Monday, July 19, 2010

Jeremiah (born still January 5, 2007 at 21 weeks) and Miles (born still July 17, 2007 at 18 weeks); early miscarriage February 2009
Twin Cities, MN

Jeremiah's Story

The day I found out I was pregnant with Jeremiah we were on family vacation in Yellowstone. Hubby and I were thrilled. A few days later we stopped at the cemetery in my hometown to visit my sister's grave - the same grave where Jeremiah would be buried just a few months later.

I'd been nervous about getting pregnant again because of how small my children David and Tania had been at full term, how brutal and long labor was (30+ hours each) despite their small size, how doctors had commented on the placentas and cords, and all the other complications. I went to the OB/GYN just weeks before I got pregnant with Jeremiah to get a checkup and ask if she could see any reason to be concerned about another pregnancy with my history. She said everything seems fine and there was no reason to expect any recurring problems.

With Jeremiah, I had morning sickness in the first trimester, as expected, and was measuring right where I should be all along. I was quite hopeful that maybe this time I'd have a normal pregnancy, maybe this time the baby would be healthy, maybe this time I wouldn't have lasting injuries from the delivery, maybe this time we wouldn't have to move to a new state right after the birth, maybe this time we wouldn't lose our health insurance, maybe this time things would be OK.

Then just before Christmas (maybe it was Christmas Eve - wish I could remember the exact date) I was wrapping presents in my bedroom after the kids were asleep, when I suddenly got the impression that there was a man standing about 6 feet in front of me and that he'd come to take the baby. I thought I was being ridiculous and paranoid. Sure, I'd had some trouble with both of my previous pregnancies but not until the third trimester, and things seemed to be going perfectly this time. I went to lie down for a minute and thought I felt the baby move, so I dismissed my impression as silly worrying. Only later did I realize that the movement I felt that night and in the following days was his body moving around in the amniotic sac in response to my movements.

By New Year's Day I was getting worried. When I was 20 weeks pregnant with David he was kicking hard enough that hubby could feel it, but nothing like that with this one. I had an appointment the next day which I hoped would end the worrying.

My two small kids came with me to the appointment and played in an adjoining room while the midwives checked me. My measurement was 21 cm - just right. But when they tried to find a heartbeat with the Doppler and couldn't. They tried another Doppler and then another. Nothing. They said to call the OB/GYN clinic and get in for an ultrasound. I gathered up my kids and went to the car, stunned. I called hubby at work and told him they couldn't find a heartbeat. He left work immediately and somehow I managed to drive home.

Next we went to the clinic at the hospital and they couldn't find a heartbeat with the Doppler either, but told us we would have to get a detailed ultrasound to confirm if the baby had died. Since it was the day after New Year's everything was booked and we were told we'd just have to wait until the following day for that. What a long miserable night that was, knowing our baby was almost certainly dead inside me.

The next morning a friend watched our kids while we went for an ultrasound. That's when we found out our baby was a boy - with no heartbeat. There were no obvious problems or deformities seen. We cried all the way home.

In the afternoon we met with a doctor and discussed our options - either wait and see if labor would start on its own or go the hospital to be induced. The choice seemed obvious - go to the hospital. I was horrified about what was about to happen, but also anxious to get it over with.

At the hospital we had to walk to our room in the maternity ward, past all the beautiful, healthy, live babies being wheeled down the hall to their mothers. It was devastating. I was given drugs to induce labor, but decided to forego an epidural. As midnight approached the pain was as intense as it had been for my full-term births. Since time had lost all meaning, I don't know how long it went on like this - maybe an hour, or even just a half-hour?

When the pain eased up for a few minutes I got up to use the bathroom and felt what I thought was his head coming out. After quickly going back to the bed, he was delivered breech by the nurses. I was glad they were in the room at that time because I had been afraid of being alone when it happened, as babies so small can come without any warning. He came out with the amniotic sac intact, so the nurses broke it open, took him out, cut the cord, and put him on a folded up blanket. The nurse asked, "Do you want to see your baby?". I had her describe what he looked like so I could be prepared in case there was something horrifying about him. She responded that he looked perfect, but had some swelling of his head and neck, which commonly happens after an intrauterine death.

