Guest Writer Wednesday: Shattered Dreams with Silver Linings
TRIGGER WARNING: This is a story of loss and stillbirth, with pictures.
One year ago, I was 28 weeks and 6 days pregnant.
Chris and I had dinner. We had eaten baked ziti that a wonderful co-worker cooked for us as I had been struggling with high blood pressure during pregnancy and my coworkers felt that a meal train would be helpful. During that dinner Chris and I reviewed a blank birth plan. Chris felt a birth plan was ridiculous. He didn’t understand why things needed to be written down or why certain things should be skipped or questioned. I felt strongly how I wanted things to go based on my experience as a labor and delivery nurse. I walked away from that discussion feeling annoyed and stressed. I wanted things written down so there would be no question about my wants during birth. I went to shower to decompress.
Immediately after the shower, I went to listen to my baby’s heartbeat as I always did before bed. I was picking up a reading of 90 which I just knew was my heartbeat… I could not find his. Just three short days earlier we had been seen for decreased fetal movement. During that appointment, I was assured that he had repositioned himself so that I could not feel his movement as easily. I called Chris in from the shop and he desperately grabbed the doppler out of my hand. I told him we needed to immediately get to L&D.
Upon arriving they had remodeled and would not let me in the entrance we found as it was for staff only. By this point I am hysterically crying and no one is helping. Mind you, this is a labor unit that I used to work on and knew many of the employees quite well. I finally get called back and placed in a triage room where I sat for 30-45 minutes before a nurse came in to even attempt to put my baby on the monitor. At that point, it was too late. I knew this before the ultrasound was even brought into my room. My baby was gone.
The doctor who came in was a hospitalist whom I had never met. She kept uttering that the ultrasound was new to her and to hold on. “Try moving it here,” she would say time and time again. Finally, she got a good view that showed no cardiac activity on my baby boy. I was in complete shock. There was no crying. The first thought was, “I have to call my boss and cancel tomorrow’s patients,” as we were starting a new clinic the following morning. I’ve never had to make such difficult phone calls as I did that night to notify my boss and my families.
Upon confirmation that our sweet boy was no longer with us my clinical brain kicked into gear. Was this to protect me for the process? I don’t know but it did seem to help me make decisions regarding our son and the labor process. I elected to begin induction immediately with Cytotec. During this time, I was experiencing blood pressure readings greater than 220/118 and was not responding to IV medication. After a few doses of labetalol (commonly used in pregnancy) I suggested that we try IV hydralazine as it had worked during surgery for me before. It brought my blood pressure down to a level that was less frightening. My labs were slowly coming in and the results were not good. They were consistent with pre-eclampsia even though it was believed that I had chronic hypertension. We later realized that the chronic hypertension was never in the picture.
I remember sitting in that bed and reaching out to my friends to let them know what had happened. I vividly remember scrolling Facebook and seeing that a fellow reiner’s daughter was born that night which just added to the pain. I began the Cytotec at midnight which involved placing the pills inside my cheeks for 30 minutes while they dissolved which was less than appealing. My dad came and Chris’s parents came. I asked my Mom and Stepdad to wait until the next morning because I knew it would take some time since I have been the nurse for these situations many times. They meant well and I wanted them to meet their grandson once he was born, but I truly believe it stalled my labor pattern. Once we asked everyone to give us space I went into a regular labor pattern. I labored on the birthing ball, leaning on the bed, on hands and knees, on my side- you name it I tried it. Chris was beyond amazing providing me support through my contractions by massaging my lower back and applying counter pressure. I could not have asked for a better support person.
For as long as I can remember I have wanted a family and I have wanted a natural, unmedicated delivery. I was continuously asked if I wanted an epidural as I was told, “You shouldn’t have to feel this pain…you’re hurting enough.” I pushed back as I knew in my heart that I wanted an unmedicated delivery and that I was capable of it. I knew my baby was not in pain and not in distress as he had already passed earlier that day. Did I mention he had a strong heartbeat at 2pm? Everything can change in the blink of an eye. My gut had told me that I would be having a baby that week, however, I thought it would be Thursday when I was scheduled to see the high risk doctor, nephrologist, and my regular OB.
