*****Warning: this post contains content about late pregnancy loss and images which may upset or trigger some readers.*****
My husband, Damon, and I had a blended family, of sorts. I had two children from a previous marriage- Riley, my son, and Cadence, my daughter. We had one son together, Asher. We decided to round out the family and have one more child together- my first planned pregnancy, as chance would have it! Just goes to show you how the universe has plans of its own, regardless of your personal thoughts or opinions on the matter. Ever the OCD control freak, I told Damon that he had a window of exactly three months to knock me up. This was because my mother and father had given their three children, their spouses and THEIR children (a whopping 17 people in all) an all-expense paid trip to Disneyland as a sort of family reunion. I was NOT going to miss that trip due to being 9 months pregnant or having a brand new infant. Therefore, I decided to ‘plan’ my pregnancy so that our last family member would be between 1-3 months old when we embarked on our great Disney vacation. (At the time, I wanted that kiddo now or never, so that he would be about 2 ½ years younger than Asher, which is the age gap between my older kids.) I didn’t think it would be difficult. I’m notoriously fertile, with every pregnancy having its own “How the heck did THAT happen?” story of conception. However, two months went by with no positive pregnancy test. On our third and final month of trying, I had a very faint line show up on the pregnancy test, and immediately I was filled with dread. Terrified that I would miscarry, I had hCG tests drawn to confirm my pregnancy. Then I had early ultrasounds done to find a heartbeat and ensure proper growth. It’s a good thing I’m an L&D nurse with easy access to all these things and the people who order them. I chalked up my worries to that very fact- that in OB, I was privy to all the millions of things that could go wrong and the old saying is true: Ignorance is bliss. I never worried with my first two pregnancies, just had blind faith that when people get pregnant, people bring home babies. Looking back, I think my next decision was an attempt to prove to myself that not only would I bring home a baby, I would have the most low-risk, easy pregnancy possible. My husband, early in our relationship, after my announcement that I was a labor and delivery nurse exclaimed, “So you deliver babies, huh? I’ve ALWAYS wanted to have a homebirth!”
At the time, I worked at UNMH, which is the biggest teaching hospital in the state of New Mexico and the only high risk NICU- meaning we saw almost all of New Mexico’s really high risk pregnancies. I LOVED my job- the adrenaline rush couldn’t be beat. However, that environment (even with their relatively low c-section rate) was not particularly conducive to a true understanding of normal birth, not as a brand new nurse. Therefore, my husband got a long lecture of all the things that could go wrong throughout pregnancy, labor, birth and the immediate postpartum period and how homebirth may be for some, but I was DEFINITELY not going to risk MY baby and deliver at home. However, my views on birth started to change when I had more and more exposure to normal, healthy women having normal healthy births. I began to feel more empowered and so, with my third child, after having an epidural with my first and some IV pain meds with my second, I had my first completely unmedicated birth. I arrived at the hospital, hesitant to call out sick for my shift that day in case I was in false labor. I happened to be 7 cm- guess it was the real deal. I declined an IV and pain meds, hopped into the shower on a birthing ball for an hour, then got out and, screaming like a banshee, brought my third child into the world.
Afterwards, I felt like something of a bad ass. I DID IT. Then, after another one of my L&D friends became an absolute goddess in my eyes when she had an amazing homebirth and even lived to tell the tale, I decided to one up myself and become the ULTIMATE bad ass and do it again…this time at home. So, I brushed my fears aside. One of the CNMs I worked with, while I was voicing concerns to her about the pregnancy, said, “Cara- you are an L&D nurse. You know it will either work out and you will have a baby…or it won’t. And there isn’t much you can do about it either way at this point.” Knowing she was right, I started casually checking out homebirth midwives in the area. I didn’t worry about hurrying to be seen. In the logical portions of my brain, I knew that I was low risk and relatively healthy. Besides, I was a frickin’ labor and delivery nurse. I was perfectly capable of checking my own blood pressure, dipping my own urine and obtaining Doppler heart tones on my baby. Everything seemed to be progressing fine.
