When Loss is Part of Birth
By Rhoda Baughman, CLE, CLD, CBE, DEM
The simple fact is the United States loses more babies and moms than thirty other industrialized countries. I know that death can be a very hard subject to talk about, but it is one that we should not be afraid to look at and explore.
More than likely you do know or will know someone in your lifetime that has experienced the loss of a child or the loss of a mother during the birth process. The simple fact is that with all our medical safety nets, death in birth still happens today. I am going to share with you one couple’s experience of labor and birth and the process that they took saying goodbye. This couple did everything possible to make sure that their pregnancy and birth would be a safe one. They had all the tests, ultrasounds and doctor visits but the unbelievable still happened to them. In the many years I have served families I have walked through very difficult situations with some of them. Their experiences have taught me many great lessons. The story that you are about to read is one of those experiences that left me in awe of how death in birth can be empowering and leave those involved stronger. It is about this couple’s need for those who were involved in the birth of their child to actively participate in their process of saying goodbye. Each and every person will choose to deal with grief differently just the same way each and every one of us births differently; there is no right or wrong way to grieve. For this couple in this story it was important for them to have their child remembered as being held and loved by those who would remember him. For the mother it was important that she saw those around her counting her sons fingers and toes and telling her just how beautiful he was. For the father he needed to hear how strong his son was and to see his wife being tenderly cared for during this time.
This is Luke and Amy’s story of giving birth and saying goodbye. This is a story of how two people took responsibility for the birth of their child. Their choice of care for their pregnancy and birth involved a wide spectrum of professions, both medical and holistic. This may not be how you or I would choose to deal with loss, but this isn’t about you or me. This is their story of how when the unexpected happened in birth it was still empowering and fulfilling.
It was a beautiful day in early May of 2003 and I was driving to a birth two-and-a-half hours from my home. Spring was in the air and I thought to myself what a wondrous time to be having a baby. Everything was singing new life and I rolled my window down and took in a big breath of air as I reached my arm out the window to soak up the warm sun. You could just smell the fresh flowers and grass - everything was so green.
My thoughts turned to Luke and Amy as I made the final turn onto their road. Amy and Luke had tried for five years to have a baby with no success. They then decided that they would quit trying and just enjoy their marriage together. Three months later a baby was on the way. Amy’s pregnancy had been uneventful and everything was in place for her to have the birth that she and Luke had planned. As I drove up to the house I was met at the door with smiles and hugs. The couple was excited that today would be the day that they would welcome their little one into the world. Their midwife, Holli, was already there and had listened in to baby and was getting the last minute items around for the birth.
As she took another bite of her sandwich Amy had expressed to me how she couldn’t believe that she was actually in labor. She laughed as she told me she thought she would be pregnant forever. She turned and moved with a waddle to the living room. Luke followed behind ever doting and rubbing her back as she walked. I followed behind and was led into the living room where Holli was making sure that the birth pool was being filled properly. Another contraction was coming and Amy turned to Luke. She wrapped her arms around his strong neck as he helped support her she made wonderful groaning sounds as she worked through the contraction. The contractions were about two to five minutes apart and were lasting about two minutes in length she was dilated to 6 cm and was moving along very quickly for a first time mom.
The pool was ready and Amy could get in. She slipped her robe off and Luke held her arm as she stepped into the warm water. You could see the relaxation come across her face as she sank into the pool. She let out a big sigh and said the water felt so good to her back and legs. Amy stayed in the pool only getting out using the bathroom. Luke, Holli and I stayed by the side of the pool to be close to her and to offer encouragement when the contractions came. Every so often she would reach down and grab her belly as she would tell the baby to quite kicking or moving around.
Another four hours passed and Amy was complete fully dilated and we waited for her body to start pushing. She had about a twenty minute break from transition when she said here comes another one as she reached for Luke. This contraction was different; she immediately found her body taking over as an uncontrollable urge to push came. The process of moving the baby down seemed to be taking a while but with each contraction she was making change and the baby was making passage through the pelvis.
