Abstract
Francesca Segal was already an award-winning author when she became pregnant with her twin girls. In Mothership we are invited to join her, her husband (Gabe) and her twin girls (A-lette and B-lette) on a 56-day journey that follows the premature birth of the girls who arrive unexpectedly at thirty weeks. It describes how the author’s world of a mother to be goes from being happily pregnant with twin girls ‘pregnancy was like performing a perpetual magic trick, to move around the world in silent company of my daughters’ to suddenly and shockingly giving birth prematurely ‘taking my unready daughters from within me felt not like a birth but an evisceration.’
Her prose is lyrical and touching written with such a raw intensity it was impossible to put the book down.
In the beginning we are drawn into the, at times, intensely painful, raw, terrifying world of the Neonatal Intensive Care Unit (NICU). However, we are also introduced to the overwhelming love and support she is offered by the army of hardworking junior doctors, nurses, and most of all the other mothers who are fellow passengers on the same journey in ‘The Mothership’. Most of all, even though at times I was scared to turn the page when one of the girls became perilously unwell, there is a wonderful sense of hopefulness and a holding on to the future. The book balances sadness and worry with gentle and at times less gentle humour. I laughed out loud at some of the WhatsApp conversations shared by Segal and her friends and found myself desperate to join them in ‘The Pastry Slice’.
Segal writes with incredible honesty about the shortcomings of the NHS: not being able to stay with her babies in the hospital (due to limited resource); the failure of the first consultant to either introduce themselves or acknowledge her identity by calling her mum (still happening then); the poor pay of nurses (still happening) and incredulity when one twin was sent to a different hospital (due to limited resources) which meant she had to constantly run back and forward between the local and the central hospital to spend equal time with them both. She also conveys the power differential that many patients and parents experience between herself and the medical team in situations where she wanted to challenge or disagree with statements or decisions but found herself unable to do so.
Segal points out that for all its flaws the NHS is still a precious commodity enabling her daughters to be cared for without any need for insurance or payment as there would have been, were she to still be living in the USA. She is also able to name the many heroes that gave over and above along the way. The importance of the small acts of kindness described in the book are profound!
Segal manages to expertly convey the tenuous thread by which these tiny little human beings hold onto life and is not afraid to ask difficult questions about why as a parent she can’t stay with them, the debate about pain perception in neonates and the dilemmas she had about how to divide her time between them. She is brutally honest about the rollercoaster of emotions she experienced as well as the fear that showing what are normal and reasonable emotions of guilt, sadness or despair might get her labelled mad or in need of psychological care. I was curious about the lack of a psychological presence. Where was the NICU psychological support?
As professionals there is a danger that one can lose touch with the unique experience of a new mother and their babies in an NICU. For all the NICU psychologists and psychotherapists out there – read this book to connect your theories and beliefs about premature babies with the reality described here. Segal acknowledges the importance of early experiences and associations and attachment and writes frankly about the guilt and deprivation she experienced. For anyone else – read it anyway – it is a privilege to be able to share 56 days with these two very precious little girls and a joy to turn the last page and welcome them home.