A Glimpse At the Other Side...

"Pregnancy and birth are miraculous journeys. This amazing time of life is full of mystery, anticipation, joy, hope, and wonder. Feeling the powerful energy of birth and new life, watching as a new family is born unto each other. These things humble and amaze. These are the things that we celebrate when a baby is born. But there is another aspect of pregnancy and birth. There is an unexpected place in this journey where some families may find themselves. When a baby dies, a world is turned upside down. There is confusion, sadness, fear, and uncertainty that cannot be explained. There is sorrow where there should have been joy." (Now I Lay Me Down To Sleep Foundation)

Whenever I tell people where it is that I work and what I do, they invariably "ooh" and "ahh" and say things like "how fun, you get to be around the babies!!".
And yes, I agree, I LOVE what I do and I think it is the most amazing area of the hospital to work. But, I also know that with all the joy, laughter and exciting moments that we are privileged to witness, we also attend to the other side of life...
There is a rule among good l&d nurses - you never leave a baby alone to die, no matter how early in gestation, we know that it is a person. Even when the family is unable or unwilling to be there, we stand by, walking the little one home until it has breathed its last and its little heart has ceased to beat.
There is something so incredibly sorrowful about a demise. A life that has never had a chance to be... never experienced life as we know it. I think that is part of what makes it so hard for the parents -- all the unknowns, the "I wonder what he would have looked like at 12, what profession she would have chosen, what kind of an impact he would have had on the world..." All these questions that will never be answered...
I remember one of my first term/near term demises that I cared for, those are some of the hardest to care for... because if not for just one hour, or one day earlier, the baby would have been alive and okay... WHY? That question reverberates throughout the room, among the nurses and doctors and especially from the heartbroken parents.
This couple, young and educated professionals, had gone through a couple of terribly hard years, losing several close family members, going through some major life upsets... and then they found out that they were pregnant. Quite a surprise, but a wonderfully welcome one with all of the pain that they had been experiencing lately...
Everything with the pregnancy was perfect, no major sickness, no problems, it was a boy, they were soo excited because she had lost her brother just a few months earlier in a freak motorcycle accident and they felt like this was a direct blessing from God.
One night, at about 35wks gestation, as she and her husband were watching TV she felt as if the baby "jumped around inside her" and then she didn't notice movement after that. The next morning, she still wasn't feeling the baby moving and starting to be concerned she called her doctor and was told to come to l&d for monitoring. On the way to the hospital, in the middle of hideous rush hour traffic, her water broke. Panicked, she called EMS and waited while they wound their way through traffic to get her and then to our hospital, where her husband met her.
The sick feeling you get in the pit of your stomach when a patient tells you this story as you go to place on the monitors for the baby's heartbeat, it is an awful feeling. You fight not to show on your face what you are thinking, so as not to panic the terrified parents who are desperately searching your face for a clue that everything is going to be okay.
Sadly, their baby's heartbeat was not to be found, an ultrasound confirmed that their baby had died, though no reason could be found for the demise. The devastated couple sat in shock as the resident doctors and nurses explained to them that they would be inducing labor and proceeding on to deliver their baby vaginally.
I met them as they were in the midst of the induction, contractions were starting to get more intense and she wanted her epidural. It was a busy night and there were several women in labor ahead of her on the "epidural waitlist", but because of her situation the anesthesiologists bumped her up on the list and did her epidural next. There is absolutely no sense to being in labor pain when you are not getting anything good at the end of it.
Once we got her comfortable, I settled her in to rest and then after assuring them that I was available if they needed anything proceeded to let them have their space. They were quiet, she was very teary but even still, they were such pleasant people. Her husband remained by her side, quiet but very supportive of her. He never spoke much, simply holding her while she cried and asking quiet questions about things that needed to be done, etc. She progressed fairly quickly and soon it was time for her to push and deliver their son.
As she got closer to delivery, the head beginning to crown, the resident doctor said to her, "once it is born we will take it away over to the baby bed...", her eyes got big and she looked at us, scared. My charge nurse was in the room to help me on the delivery and she broke in, saying "no, we will put your baby on your tummy, so you can hold your baby". The poor girl nodded with tears filling her eyes. She pushed again and the baby was quickly delivered. As the doctor brought up the baby, a beautiful boy with a head full of dark wavy hair, the dad who up to this moment had been quietly standing at the side of the bed, cried out "Oh, he looks like he is only sleeping, it’s not right...he is so beautiful" and burst into tears.
The doctor placed the baby up on the mom's tummy and we gently dried him off with a blanket. The sobbing parents held onto their precious, lifeless baby and wept together. I remember that the room was silent except for the choking sobs of the distraught parents as they cuddled their only child in their arms and grieved over all that had been lost.
The resident doctor, my charge nurse and I were in tears as we moved quietly about the room, cleaning her up and getting the bed back together before stepping out to give them some privacy.
Later as I gently washed this beautiful little boy, I found myself wondering what he would have been like as a little boy, as I cleaned his perfectly formed tiny hands and fingers I wondered... As his mother kissed his tiny toes and cradled his little feet in her hands while his daddy wiped tears from his cheeks and kissed his soft, downy head, "why?" resounded through my head. We held hands as a priest prayed over him and baptized him. Finally, they kissed him one last time and said goodbye, then handed him, their precious child, to me. As I walked this little bundle to his temporary resting place I fought to keep the tears back.
Yes, my job is one of the best, most fun places to work... but it is also one of the hardest and saddest places.