I finally decided on a midwife team when I was around 14 or 15 weeks. They were exactly what I wanted- educated and experienced, compassionate and friendly. My visits with them felt like old friends getting together for tea. We started working out all of the details of what we knew would be a beautiful homebirth to celebrate the arrival of our final baby. I even hired a birth photographer to document it all because, dangit, I was going all out. We included my daughter, Cadey in every aspect of the pregnancy; not only had she never forgiven me for not being at Asher’s birth, but I had also developed the belief that something missing in today’s society is the inclusion of mothers, sisters and daughters in the birthing process. I wanted Cadence to feel the power in herself and the awe of women’s strength that I felt every time I attended a birth. I wanted her to see birth as a normal, amazing part of life. I didn’t know at the time that I would be teaching her that DEATH is also a normal, amazing part of life.
I found out around 7 or 8 weeks that another of my L&D friends was also pregnant, and was due 7 days before me. I started having this nagging feeling that only one of us would have a baby at the end of everything, and I remember thinking “I wonder if it will be awkward for the one who loses her baby”. We had a 28 week IUFD (Intrauterine Fetal Demise) who was induced for several days on the unit before she delivered, and I remember saying to one of my co-workers, “I don’t know if I could come back to L&D after something like that. I think it would be too hard.” I started having weird dreams too- but every pregnant woman does! With my first, I dreamed that I delivered early and my child was a kitten, who I tried to put back in to ‘finish cooking’ but instead, he escaped out the front door and ran off down the street; that premonition definitely did not come true. Regardless, I mentioned at my last ‘normal’ appointment with my midwife that I felt like I just wouldn’t be lucky enough to deliver four healthy babies into this world and she said, (of course) “That’s not true!” But it was. The week of our anatomy scan around 22 weeks gestation, as we approached viability and I began to feel the baby move (although less than I remembered with my other pregnancies- I chalked it up to it being a lazy baby) I started to believe that I was just being paranoid. Damon and I decided on names for both a boy and a girl; we wanted the sex to be a surprise. For a boy, we had chosen the name August Alexander. The anatomy scan came back abnormal. I got a phone call from one of my midwives around 6:30 pm that night. I felt my old friend, Dread, welling up inside of me when I saw her name on the caller ID. She tried very hard to reassure me – “The radiologist says it’s probably nothing, but we just need to be sure!” – although the fact that the radiologist had told her to call his private cell if she couldn’t call him back within business hours to address his concerns said otherwise. The ventricles in our baby’s brain were ‘slightly enlarged’ and there was possibly a choroid plexus cyst in the brain. My husband asked me what all this meant. I told him, “There’s the chance that both of those things will resolve on their own before birth- or there’s the chance that our baby will have a severe problem. Basically, the baby is totally f**ked or its fine”. We decided not to overanalyze the findings and wait patiently for our Level 2 ultrasound with the perinatologist. That may have been what we DECIDED, but I definitely couldn’t stop my brain from spinning. I stopped into my work a few nights later to drop off some food. Someone made a comment that even though my pregnant coworker was a week ahead of me, I was bigger than she was. This was true- My belly had definitely started growing A LOT in the past few weeks. I didn’t know it at the time, but it was because my baby was incapable of swallowing and my uterus was filling up with amniotic fluid like a big water balloon. Instead, I tried turning it into a joke.
I said, “That’s because my baby’s head is so big.” They laughed for a moment, then stopped. “Really?” “Yeah- the ventricles in the baby’s brain are enlarged and there’s a possible cyst growing. Actually, the rest of the baby is measuring small! But chances are everything is ok- Those things spontaneously resolve all the time.” That’s what I kept telling myself. The level 2 ultrasound was scheduled during one of my husband’s summer college finals. I told him it didn’t matter – I was just going to get some cool 3D pictures of the baby and I would call him afterward. My sister-in-law insisted on coming, just in case I “got bad news”. I remember looking at the ultrasound screen and thinking “Gosh- the baby’s chin is so small. That’s not a good sign.” I held myself back from asking the sonographer probing questions – I knew he couldn’t tell me anything anyway – and tried to keep the conversation light. That was my approach when the perinatologist came in, also. However, when she zeroed in on my baby’s clenched hand right before being called out of the room and told the tech “Just watch this hand- see if it moves”, it was harder to be light hearted. Dread and fear settled onto me like a thick cloud, making it hard to breathe, as we all watched that hand stay frozen in its fist, willing those fingers to wiggle. I didn’t know at the time that the baby couldn’t wiggle those fingers free, that in fact his fingers were webbed together and neurologically he was incapable of opening his fist, but I knew it was bad. After the ultrasound, the doctor took us into her little sitting room on her little couch, a room trying to be calm and comforting but was in fact designed for horrible things, to tell excited moms and dads and families that there was something terribly wrong with their baby. Then the doctor said, “There are a lot of markers for Trisomy 18”, – that’s when I felt the floor coming out from under me. She kept talking about abnormalities of the brain and heart, the clenched fist and rocker bottom foot, and I tried to ask all of the appropriate questions. Even with all of my doubts and fears…I hadn’t logically thought any of it was TRUE. And then now, with every beat of my heart, the realization that my baby would die began to pound in on me, a physical pulsing of the world around me, crushing me. I have never had to focus so hard on pulling air into my lungs and pushing it back out again. My sister-in-law began to get a little emotional, but I held it in check. I would not break down on this stupid couch in this stupid room. I agreed to the amniocentesis. There was no point getting upset until we knew for sure, I told myself.
