Fetal Heart Rate: Not Detected

I killed my baby. Not directly, not intentionally, but my inactions caused her death. Apparently I have left the “Anger” stage (for now) and have delved right into the “Bargaining” stage.

My first inclination that something wasn’t right was on my 37th birthday. I was 37 weeks and 4 days. It was a Friday night.  My husband and I were laying on the futon mattress on the floor in our daughter’s room. We were trying to get her to lay down but she was too busy playing. “I’m not feeling the baby move much,” I remarked to my husband. I had a busy day at work and hadn’t been paying close attention to whether or not she had been moving. He reassured me that the baby was fine, that there probably just wasn’t much room in there. I got up to get some cold water and lay on my left side. Was that movement? I texted my midwife. (You can read more about my midwife here). She wrote back “Babies have less room to move as they get bigger. It is not uncommon for there to be gradual decrease in the strength of their movements. But it shouldn’t be abrupt and the frequency should not decrease…If there is a noticeable decrease in movement, you may want to go in for an ultrasound to check things out. You could wait until tomorrow or you could go in tonight depending on how concerned you are. What does your gut say?”

My gut said we should go in–better to be safe than sorry. But that’s not what I did. I didn’t go in for an ultrasound. I wanted to believe that my baby was moving, that she was okay. My husband kept saying “I’m sure she’s fine.” And I wanted to believe him.

My second inclination came four days later.  My midwife came over for a prenatal appointment and I distinctly remember her moving the Doppler around on my belly, finding a heartbeat and, pausing, she said “I guess that’s her heartbeat?” But was it my baby’s heartbeat or was it mine?

One week later, my husband became sick. Very sick. He stayed home from work for two days, and that says a lot, he doesn’t miss work. I was concerned as he had a few of these episodes prior and I thought perhaps it was his gallbladder or appendix. On Saturday morning I insisted that we have things checked out. I’ll spare you the details, only to say that he was admitted to the hospital overnight for observation and is presently fine. This is only important to mention because while I was fretting about my husband and caring for my living child, my baby was dying inside my body.

I requested my records from my midwife and they arrived in the mail today. There it is, in her scratchy printing (because she still hand writes her charts even though everyone else in the world is using i-pads and smartphones):

5/8/17

Fetal Heart Rate: Not detected.

Baby suspected dead at 9:30 am. Baby confirmed dead by ultrasound around 11 am

Apparently normal, healthy baby had died at least two days prior. Mother thought she was still feeling the baby move. Absent FHT [fetal heart tones] at normal prenatal visit on 5/8/17 was the first indication of fetal demise.

Stillborn–known dead

 

If only I had….

How have you managed any guilt you feel from your grieving experience?

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The Dresser

My first daughter was born in May 2013. I had planned it that way, so that I could have the summer off for maternity leave. It was perfect (other than the fact that we don’t have air conditioning in our house and it was a bit humid that summer). My husband has a more relaxed schedule in the summer and that year he was able to work mostly from home, calling in for conference calls as needed, with the occasional trip into the office. It worked well, he would put our girl in the Boba and water the garden while I snagged a nap.

So when we finally decided to take the plunge and have our second child, I wanted another spring baby. We became pregnant in August with an expected arrival for the beginning of May. Having our second child at the same time as our first was perfect–another summer maternity leave, and another girl, to boot. We didn’t need much–I had kept everything from my first daughter “just in case.” I did end up purchasing an infant wrap to use in addition to the more structured carrier we already had. My cloth diapers were a bit tired so I mailed them off to a seamstress to have the elastic replaced. We received a few gifts–a blanket that my mom’s cousin cross-stitched; a pink and white polka-dotted dress from one of my husband’s colleagues; a yellow duck “lovey” from friends; and a Target gift card from my coworkers. We purchased a dresser to house our layette.

We didn’t have a nursery for this baby. I had asked my daughter if she wanted to move her bedroom downstairs and give her upstairs room to the baby but she said “maybe when I’m 5,” so we kept her room as is, down the hall from ours, and set up the crib in the corner of our large master bedroom and the dresser across the way.  On April 9th, when I was 35 weeks and 6 days, my almost-4-year-old and I found the tiny baby clothes and blankets in a dusty box in the garage. I washed them all and she helped me fold them and put them away. We hung up the dresses on hangers.  She especially loved a white dress that she had worn as a baby. “When the baby comes, I’m going to dress her in this bootiful dress and these cute socks and this pink headband.” She declared. And everyday she would open the drawers and peek inside to make sure the socks and headband were there and the dress was still hanging in the closet.

But then our baby died and my daughter did not get to dress her baby sister in that outfit.

