The changing of the years

Last year my New Years facebook post was

“2013, you were rough. 2014, who knows what you will bring,”

and I linked my blog publically for the first time. Now that a full year has passed, I keep thinking how I want to reflect on the past year and approach this new year. 2014 brought me Mabel, which of course was wonderous. But save for a few moments when I thought she might actually live it was so very painful. It was a dark dark year for me, despite the outpouring of love and support I received in the wake of my daughter’s death. I still have thoughts that I’m ashamed of. I still have trouble letting myself be happy. I could go on enumerating all the wonderful things people have done in memory of Mabel and in support of Chris and I. I could further go on listing all the struggles I have had. But right now, after a multi day GI virus and the fatigue of the first holidays without my girl (hence the blogging absence), I am tired. So today I simply sum up my thoughts on the changing of the years.

 

2014, you were rough. 2015 please be kind.

Advertisements

Infertility in Labor and Delivery

Oh my. So much is said here. Infertility is another kind of loss- a more invisible one, so I’m glad this blog took a post to highlight it. It also makes me think of all the L&B nurses, OB providers (among many others) who care for these women who might too be struggling with infertility. She said it best: “This New Year, I hope everyone gets the gift they’ve been longing for. “

ADVENTURES OF A LABOR NURSE

Every day I work, I take care of pregnant women. Some of these women wanted to get pregnant, while others got pregnant unexpectedly.

View original post 927 more words

I’m not a total Grinch

I’m just not into Christmas this year. Thanksgiving is the big holiday in our family and there was a lot of emotional build up for me beforehand and very emotional during the holiday. I was relieved when it was over. Christmas, I feel less stress, less pressure. We told our families that this year we would be having a nice quiet Christmas at home- just me, Chris and the puppy. We’d still do gifts and everything for everyone, but I knew I wouldn’t really be in the mood for festivities. I can’t even seem to bring my self to get a tree. We had a super nice offer to cut down our own from a friend’s property. She warned us, it would likely be a Charlie Brown type tree, which seemed very fitting. Plus, she herself is a babyloss mom, so it seemed like the perfect solution. Yet I still could not seem to get my act together to do it. I would have not even thought about a tree had it not been for some beautiful ornaments that friends and family had given us in memory of Mabel. Instead, we decided to give our year round houseplant, Igor some Mabel festiveness.

I promise, Igor is not as sad as he looks.

I promise, Igor is not as sad as he looks.

I’m not a total Grinch. I don’t even care that others are having baby’s first Christmas or celebrating with their complete families. I could be bitter if I let myself, but I think I’m ok. I think I’m just simply sad that my family is one less this year. I bought presents happily for others and celebrated an early virtual Christmas with some far away family.

I also decided to donate in memory of Mabel this holiday. As I mentioned before, I can’t seem to do the more traditional “buy a gift for my own baby and donate it” that a lot of other babyloss parents do. Still too painful to shop for a 10 month old baby. So instead, I was inspired by another babyloss friend who felt similarly and adopted a senior citizen. I was a bit late in the game and there wasn’t really a similar program around me, so I cold called a local nursing home and asked if I could donate some small presents and what their residents might like or need. After talking I learned that a lot of the men in their home get neglected when it comes to donations and so I agreed to make some gift bags for them, with needed supplies. I assembled ten gift bags with male body wash, cologne, lotion, tissues and socks. I put them in festive bags and attached a little note:

“Merry Christmas! A gift for you in memory of Mabel, a beloved baby who lived for six precious hours on February 15, 2014”

FullSizeRender (10) FullSizeRender (11)

So I’m not a total Grinch. I’m just doing Christmas my way.

How are you doing Christmas this year?

Would you rather know?

The thought came up in my bereavement group. Someone said they just wished they were told that babies died- that these awful things can happen- hearts stop beating in utero, water breaks too early, placentas abrupt, birth defects are incompatible with life, babies are deprived of oxygen in labor. Being someone who knew that babies die for all sorts of terrible, but not common reasons, I can’t identify with that wish. In some ways I wish I didn’t know. Of course, I sought information and am thankful I knew what I knew so I could prepare. But in general, I’m not sure all pregnant women want to know. And as a provider I’m not sure I want them to know. There are some things, yes, I think it’s important they know- ones that they have control over or can test for, but the unpredictable? I don’t think I want all my patients living in unnecessary fear. I’m sad I missed out on the blissful ignorance of a first (or second, or third…) pregnancy. I thought it was bad enough having extra information as a midwife, but then being given the actual knowledge that my baby might die, I never really enjoyed being pregnant in the way I wish I could. I’m not sure I ever will.

I had a patient- an educated one, a nurse in fact, in front of me for her first OB appointment. I was doing my usual spiel when we got to genetic testing. I don’t have endless time, so I try to summarize and simplify the issues as best I can. She had no risk factors, so I talked of a test that can detect the risk of having a baby with Down Syndrome and trisomy 18 and 13. I usually qualify the statement, explaining most people are familiar with DS, but the other trisomies can be more severe and those babies don’t often survive the pregnancy and rarely live into childhood. I talk much more in detail about them if people ask (surprisingly few do), but it is important for me to let people know what they have the chance to test for. If a woman declines testing, I have to ask “If you knew you were going to have a baby with DS or a trisomy, and you knew that baby wouldn’t live, would you terminate the pregnancy?” I am pro-choice (pro-information!) and just need people to be comfortable with their choices. And sadly, medically legally, this question is important. There have been wrongful life cases in Connecticut (talk about sad, people suing their providers because they wish their living child had been terminated). I need to document their wishes. I don’t even cringe when people say yes, they would terminate a baby with DS. But I have a problem when people declines testing because they think it won’t happen to them.