Holli had asked Amy to get out of the pool so that she could monitor her pushing progress a little easier. Squatting was a good position for Amy to be in as her pelvis opened up to make room for her baby. The baby seemed very eager to come and was very active in the decent process. The decision was made to put Amy and Luke in bed and let her breathe through the contractions so that she could have some rest.
Holli and I stepped outside the bedroom and were talking to each other about what else could be done to help facilitate the birth process. Both of us felt as though there was something Amy was holding back, something she wasn’t telling us, something she was not able to say herself, something she didn’t want to say out-loud. After about thirty minutes of rest we went back to the bedroom. Holli and I knelt by the bed and we simply laid our hands on her and she began to sob. No words left our mouths we were simply just ‘with her’. She cried uncontrollably for about 15 minutes then we began asking Amy if she had any concerns or fear surrounding the birth. After her crying was done she looked at Holli and me and told us that from the begining of the pregnancy she never thought this baby was here to stay.
Could she be right? Did she have a ‘knowing’ from the very beginning? I will never forget how she turned to Holli and me and thanked us for being there with her and for sharing in this experience with her. She then stood up and announced that she was ready to have her baby. As she walked to the door way a contraction came upon her. A groan of sadness and happiness was leaving her mouth all at the same time. She was amazing, so strong, and so confident. Luke was by her side and tears streamed down their cheeks as they began to finish the process they had started earlier that day.
The two of them birthed a baby boy. That child never moved a muscle, never opened his eyes, and never made a gasp. How could this be? He always had good heart tones, the ultrasound said everything was fine, he was active in birth but . . . he wasn’t here to stay. Resuscitation was preformed until the ambulance came to the home and he was taken into the hospital. Upon arrival and admittance to the hospital there had been no improvement and the decision was made to let him go. Amy and Luke asked that we go back to where their son was and say goodbye with them.
Amy sat in a chair next to the bassinet with Luke standing by her and she was handed her son. She began to talk to him and thank him for coming and tell him that he should not be afraid. She talked to him about the plans and dreams that they had for him, and the family that was looking forward to meeting him. She told him how much they wanted him to stay and how they would miss him. Then she did the most amazing thing. She looked up at Holli and me and asked us to hold her son. We each took a turn holding him as she pointed out different things about him. She kept saying, “He’s so beautiful, isn’t he?”
He was beautiful and everything about the pregnancy, labor and birth was amazing. On that wondrous day in May Amy and Luke met and said goodbye to their child. Amy and Luke walked away from their experience and were empowered. Yes, they were hurt, sad, angry and devastated but it was their birth, the birth and death of their son. As a care provider it is hard to know how to handle these painful situations. What if Holli and I would have said no when she asked us to hold her dying son or didn’t acknowledge the feelings of fear that she was having at the birth? You see sometimes it is not our job to try to make things better, but rather to sometimes just be the witness of what is happening - good or bad.
Holli and I had no great words to say but we cried with them, laughed with them, and shared their experience with them. Over the next two and half years we shared in the healing process with them and we watched their grief slowly turn to smiles again. We talked about how old their son would be and wondered if he would be walking or talking and who he would have looked like. Amy often talked about how her arms physically ached for a baby to hold. For them, talking about their process of birth and death was a source of healing. There was no shame in their decision of place of birth nor did they ask “what if”. They taught me that I did not have to have great words of encouragement to say and that I did not have to be afraid of the silence.
As time passed we laughed at funny things that happened during her labor process. We talked about the great joy she found in pushing her son out. She loved the fact that it was “her birth” and she was where she wanted to be and with the people she wanted to be with. Amy and Luke called when they found out she was pregnant again and we walked through all the emotions that came flooding back to the surface. Wounds that we thought were healed began to hurt again, but that was OK. They would be Ok.
Holli and I were privileged to share in their second pregnancy and birth. It was amazing to see such courage, strength and love. They choose another home birth just as they had planned on a beautiful day in May. This son was here to stay. Today when we talk about birth we don’t often think about death. We just assume that one will go to the hospital and have a good birth experience with a healthy baby as the outcome. Many of us believe that loss won’t happen to us and that death in birth only occurs in some poor, isolated country. All too often we have some misguided thought that death doesn’t happen with a doctor or in a hospital.
