Friday, November 01, 2013

October 25, 2013 to November 1, 2013

Angel

At about 7:00 pm. on Friday, October 25th, at 18 weeks and 2 days into my pregnancy, I felt tired and needed to lie down. The baby in my womb seemed to be moving all over the place, and it was very difficult to stay standing while I was making dinner. Simon came home and found me lying down on the bed. I told him that I felt like the baby was trying to push out through my stomach! We had dinner together, and I was uncomfortable. I thought I might be having Braxton-Hicks contractions, which had also started early in my pregnancy with Leo.


Simon put Leo to bed after dinner. Normally, he goes to sleep rather quickly. That night, he wouldn't sleep. After two hours of trying, Simon was frustrated and I took over. I read him a story, sang some prayers, and then for the first time, as a last resort, let him look at pictures of us on my iPod. It was after 11, and still no sleep! I was also very uncomfortable lying there, and couldn't find a good position. My back was hurting and I was still having Braxton-Hicks contractions.


At about midnight, Simon came in the bedroom and took over with Leo. He picked him up and started walking with him in the living room, while I tried to sleep. I had had a very long day and was tired, and had also been used to going to bed at around 10. It was now after midnight.


I must have fallen asleep, because I awoke to Simon putting Leo in his bed, and coming to bed himself. Simon fell asleep immediately – Fridays he works 3 jobs in a row, so it's a long and demanding day, and getting Leo to sleep was extremely frustrating and taxing.


I lay in bed trying to get comfortable, and must have fallen asleep sometime after 1. At 3 am I awoke to more abdominal discomfort. I touched where I felt it most, and it was hard. At first I thought I was feeling the baby's head pushing against my hand. Then it stopped, and everything was soft again. A little while later I felt it again. I thought about it a little and realised that the baby's head was not that big, and that these must be Braxton-Hicks contractions. I remembered having read that if you change position, they should stop. I got up and walked around in the living room for about 10 minutes. They didn't stop. I have a wonderful book about pregnancy and childbirth called "Birth and Beyond". I looked up contractions and read that contractions in early pregnancy could indicate a threatened miscarriage.


I immediately woke Simon up, telling him that we needed to call the on-call doctor. He got up, and I called our doctor's office to get the number from the voice mail message. We called the on-call doctor, and explained what was happening. By then, the contractions were very intense, and about 4 minutes apart. I realised that I was in labour. He told us that since there was no blood, it didn't qualify as an emergency, and they couldn't send an ambulance, but that we should come in immediately, and then they would decide whether I needed to be admitted to the hospital or not. Simon called a taxi, and we started packing a bag.


I went into the bedroom for something, and then felt a very strong contraction. I felt something opening inside me and said out loud "Oh noooo", as my water broke. The rush of warm amniotic fluid down my legs, was unmistakeable, and as I ran into the bathroom, I heard myself moaning "it's too late." Simon rushed to my side as I noticed the blood, and immediately called the emergency number. They were sending an ambulance, but I already knew it was too late. The contractions subsided, as I changed my clothes, and went to lie down on the couch. I didn't want to wake Leo who was sleeping in our bedroom. Simon cancelled the taxi he had called, and finished preparing the bag.


The ambulance arrived about 10 minutes later, maybe 15... my concept of time was dramatically altered. I was lying there trying to wrap my head around the fact that I wasn't halfway through my pregnancy and was now in labour. I was experiencing my third miscarriage this year. The contractions had subsided in intensity and frequency, but were still coming, and I found myself automatically using the self-hypnosis techniques that I had learned for Leo's birth to control the intense feelings I was having.


The paramedics arrived. I thought there were 2 and a doctor. Simon informed me later that there were 5 or 6 people there. It was all a haze. I gave them the history, and because we live up half a flight of stairs, they asked if it was possible for me to walk down, and I did. They told Simon that he couldn't bring Leo in the ambulance because they had no way to secure him, so at that point we realised that I would be alone in the ambulance, while Simon and Leo would come to the hospital in a taxi.


