Claire’s story
Where does Claire’s story start? Where to begin our journey?
Whenever I start thinking about where to begin my mind goes to the first week
in July.
On July 7th I was leaning against the kitchen
counter casually looking through my Facebook newsfeed. I saw a post from a
friend who was a few weeks ahead of me in her pregnancy. I started to excitedly
read the post, thinking “oh yay her baby has come….” I don’t think the thought
even finished in my head before I finished reading the first sentence and my
heart shattered for her. Her baby was stillborn. I hugged my belly close and
felt lucky. Little did I know that exactly one month later Bennett would be
writing a similar post about our own baby.
I had frequent BH contractions all throughout July, many
more than I remember having while pregnant with Ian. On Sunday evening, July
31, they started to feel different than the painless tightening I’d been having
throughout the month. I knew these were likely warm-up prelabor contractions,
and I was excited to be taking that next step towards labor. Monday, Tuesday,
and Wednesday I continued to have irregular, mild contractions.
On Wednesday I was 42 weeks exactly. I was starting to get
nervous that labor hadn’t started, but at the same time, my contractions were
starting to come more regularly and slightly more intensely. By Wednesday
evening they were coming around every 10 minutes. I called Katie, one of my
midwives, and we talked for a few minutes. She told me to try and sleep, but to
call her if I wasn’t able to. I did my normal kick count before falling asleep
and all was normal.
I’d been having broken sleep for weeks so the fitful sleep I
got Wednesday night was nothing out of the ordinary. My midwives guideline was
to call if you were up for more than an hour with contractions, and I was not. At
some point in the night I fell into a deeper sleep because my contractions had faded
out, although I didn’t really register this until the next morning.
When I woke up Thursday morning I felt a bit off, but I
thought it was the absence of contractions and feeling completely discouraged
that at 42+1 labor had again failed to start. She was usually a pretty still
baby in the mornings so it took me a while to realize that her stillness was
not normal and the strange way I felt was not just an absence of contractions
and discouragement that labor had stalled.
I had always done kick counts in the evening so I knew she was normally
quiet in the mornings, but I couldn’t quantify that for myself. Looking back, I
actually think she died in the night, probably when my contractions faded out,
but of course that’s just conjecture. Or, maybe it’s just wishful thinking
because if she died during the night while I was sleeping, there’s no way that
what I did or didn’t do that morning could have made a difference.
By the time I decided something was wrong, it was almost
time for our home appointment with Katie. Once I felt something was wrong, the
feeling escalated quickly to knowing something was very very wrong. Katie and
Allie arrived at our home and started the normal visit discussion of how I was
feeling, and how things were going. I couldn’t focus on the conversation and
asked if we could just listen to the heartbeat. I think I knew on some level
that she was gone before the Doppler ever failed to find a heartbeat because I
was not surprised, just numb and sad. All during the searching, trying different
angles because maybe she’d turned breach or was in a funny position or…..I
knew. I will never forget the white noise emptiness of the fetal Doppler
failing to find her heartbeat.
Katie called the hospital to let them know she would be
bringing us in and to send them my records. We asked my mom to stay with Ian,
and then we got in the car and drove to GW hospital. How we stayed calm and
together I’ll never know. Shock? Disbelief? I knew there was no hope, and yet
how can you not hope that maybe just maybe there is a chance?
Everything with GW went smoothly because of the strong
relationship MAMAS has with the midwives there. We stood there numbly while
being handed paperwork and while they found a room for us. All the time Katie
and Allie were with us, touching us, trying to help us stay together. I felt
like everyone knew it was hopeless, and yet no one will say anything without
ultrasound confirmation.
We were taken to a room, and got situated for the
ultrasound. The OB (I think it was an OB) said they would take a second to
orient themselves and make sure they had a clear view. So there was a minute of
silence where I had one last hope that this would all be ok before she said
something along the lines of “We have a clear view of the heart and there is no
heartbeat. I’m sorry. Your baby is dead.” Bennett and I remember this moment
slightly differently, and I’m sure both of us are actually remembering inaccurately.
Whatever was said, it was said with kindness and compassion.
I remember crying. Bennett crying. Other people crying and
trying to give the only comfort they could through presence and touch. The
hospital staff stepped out to give us some time to process. Allie and Katie
stayed for a bit longer before also giving us some space.
Through the pain of this time I remember thinking….