We held him for a long time - our perfect baby in miniature. He was 8 1/2 inches long and barely under one pound (15+ ounces). We were amazed at his tiny fingernails, his perfect feet, his face that looked so like David's when he was born. If he'd been badly deformed, I could at least be happy for his sake that he could find peace in death rather than living a life of extraordinary pain and difficulty. But there was no sign that he was anything other than perfectly healthy, which made the situation feel all the more tragic. I hoped that with all the testing to be done we could get some kind of medical explanation for our loss.

The name Calvin had been chosen long ago if the baby was a boy, but since the unthinkable had happened we decided to name him something we'd never thought of. At my sister's suggestion, we named him Jeremiah, from the scripture Jeremiah 1:5 "Before I formed thee in the belly I knew thee." We felt this name was more appropriate for the situation, and especially since Jeremiah was born on January 5 (1/5).

As we were holding Jeremiah, the doctor became concerned because the placenta had not delivered and there was still quite a bit of bleeding. According to her, the odds of this happening for a mid-trimester loss are about 1 in 5. The placenta did deliver soon after, but was incomplete. Hubby held Jeremiah and nervously rocked him back and forth just as if he were alive, while nurses on either side of me held my arms down. Then the doctor reached in me with her whole hand and tried to pick out the retained bits of placenta. It was so painful that even now, 2 1/2 years later, the memory of it still turns my stomach. After a few tries like this with little success, the nurse put in an IV and gave me Pitocin and Fentanyl for pain before the doctor tried again, this time with ring forceps. The fentanyl did little for the pain, but the remaining pieces of placenta were successfully removed and I was relieved to avoid a D & C.

After this ordeal the nurses took Jeremiah away to take photos and footprints. Then they brought him back for our last goodbye and we took photos. We made arrangements for a local mortuary to take his body to the airport for transport to my home state, where we would bury him at the foot of my infant sister's grave.

Later that morning we left the hospital. I'd thought it was hard leaving the hospital with empty arms when David was born, because he was in the NICU for 5 days but I was discharged after only one day. This time we left the hospital with only a memory box. It is nice to have something tangible to remember our baby - a little teddy bear the nurses had photographed him with, his tiny perfect footprints in ink and in plaster, and a few other small momentos.

Once home, our greatest joy was to see and hold David and Tania again. It was so sad to tell them their baby brother had died. Tania was not quite two years old, and didn't really understand. David, however, had been very excited about the new baby we were going to have.

Over the next week, I took down the crib and packed away the maternity clothes. Hubby tried to work from home some and made some brief appearances at the office. I lost 10 pounds in 3 days - why bother eating when the baby I was trying to hard to nourish was dead?

We arranged everything for the burial out of state. The mortuary in my hometown provided a tiny casket for Jeremiah at no cost and we were able to transport and bury him without spending a large sum of money. My parents (especially my mom) had been opposed to our burying him because of the cost and inconvenience, and would have preferred that we had the hospital 'dispose' of him. While it certainly is costly to pay for a birth and a burial at the same time, we felt this is the right thing to do for our son. Thankfully, my parents did not object to our burying him with their daughter, my sister - and I'm certain she doesn't mind sharing her grave.

Our time at the cemetery was brief because of the bitter cold. We had a lot of family come to support us, as well as my friend and her family. We were very grateful we were able to bury our son. It felt like closure. We had no idea our nightmare was just beginning.

After returning home, we tried to establish a new "normal". Hubby went back to work and I tried to make life as normal as possible for the kids. Every moment of every day I missed Jeremiah horribly and felt that I mourned him all alone because not even my husband could comprehend how devastating the loss was for me. I'd felt him growing and moving inside me and felt his spirit always with me for months, and now there was only an emptiness that nothing else could ever fill.

