Mom to Hannah Marie
Stillborn at 23 weeks on November 5, 2011
Maple Grove, MN
On the morning of November 3, 2011, I had a routine midwife appointment. I’d been writing down a myriad of questions since my last appointment and my midwife, Kathrine, patiently and thoroughly answered everything for me. At the end of the appointment, she had me hop up on the exam table to check for baby’s heartbeat. She tried for a while with the doppler but couldn’t find anything. Neither she nor I thought much about that because we knew from my 20-week ultrasound that my placenta was anterior (on the front wall of my uterus), so it provided a nice buffer and we’d only ever heard the heartbeat with the doppler once at 11 weeks. So she rolled in an old ultrasound machine that the clinic had donated to them and tried to find it with that was but was again unsuccessful. It’s a really grainy machine and she couldn’t even get a good picture of the heart, much less a good enough picture to see if it was beating. She decided that I should get in for an ultrasound that afternoon at a different clinic, and she called and set that up for me.
I drove home, picked up the kids from my neighbor, and called Dan. I told him what had happened and that I had an ultrasound scheduled for 1:30. I said that I wasn’t nervous but that I really didn’t want to go alone. So he came home, we got Jack on the bus after lunch, brought Leah to a friend’s house, and headed to the ultrasound.
After checking in, we were brought into an ultrasound room and the tech asked me a couple of questions and started the ultrasound. The screen was turned away from me, and as soon as she started, she didn’t say a word. That was my first indication that something was up. She knew we were there to check for a heartbeat, so I assumed if she saw a heartbeat, she’d tell me and show me the screen and we’d all breathe a sigh of relief. She continued to take measurements and pictures in silence for about five minutes. Then she turned off the machine and said, “I’ll be right back” and left the room. And I lost it. Dan held my hand and prayed while I bawled. The tech came back in about ten minutes later and said, “I talked to the radiologist and your midwife would like to see you right away at her office.”
So we drove down the road back to my midwife’s clinic where she met us in the hallway and hugged me while I cried. We found a room and she said, “What did they tell you?” I said, “Nothing, but I know it’s not good.” She confirmed that the baby had passed away and that we would have to induce labor. She said I could safely wait a few days if I needed to, but staying pregnant just felt too odd. Besides, Kathrine was on call at the hospital for the weekend, and she’s really the only midwife in the practice (there are three total) that I know very well. So she called North Memorial to make sure there would be room for me on Friday morning, and we decided to go for it.
On Friday morning, my mom came to stay with our kids for the day(s) and Dan and I packed up and headed to the hospital. We checked in at Labor and Delivery and were brought to our room. Kathrine arrived shortly after we did and we talked through what we’d be doing to induce labor. After some paperwork and asking lots of questions, I got my first dose of cytotec (a tablet that is placed behind the cervix to help it start to dilate and efface). I was already at about 1 cm and 50% effaced, so I figured it wouldn’t take too long to get to 4 cm (which is where my midwife wanted me to get before delivering). I was wrong. I don’t know why I thought this would be faster than my labors with Jack and Leah (30 hours and 28 hours, respectively). I got the cytotec every four hours. After the second dose at about 2:00 pm, I also started a drug called fentanyl to take the edge off of some of the pain. Even though I had two unmedicated births with Jack and Leah, I had decided early on in the day that I was not about to tough it out with this one. I told my midwife that I could handle physical pain OR emotional pain–not both. The fentanyl worked okay for a while. I got a third dose of cytotec at 6:00 pm and was still at 1 cm and about 75% effaced. Kathrine said she would have liked to have seen the second dose do more than it did, so after the third dose didn’t do much either, she decided we should probably try pitocin to get some contractions into a good labor pattern. I told her that if she was going to talk pitocin, then I was going to talk epidural. Just the thought of it freaked me out, but again, I knew I didn’t want to feel this.
Luckily, they weren’t in a hurry to start the pitocin, so they let me get the epidural first and make sure I was getting relief from it before the pitocin started. I’m so grateful for that because the epidural experience was an adventure. The anesthesiologist was a very dear man and felt terrible, but it took him three tries to get the needle in the right place. And holy mother of God, every time hurt so bad. He finally got the needle in correctly, but even then, something was wrong with the medicine actually making it into the tube. About an hour later, I was finally feeling relief and they started the pitocin.
