There are few things as precious and remarkable as growing a new human being, so when a pregnancy doesn’t go to plan, it can be devastating for the parents. At the Fetal Medicine Unit at St George’s Hospital London, they perform pioneering surgery on babies in the womb, and try to give the sickest babies a chance at life.
Early last year before Covid struck, producer Joy Ash and I embedded at this super specialist unit to begin a year long journey into the world of high-risk pregnancies, a C4 commission for Wonderhood Studios. The first thing you realise is that Fetal Medicine is a place of intense joy and intense sadness; one in four pregnancies end with baby loss and many of the women coming to this unit have particularly high-risk factors.
Take the case of identical twins in episode three of our series. The mother discovers that one of her babies has a form of spina bifida where the brain is protruding through the back of the skull, but her other twin baby is healthy.
Her choice: to leave the pregnancy to run its natural course with a very high risk she loses both babies, or to improve the chances for the healthy baby, by opting for a selective termination of the poorly twin.
These cases are fraught with ethical and moral dilemmas and only the parents can choose what is best for them. This, in turn, puts a huge responsibility on the consultants as they help patients navigate these unspeakably hard decisions.
A space for testimony
I wanted these films to be a space for women to testify to their own experience in order to help others, and that meant telling their stories without sanitising.
As a society, we don’t talk about baby loss and termination, so we actively decided not to anonymise or cut away in our storytelling when dealing with such emotionally complex issues like these. We wanted to honour what the parents were experiencing, not create shame nor censor their excruciatingly difficult experience.
All the patients we followed had high-risk pregnancies, which are unpredictable by their nature and unfortunately some of the mothers did lose babies. We feature both a selective termination and a stillbirth, and we wanted to be respectful to that loss of human life whilst helping the parents through their acutely personal grief.
Documentary makers have captured the moment of life over the years but the moment of death, and documenting it, is still difficult so we wanted to confront it as sensitively and truly as possible.
This meant finding creative ways of filming these highly sensitive experiences in quite tight spaces, often with very little notice. Alongside single camera filming, we built a bespoke three camera mini rig which we could move anywhere in the hospital very quickly.
The scan room was the ‘main stage’ where both good news and bad are revealed. The emotions fly high here so you need coverage to slow things down. I used Blackmagic micro cinema and pocket cameras with prime lenses and local monitor/recorders, which meant that I could move around with a single camera while monitoring the coverage.
Because each rig was small, I could set them back from the action so they didn’t distract those in the room; they could also be moved into the operating theatre or labour ward more easily. As we were following multiple stories, some days we would move the rig multiple times.
Secondly, behind this set up we were trying to build strong relationships with the patients, to earn their trust but also to seek honesty in what we filmed. Capturing honesty in people’s lives is really down to active listening, which can also be very cathartic for the person sharing.
I’ve heard the power of sharing feelings with another described like a tumble dryer, where feelings are mixed up together. Talking through them helps you get the load out of the dryer and sort each piece into different piles. It’s not a perfect analogy, but the picture helps me understand the value of active listening alongside the editorial.
Four am in the middle of a campsite last summer, I left my family and whizzed back to the hospital where a patient we had been following was in labour. We had discussed at length the filming of her birth, because one of her identical twins had already died.
When I arrived the couple were calm but pensive; neither of them had seen a dead baby before, and neither had I. We talked, I checked, I listened and we agreed to proceed. Filming the birth didn’t mean we had to broadcast it – the passage of time lay ahead, and that time was important.
I have never witnessed such strong grief followed by such intense joy in such a short space of time. The first twin was stillborn, followed by the second which was born alive. While this was expected, it didn’t take away from the raw emotion the couple experienced.
Many months later, after a lot of careful consideration, the couple decided to share this experience in the film. They firmly believe that showing the stillbirth will help other parents by giving them a reference which is currently missing in social dialogue.
Our commissioning editor couldn’t have been more supportive. Channel 4 was made for this kind of disruptive filmmaking but it still takes bravery from the contributors and the broadcaster to actively go ahead and support it.
For some, watching this scene will be extremely difficult and trigger a whole range of deep emotions, but our fervent hope is that by showing this, it will help create a much-needed conversation around pregnancy complication and loss.
Also featured in Broadcast on April 26th 2021