Mrs Suslak says.

The UK has one of the highest rates of premature birth in Europe, and each year 40,000 babies are born too early. But Mrs Suslak is convinced of one thing – that despite the plethora of books, videos, and courses for the new mothers-to-be, there is something missing from pregnancy education: the signs, symptoms and risks of premature labour. And there will always be the question hanging over her for which there is no absolute answer: are Jack’s disabilities a direct consequence of her premature labour, which she failed to recognise?She has gone over and over it in her mind and knows there is nothing to be gained from the “if onlys” or the feelings of guilt. Jack and Anne are too demanding of their parents’ energy and time to allow this self- indulgence. She gave birth to a girl, Anne, who is strong and healthy, and a boy, Jack, who is brain-damaged, physically handicapped and blind.Even now, four years later, there is a sense of bewilderment in Julia’s voice as she describes the abrupt end to her pregnancy. She went into premature labour at 29 weeks, but was oblivious to the mild symptoms associated with it, and as a result was admitted to hospital only in the latest stages.

Her first surprise came at 12 weeks when she found out she was having twins. “It was,” she recalls, “a very pleasant discovery, to see them there on the scan – there was no history in my family or my husband’s of twins.” She adjusted her reading material to include the sections on twin births, and resumed what was a textbook pregnancy at every level.
Julia’s second surprise was more subtle and decidedly less pleasant. When Julia Suslak became pregnant for the first time at the age of 34, she did not want any surprises. She immersed herself in reading about every aspect of foetal development, labour and birth. Approaching the pregnancy as she would a workplace project, Mrs Suslak proceeded through the library of books she had acquired, studying the diagrams and matching the changes in her own body, while imagining the changes in her baby’s.