I look back at some of the people I’ve cared for who have had losses and I feel terrible. How could I have cared for them better? Some of these women I was barely acquainted with and some I knew quite well. I know no one can really imagine what it’s like or what someone needs unless they’ve been there themselves. But now that I know what I’ve needed, I feel like I’ve failed these other women. Could I have called them more? Did I remember their due dates? Did I make sure someone (if not me) was following up with them? As if it weren’t awful enough to lose your baby- to not have enough follow-up? These poor women must have felt so alone in their grief. And I, as a midwife, should understand the significance of having a baby and the significance of losing a baby. Perhaps it’s because I hadn’t even had a baby before. Maybe our practice is too big and some people don’t get anchored to one of us. Maybe I felt too awkward or didn’t know what to say. Maybe I thought I would be a reminder of something sad. Maybe I didn’t want to be reminded of something so sad. Maybe I felt ill-equipped to deal with grief. All these things have some truth but are also bogus. If I could rewind and change how I was, I would. I would call them every week on the weekly anniversary of their baby’s death. I would call on their due date. I would ask, “tell me about your day” instead of “how are you?” I would say their baby’s name, have them to tell me their birth story in their own words and ask them to show me pictures. I would ask how they chose their baby’s name, what they remember about their baby’s body and how they plan to memorialize their child. I would go to their babies’ wakes. I would send a card. I would hug them sincerely and cry with them. I would tell them that their engorgement could last a week and to start icing and binding as soon as possible. I would make a plan with them for how to survive the days. I did some of these things with some people. But the experience of going through this has shown me just how inadequate I was. I am so sorry. I will be different, I know that. I will be better.
I think as I go back to work in the hospital, normal birth will be hard. I will be reminded of all the things I did not have. Because we are human, we midwives can not help bringing a little of our own experience into the delivery room. Before Mabel I had never birthed, so I was a blank slate- no prejudices or experiences to color my care. But now all my care will be colored. I know I will help woman through fear of childbirth, but think what do they fear? I will comfort women in their pain, but think what pain do they really know? These are not fair questions. Sometimes I fantasize about having a specialty practice- where I just help people through losses. I feel like I might be inadequate at helping women through joyful births.- it might be too painful for me. How can I give good care when I’m hurting so much? But someone facing a loss- that I know. It’s a familiar pain. I can empathize. When I was pregnant and then later grieving my loss, I was desperate to know someone who has done it. Not necessarily to see how they survived, but to have the sympathy of someone who knows the depth of this hurting.
Send me the babyloss moms. Send me the poor fetal prognosis moms. Send me the moms of babies born still. Send me the moms pregnant with babies with Down Syndrome. Send me the moms with infertility. I have not been all these people but they all experience a pain I am too familiar with.
I truly do not know how I will be as a midwife again. My instinct is to gravitate towards what I now know- loss. But it might be too sad, to live loss over and over again with people.
I have heard of some programs at other hospitals. Perinatal hospice and difficult diagnosis teams. Mulitdisciplinary teams that help people like me navigate the system. Social workers, nurses, neonatologists, pediatric surgeons, bereavement specialists, OB providers all working together to help a couple with difficult decisions when handed a possibly fatal diagnosis for their baby. I had excellent care, yet there were many times where I felt a little lost. What specialists should we be seeing? What information do I need to make decisions? I don’t think I really understood that Mabel was likely going to die until we met with the neonatologist. We had to decide on monitoring, when we would intervene to save our baby, how aggressive to be with treatment. There were almost impossible decisions to make. If I, with all my knowledge of what these things mean, had trouble, how would someone not in my field manage? My hospital is a well known one, perhaps the best in my state, but no such program exists. Wouldn’t that be a wonderful thing to bring to my hospital? Then I could truly say, send me sad and worried mothers to be and I can help.