On June 25th, 6 weeks and 6 days after the worst day of my life, I sobbed as I packed up all those clothes. The tiny socks. The soft cotton onesies. The patterned cloth diapers. The beautiful dresses. I felt like I was packing up my broken heart. What I didn’t pack away were the gifts meant for this baby–the cross-stitched blanket; the polka-dotted dress; the yellow duck. And the white dress, pink headband, and tiny socks that her older sister selected for her first outfit. Along with a memory box from the hospital,–with tiny footprints inked inside– and my daughter’s ashes, it’s all I have left.

 

What physical memories have you held onto? What have you let go?

Everybody Gets a Baby! (Not You.)

Us bereaved moms, we are more difficult to identify…but our eyes, they are filled with a despairing grief….And always invisible to the naked eye is her shattered heart.

“Look at that cute baby!” squealed my four-year old. We were at the grocery store.  Looking around, I noticed SO MANY babies. Everywhere I go, I see babies– not only at the grocery store, they also dominate parks, restaurants,  and Target. Their chubby legs teeter around at birthday parties and their parents clog up my Facebook feed with adorable pictures, captioned with milestones my youngest daughter will never experience.  Even G-D Daniel Tiger has a baby sister.  In my daughter’s preschool class alone, three classmates got baby siblings this spring.  In the past two weeks, my daughter and I have visited goat kids and encountered baby ducks in a parking lot. Literally, everybody has a baby.

Ok, I know not literally. It just feels that way to me, because I don’t have my baby.  One day, while watching a mom strap her infant into the carseat, I mused aloud “why does everybody get a baby except for us?”  Since my daughter was with me, she occasionally will repeat this sad phrase–”Why did everyone gotted a baby be-cept for us?”

One can identify a baby easily, even though they are small. The tiny ones are tucked inside car seat carries or strapped to a parent’s chest. Sometimes they are swaddled in a blanket and passed around to other cooing adults. Older ones are in strollers or sitting up in shopping carts, waving and babbling. Even the mom who doesn’t have her baby with her–who was able to sneak away to Target by herself–even she is identifiable. She is the one leaking milk through her shirt, the one with spit-up on her shoulder.  Her hair is unkempt, her makeup not done, barring a little lipstick. She is the one comparing breast milk storage bags and debating which pacifier to purchase.  Her tired eyes glance enviously at me, holding my Starbucks and casually strolling kid-free. What she doesn’t know is that I am on “maternity leave.” A maternity leave without a baby.

Us bereaved moms, we are more difficult to identify. We may still have the unkempt hair and makeup-free face, but our eyes, they are filled with a despairing grief, the delicate skin beneath them dry from rivers of tears. Our mouths may be perpetually turned down or frozen in an anguished wail. If you look closely at this mom, her hair has more white strands than it did prior to her baby’s death. Depending on when she lost her baby, she, too, may have heavy breasts leaking milk that her baby will never drink. What you cannot see are her stretch marks, proof that her body once held a baby.  And always invisible to the naked eye is her shattered heart.

Sometimes it feels like the universe, in Oprah-like fashion, is shrieking “You get a baby! You get a baby! Everybody gets a baby! (Not you).”  Last night as I was laying with my daughter at bedtime, she pondered “Why did everyone gotted a baby be-cept for us?”  I don’t know, sweetheart, I don’t know.

Do you have a pity party for yourself when you see others’ babies? What coping strategies have you found helpful?

When Anger Festers

I am enraged that you said death may have been the best outcome for my baby. That perhaps if she had lived she would have been cursed with medical problems and lifelong disabilities.

I had a midwife. I say had because I no longer need her services. I am no longer pregnant. She was actually more than a midwife, she was a friend. I say was because after I delivered my second daughter I began to feel angry and hateful toward her.  Let’s call this midwife Laura for the sake of anonymity. Laura is a CPM. She assists moms in home birth deliveries. That’s right, I planned to deliver my baby at home.

My first pregnancy was also a planned home birth with Laura but I ended up delivering at a hospital. I was of the belief model that pregnancy, labor, and delivery are normal conditions and that a low-risk woman (me) need not see an obstetrician-gynecologist (ob-gyn). Ob-gyns are trained surgeons who look for problems, administer interventions, and before you know it, they are cutting you open to deliver your baby. I wanted to deliver at home, amongst my own germs, in a birthing tub with only my husband and two midwives. But as it was, I ended up laboring for three days at home, my blood pressure rose, and Laura recommended that we transport to Hospital X where I had an epidural and delivered my healthy daughter with the assistance of a family physician and a resident.  Laura stayed with me to advocate for the skeleton requests of my birth plan and to fill in my pregnancy history.

