Sunday, August 01, 2010

I've been to three lovely waterbirths since my own baby was born. He came with me, Violet came to watch the baby. Each time, the mama had her baby within two hours of me arriving. Simply gorgeous births.

Then on Wednesday, July 28th, I heard from a client what no midwife ever, ever wants to hear. She texted me: "Can I come over and hear the baby's heartbeat? I haven't felt any movement today." She was 33 weeks and 1 day. I told her of course, to come right over. She replied she was waiting for her husband to come home because she wanted him with her. That's when I knew it was more serious than just a simple worry.

I had just seen her eight days before for a completely normal prenatal. Baby was active, heartbeat was 156.

Her other three children came and played with my kids. We went into my office and I went straight for the doppler. Filling the room with the sound of a galloping heart would be reassuring for everyone.

I placed the doppler where I felt the baby's back. Nothing. I tried the other side, thinking, maybe, just maybe I heard something in the middle. I listened for a long, long time. In the upper right quadrant I heard a beat, but it didn't sound like the clapping of fetal heart valves, and it was too slow for this baby. Feeling the mom's wrist I realized it was her heart I was hearing. I listened all over the fundus. No placenta sounds either. No "windy hilltop" sound. No thumps. No bumps. No swishes. I got out my fetoscope and listened with that all over her uterus. No sounds. I now know what the term "silent womb" means.

I asked her when she was positive she felt the baby move last. She said that she thought she felt the baby move on Tuesday, and she had for sure felt hiccups, but the last voluntary movement she remembered for certain was Monday night after her prenatal yoga class.

I went to the kitchen and got some new batteries for the doppler and listened again. I was sure I had to be wrong. It had to be an equipment malfunction, or maybe I just was listening in the wrong place. I sat down next to L (the mom) and put my arm around her. I told her we needed to go to the hospital for an ultrasound and I asked if they wanted me to go with them. They did. They left their other three children at my house to play and off we went.

At the hospital, we had several nurses over the next few days that I knew from my doula days at this hospital. The first nurse tried getting the monitor on the baby, cautioning the parents that she might not be able to find it right away. She was not able to find it at all. They brought in the ultrasound machine.

I've seen many ultrasounds, but never one like this. So still. No flapping heart valves. No four chambers seen moving and clapping. No movement from the baby. They called in a doctor who ordered a level II ultrasound done by a technician.

We had to wait many hours for the second ultrasound. It showed the same thing. The blood flow studies showed no blood flow in the baby or placenta. The doctor on call was recommending they begin an induction that night. L didn't want to. Her parents are 15 hours away and she wanted to go home, tell their other children, put away some of the baby things, and have a bit of time to process everything.

I didn't sleep much on Wednesday night. And when I did, I dreamt of her.

They returned to the hospital around noon on Thursday to begin the induction. I told them I would do as much or as little as they wanted from me. That I would support them 100% in any choice they made. If they wanted me to watch their other children, I would do that. I desperately wanted to be with them, and to midwife them through this. And I desperately wanted to stay home with tissues and chocolate, crying into a glass of wine. They wanted me to come. They told me, "You are our midwife. We wanted you at our birth, and we still do." So I waited.

And waited.

The wait was agony for me, I can't even fathom what the wait was like for them.

It wasn't until Friday at noon that she texted me that the contractions were starting to feel "real" and she was ready for me to come. The next 24 hours was filled with more interventions and drugs than this mother ever imagined would be used in a birth of hers. Each step was her call, her terms, her time. Each step we talked about, discussed, went over pros and cons.

We talked for hours. We laughed. We cried. We walked the hospital halls at 3 AM together.

How strange to be at a birth without the usual galloping rhythm of the monitor overlaying the ebb and flow of the labor. Just an eerie silence. How strange that all the doctors and nurses who were so sweetly respectful and extremely gentle don't realize that every mom should be treated with such love and care and respect.

The photographer for Now I Lay Me Down To Sleep was not available on the weekend (out of town) so I had agreed to take any pictures they wanted.

When the time came for her to push her baby out, she was so gentle. She looked just like any birthing woman -- strong, beautiful, glowing, joyful. Yes, there was joy here, holding hands with the sorrow. As they laid him on her skin (as she requested) and eventually up into her arms, she smiled down at him with a peace I could not imagine.

Her sweet boy, about 5 days gone in the womb, didn't look as bad as we had feared. I took 134 pictures for them, of the birth, and the baby. Closeup shots, macros of baby lips, fingers, and toes.

After all the family had a turn rotating through the room, holding the baby and mourning, I got to hold him too.

I have no clue how I did this thing. After returning home and looking at the pictures I had taken, I realized with a kind of strange awe that this was not something everyone could do. How did I? How did I do this thing? This impossible thing?

One week after hearing the silent womb, I had to leave for a family vacation. I can't fathom how horrible I would have felt if I had been gone when all this happened. I had time to spend three days seeing them through the birth of their baby's body, bring them their pictures and a meal, and attend the memorial service.

I love my ladies and their babies so deeply. Truly this is a loss for me too, but having been through it, I still can not imagine their pain.


Mrs. Spit said...

I was so thankful for our midwife, who walked us through our options, who was so kind and compassionate.

There are some excellent resources out there. Please email me if I can help you with any of them.

Gille said...

My gosh. I can't imagine the strength in either you and that family or that pain. I ache for all of you.

manhattandoula said...

I'm in tears for you all. How hard life is sometimes.

Emily said...

so so sad. your strength and support must have meant the world to them.


Lowa said...

Oh my, I can hardly see the keyboard to type this. A friend I met in the blog world went through the same thing last fall, at 38 weeks, if you can imagine. It was just agony for me, I can't imagine what you and the family go through in a situation such as this. Just heart wrenching.

I am praying for all involved.

Nicole D said...

Hi there! I am so sad for you and this family. I wish you all peace and healing - you are all in my T&P.

My very first certified doula client was a still birth and a micropreemie. It is so hard, but oddly reverential and sacred.

I have hopes, in the future, to have a network of doulas across the country who volunteer, like NILMDTS, for births where babies are born still.

Someday, not now.

What you have given to this family, they will remember for all of their lives. Find healing, find peace for yourself.

And cherish the memory and short life of this little one - you will forever be one of very few who hold the torch of remembrance that they ever were.

Tamera said...

I know how hard it is to deliver an IUFD (inter uterine fetal demise). What a blessing that you were there for them.

Housefairy said...

They were blessed to have YOU...and definitly steer them to resources, happy sad mama is a blog that can help if that is even possible. (hugs) to all.

Zion said...

Beautiful post.x