Faces of Loss, Faces of Hope

Angela
Mom of Charlotte Ava
May 14th, 2010, 10:10am-May 14th, 2010, 11:47am
Salem, Oregon

My labor and delivery were normal; it was the immediate aftermath that was a complete disaster. My water broke on the 13th of May. I was 38 weeks pregnant. I woke up around 7:30 when Jonathan was leaving for work, went to the bathroom and went back to sleep until 8:30 when I decided to get up and eat breakfast. I headed for the kitchen only to have an incredible urge to go to the bathroom. I muttered about having an impossibly small bladder and headed for the bathroom. When I was finished there was an audible pop and I called out, “What the heck was that?” I had left the bathroom door open since it was just the dog and I in the house. The dog heaved herself off her bed and peeked into the hallway. I looked in the toilet and couldn’t see anything so I shook my head and informed the dog pregnancy was weird.

I stood up and instantly soaked through the underwear I had on. I pulled them off, put on another pair and new pajama pants. When I soaked through that clothing in a minute I realized my water may have broken. I rummaged in the bathroom closet, found a pad and pulled on another set of clothes along with the pad. When I soaked through that in a short amount of time I knew it was time to call someone.

I couldn’t figure out what to do since there was so much amniotic fluid. Eventually I decided to forgo pants, climb in the bathtub, and call Jonathan and my midwife. I tried Jonathan’s direct line as well as the main switchboard at the clinic where he works. When I couldn’t get through to either after multiple tries I decided to call my midwife. By this time my hands were shaking and I was desperate to talk to someone. When my midwife didn’t answer her phone I called Bella Vie. Since Thursday is not a prenatal day no one answered at the birth center. I was cold and couldn’t think what to do next so I placed the phone on the sink and took a shower.

As soon as I was done showering I picked up the phone and tried my midwife again. I was so glad to hear her voice when she answered her phone. She asked me if my amniotic fluid was clear (yes), if I was feeling any contractions (no), if I had had breakfast (no), and if I had felt the baby move (yes, in bed this morning, but not since my water broke). She told me to eat breakfast and call her if things progressed. I called Jonathan’s work again and spoke with someone at the front desk. I explained it was an emergency and I had to talk to Jonathan, but I didn’t tell her why. After a few minutes I was connected with Jonathan and I told him my water broke. I told him to stay at work because I didn’t have any cramping or contractions. I did ask him to come home after lunch instead of going to the prison with one of the cardiologist’s as he did every third Thursday of the month. I was paranoid he would be scanning prisoners, I would need him to come home, and there would be no way to reach him.

At 9:45 I started having slight cramping. Jonathan came home around 1:00 or so and we went for a walk around the block after he had had lunch. It was a beautiful day and lots of people were sitting outside their houses. We stopped to chat with a couple people as we shuffled down the street, trying to get my labor to start. When we were almost home our vet called to tell us our dog’s blood tests had come back positive for hypothyroid. When he asked how I was doing I cheerfully told him I was in labor. “Oh!” he exclaimed. “Well, definitely finish that before you pick up her medication.”

What followed was a long, long period of light contractions. I would have three or four contractions, and then nothing for ten, twenty or thirty minutes. I spent a lot of time pacing in the backyard and the house. I also did a lot of squatting because I wanted to make sure the baby was in a good position. And I was trying to encourage her to come out quickly. We talked to my midwife throughout the day, but we never had much to report. Around 10:00 the contractions started coming closer together. At midnight when the contractions were 3 ½ minutes apart, we called the midwife and arranged to meet at the birth center at 1 am.

The rest of the night was a long period of close together contractions, but nothing too painful or intense. I drank a lot of Recharge, which is basically organic Gatorade, drank a lot of water, ate some cheese and crackers and sat in the birthing tub. I think it was around 5:30 or so when I decided to get out of the water and try walking around. I repeatedly told my midwife and her apprentice the contractions weren’t very bad and I didn’t see what the big deal about birth or labor was. I’m sure they were laughing at me in the kitchen in between taking turns napping.

Between 5:30 and 7:45 or 8 I cried, ate a little breakfast and had my cervix checked to see how far I was dilated. At the birthing center they don’t check your cervix unless you ask them to. I was terrified they would say I was only 3 cm, but I was 7 cm and almost 100% effaced. I told Jonathan I wanted to walk around outside since it was a beautiful morning. I made it a few steps when I was hit with the most intense contraction I had felt. Okay, I told Jon, I want to get in the tub NOW. I started peeling off my cardigan and headed back inside.

From that moment until she was born was very, very intense and painful. For a lot of that time Jonathan and I were in the bathroom and the midwife and apprentice were in the bedroom. I think they came in when I started pushing. At one point my secondary midwife's voice joined the fray, but I don’t know when that was. I had my eyes closed, I was focused inward, and it was all I could do to stay on top of the contractions.

