A little girl with a beautiful name

Today I learned that the baby of a friend was born sleeping yesterday evening.  Though she was not expected to live, her loss has struck me deeply.  From experience I can say that knowing ahead of time just draws out the grief, it does not lessen it.  Today, and in the future, please join me in thinking of her mom and dad and of the little girl, with a beautiful name, who they said good-bye to.

 

Wishing her strength.

 

 

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Battle scars

I used to be a runner. I’ve written about it here, talking about how running became hard for me physically and emotionally at the end of pregnancy. I was proud of how far along I was when I went for my last run – 31 weeks. I would go for a run (ok, ok a very slow jog), usually before work 3-5 times per week, getting my 3 miles done in 35 minutes or so.

When I was hospitalized at 34 weeks, I had to be on the monitor 23 hours a day and wasn’t supposed to leave the hospital, so I was limited in my exercise ability. I settled for a mini-bootcamp with an exercise band and medicine ball I had gotten as gifts.

After Mabel was born, I knew I needed exercise. We commonly tell patients, no real exercise until 6 weeks postpartum. I used to tell my patients that they could do some light exercise, like walking, when their bleeding stopped. I did not take my own advice. I was doing yoga at 10 days postpartum and back at bootcamp (with modifications and accompanied by my midwife) at 2.5 weeks. I will now counsel patients differently.

But even before I started back at bootcamp, I would walk. Chris and I would hit up the local “rail trail” (and old railroad track converted into a paved path frequented by walkers and cyclists). It was winter and our area had been hit by an enormous amount of snowfall, so rather than brave the sidewalk-less streets in our country-living town, we would bundle up and head to the rail trail nearby. Our town plowed a mile and a half of it in the winter, so it was a safe place to walk and get fresh air. At first the walking was slow going, but as the days progressed, I could do more faster. I was limited mostly by my pelvis. There is a bone- the symphasis pubis- in the front part of the pelvis (the pubic bone in more common terms) that has a joint in it. In pregnancy, the body makes a hormone called relaxin, which, as its name implies, relaxes the joints in the body. Its main target is the pelvis, loosening the hinges to make more room for a baby to pass through. Many pregnant women speak of loose joints that sometimes can be painful and that’s due to the relaxin, which works on all the joints- not just the pelvis.

My body made plenty of relaxin. As pregnancy progressed, I would be sore after a run. I’d feel it in my pelvis, my symphasis mostly. I remember vowing the day after the Thanksgiving turkey trot we ran that I was done running- my pelvis ached! I’d need a little assistance getting off the couch and climbing stairs would smart. I’d ice, stretch and see the chiropractor, but nothing really helped. So eventually I gave up running and moved on to bootcamp. After Mabel was born and we were walking I felt that familiar burning, lingering pain in my symphasis. I wasn’t worried; it can take time to heal. I eventually worked myself up from walking to interval jogging to my usual three-mile stint at a slow pace. Week after week I’d keep at it, slow and steady as I regained my stamina. Though I gave it time, my pelvis seemed stationary in its healing process. I continued the stretching, ice and the chiropractor but found myself running less and going to bootcamp more. I think I’ve run once in the past two months.

I finally made an appointment with physical therapy to try to get some help, but part of me realizes that my jogging days might be over. I am well past a reasonable recovery time and have come to accept that this might be one of my battle scars. I was fortunate to never get a stretchmark in pregnancy- the only few I have developed on my breasts during the rapid and impressive engorgement I experienced a few days after birth. The shape of them have changed too. Other than that, I have few physical reminders that my body once bore a baby.

Part of me hates the loss of running due to my invisible battle wound on my pelvis, but part of me thinks of it fondly. Just like the milk that came in so insistently after Mabel was born, my painful pelvis is a reminder that though there is no baby, there was a baby.

What about you- what are your battle scars? Are they public or invisible? How do you feel about them?

 

*************

Today is a special day, a little girl named Calla was born two years ago today. I’ve never met her.  I didn’t know her mom or her dad or her two big brothers when she was born.  I only know them now because Calla Pearl was born sleeping.  Though I wish that weren’t the case and she were a lively two year old sapping her mom’s energy, I am grateful that I have met Calla’s mom and her family.  Today I tried to picture what I think she would have looked like as a two year old.  I base my vision on the precious photo her mom showed me and how her two older brothers look.  But I know she is and ever will be the baby born too soon and too silent.  I think of Calla being a friend to Mabel, showing her how to be a baby separated from her mother, in the way Calla’s mom is helping show me how to be a mother separated from her baby.

Happy Birthday, Calla Pearl.

I got to be a mom… for a moment

Last week, she gave me condolences about my loss. It always warms my heart for a patient to take a second out of a time that is really meant for her and say something. I have a sign at the check-in desk, informing patients I had a loss. Some days I receive no comments and my daughter’s existence remains silent, other days I could have three or four people say something. But this patient became special, when she went a step further.

“How big was she?” she asked.

My heart swelled! It’s didn’t end, when I said my usual, “thank you. And thank you for saying something.” I got to say more!

“Five pounds four ounces,” I announced proudly. “She was born at 36 weeks, so she was a little early.”