When I became pregnant the second time, I knew I was pregnant. I did not take a pregnancy test, I just knew. This baby was planned. I hemmed and hawed over what I wanted this delivery to be like. I reflected back on my first experience. We had been lucky, we had a good outcome despite a difficult labor. Seeds of doubt floated through my mind.  Why did Laura wait for my blood pressure to get so high before recommending transport? Why didn’t I express my desire to go the hospital sooner? What was the least risky path for this pregnancy, labor, and delivery?

I told my husband I wished to deliver at Hospital A with a group of Certified Nurse Midwives.   My first daughter was born at Hospital X, about 12 miles and 25 minutes from our home, and although I didn’t end up with unnecessary interventions, I felt Hospital X was too risky. Hospital A had a good reputation for accommodating all sorts of birth plans, plus they had a labor tub. But Hospital A was about 35 miles and 50 minutes from our home, through curvy backroads and small rural towns. Being due in May meant we wouldn’t be traversing winter conditions on the way to delivery. But my husband felt uncomfortable with the plan and since I really didn’t want to deliver at Hospital X, we settled on another planned home birth, even though my gut told me not to.

I was 17 weeks along when I first met with Laura for this pregnancy. In all, we met seven times. Our appointments lasted two hours or more. In general, I was satisfied with the prenatal care I received. Each appointment began with talking—we’d start with general chit-chat and move on to relevant topics–my past birth experience and my hopes for this one. At each visit Laura would check my blood pressure and use her Doppler to listen to my baby’s heart. I had two risk factors: Advanced Maternal Age (AMA) and a body mass index (BMI) of 31.8 which put me in the obese category.   At my first prenatal visit–the one at 17 weeks–I specifically asked Laura if either was contraindicated for home birth. She assured me that I was still a good candidate to deliver at home.

The seventh visit, the morning of May 8th, Laura came to my home and her Doppler could not find my baby’s heartbeat. That was the day I transported to Hospital A to deliver my dead child.

was not angry with Laura right away. I was grateful, in shock, numb. She advocated for me in the hospital, requesting a CNM rather than the ob-gyn on call. She stayed with my husband and me as we held our dead daughter’s body. She cried with us. She came to my home, she held my hand, she let me cry huge, wet tears of grief all over her shirt. She organized meals and visits with friends. She came to my daughter’s small memorial service and shared kind words. Something bothered me but I couldn’t quite put my finger on it.

I wrote my daughter’s obituary. Despite a horrific experience, the hospital midwife and delivery nurse were amazing and my husband and I wished to acknowledge them in the obituary. After I finished writing, I asked my mother-in-law to proofread it. “What about Laura?” she asked. And so, I included a thank you to Laura in the obituary. Afterall, she had overseen my prenatal care, helped me through contractions and squeezed my hand as I pushed my baby out of my body. But as time moved on, the anger and hatred built.

A letter I cannot send.

I am angry. Furious. This anger isn’t logical or deserved. But it is true.

First, I am mad that you, as the midwife I hired, failed me. I am angry that you didn’t demand I go to the hospital when I reported decreased fetal movement and that you didn’t review kick-counting with me.

I am livid that you are pregnant. You already have THREE children. Plus you didn’t even plan this pregnancy and you aren’t even married to the father of this child. My husband and I planned our pregnancy, a May delivery. We had hopes and dreams, we prepared our daughter for her role as a big sister. Our baby was wanted, she was already loved so much.

I am irate that your unplanned baby survived when you fell down your steps. I never experienced any trauma but my baby died. I am angry that you made the correct choice to go to the hospital to be checked and I did not.

I am enraged that you said death may have been the best outcome for my baby. That perhaps if she had lived she would have been cursed with medical problems and lifelong disabilities. And when I expressed uncertainty about another pregnancy, you told me I could simply adopt or foster children to complete my family…

Illogical, I know, this rage–it makes no sense at all. Yet it is how I feel.

As you grieved the loss of your baby, who, if anyone, did you feel anger toward?

Lost Dreams

…I am furious that I do not have memories of my daughter, for when a baby dies, it is dreams that are lost…

 

“I don’t think most people truly understand how much is lost when a baby dies. You don’t just lose a baby, you lose the 1 and 2 and 10 and 16-year-old she would have become. You lose Christmas mornings and loose teeth and the first days of school. You just lose it all.” 

– Stephanie Page Cole

Anger. It’s one of Kübler-Ross’ stages of grief.

Until recently I hadn’t considered how anger and grief intertwined. When my paternal grandma died, the day before her 95th birthday, I was sad but I didn’t feel angry. She had a wonderful and fulfilled life–married to her husband until he passed 21 years prior. She raised two sons, taught for 40 years, and spent time with her 3 grandchildren in her retirement years.  Two years later my maternal grandpa died. He was 86 years old and had suffered from dementia for several years prior to his death.  He had a long life, raised 6 children, worked incredibly hard, and in his later years spent quality time with 12 grandchildren. I felt sad but almost relieved that he was no longer suffering. I wasn’t angry. I have wonderful memories of these grandparents.