In the ambulance, away from my family, not knowing what was going on, the fear stepped in. I was bleeding clotted blood, and could feel it coming out. I also felt the contractions. We sped to the hospital.


They took me up to the delivery room. Much like the one we saw when we did our tour of the hospital before Leo was born, the one I choose not to have my babies in when I opted for home birth. They put me in the bed, and I expelled a large amount of clotted blood. I was already connected to a blood pressure monitor, and at that point the midwife checking the monitor announced that my blood pressure had dropped and they needed to do something fast. The paramedic had already attached a mainline to my hand while I was in the ambulance and they attached a saline IV drip, and also gave me something else to stop the bleeding.


Soon after this, Simon arrived, Leo in his arms. I immediately felt better. The doctor arrived at about the same time and did an ultrasound. She informed us that the baby was too far down to see anything but a head, so they didn't know if there was a heartbeat, but at this point in the pregnancy, there was no chance of saving the baby, and that their priority was making sure that I was OK. She told us our options: continuing with the birth which was already in progress, speeding things up with cytotek, or have a D&C and they would remove the foetus from my uterus surgically. Simon and I talked briefly then informed them that we would like to proceed, and that I didn't want an epidural or any drugs. I felt that the birth was going fine and was very manageable using hypnosis. I also didn't want any more trauma. They said that as long as my blood pressure remained normal (they now had me on two IVs at the same time, one in each hand, and the blood pressure cuff on me, checking my pressure automatically every 5 minutes), they would continue. The doctor left and I was there with Simon and the midwife. I wanted to sit up, so we had Simon take Leo out of the room, and I gave it a try. Immediately dizzy and threw up. At this point, the contractions were about 3 or 4 minutes apart again.


Simon had called his mom from the taxi, and Lis and his sister Nana arrived shortly after this. Lis came in to see how I was doing, and then went back to the waiting room so that Simon could come in. By the coincidence of Nana being at her parents' house spending the night on the couch that night, two things happened: she heard Lis' phone ring, which would have gone unheard if Nana hadn't been there, and my original birth team from birthing Leo was now all together. I felt empowered.


I need to explain something here, because I know many women describe birth in different terms than I do. I had a beautiful experience birthing Leo. I used hypnosis to relax and guide my mind through what my body was feeling. Simon and I had done the Hypnobabies Self-Study course together, and he was a wonderful Birth Partner, and very much a part of the process. We had been very clear and specific in writing up our birth preferences, and dlet the midwives know exactly what we wanted from the birth. They had respected the fact that we had done our research and knew what we wanted, and were very accommodating and worked hard to give us what we wanted. As a result, I birthed Leo in our quiet, calm bedroom feeling amazing, empowered, and very happy. Fast forward to what was now about 7:30 am. Saturday morning, and I felt that although we had lost our baby, here was the chance to bring its body into this world in the same gentle, calm, respectful way, and it seemed like a no-brainer to do that.


The midwife responsible for me at that time understood what we wanted and helped us to do that.


Things continued the same way for the next couple of hours, until the midwife shift change at 7 am. She handed things over to the next midwife, explaining that I was doing well with managing the contractions and had had a natural home birth before, and also that we had accepted that the baby would not survive.


They arranged to bring another bed into the room for Simon. He was so tired, and was falling asleep on himself while helping me through the birthing waves. I was so worried about him, he was so tired, and had the responsibility of checking on Leo, who hadn't gone back to sleep, and helping me through the birth. At some point, I'm not sure when, probably before 7, Leo had gone home with Nana and Lis. They brought the bed in, and Simon and I continued.