“How will we tell Ian?”
“Of course we are dragging 2 pregnant midwives through this
hell.”
“It’s my fault.”
I was numb, and yet heartbroken. Crying and yet detached. It
felt so surreal. There was no way this could be happening to us, except it was.
After a while, Bennett went to go get Katie and Allie to
start talking about what would happen next. I knew I needed to move forward. I
couldn’t begin truly grieving because she still needed to be birthed in some
way, and regardless of the process, it was going to be a hellish ordeal.
I was checked to see if induction would be an option, and I
was 1cm dilated and 80-90% effaced. Since this was a primary VBAC for me, the
providers did not feel comfortable using any cervical ripeners so our options
were very much dependent on that cervical check. We were given the option to
induce with a Foley catheter and low dose Pitocin or do a cesarean.
The GW providers went over the risks and benefits of both
options, providing really good informed consent, and we had the opportunity to
discuss the options with Katie and Allie as well. Katie and Allie helped us
navigate what each option meant and provided a good sounding board for our
questions. I knew I wanted to avoid a C-section, but I didn’t know how I would
be able to face labor with no baby at the end. I remember Katie taking my hands
and telling me that it was ok to make any of the choices; it was ok, and they
supported me no matter what. I could throw out the whole idea of avoiding pain
medication if that felt more right. And if I wanted to keep things as natural
as possible, I could still change my mind at any point. There was no shame in
any of the options.
One of the things I really appreciated during this process
is having MAMAS, my midwives who had cared for me throughout my pregnancy,
supporting us emotionally as well as with information. This was my second
planned out of hospital birth that ended in the hospital, and we did not have
this same level of support for my cesarean with Ian.
During Ian’s birth, I felt that my midwives no longer
believed it was their responsibility to make sure we knew all our options and
their risks and benefits as soon as we had confirmation he was breach. But
Katie, and later Mairi, continued to make sure we had a safe place to discuss
options and insure we had all the information we needed to make informed
decisions.
After talking things over, we chose to induce first with the
Foley Catheter and to add in Pitocin later because I was not ready emotionally
for the intensity of Pitocin. At some point Katie called our doula, Lindsey,
and she joined us. Katie also called my mom to update her. After checking in on
both my and Bennett’s mental states, Lindsey began helping us take ownership of
the birth by making sure our birth plan was given to the hospital staff. It was
well received, and they thoughtfully discussed the few preferences that weren’t
standard for the midwives’ care.
During this time the hospital staff was also talking us
through some of the decisions we would need to make after the birth. There are truly
no words to describe talking about autopsies and funeral homes while preparing
for induction. I couldn’t cope with the decisions that needed to be made and
move forward so we asked to put them off until after the birth.
The Foley Catheter was placed and we let it do its dilating
through the evening while Lindsey and Katie kept us company. I needed to keep
the reality of the situation pushed to the side as much as possible to be able
to move through the birth. Lindsey offered to play DJ so that we always had
music going. We tried to talk about “normal things” as much as possible.
I’d like to pause here to let you know our music choices.
This was not empowering birth goddess music at all. Instead we opted for 80’s pop
and 90’s one hit wonders. The staff coming in and out of our room probably
thought we were crazy. They came in all ready for sadness, but instead were greeted
with “Summertime” by Fresh Prince, “Come on Eileen”, and of course “Like a Prayer”
by Madonna.
One particular awkward moment occurred while they were adjusting
the Foley catheter, and “The Humpty Dance” was on full blast. Two women were fussing
with a catheter line and in the background was “THE HUMPTY DANCE IS YOUR CHANCE
TO DO THE HUMP”. One of the women replied “This song is ridiculous!” It was a
welcome moment of humor.
Bennett went to Whole Foods for some snacks and processing
fresh air time while Lindsey and I talked birth worker to birth worker for a
while to distract me. It was nice to retreat to the safe distance of
professional gossip.
The day slipped by. I was completely out of touch with time
during our entire time at GW. As it got later, I knew we either needed to move
things along or rest. I was completely exhausted, and I knew I would need all
the energy I had and then some to face Pitocin without an epidural. We decided
to try and get some sleep. Mairi, one of my other midwives, had come to check
in on us and relieve Katie, and suggested I take the Benadryl the nurses were
offering to help me sleep. We decided it made more sense for everyone to go
home and sleep since we were going to try and sleep.
