Reasons to be grateful

Is it heresy if I admit that before our miscarriages I never really thought about the NHS – which is 70 years old today – that much?

It’s an odd thing for a health journalist to say, I realise.

In an abstract, political sense of course I was glad it was there. And as a journalist I suppose I did ‘think’ about it in the academic sense – I had to be on top of the issues concerning its funding, the treatments it had or hadn’t approved, the mess over junior doctors’ pay. And then there were the people I’d interview for articles who would almost always tell me how very grateful they were for the NHS. (And I’d almost never include the quote.)

Of course I knew that the NHS did amazing research and pioneering work. That there were brilliant, dedicated people working in it doing heroic things everyday.

But still, with the enormous privilege, selfishness and arrogance of a young and healthy person, I just didn’t really get it. It was not something I, personally, had depended on in any meaningful sense yet. So I didn’t think about it in a meaningful way.

The NHS – while obviously A Good Thing – was largely there for other people. Not me. Not yet.

Even when I was first pregnant, I was a low-risk, light-touch, check-the-box kind of patient, breezing in and out of brief appointments, with no cause for concern on either side. I was healthy, I took responsibility for my own health, I didn’t need looking after and I didn’t anticipate needing to be any time soon.

And then one weekend you haemorrhage more blood than multiple sanitary towels, your thickest jeans and a winter coat can hope to contain, get shown a blank space on a black screen where your baby should have been, and everything changes.

Since that first miscarriage, and the further we’ve gone down the pregnancy loss rabbit hole, with each miscarriage, and with each fresh round of scans, treatment and tests, my sense of simple, but profound, gratitude for the NHS has deepened.

I have genuinely lost count of the number of scans I’ve had now. The battery of blood tests I’ve had alone –  trying to identify a cause for our miscarriages – would cost close to £1,000 privately, by my reckoning. Let alone the two surgeries.

No. There are many things I have found to worry about in the last two years as we’ve tried to have our first child – but the cost of our treatment has never been one of them. And it occurs to me how much worse this would all be if it had. Losing a baby is one thing, writing a cheque for it afterwards is another.

Even the thought of dealing with insurance paperwork in the midst of that grief and shock feels painful to me. How does that work? Would recurrent miscarriages affect my premiums? (That’s a genuine question. Overseas readers, I would love to know your experiences with this.)

No, the beauty of the NHS – the radical kindness as writer Mark Haddon put it – is that whoever you are, however much you have in your bank account, at your lowest moments it’s got you. You’re not going to miss the deadline to claim the money back for your treatment  because you were too mired in grief.  It’s already covered.

Whether you pay tax or you don’t (can’t) there will be somewhere for you to go. Someone will see you, scan you, dress your wounds, anaesthetise you, operate on you, bring you round again, and then hand you a cup of sugary tea when it’s all over.

None of this is to say the NHS is beyond criticism – and when it comes to baby loss it is far, far from perfect. (Which is why I recently took part in the Government’s review into early pregnancy loss – but that’s for anther day.)

Yes, there have been brusque consultants,  and blank-faced GPs, doctors who can’t – or won’t –  meet my eye when I tell them my pregnancy history. There have been unfortunate waits in rooms full of smiling, visibly pregnant women. There have been occasional cock-ups over appointment times and – once – a scan they forgot to cancel meaning we still got sent the reminder letter. The postal equivalent of a dropkick to the stomach.

But you know what? I’m still grateful. I’ll take the not-so great along with the good if it means it’s free, for everyone. No questions asked.

I’ll take it along with the midwife who bear-hugged me, having found me crying, waiting outside a not-yet-open early pregnant unit while my husband was parking the car; and the healthcare assistant who squeezed my shoulder during a scan and confided that she’d had 11 miscarriages and to hang on in there; and the smiling catering assistant who brought me a plasticky white-bread sandwich after my last surgery (which sounds bad, but in the circumstances was better than any precious wholemeal version could have been).

So what exactly has changed for me? Perhaps until now I still thought that my health was largely controllable. We hear so much about obesity, smoking, and alcohol, the preventable things that supposedly put such strain on the health system, it’s easy to start to think that way.

But of course, health – and the need for healthcare – is often random. It’s just one tiny example, but there is apparently no medical reason for our miscarriages. It is just chance. It could happen to anyone. And if it can happen to anyone, that means everyone.

Perhaps what I meant earlier is not so much that I never thought about the NHS before, but that I never felt about the NHS before.