But when my baby, my 2nd daughter, died inside my body, when I experienced contractions, nausea and exhaustion while pushing her out, I became furious. Not immediately but weeks later. After the shock and numbness dissipated.

I am filled with rage.

I am angry that when, at 37 weeks, I noticed decreased movement, but convinced myself she was moving normally and didn’t seek medical attention.

I am angry that I was skeptical of the safety of ultrasounds and did not have any in the third trimester.

I am angry that I endured a pregnancy of nausea and vomiting, heartburn, sleep deprived nights, and uncomfortable-ness only to have my baby die.

I am angry that if I were destined to lose my daughter it didn’t happen at 9 weeks, 12 weeks, 18 weeks or 26 weeks. Anything but 40 weeks.

I am angry that I said things like “I’m never doing this again,” “thank goodness this is the last time I’ll ever be pregnant”  and “there won’t be any trying for a boy.”

I am angry that my careful child spacing failed–that my living daughter will either be an only child or not, but she will not sing to, read to, or play with a sibling who is four years younger than her.

I am angry with my body for betraying me and my baby.

I am angry that I failed to keep my baby safe–perhaps the most important job a mother has.

And I am furious that I do not have memories of my daughter, for when a baby dies, it is dreams that are lost.

We’ll go to the beach with a 2 month old and 4-year-old. I’ll have my summer maternity leave with my baby. At Thanksgiving we’ll need to bring two car seats on the plane. Next summer we should visit my parents, the girls will be one year and five years. We’ll go to Disney World when the girls are five and nine. The girls will have each other to play with and color with. Eventually they can have the two downstairs bedrooms. Or will the want to share a room? We should remodel the downstairs bathroom so they have space for hair dryers and makeup…

Lost dreams, lost life. Not just the loss of my baby’s life, the loss of my family, the loss of my dreams for all of us.

What short-term and long-term dreams were lost when your baby died?

1 in 160

She is not snuggled in the Boba wrap I purchased off of a Facebook swap and sell in the parking lot of TJ Maxx. 

One in one hundred sixty. That is how many babies are stillborn in the United States each year. That is 0.00625%. That is 23,600 hearts that stop beating prior to birth. That is 23,600 grieving moms. Per year.

I didn’t know any of this until my second daughter became that statistic. It never crossed my mind in the 40 weeks I carried her in my body that she wouldn’t survive. Stillbirth–the death of a baby in utero beyond 20 weeks gestation–that is something that happens to other families–not mine. After all, I’m a college-educated woman. I don’t smoke or use drugs. I abstain from alcohol while pregnant. I took vitamins before I got pregnant and continued taking them throughout my pregnancy.  I don’t have diabetes or high blood pressure. I had already delivered one healthy child. I planned my pregnancy, this baby was wanted. And surely if a baby is wanted by her family then she should live.

There are a lot of things that really stink about one’s baby dying. There’s the obvious one–my baby is not here with me. She is not snuggled in the Boba wrap I purchased off of a Facebook swap and sell in the parking lot of TJ Maxx. Then there are agonizing questions like should we bury our baby or have her cremated? If she is cremated do we keep her or scatter her? What can a person really say at a memorial service for a baby who never took a breath? How can I possibly write my daughter’s obituary? These are the pieces of infant loss that scream in one’s head. But there are also whispers, quiet reminders of this living nightmare. Silent tears when a Pampers commercial comes on. Watching other moms cuddle their (living) babies. Toting 40 weeks of baby weight without a baby to show for it. Feelings of phantom movement inside my belly. Turning maternity leave into bereavement leave.

One thing that surprised me was how common stillbirth is. Yes, it’s only one out of one hundred sixty births per year. But that is 23,600 hearts that stop beating prior to birth. That is 23,600 grieving moms. Per year. I have had a number of people share with me that it happened to someone they know. Their mom. Their sister. Their aunt. Their friend. Themselves. In sharing this with me, I realize that I am not alone. And if this has happened to you, please know that you are not alone either.

Ten days after I delivered, I attended a local support group for parents who have lost an infant. A week later I received a card in the mail from the only other mom who attended that night. I will leave you with this excerpt from her note “I wanted to remind you that I am still standing and I know many women who are also still standing–not necessarily because it was easy or because we wanted to–but because it is the only choice we have. And it is worth it.”

Are you and your baby a 1 in 160 statistic? Do you blog to heal? I would love to hear from you.