A few weeks later all the test results were in. All were negative except for a moderate positive result on anticardiolipin antibody IgG, which we're told is not significant unless there is also a positive result for IgM; after six weeks this was retested and the level was "inconclusive". I got copies of my file from my doctor and noticed on the pathology report that Jeremiah's cord was "hypercoiled". No one had mentioned this to me. I called my doctor . Wasn't it suspicious and strange that all three of my babies had something odd about their umbilical cords and/or placentas? I was told the answer is no - this loss was just a fluke, just bad luck. I could go ahead and try for another pregnancy as soon as I wanted. He discussed it with the perinatologist and she said I should take baby aspirin in my next pregnancy, just in case. Take and aspirin and call me in the morning, basically.

With all the test results in and no clear answers, we decided to try again. We were worried but felt the odds were on our side. We'd never heard of anyone suffering multiple losses like the one we'd just had. Our doctors said they'd never seen it. We figured it would probably take several months to get pregnant so we might as well start trying. We never imagined that in six month's time we would have another dead baby in our arms.

Miles' Story

To our shock and great joy, we found out I was pregnant again on the first try! Even better, we found out on Easter Sunday and the due date was just before Christmas! It seemed like such a beautiful blessing.

This pregnancy was not considered high-risk because Jeremiah’s death was supposedly random, even though I had pointed out to my doctor that all three of my pregnancies were complicated by cord/placenta issues and it didn't seem random to me. The perinatologist said to take baby aspirin, and I did so from the day I found out I was pregnant. Despite past problems, I was hopeful we'd come home with a live baby this time even if we did have some complications. I'd never heard of anyone losing multiple babies to cord problems, and my doctors assured me they'd never seen it happen twice.

The first trimester was uneventful. I first heard his heartbeat on May 16, which was Jeremiah's due date, so it was bittersweet. Naturally, I was nervous about the possibility of another loss, but the first trimester passed without excessive anxiety partly because I knew that if I lost the baby at this early stage it would be less traumatic, at least in a physical sense.

Hubby and I had decided early on in this pregnancy not to tell family and friends about our good news, though we made a few exceptions for good friends who are geographically distant. This was to prevent the news from reaching our kids through comments like "You're going to have a new baby at your house!" or "You're going to be a big sister!". We didn't want to get the kids all excited about a new baby again until after we passed the midway point and had an ultrasound at the perinatology clinic.

By 16 weeks, the stress was starting to build. The doctors at the OB clinic said I could come in anytime for a quick check if I got nervous between the regularly scheduled appointments. I did so at 16 weeks and baby's heart seemed to beating normally. On Thursday, July 12, I started to get very worried and called the clinic the next day to see if I could come for a quick check, even though I had an appointment scheduled for the following Monday. They said they were too busy and I should just keep the Monday appointment. By Sunday, I was frantic and it didn't help when my two-year-old daughter kept saying very matter-or-factly and without a trace of fear, "There's a ghost over there, there's a ghost over there" as she pointed to the corner of my bedroom.

My hubby came along for my Monday appointment because I was nervous, but hopeful that I was just being paranoid because of our last loss. Being nervous at this point would be perfectly normal, after all. When it came time to listen to the heartbeat with the Doppler, there was dead silence. As the doctor went to get an ultrasound machine, I remember crying and saying, "How can I go on? I kill my babies!".

Unlike last time, things moved along this time at breathtaking speed. In less than 24 hours I went from hopeful but nervous, to going home from the hospital with empty arms again.

This time I was at a different hospital to have labor induced because the one I'd gone to last time was too full to take me right away, and I wanted it over with. In retrospect it may have been better to wait. The experience at the hospital this time was horrifying. Last time the nurses and doctor had been very empathetic because most of them had also lost babies. This time it was strictly business.