“She was beautiful.” She had not only taken the time to read my sign, but she had looked at the photo beneath the words.

“She was, wasn’t she? Thank you! She looked big for her weight. She was a little chunker!” I grinned.

For that moment, I got to be a mom. Those four little words opened me up, allowing the pride and love I have for my daughter spill out. I hope she knows how much her extra effort made my day.

Have you had any experiences like this, where you felt more like a traditional mom than a babyloss mom?

To tell or not tell?

“And you! I heard you had a baby!” she said to me as I paused to look something up in her chart. I had already given her the half-hearted congratulations that I use to begin each of the New OB visits.

Heart pounded.

Face flushed.

Breath caught.

“Congratulations!”

“Thank you,” I said, softly, giving a small smile. I waited for the follow up question… Something to trigger me to say the words, “my baby died.”

But nothing followed.

I was left with so much unsaid in my head. I finished the visit somewhat distracted, waiting for some sort of question that would spill my secret, but one never surfaced. She left that visit thinking we shared something in common- a baby at home- but I must be shy or private and so didn’t welcome questions about her.

This interaction stuck in my ribs all day long, into the next even.

I should have told her.

She wasn’t a stranger- I had delivered her first baby and I would likely see her again in pregnancy. But she wasn’t close enough to know the real story. She’ll probably find out and then maybe she’ll feel bad that she said something (she shouldn’t) or think I don’t want to talk about my daughter (I do). I have so far always answered questions truthfully when asked, even when it’s awkward. But I don’t volunteer the info. It feels attention grabby or pity pulling. Especially with patients, it disrupts the visit.

What do you do? Do you ever volunteer the info? How does it go?

While I was grieving

“Wow!” He was amazed at the vegetable plants I was showing him.   “When did you do all this?”

I was showing off my garden to my cousin-in-law as we waited for his wife to meet us for dinner. He’s good company, always polite and thoughtful, one of those people whose picture would be in Webster next to “nice guy.” He’s also a physician and so we often enjoy sharing medical stories we collect at work.

I pointed out each plant, telling him which ones we started from seed (the carrots, the basil and the tomatoes, though the latter two were gifted to us by a friend who started them from seeds) and which ones were seedling transplants (the rest- the squash, cauliflower, potatoes, peppers, onions and beans). I felt a little embarrassed because the squash plants were yellowed and scrawny. I would have removed them had not a huge yellow bulb been growing at the end of the dead-looking vine.

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Otherwise, it was a nice looking garden. It sat in a 8 x 12 foot patch, along our driveway, partially shaded by a tall, voluminous tree. Tall metal green posts lined it holding up black deer netting, giving the space an almost crib-like feel. Six rows of vegetables ran perpendicular to the driveway, each separated by rows of small rocks, cataloging the burgeoning plants.

I guided him around the corner of the garden to show him the side. The grass had a bit of a dip, putting the garden on the slightest slant. There on the side, piled on top of each other, were multiple fifty pound rocks stacked into a makeshift wall.  For three and four hour spurts, I used to sit in the dirt that would become my garden and dig with a spade, then a a shovel, then a pitchfork until I unearthed all the stones and mini-boulders that the Connecticut soil was secretly holding.  At the end of each day, the pile of rocks would grow and I had physical evidence of what I did each day.  My arms would ache, my back would by angry and my shoulders would spot a few new freckles as reminders of the hard labor I had put in.  It was a good mental distraction from the thoughts that consumed me at the time.

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“I dug them each up.”

I smiled as I saw him take in my handiwork.

“You dug them up? Yourself?”

“Mmmhmm.”

“When did you do all this?” he asked again.

“While I was grieving.”

We wandered over to my flower garden. Like many bereaved mothers I know, I have a spot in my backyard dedicated to my dead child. I had wanted to put a garden by the white decorative fence ever since we moved in a year ago, but didn’t know what I wanted there. Now a lilac bush, a gift from my midwives, sat in the center. Salvia, peonies and other perennials surrounded it with buckets of colorful annuals interspersed between them. A small hand painted sign marked the edge, announcing “Mabel’s Garden,” a Mother’s Day gift from Chris.

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“Wow! You did all this too? When?”

“While I was grieving…”

Relating to my patients

I had a shadow with me in the office again this week. A doctor, new to our practice followed me around for a day last week to get familiar with our electronic medical records and the ins and outs of our office. This week our newly acquired midwife did the same. I’m apparently the go-to provider to show people the ropes. It’s interesting being shadowed, especially by people with more experience than me (as were both the doctor and midwife.) I felt the need to represent the practice well and to represent myself well. Last week I felt empowered at day’s end because I didn’t feel self- conscious being watched as I cared for my patients. This week, I felt pretty much the same, but I had a few moments of unexpected pain throughout the day too.

“Are you having a boy or a girl?” the new midwife asked the pregnant woman, in an effort to fill the void in conversation as I flipped though the patients chart.