But by the time I got home, it all hit me. When I finally had to say it out loud. There is something wrong with the baby. Chances are, this baby will die. Once you say those words, you realize all of the things you envisioned for the child growing inside of you will never come to pass. A whole lifetime of expected memories- hugs and kisses, giggles, tears, gentle moments at night watching him sleep, wondering what kind of person this baby will grow to be– gone. That was the first time I cried for my child, and it wouldn’t be the last. Every day until his birth and every day for six weeks after, plus immeasurable times since, I cried. Before, I would have thought it was impossible to have that many tears in your body, that eventually they would dry out. But that was BEFORE. Everything in my life, from that point forward, would be categorized into BEFORE and AFTER.
The next six weeks or so passed in a rollercoaster of emotions and activities and thought processes that I will not go into now. All that is needed for you to know is that we did our best to love our child, our August. We celebrated his life the best way we knew how and prepared our children and families for his death. We considered saying good-bye to him at a gentle, quiet homebirth, but that option was ruled out due to my increased risks with the pregnancy. Instead, on July 30th, our son made the decision that he was tired and his heartbeat became very irregular. We made the decision to induce labor, in the hopes of delivering him alive, at least for a little while. We drove to the hospital. I was very lucky that I worked in a wonderful, supportive L&D unit. I called up a friend to be my private nurse, and she graciously agreed, coming in on her day off to take care of me. I was also blessed to have one of my midwives do the same, along with the midwife who was already on call. My family and in-laws waited nearby, ready in case he was born alive, ready to say goodbye and my birth photographer, who had become an important friend, was there to document it all. I labored throughout the night, knowing each contraction was bringing not life but death. My nurse and my midwives silently moved in and out of my conscious awareness, quietly supporting and loving me, but the battle I fought was all my own. No one else could do it for me. I delivered my son, August, sleeping into this world on the morning of July 31, 2013, at 8:01. He hung in there with me until the very end, so that I wouldn’t be alone on this terrible journey, hung in there longer than anyone honestly felt he would or could, and I’m thankful he kept me company on that dark road. And it’s ok that you decided to leave when you did, little man – I would’ve checked out while being squeezed through a vagina too. You gave me more than you ever needed to or that I ever deserved.
AFTER. After I lost my son. After I went through the pain of labor to hold a dead baby in my arms. After my world crumbled to pieces, after I stood there, drowning, screaming for somebody to help me as the darkness swallowed me and I couldn’t breathe and the rest of the world kept moving like everything was ok. After I started to accept that August lived exactly the life he was meant to, and that it held a beauty all its own. After all of that – with the pain of my empty arms consuming my days –I told my husband we could try again. One last time. Because my arms needed to be filled. Three months later, I watched my ovulation test show up positive on August’s due date, October 22, shortly before heading into work that night to, surprisingly, deliver another couple’s baby boy, who they named August. A few weeks later, those two pink lines showed up on my pregnancy test. This time, however, was different. I didn’t tell my husband I was pregnant for almost 4 weeks, not until after I had a friend do a quick ultrasound to confirm there was a heartbeat. Because there’s no use getting everyone excited, I told myself. Just to fail them all again.