Cytotec is a drug that is most commonly used for babies who have passed or missed miscarriages which have not yet passed on their own. It can also be used for postpartum bleeding though its original indication is for gastrointestinal conditions. I knew I would be slow to respond as I had responded to it slowly when I had a missed miscarriage back in 2012. I was offered Pitocin or a foley bulb to get things moving more quickly, however, I knew that would mean he would arrive sooner and I was fearful of that. I was not ready for labor to be over. These were my last moments carrying my son inside of my womb. Cytotec caused frequent trips to the bathroom and many people aren’t made aware that it is a potential side effect. I was so afraid that my sweet boy was going to be delivered on the toilet since I have taken care of many moms who describe the urge to deliver as the same urge to have a bowel movement. I asked for a dose of Phenergan due to the relentless heaving I was experiencing and it allowed for a short nap since I had not slept since being admitted and it greatly slowed down the nausea/vomiting/diarrhea. Much later that night I was lying on my side with the peanut ball and remember telling Chris to go get the nurse- he was coming. She checked and he was ready to be born.
My doctor, the same doctor who gave me my first job out of nurse practitioner school, came in and asked where the baby was. I told him I was letting him labor down. I didn’t want to push long but also knew that preterm/stillborn babies have a way of rapidly delivering when induced. I was fearful of pushing too hard and damaging his sweet, lifeless body. I had seen it too many times in my career. My doctor held my hand on one side of the bed while Chris held my other. He encouraged me to push and with two pushes my baby was out. I recall screaming, “Holy fuck the ring of fire is for real!” I had warned patients of the “ring of fire” so many times but to feel it was amazing. Chris was the first to see him as he had a short cord and I had to wait for them to cut the cord to get him to my chest. Those were the longest moments of my life. I asked if my placenta appeared to have abrupted once it delivered. It did, however, there was no way to know if this happened before he passed or during labor due to the Cytotec induction and difficulty tracing my contractions. My little boy looked just like his father. In fact, I could not see any of my traits until a week later when looking at his photographs.
I spent the next 18 hours holding my son’s lifeless body. I couldn’t put him down or let him go. I am lucky that I delivered in a hospital that allows the funeral home to pick up directly from the room instead of requiring my baby to go to the morgue. I don’t think I would have been able to let him go there. It was an easy decision for me to decide that I wanted a private burial as I knew that was one of the first questions to come up when a baby passes. We quickly made funeral arrangements and had our son buried about 2 miles from our home. The day of his funeral was supposed to be the day of my baby shower.
He was our miracle baby after battling unexplained infertility for years. We had done all of the possible treatments which led us to IVF. I had low expectations for our first transfer as I had read that there was a slightly lower success rate with fresh transfers on the first try. Our little embryo stuck and grew into the son that I never knew I wanted so bad. I had always been team girl but as soon as I found out I was going to be a boy mom- things changed.
People ask how do you survive the loss of a child. They tell you how strong you are. Is there really any other choice? Luckily for me I was able to direct my focus on the silver linings of this awful event. Not everyone is able to do that and I can understand why, however, it was important for me to find these silver linings and focus on them to keep my mental health in check. I saw my former therapist a few short days after discharging from the hospital. This helped immensely in this past year since losing our son. Another helpful thing was pumping and donating my milk. Some women want their milk to immediately dry up after a loss and I can understand that too. For me, I needed to know that my body could do SOMETHING right and I wanted to benefit other babies who needed breastmilk rather than formula. I pumped for six short weeks but it helped me mentally process all that I was going through.
People ask how one could possibly find any good in a situation like this.
It has brought our relationship MUCH closer together and led me back to my dream career. You see, I went to school to become a Women’s Health Nurse Practitioner, however, there were no full-time jobs when I finished. I returned to school to obtain certification in Psychiatry/Mental Health which had plenty of jobs available and this is the field I was working in at the time of delivery. Throughout my pregnancy and especially after the loss of Alex I felt a very strong pull to begin searching for jobs in OBGYN again. I finally landed that dream job in February of this year. I get asked how I can work in the field so quickly after losing my own baby to stillbirth and after struggling with infertility. I have found my own experiences to make me more compassionate and understanding of others. I am able to see all of the happy outcomes which far outweigh the bad ones and that gives me hope for the future. I have never been so happy to go to work at any other job and I know this is where I was meant to be all along. Yes, there are difficult times when I see the women who so easily get pregnant or when I am the one talking to a patient after a loss. That is always a hard hit but my own experience has allowed me to compile multiple resources for those families and to understand the different ways grief shows itself.
As an NP in the field of OBGYN
I have found my own experiences to make me more compassionate and understanding of others.
Here I am a year later and I see other people with their babies and I wonder what Alex would be like now. How would he look? Would he be walking? Talking? Would he have any interest in horses like his father and I? I do pray that we have another chance of a family and I know that we will always have an angel looking over us. If only I could tell him how much good his short life brought to us. I know he is up there watching over us.
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