In the morning, the Foley catheter fell out. Due to the busyness
that accompanies shift change, it was mid-morning before we started talking
about the Pitocin plan. The nurse and midwife were happy to wait for Lindsey to
get there before starting Pitocin. Bennett also checked in with Mairi, and we
decided she should do a few prenatal visits before joining us in a few hours.
I was very scared of Pitocin contractions. I didn’t know if
I had it in me to work through them without pain medication, and yet the idea
of being stuck in bed, numb, was equally as scary. I remember asking Lindsey
how people cope with Pitocin when it doesn’t provoke the same endorphin release
that oxytocin does, and she said we will need to help your body produce
oxytocin and endorphins in other ways.
From the time Pitocin started to the birth it was about 13
hours. The Pitocin was started at a 2, moved up to a 4, put back down to a 2
when my contractions were double peaking and coming too close together, stayed
at a 2 for a while, was then put back to a 4, and sometime when I was in the
shower later on it was increased to a 6. It was hard; it was scary; it hurt;
and I honestly didn’t know if I could do it at several points.
There’s no way I could have made it through without Bennett,
Lindsey, and Mairi, the great nurses we had, and Nora, the GW midwife on duty
when we got there on Thursday and again on Friday night when Claire was born. I
don’t know how these contractions compare to ones without Pitocin since the
Pitocin was kept pretty low, but they were a struggle to handle. I didn’t know
if I had the emotional reserves to move through this process, and I still don’t
know how I kept going. I’ve been told I was strong, but I didn’t feel strong.
Besides the IV for Pitocin and a contraction monitor, labor
was allowed to progress as if it was a physiological birth. The only 2 cervical
checks I had were when we first got to GW to assess if we could induce and when
the Foley catheter came out to see how much I had dilated. A lot of the
laboring process is a blur. Lindsey was amazing switching between hands on
help, meditation/hypnosis, and guiding Bennett what to do. She also reminded me
I could sneak food while I was still hungry and made sure I stayed hydrated
throughout the birth.
In the beginning especially I needed lots of hip squeezes,
and I remember feeling bad because they are so exhausting for someone to do
contraction after contraction. At one point Lindsey realized that the baby was
hitting the rim of my pelvis and had me do some abdominal lifts during
contractions which really helped. I will forever love our nurse on Friday who,
when I told her that getting my blood pressure checked caused me anxiety, went
to get approval for it to be checked every 2 hours rather than every 30
minutes.
I felt very supported, but I honestly didn’t know if I could
keep going at several points. At one point I was completely ready to give up. I
couldn’t find a position that the contractions were manageable, and I was
tired. I was losing my focus and my strength to keep going. I remember thinking
who the hell cares if I do this without pain medication anyway….. I’m pretty
sure I was cursing some and saying “I can’t do this” over and over.
This was probably my lowest, most defeated point during the
whole labor. At that point Mairi suggested the shower, and since I had planned
to use a birth tub at home, I thought I should at least try it. That, plus Mairi’s
suggestion to vocalize low with the contractions saved me, and I moved into the
I can do this one contraction at a time mindset. I apparently spent hours in
the shower. I was completely zoning out between contractions and was beyond any
concept of time. At one point I threw up, and I remember thinking please let
this be transition because I was so tired. Bennett told me that Lindsey spent
most of the time I was in the shower with me, keeping me hydrated and keeping
me company. At that point things were such a blur I was registering the support
more than who was actually there.
After who knows how long, I was getting cold even with the
unlimited hot water and starting to push just a bit with the peak of each
contraction. We moved to kneeling on the bed, but I couldn’t find a comfortable
way to rest in-between contractions. While I was kneeling and pushing,
apparently it was critical that they draw more blood for….I have no Idea. They
had tried to draw blood while I was in the shower, but I think I yelled at them
“no!” so I wasn’t given the option to decline again. So while I was struggling
with contractions, I had a nurse trying her hardest to gently take blood
without completely breaking my focus. I still don’t know why exactly they
needed blood so badly.
I was so tired at this point that Mairi (I think) suggested
a position change to help me rest between contractions. I pushed on my side for
a while, and that is how her head emerged. I thought I would feel the burning
and pain more in my perineum but I felt the burning more near my urethra. I was
scared that I was tearing badly, but I know that is a very normal fear. Mairi gently
asked me if I wanted to touch her head like we had talked about during prenatal
appointments and I said no, but ended up doing it anyway. She also asked me if
I wanted her directly after she was born or a few minutes to collect myself,
but I said I wanted that skin to skin time.