The patient sitting in front of me said she didn’t want testing and when I asked my standard question, “If you knew you were going to have a baby with DS or a trisomy, and you knew that baby wouldn’t live, would you terminate the pregnancy?”

She responded, confident that her age of 33 put her at no risk, “Well, that’s really only a concern when you’re 35, right? And I have no family history.”

After a few more failed attempts of trying to get her to understand that it can still happen despite no risk factors I finally said, “Well, I had no risk factors- I was 33 and had no family history and I still had a baby with a trisomy. So it can happen to anyone. What I need to know is would a trisomy diagnosis change your management?”

I hated bringing Mabel into the conversation, but she just wasn’t getting it. I felt she needed to know.

I had another patient with a subchorionic hemorrhage that kept getting bigger and bigger each week in early pregnancy. She had two late first trimester miscarriages and had been about to pursue IVF when she found herself spontaneously pregnant. As the hemorrhage grew, we providers all held our breath, thinking this pregnancy might go the way of the others. If she remained pregnant, it was so big she was at risk for placenta abruption in the second and third trimester. She was educated too- another health care professional and said to me as I expressed some of my concerns “We are just taking it day by day.” She is still pregnant, in the second trimester. I have mentioned placental abruption, so she knows. But I haven’t gone into detail, saying I’ve known people who had such a case and preterm babies who died. She didn’t need to know. Or perhaps she did know, she just didn’t need to hear it harped upon by me.

So how much do we tell pregnant women? We can’t induce everyone at 39 weeks because some babies’ hearts stop at 40 weeks. We can’t do c-sections on everyone because babies’ hearts can stop in labor. There are risks to those as well. I don’t even tell women to do kick counts daily- it only increases worry. Do kick counts when they are worried, I tell them. Women know their babies best- if baby isn’t moving like normal, then take the time. This is the struggle I have as a midwife- I know the bad that can happen. But I also know most of it is unpredictable. So I take this burden on myself; I worry for my patients, so they can have the blissfully ignorant joyful pregnancy that they deserve. Worrying about unpredictable things can only increase stress and cortisol levels, which isn’t good for moms or babies either.

(disclaimer: I don’t mean to minimize anyone’s anxieties around loss, especially once you’ve experienced it. once you’ve known loss, worry away! You’ve earned the right to worry, even if it’s about unpredictable things. Your innocence was lost like mine.)

What do you think? Do you wish you knew babies died? How would it have changed things? Do you feel the need to lecture pregnant women on the awful that can happen?

Sunday Synopsis

El Deafo, How a girl turned her disability into a super power– I love how this normalizes a disability.  I hope there are more like it to come!

10 Ways C-sections and vaginal births are exactly the same. I know many of you had to have a c-section, which may or may not have been part of your birth plan.  I know my birthplan went out the window when we learned of Mabel’s prognosis.  I was prepared for an emergent c-section if needed and I gave up up on the vision I once had of a joyful, intervention-free labor and birth.  Instead, my labor was full of fear and dread and I opted for an epidural.  I could go on at lengths about how I feel I failed as a midwife there.  and that’s just an epidural.  I know many woman who struggle having had a c-section and I think this article is great for proving just how brave it is to go through that.

Bereaved Parents Voices Heard at Last- I like this article because it’s about giving babyloss moms voice- highlighting that our experience matters with our care- both the good and the bad.

Freshpet Holiday Feast– just because its funny.

Have you read anything lately that spoke to you? 

Baby’s First Christmas

 

I was walking in the drug store and my eyes caught this on display:

FullSizeRender (3)

I was sad.  It hurt to think that in another world I would be buying one of these for Mabel.  I also recognize, I am extremely fortunate to have many an ornament o hang for Mabel- many gifts that came and are still coming in her memory.

I was also reminded of a conversation my sister relayed to me.  She and my niece were unpacking Christmas decorations and my sister pulled out a stocking that said baby’s first Christmas.  My four year old niece declared that her little six month old brother would share it with Meghan’s baby.

My sister shared it with me with caution, knowing it might be painful- and it was in a way. It was painful in the way that Christmas is in general.  But it was also really quite sweet.  I was also impressed that she was able to realize at age four that this would have been Mabel’s first Christmas- something I worry that grown ups will forget because it has been ten months since her death.

Is this your baby’s first Christmas? Second? Third…?

 

White roses

“Wow! those are beautiful flowers!” exclaimed the lady checking me out at the grocery store.  I too was surprised that such a gorgeous bouquet was sold at my local shop.

“Yeah, I couldn’t help myself,” I admitted.  As I walked by the flower shelf I was immediately drawn to the simply arranged bouquet of white roses.  Perfect for such a little baby, I thought.

“Sometimes you just have to treat yourself,” she responded.

“Oh, they’re for someone else, but I still couldn’t resist.”

How can I help, but indulge my baby?

How do you indulge your lost loved one?

 

FullSizeRender (2)FullSizeRender (1)FullSizeRender