I narrated everything I was feeling. I warned everyone of each contraction, told them how intense it was, and informed them whenever I needed to push. I do remember the strange sensation of pushing without really doing anything. My body was pushing and I didn’t have any say in the matter. 15 minutes before Charlotte was born I heard Jonathan’s phone ring. I opened my eyes, looked at Jonathan and said, “That’s your mother.” Other than that I kept my eyes closed, huddled against the side of the tub, squeezed Jonathan’s hand and screamed.

I remember someone holding me up from behind so I didn’t have to support myself on one hand. I remember thrashing around a bit when I was encouraged to get in a better position, because I wanted to stay where I was comfortable. I remember screaming. I remember being pressed to the side of the tub and holding onto Jonathan. I remember telling everyone “I’m done now. I want to go home.” I remember thinking – I am never doing this again. I remember the midwives checking her heartbeat periodically with the Doppler and trying to push them away because I didn’t like “that thing” they kept putting on my belly. I remember Charlotte moving lower and lower. I remember asking for help and then accusing everyone of not helping me. I remember someone telling me to feel her head. I remember them getting one poor heart tone. Just one, but a normal one due to head compression. I remember them asking me to get out of the tub and on the birthing stool. I remember trying to get out, having a contraction and then refusing to get out. I remember them pulling me out, setting me on the stool and telling me to push. I remember pushing Charlotte out. As soon as her head popped out I felt immense relief and swore I would never have another baby. Jonathan caught her, which I didn’t realize until later, and they placed her in my arms. I was shaking, couldn’t take in what had happened, and I held her for a couple seconds.

When they placed her in my arms, this bloody tiny bundle they kept calling my baby, I knew something was wrong. I felt, with that bone deep Mama knowledge only mothers posses, that my baby was not long for this earth. I could feel her soul struggling to depart even as I held her close for those few precious seconds.

Then my primary midwife took her from me, I heard someone say I need resuscitation now and everything went crazy. What happened next is a blur and I have a hard time remembering what happened when. I was on the birthing stool, wrapped in two white towels. Jonathan was across from me, sitting on a stool, or the edge of the birthing tub. After he caught her and she was handed to me, and then swiftly taken away, he stood up and moved out of the way. I had my eyes closed when I was pushing, but I wish I would’ve opened them because I didn’t get to see Jonathan catch our little girl. Within moments of Charlotte being born the bathroom was filled with midwives and apprentices.

I sat on the birthing stool, rubbed her foot and talked to her. She opened her eyes and looked at me. Jonathan moved next to me and started talking to her. She opened her eyes and looked at him. There was blood being pulled out of her stomach. They were trying to resuscitate her. Everything was very chaotic.

The midwives worked hard to keep Charlotte breathing while the apprentices took notes, called the ambulance service, and requested Life Flight. I remember looking down and wondering what the receptionist was doing in the room. For a moment I forgot she was a trained midwife. It is very strange to see the receptionist giving your baby mouth to mouth, but she did an incredible job.

A midwife I had never met was crouched next to me, rubbing my leg, checking my bleeding, and I asked her over and over: “Will she be okay? She’s too small. Is she too small? Will she be okay? What’s wrong?” She rubbed my leg and told me they were doing everything they could.

I was losing a lot of blood. I watched the blood spill onto the floor and slide underneath the board Charlotte was laying on. I don’t do well with the sight of blood; I thought I was going to faint. I kept thinking I should point out the blood loss, but I couldn’t form my thoughts into words.

Someone said, “Hey, where is that blood from?” and Jonathan said, “She needs Pitocin, give her a shot of Pitocin!" I had a midwife crouched on either side of me and I received two shots of Pitocin in each thigh.

Many midwives do not cut the cord immediately after the baby is born. Instead, they wait until the cord has stopped pulsing because they want the baby to receive as much as it can from its mother. I don’t recall if the placenta came out before or after I received the Pitocin shots. It dropped into a silver bowl at my feet. It was dark purple and soon after it fell in the bowl they cut the cord and Charlotte struggled to breathe. Her color was terrible, grey and pale. It was obvious her connection to me was helping her stay alive and allowing her to be resuscitated.

It was around this time the paramedics came in. They asked, “What do we have here?” One of the midwives started rattling off numbers and statistics, but all I heard was “We have a full term baby.” As soon as I heard that I felt immense relief. Charlotte was so small I was worried we had miscalculated and she was premature, too small to live outside a hospital incubator. (Days later, when I mention this to my midwife she says she dated Charlotte at 38 weeks.) They told me they were going to wrap Charlotte in what looked like tin foil to keep her warm and then the baby was passed to my midwife who placed her on the gurney.

The EMTs were going to transport Charlotte to the bottom of the hill where Life Flight would be waiting to take her to Salem Hospital, which has a NICU. Willamette Valley Medical Center in McMinnville was a couple minutes closer, but we needed a hospital with a NICU and we signed a form asking to be transported to Salem if anything went wrong.