At about 8 am., the midwife checked me, and despite what I had thought earlier, I wasn't dilated much. I thought back to my fear-clearing part of my hypnosis, and realised that my body wasn't opening for this baby because I wasn't ready to let go. Despite what I knew, that the baby wasn't going to live, and probably wasn't alive, something in the back of my mind felt that by keeping it inside I could protect it. I had had an inkling of this back in May. I had had a miscarriage in February at 6 weeks gestation. In May, I had made it to 10 weeks but then found out in an ultrasound that the baby had stopped developing back at the 6 week mark. I went home and immediately felt my body open up and release the embryo within an hour.


I didn't feel that opening up happening here. I felt the same strain of not wanting to lose this baby. I talked to the midwife about this and told her that we had done hypnosis for the first birth. She informed us that she had a Ph.D. in hypnosis for childbirth and was really willing to help me and talk me through this block. But I was tired, it was 8 am and I had been up for most of the day and night since 6 am the day before. The contractions had subsided, Simon was falling asleep in his bed, and I had a chance to nap, which I took.


An hour later, I awoke, refreshed. I asked the midwife if I could try to stand up. I was feeling so helpless, stuck lying on my back, IVs in each hand, blood pressure cuff on my arm. We did it little by little, and I managed to get up without feeling dizzy. Within half an hour or so, I was sitting in the chair next to the bed and able to stand without any trouble. I requested a birthing ball, which they brought for me, and spent the next hour or so moving around, trying to get things going again, while Simon slept. The midwife checked me, and I still wasn't dilated any more.


At about 11:30, I asked the midwife if she would assist me, through hypnosis, to 'let go' of the baby. I knew it was what was not letting the birthing proceed, but I didn't know what to do. She did some relaxing exercises with me and a short guided hypnosis where she repeatedly reminded me that it was OK to let go of the little one.


She then asked Simon if we had any spiritual beliefs. Simon told her that I am a Baha'i. She then said that it was her experience that it was really helpful for people to get in touch with their spiritual side in whatever way they were used to. Simon, the amazing, thoughtful person he is, in the few minutes he had had to pack my bag, had thought to pack my Baha'i prayer book, which he took out at this point. I directed him immediately to the long healing prayer, and he began to read. I recited the verse that repeats, and he read the other parts. Together, over the next 10 minutes, the Words of Baha'u'llah encircled us and connected our souls. During the course of the prayer, there was only one contraction, and when it was over, I felt reborn and with renewed energy. I was also confirmed in the knowledge that our little one was safe in God's hands. My job as mother to this baby was over. I got up and used the ball to rock on the bed, and then bounce on the floor, and within a few contractions, I could feel that it was time for my baby to be born. Lis came back at that time, and within a few minutes of her walking in the room, I pushed, and in two strong contractions, at about 12:25 pm, our little Angel joined us.


We had been prepared for the birth of a very premature baby with no vital signs, and that's what we had. Our little one was a week or two away from the physical signs of gender, so we don't know if it was a boy or a girl. I don't remember what I expected, but I didn't think I would see something so perfect, so obviously human, but with transparent skin. I didn't expect to be holding my baby and see fingers with little fingernails on them, and a perfect little foot as big as the top joint of my little finger, with tiny little toes the size of sesame seeds. I didn't expect to see a beautiful little face with closed eyes, and high cheekbones and little hollows under them that bore an uncanny resemblance to Simon's. The most beautiful little lips, and inside that little mouth, a perfect little tongue. Most of all, I didn't expect my still little baby, with no pulse and no breath, to be still warm from my body. I didn't know that I would get to hold my warm baby to my heart and say goodbye.


But I did. And so did Simon, and so did Lis. We had a beautiful, quiet moment to say goodbye to the little Angel whose eyes would never open, but who will always be a part of our family.