At 9 weeks, I had my midwives run a blood test that is 99% accurate in diagnosing the major trisomy disorders. Because if this baby had Trisomy 18, I couldn’t go through all of that again. I would end things now and be done with all this baby nonsense. The test came back normal. The CNMs who had delivered August in the hospital a few months earlier had agreed to care for me again this time. Then, if we still wanted a homebirth, they would be my labor support while a CPM managed the actual birth. Because they had walked through the fire with me, and they knew. My friend and birth photographer was there to hold my hand the whole way through. It was like we would have the whole gang together again, but this time leave the sorrow and heartache behind us. This time, we would have that homebirth we had dreamed of…beautiful, real, free from the interventions of hospital staff and routine and impersonal procedures. Completely intimate and empowering. I only wish it was that easy. I read a quote while I was pregnant with this Rainbow Baby of mine and it resonated with me: Not only hidden from our sight by the place of gestation but hidden from our hearts by the place of fear. How true that was. Always waiting for the Doppler to come up silent when I checked for heart tones. Always waiting for someone to say, “I’m sorry, Cara…but it’s happened again.” Always waiting to be told I would labor again to bring death, and not life. We didn’t tell our families until we were 16 weeks. I was terrible at making and keeping prenatal appointments. Because it is what it is, right? There was nothing I could do to ensure my baby would survive…there was no amount of love or hope or wishing that would bring life to us when death was written in the stars. So…screw it. Except I may have used more colorful language in my assessment of the situation. At my anatomy scan, I almost went into a full fledge panic attack as I watched the sonographer sweep that probe back and forth over my belly, routinely going through the motions of the standard measurements. “Wait!” I said. “The baby’s hands, are they moving? Are they opening? ARE YOU SURE?” Looking at me with a smile, the lady reassured me that they were. “I’m sorry.” I mumbled. “My last baby had Trisomy 18. My last baby died”.
My husband got a much anticipated internship in Texas over the summer, and would be gone for the delivery. “Is it ok if I go?” He would ask. “Of course.” I said. “You can be there on Skype, and I’ll have my midwives.” In my mind, I would finish my sentence…”If I even have a living baby inside me then.” At 34 weeks, my midwife sat me down and was bluntly honest with me. “You aren’t in a good place. You need to heal mentally and emotionally to prepare for and connect to this baby” she told me. She was right. And it wasn’t that I didn’t love the baby I felt moving and growing inside of me. Because GOOD GOD, I did. But at the same time, that fear. That all-consuming fear. Because the more I loved, the more it would hurt when this child was also taken from me. I didn’t know if I could handle it, I didn’t know if I could come back from it again. And I had other kids that needed me too. Finally, around 36 weeks, I ordered my homebirth kit (just in case I would need it). Because maybe I would bring this baby home. Maybe I did deserve one more living child. Maybe my punishment for all those mothering mistakes I had overanalyzed was finally over. I began to feel an increase in back pain on June 21, around 36 ½ weeks from my conception date. That night, at 11pm, I felt like maybe it was the real deal. I had decided to deliver at one of my midwives’ houses, because that was where I felt safe. And being able to birth a baby successfully – especially after losing one – is all about where you will feel the most safe, isn’t it? So my birth photographer showed up and we loaded up the car complete with my sleepy 8 year old daughter but without my birth kit which had not yet arrived. I learned you don’t actually need much to have a baby! Imagine that. We drove an hour to find my homebirth midwife, my two CNMs, and one of my L&D friends (the one who had actually had her own homebirth about 18 months before, at the beginning of this journey) waiting for me, soon to be joined by the nurse who had been there with me to say good bye to August less than a year before. The birth was everything I had hoped it to be and – even more so – it was everything I NEEDED it to be.
Through this final birth journey, I felt like I finally found peace. I finally found grace. And I finally found hope. I reached into a place deep inside myself and found faith in who I was again. When I reached down and pulled my screaming, breathing, LIVING baby to my chest, and my daughter announced amidst the cries that he was a BOY, and my fears of that silent birthing place were swept away –I felt life breathe itself back into my lungs and heart and soul. And I felt August –gently, calmly, lovingly—lift himself from where I had been ferociously holding onto him, dragging him down, and I knew it was ok to say goodbye. Not to forget. Not to stop loving. But to move forward and live my life for both of us, and to let the joy of my newborn son, Elliot, finally enter me. And on that day, my heart became whole again, scar tissue and all.