From this point forward I have had to piece things together. Jonathan said it took a long time for Life Flight to come. Once they arrived they couldn’t decide where to take her, even though a team was waiting at Salem Hospital and that is where they were told to transfer her. Jonathan said they worked on Charlotte in the ambulance for a long time. I was told Charlotte’s heartbeat was in the 90s in the ambulance. It was a very messy situation and once Life Flight arrived they decided to transport her to McMinnvill even though they did not have a NICU because they could not intubate her.

I was moved to the bed so they could start cleaning the blood off me. Midwives and apprentices were coming in and out of the room, phones were ringing and I was overwhelmed and drained. I didn’t understand where my baby was, why they had to take her away. She was doing fine, her heart tones were good until the very end.

I remember Jonathan coming in and laying down next to me on the bed. I remember people praying. I remember eating a few eggs, a few bites of sandwich. I remember Jonathan giving his dad permission to meet the helicopter. I remember trying to get up and into the bathroom. I remember getting dizzy. I remember lying on the floor next to the toilet. I remember someone asking me what my age was, because they were trying to assess how out of it I was.

I remember Jonathan leaving to go to the hospital. I remember my Mom arriving. I remember getting stitches. I remember someone handing me the phone. It was my father-in-law, he asked me if my mother was there. My mom took the phone and went outside. As she was finishing the conversation, she saw my dad driving up the road to the birth center. “I’m going to go meet your dad,” she told me. I remember my secondary midwife telling me “As someone who has almost lost a child, you need to get up, we need to get you to the hospital, you need to be with your baby.” When my mom tore out of the room to meet my dad I knew Charlotte was dead. My parents came in, my dad put his hand on my leg and cried while he told me Charlotte was dead. I asked Jennifer to bring me my yoga pants, I started to get out of bed and I said, “Take me to Jonathan. I want to see Jonathan.”

I had a difficult time getting up, getting dressed and going to the hospital. Unfortunately I had the perfect combination of things happen which made it nearly impossible for me to stand up without fainting. I missed breakfast, I missed taking the medication which helps regulate my thyroid function, I was in shock, and I had had a mild hemorrhage. I would stand up, start to fall down, rest. Someone would put Recharge in my face, I would drink, stand up, feel faint, rest. I eventually made it to the couch near the door. Someone handed me orange juice, but someone else said “Oh no, she doesn’t like orange juice.
I grabbed it and said, “I’ll drink it if I have to. I need to get to Jonathan.

The drive to the hospital was awful. It was sunny out, very bright, I thought I was going to be sick, and all I wanted was to go home. I didn’t understand why I had to see my dead baby. I didn’t want to hold her, touch her, look at her. I wanted to go home and sleep. It was about a 20 minute drive from Bella Vie to the hospital and my dad drove it fast and jerkily. I wanted a smoother ride, I wanted Jonathan to be next to me and I still couldn’t figure out why I needed to see my dead baby. I was numb and shaky and all I wanted to do was lay down and sleep.

As I was being wheeled into the hospital I remember being glad someone else was in charge. I had no idea where we were going, but everyone else seemed to know exactly what to do. I was wheeled through the ER, someone at the front desk said something to us, but we kept going and eventually ended up in a room where Jonathan was waiting with my midwife.

When Jonathan saw me he hauled me out of the wheelchair and said, “Come here, come sit here with me.” My head was spinning and I couldn’t see any furniture where Jonathan was heading. Just a wall and a door. When I realized he wanted me to sit on the floor with him, I pulled back and said, “No Jonathan. I can’t get down there.”
“Are you sure?” he asked.
Someone grabbed our arms and said, “Here, sit here.” Jonathan and I sank into two hard plastic chairs, he wrapped his arms around me, and he sobbed.
“Our little girl didn’t make it. She’s dead.”
“I know,” I said. “I know.” And I stroked his hair while he sobbed and I sat there, numb, in pain, confused, and in shock.

I don’t remember when a nurse came in with Charlotte, but I remember her being placed in my arms. I was absolutely freaked out by her weight, the blood around her mouth and nose, the tube that was still in her mouth. I didn’t understand why she had tubes in her when she was dead.

When I next looked up everyone was gone, it was only Jonathan, Charlotte and me. We sat in those awful plastic chairs, he wrapped his arms around us and for a moment we were three, just like we had planned.

We will probably never know why Charlotte died. We've been told her lungs would not inflate, but a reason for this has not been found. I have to believe she was not meant to live here with us. My precious, tiny girl. Born May 14th at 10:10 am. 5 lbs. 7 oz and 19 inches long.

I miss you every moment of every day, Charlotte.

Angela blogs at Little Bird
You can contact her at rodman.angela@gmail.com