We midwives become masters of small talk, chatting during potentially awkward times. I usually use the time I spend doing a breast exam to talk about the new pap smear guidelines with my patients. At the beginning of each visit I get a good social history from my patients (relationship status, job, what’s new…) and often use that to create conversation during a pelvic exam. “So what are your wedding colors?” or “How long have you been at your job?” are good time fillers. I often ask couples to tell me how they met while I’m in the labor room pushing with a woman.

Prenatal visits are quicker, having gotten the big chunk of the social history in the initial visit and so asking more “fun” questions about the pregnancy has been my fall back for conversation fodder. “What are you having?” or “Are you having a baby shower?” or “Does your younger child understand what’s happening?” are all non-essential questions but help support the bond between patient and provider.

I don’t ask those questions anymore.

They are too painful, too intimate. They make the pregnant belly in front of me more real and thus more of a reminder of what I have lost. If the conversation picks up from there, it’s hard not to try and relate to my patient. When someone tells me they are getting married in September, of course I’m going to say “Oh, how lovely! I got married in September, too. We had great weather, I hope you do too!” It’s human. Patients like it and it makes my job more enjoyable too.

If a patient replies, “We’re not finding out,” to the what-are-you-having question, I want to say “I didn’t either!” I did it while I was pregnant, so my natural inclination is to do it now too. But I hold my tongue, because then they might ask, “So how old is your child?” And then I have to disappoint them with the news that my baby died. Since I can’t seem to hold back my attempts to try to relate, I simply just don’t ask. I think my relationship with my patients suffer because of this.

Being observed, I wanted to tell my new colleagues, I’m better than this. I usually am much more chatty and ask those kinds of questions. I actually had the chance to exactly that last week, at the end of the day after a conversation about Mabel, and that made me feel better. But this week with my new shadow, I heard her have conversations with my patients that I should be having… if my baby lived.

“What do you have at home, a boy or a girl?” The new midwife asked my patient who was having back pain.

“A boy.”

“Oh, I have two boys! I know how they can be, running around…” she said laughing. “Make sure you bend with your knees and not at your waist, when you pick him up.”

My chest ached witnessing this conversation. Oh, how I wish I could relate to my patients this way! I don’t have living kids to bond with them over and I hesitate to bring even my pregnancy experiences into the conversation, for fear that they will lead to the words “my baby died,” bringing sadness and attention to me in the exam room, when the focus should be on them.

It’s the same kinship I feel with patients who have had babyloss. I’m sure many of you have felt it too- when you’ve met someone who either shares their story with you or when you’ve heard of someone else and you reach out to them. It’s natural to want to say “me too!”

This is just one of the many secondary losses we experience after our babies die. I have lost the joy I had in relating to my patients. What are some of your secondary losses?

BabyLoss: Pregnant Before and After Pictures

I saw this link on my facebook feed. (*warning to the baby loss- photos of pregnancy and newborns*)

http://beingmommydaily.com/pregnant-before-and-after-pictures-heartwarming

if you haven’t clicked, let me tell you: it’s a series of side by side photos with a woman very pregnant next to herself in the same clothes, standing the same way, holding her newborn at tummy level.

This was a link I would have clicked on easily in the before. My job as a midwife and my natural draw towards pregnancy and newborn photos would have made the link a good match for me.

Now, in the after, my facebook feed is pretty empty of kids, babies and bellies, thanks to my weeding out and unfollowing of friends who have such things. But I am also in the OB community and so some career related posts sometimes pop up.

I clicked on it.

I know what you’re thinking- I’m sure some of you babylost have your own idea. Perhaps I was a glutton for punishment. Like how even though I’ve blocked babies from my feed, I every now and then look at certain people’s pages. I make myself sad by doing it and perhaps that’s why I do it- I want to feel sad, on my own time, when I click, not when I’m surprised in my feed. Perhaps it’s training, recognizing that bellies and babies are a reality (an everyday reality in my working world), and forcing myself to look at these kinds of photos will help desensitize me so I can react in real life like a real human instead of the grief monster I have become.

But that’s not why I clicked this link.

I clicked because I honestly thought I would see some mothers empty handed.

Isn’t that crazy? Have I become too entangled in the babyloss world that my reality is blurred? Of course pictures of mothers with empty arms would not be called “heartwarming!” Maybe my facebook feed is so saturated with StillStanding Magazine and Down Syndrome Bereavement Support Group posts that I forget that there is anything else? Maybe I’ve become so open about my loss and have found so many of you out there to talk easily of our dead babies, that I expect the world to do the same?

I’m not sure why I thought they’d have empty-armed mothers there, but I think they should.

Perhaps this is a challenge. Could we come up with some of our own photos? Can you find a photo of yourself pregnant and restage it now? You can have empty arms or holding a photo of your child or a keepsake that reminds you of him/her.

Think about it.

If you do it, post it on your own blog and link it in the comments. If you don’t have your own blog but want to share, comment and I’ll email you for the photos to post on my blog.

What do think?

I didn’t have many photos of myself big and pregnant.  It’s one of my bigger regrets.  At the time I thought I wouldn’t want to be reminded later on, but now I cherish every pregnancy photo I have.  Here I am November 2013 and present day.

Babyloss: Pregnant Before and After

Babyloss: Pregnant Before and After