At this point, after we had held the little one and said goodbye, the midwives examined the placenta, which had come out at the same time (possibly the cause of the miscarriage), and were sure there was a piece missing. The doctor came and concluded the same thing, and all of a sudden, our calm, patient bubble of a delivery room, turned clinical and urgent. An injection was prepared which would 'help' me to deliver the rest of the placenta. We had turned down this injection after Leo's birth, with much resistance, and I had instead naturally delivered his placenta about 15 minutes after he was born. I hoped in this case too, to be able to forego the injection and let things proceed. They agreed to wait, but were back a couple of minutes later, needle and alcohol-soaked cotton in hand.


I was physically and emotionally drained by my experience, and did not have the energy now to fight any more. I gave in to having the shot. And regretted it within a minute or two. The contractions the whole time, even throughout the birth had come regularly, with a wavelike pattern, gently increasing to a peak, and then decreasing back down to zero, with complete relaxation between them, starting at the top of my uterus, and then working gradually and reliably down. That was what I had prepared myself to handle with the hypnosis, and it was totally manageable. This synthetic hormone injection changed the nature of the whole contraction. A gentle wave turned into a gunshot of pain, as my whole uterus contracted at once, seemingly into a tight ball. The relaxation between the contractions was gone. The feeling was from 0 to 10 in an instant, but then instead of back to 0, it only went down to about 7, with no time to recover before 'bang' another gunshot-like contraction and pain up to 11.


I couldn't take it. They had said that if I didn't expel the missing piece of placenta, they would need to do a D&C to recover it surgically. Under the influence of the natural contractions, the idea of going under was horrible, but now, I was begging for anything that would stop this pain. In this pain-induced haze, the doctor explained that they would do it carefully with the help of ultrasound but that there was always the small chance of piercing the uterus (!). I remember thinking that I didn't care, as long as this pain would stop.

I was transferred to the operating room and opted for general anaesthesia rather than an epidural. I didn't want to be awake any more.


I awoke with Lis and the midwife on either side of me in the recovery room. Shortly after, they took me to where Simon was resting. I was informed that there was a special tiny little wing of the hospital for parents who had lost children. I went through a small double door, and entered a little haven, with a small desk in an alcove, and a small room with a rocking chair and a plant. A door on the right led to the bathroom and shower, straight ahead was a glass-enclosed balcony and stairway down to a courtyard garden, and to the left were two doors, the first of which I was led into. There was a room with a small sink and closet, a table with three chairs, an armchair, and an adjustable double bed, where my husband was waiting.


After the ordeal we had been through, this little haven was exactly what Simon and I needed. We spent the afternoon in bed together, talking and comforting each other. The midwife was just outside, and it turns out that the midwives in this department are not only nurses, and midwives, but also act as counsellors for the parents who have been through experiences like ours. Leo was having a fun time at his grandparents' house, and we had time and space to be together and start the process that will eventually end in us being able to move forward and get back to our normal lives.


By Saturday evening, I felt feverish, and the midwife confirmed that my temperature was 39.6C. This was the last thing I wanted. I had hoped to go home the next day, and now we were talking about 3 days of antibiotics. I was tired, emotionally exhausted, and we delayed the antibiotics until the next day.


I wasn't feeling any better when I woke up, and they started a round of intravenous antibiotics. During the day the midwife came in to talk to us about our options for our little one's remains. We were offered the opportunity to bring the body to our room for a short time, but declined. We were also informed that we couldn't just take it home and choose a resting place of our own. We could either purchase a burial site and have a proper funeral at a church, give permission to have the remains interred in a mass grave with other miscarried babies, and receive a letter saying that it had been done and when, or have the hospital dispose of the body along with its other 'medical waste'. None of these options seemed right to us. By definition, because our little one was born after less than 22 weeks gestation, it doesn't count as a person by the state. If the hospital got to treat it as medical waste, like the placenta, why couldn't we get the same treatment as if we had asked to take the placenta home? The midwife called the undertaker to clarify, and was told an emphatic no. We decided on the mass grave option, though it didn't feel right at all.