Mairi later told me that her head was delivered in around 10
minutes, but then we had trouble with the shoulders that just didn’t want to
rotate. The collective effort to rotate her shoulders took maybe an hour. Mairi
and Nora had me switch to my back, pulling back my legs and putting my chin to
my chest, to be able to use more
abdominal strength and allow for Nora to help turn the baby. I had so many
people supporting me at this point, I honestly don’t even know how many.
In the end, Mairi ended up gloving up and pushing down above
my pubic bone while Nora used her hands inside to rotate the shoulders and
arms. Nora really did not want to call in an OB, who I assume would have used
forceps, which would not have been good for Claire or for me. We made slow but
steady progress with them coaching me through it and helping to support my
legs. I was exhausted, but trying so hard. I was scared they would never get
her lined up, and that I would tear, but I didn’t.
We later realized that the IV line had gotten crimped so in
the end I wasn’t getting Pitocin, which probably made the whole thing more
difficult. Mairi asked to try some nipple stimulation to strengthen
contractions, and that seemed to help. Eventually everything lined up and the
shoulders came out. I think it was only a couple more pushes after that, and
she was born still at 12:27am on Saturday August 6th. Someone, Nora? Mairi? Told
us she was a girl as they gathered her up and gave her directly to me. I think
Bennett was crying at this point, but I just felt….numb….relieved it was
over….tired….it took a few minutes for the grief to come.
Once the placenta was delivered and my bleeding was checked
we were given some time alone to cry and process. Eventually Mairi and Lindsey
came back in and we talked a bit. I asked if that was real shoulder dystocia or
a result of baby not being able to actively participate. Mairi said that there
was plenty of room and that this was not uncommon when the baby can’t
participate in the birth process. Lindsey and Mairi stayed until we were ready
for them to go, and then we were given a few more uninterrupted hours to sleep
with Claire. I slept with her on my chest, trying to soak up all the sleepy
snuggles I would ever get.
Around 4:00am Nora and Eden, the nurse, came back in and
asked if we were ready to have her weighed and measured. She was 8lb 9oz and 22
inches long, almost exactly the same as Ian. Nora also talked with me some
about the birth, and about grief and healing. She echoed what Mairi had said,
that this was not a fit issue, and that she could do so much manual rotation
because there was the room to do it. And she could do all that without me
tearing because of how well I had taken care of my body during pregnancy. It
was helpful to hear. Both Nora and the MAMAS midwives did a really great job of
acknowledging the successful VBAC while respecting the grief and emotional
complexity of everything.
We were given more time to sleep and hold Claire. Bennett
didn’t want to at first, but I told him he was more likely to regret not
holding her than doing so. At some point we had some tea, ate, and slept more.
Everyone was so kind and respectful and asked before
touching or trying to look at Claire. She spent almost the whole time on my
chest except when I needed to get up to use the bathroom or shower and then
Bennett held her. It felt so good to at least have that time with her, to try
and memorize the feel of her face, her little hands and feet. To trace her ears
and face with my fingers. To express a bit of colostrum to brush over her lips.
The day time nurse Heidi was amazing. She is in charge of
the perinatal loss program at GW and spent a lot of time talking with us. She
really talked us through what to expect from grief, peoples stupid comments,
the importance of communication, how Ian might react, and so much more.
We stayed until mid-afternoon on Saturday because I couldn’t
get up the courage to leave her there. But I knew it was never going to be the
right moment and we just needed to pick one. Placing her in the bassinette and
walking away was the hardest thing I’ve ever done and the hardest thing I ever
hope to do. Heidi did her best to comfort us in the moment, and let us know
that she would take care of Claire with plenty of love after we left her,
because she too was a mother.
It’s been almost 3 months now and I am still so thankful for
the kind and supportive care we were given. I remember telling Katie at a
postpartum visit that Sunday that at least I didn’t have trauma from the birth
to deal with on top of the trauma of losing Claire. We were given all the
options and information we needed. Every decision was ours to make, and we were
supported with kindness every moment of the process.
We are left with only best guesses of why this happened. Her
umbilical cord was wrapped around her neck, body, and legs, and there was a lot
of meconium. The best guess is that her
cord got compressed, but we will never know for sure.