It was about 11:30 pm by now and I had been awake since 3:30 am, so I was very glad for the chance to rest (as was Dan). Of course, my sleep was a little interrupted by my blood pressure cuff going off every 20 minutes and the nurse coming in to increase the pitocin every half hour. But it was still nice to rest my eyes. At about midnight, my nurse took my temperature and discovered that I had a fever of almost 102 degrees. So they added a penicillin drip to my IV in case I had an infection. (At one point I was hooked up to an ekg, the epidural, a contraction monitor, a blood pressure cuff, and an IV with pitocin, fluid, and penicillin. It was quite the sight. I couldn’t move if I wanted to).
At about 1:45 am, I pushed my epidural button for more relief and it didn’t do a whole lot, so I called my nurse and told her that I needed something adjusted. I was feeling way too much and it was getting way too painful. Kathrine came in and checked me and said that she’d like to break my water. The anesthesiologist came in because my nurse had called him in to increase my epidural. By the time he got to the side of my bed, I said, “It’s too late! The baby is coming!” and I kind of freaked out. I wasn’t ready for it to happen then. I thought Kathrine would break my water and I’d have to push. That was not the case at all. The baby (still in the amniotic sac) and the placenta all came out at once. (That was a huge answer to prayer–at 23 weeks, it can be trickier to deliver the placenta without issues and there was a chance I’d have to have a D&C).
The contractions stopped immediately and Dan and I just cried. Kathrine was working on getting the baby out of the sac and she finally was able to lift it to me, where I had two warm blankets on my chest to hold it. At this point, we still didn’t know if it was a boy or a girl. I had wanted Dan to announce the gender when the baby came out, but it was in the sac and he couldn’t see anything. So once the baby was in my blankets, we all looked at the same time and saw that she was a girl, and we named her Hannah Marie. (And all three of us thought, but didn’t say out loud right away, “Jack really does have laser vision!”). Dan and I cried some more while Kathrine took care of cleaning me up a little bit. I noticed that her head seemed kind of misshapen, and I asked Kathrine if that was the problem (she had told me that the reason for all of this might be obvious at birth). She said that the bones are all still so soft at this point, so it was normal for her head to look like that. Then she told us that when she broke the sac, she had to unwrap the cord from around Hannah’s neck three times. She said that was pretty obviously the cause of death. I was really grateful that it was so obvious. I didn’t want to have to go through getting an autopsy or other tests to determine any chromosomal problems. She still sent some of my placenta and part of the cord to pathology to be tested for anything unusual.
My parents arrived shortly after she was born and were able to hold her and pray over her. It was an incredibly sacred time and I’m so glad we had it. At about 3:30 am, two wonderful women from a ministry called Missing Grace Foundation came and took such good care of us. They were really there to walk us through this experience so that we wouldn’t have any regrets. They both lost babies (one at 33 weeks, one at 20 weeks) and were coming in with clear minds and the experience (from their own births and so many others that they’ve attended) to help us through each step.
They cleaned Hannah up and put a tiny outfit and hat on her. They wrapped her in a beautiful blanket with a beanbag sort of thing behind her (to give her some weight, but it was also filled with essential oils and smelled lovely). They took pictures and video the whole time they were there. They gave us a huge basket with gifts and resources. The nurse weighed and measured her (14 ounces and 11 1/2 inches), and they took her foot prints and hand prints. But most of all, they just let us hold her and love her for as long as we wanted.
The ladies from Missing Grace stayed for a couple of hours and after they left, Dan and I decided to rest some more (since I was literally falling asleep sitting up while people were talking to me). Dan fell asleep right away on his pull-out bed and I lay with Hannah for a while before I finally dozed off. I think we both slept on and off for a couple of hours. Dan decided to go get some breakfast and I took a bath. After another hour or so in our room, we decided it was time to say goodbye to Hannah. We cried together and hugged and kissed her and let Kathrine take her away. Then we packed up our stuff, signed some papers, and left to go home.
We were so glad to pick up Jack and Leah at my parents and hug and kiss them and love them. And they were happy to see us too. So we headed home and began this very long journey ahead of us.
We have found out recently that I also had an infection in my placenta where it was attached to my uterus. So that could have been the cause of death as well. We’ll never know. And we’ll never know why there was infection or why the cord got wrapped so tightly. But it’s good to have some answers.
Right now everything is still so surreal. I can’t believe that two weeks ago, I went to a midwife appointment assuming everything was fine and ended that day completely devastated and lost. We are constantly overwhelmed by the love and support of those around us. The sadness comes in waves and sometimes it just knocks me off my feet when I am least expecting it. But we are so grateful for the promise of heaven because we know we’ll see Hannah again someday. Until then, she’ll always hold a place in our hearts and be a part of this family.
Erin blogs at http://www.erinjustwrite.blogspot.com
You can contact her at firstname.lastname@example.org