Labor was induced with Cytotec. This time it was shorter and far less painful, so I was not expecting what happened. I went to the bathroom alone at 3 am and my water broke. It was dark brown with old blood and then Miles just fell out. He was in far worse condition than Jeremiah had been. I called out for hubby and he came and helped me while a nurse was called in. I could hardly catch my breath because I was hysterical. Eventually after the nurse finally came I made it back to the bed and started to throw up because I was so disturbed by Miles' condition.

As we looked closer at him it was clear that he was perfect before death had come to claim him. The cause of death was obvious this time - the cord was constricted to almost nothing near his belly and had a few other narrowed portions as well.

Since he was not as far along as Jeremiah he was a little smaller of course, and weighed dramatically less perhaps because he'd lost so much blood into the amniotic fluid. We found out later that some of his blood was also in my circulation. I suppose he died much more quickly than Jeremiah and I'm glad of that. I know they both suffered before they died and that is very hard to live with.

Early the next morning, I was discharged from the hospital. This time we went home even more empty-handed ... no memory box, no momentos, nothing save a badly-done footprint on a piece of plain white paper. We had taken a few photos ourselves, but they are not very good.

We had hoped to bury Miles just as we had with Jeremiah. But when we called my mom to see if she could check with the cemetery about doing so, she said in an annoyed tone, "I hadn't planned on doing this today". How very rude of us to want to bury our child - we weren't planning on this today, either.

We found out from the cemetery that we could not put another preemie casket in the same grave. To have them together in one grave we had two choices: 1) buy a plot, exhume Jeremiah, and bury both babies in the new plot, or 2) cremate Miles and bury the urn in the grave with Jeremiah and my sister later on. We weighed the options and decided to go with the latter, even though we both didn't like the idea of cremation. It was just much more practical for many reasons. There was definitely some financial strain, since we'd had to pay for two hospital bills and two mortuary bills in six months' time. Also there were logistical difficulties associated with getting the body and ourselves to another state within the time allowed by law. Paradoxically, Miles was not legally recognized as human, since he was born 9 days short of 20 week's gestation (after which the death is considered "stillbirth") but he was considered "human remains" and therefore subject to laws requiring burial within a certain time period. So we chose cremation and then buried the urn privately the next time we were in my home state. Certainly there was no peace or closure this time once the burial was done, but it is good to know our babies are buried together as we wanted.

This time all the tests came back negative, including the repeat test for anti-cardiolipin antibodies and for rarer clotting disorders I wasn't tested for last time. The pathology report on the placenta didn't show any blood clots. Nevertheless, when we met with a perinatologist a few weeks after the loss, she recommended that I use Lovenox daily if I got pregnant again. I would gladly try it if I ever get that opportunity, even though I can find no evidence that this would improve the odds at all.

The aftermath of this loss was pure hell. After the first loss, we'd gotten pregnant again quickly and that certainly helped. This time we'd lost not only the baby we'd so desperately wanted, but also all hope of ever having the family we'd wanted. Hubby was expected back to work sooner this time, and I was on my own with the kids sooner, as well. In the month following the loss, hubby was often out of town or out of contact because of his job. The first day I was on my own I had a panic attack. My whole world had changed permanently, but in a way that was completely intangible to everyone but my husband.

Of course, the maternity clothes had to be packed away again - a tremendously depressing undertaking. But I was glad we didn't have to explain to the kids - again - that our baby had died. We had intended to tell them about the baby in one more week, after the 20 week ultrasound.

A baby would have been such a happy ending to this horrible year. Christmas was very, very hard. Jeremiah had died at Christmastime in 2006. Miles was due at Christmastime 2007. In 2008 at Christmastime, just after I was diagnosed with infertility, we were finally able to travel to my home state to bury Miles' remains with Jeremiah. I used to love Christmas, but I'll never see it the same way again.

Annie blog at Cradles and Graves
You can contact her at


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