That afternoon, my fever was still high, but we had finally managed to get online, and I was chatting with my Aunt Marjorie, when the midwife came in told us that she had noticed that I was O- blood type and asked if I had received the Anti-D injection, which should be administered in case of a positive blood type in the baby causing my body to create antibodies to that blood when it mixed with mine during trauma. I hadn't. She immediately administered the shot. Within an hour I was up and about, and my temperature started to drop.


By morning, I was feeling 100% better. They continued with the antibiotics, while waiting for the results of the blood tests. Simon and I spent the day Monday in a very different way. Up until then, I had been preoccupied with labour, and then fever, and he had been occupied with taking care of me. Now that I was not in pain, and was able to get up and walk around and he didn't need to be on alert for me the whole time, we got a full taste of our grief and emotional pain. We were there for each other, and the midwife on duty was also there for us. She had nursing duties, but she would also talk to us whenever we needed her. This midwife said that she had seen our request regarding the remains, and it didn't seem right to her that we couldn't do as we wanted, since the body was less than 22 weeks old. She had followed up, emphasising the age of the foetus, and the undertaker decided to find out from the national Minister of Church Affairs (separation of church and state? Not in Denmark!). She told us that if they didn't have an answer by Monday, then it would be up to their department what to do, there was no precedent, no one had asked this before us.


During the day on Monday, we informed more friends and family what had happened, we sent out e-mails and posted to Facebook. We organised the memorial service. I also received my doses of antibiotics, gave samples of whatever they needed and continued with my medical treatment, but was definitely feeling better and anxious to go home. We had only seen Leo in a short visit on Sunday, and I had been feeling extremely tired and feverish at that time. I missed him. The doctor came in and informed us that the labs were all fine, and that we could go home after my antibiotics that evening, but had to come back in the morning and be there for the three doses during the day. I was elated! Although it would be too late to have Leo home, we would be able to go home and sleep in our own bed! A storm blew in on Monday as well. We went outside to catch the bus home, but just then the buses stopped running because of the storm. We called Lis and she came and picked us up.


We got home on Monday and real life hit us. The fish I had bought on Friday afternoon to cook on Saturday was not so pleasant in the fridge on Monday night. Nor were Friday night's dishes that were waiting in the dishwasher. There was a lot to take care of, and we puttered around the house domestically cleaning things up before going to bed.


We saw Leo in the morning, briefly, while getting the car key from John as he dropped Leo off at vuggestue. He is such a happy little boy and was having no problems adjusting to the altered reality of his daily life. That made it so much easier.

We spent Tuesday morning and early afternoon at the hospital before coming home to pick up Leo and have dinner. It had been such a good place for us, and was bitter-sweet leaving there. Apparently it's the only place of its kind in Denmark, so we were very blessed to be in the place where that kind of support is offered. We also opted to see the little one one last time. It was different but still beautiful.


I drove back to the hospital on Tuesday night for my last antibiotics. The midwife told me that since we were planning the memorial on Saturday, she would only wait until Friday for an answer, that way we would know before the memorial. I was so grateful to her. That visit to the hospital was my first time being away from Simon, and I realised how much of my strength was coming from him. It took everything I had to make the drive back home without completely breaking down.


It is now Friday night as I write this. We celebrated our 4th anniversary yesterday. In the Baha'i Faith we talk about cycles of crisis and victory. This crisis that we have experienced as a family has shown us the strength of our relationship and our support for each other. We start the 5th year of our marriage on a very firm support, and knowing that we are a partnership in the deepest sense of the word. I love my husband to a degree I never before imagined. My appreciation for the beautiful miracle that is our son has also deepened manifold. Our little family was not torn up by the tragedy that we experienced, but rather lifted up.


We buried the earthly remains of our little Angel this afternoon, Friday November 1, 2013, in the beautiful light of the setting sun. Simon, Leo and I were present. I said a prayer, Simon read his poem, and Leo set a white Gerber daisy on the tiny body in the grave, wrapped in a piece of off-white silk from my wedding dress. 

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