Monday, February 24, 2014

Bella's Birth Story



                  I have been meaning to share this story for three months now.  I'm not hesitant to talk about her at all;  I just couldn't decide how to describe what happened.  Initially, I considered writing about the positives--the birth, seeing her face for the first time, the flood of support and love.  But those details cannot be isolated from the whole story--the nightmare of that fearful ride to the hospital, being told there is no heartbeat and cradling the lifeless body of a baby I wasn't supposed to meet until the next day.  So here's all of it.  The worst and one of the best days of my life all wrapped up in one horrible package.

                November 25th was supposed to be her birthday.  That was the plan.  When I was told that I'd be induced and she'd be born on the 25th, I looked it up online.  She would have turned eight years old the first time her birthday would fall on Thanksgiving.  But, things went wrong and everything changed.  Instead, she was born on the 24th; her birthday will fall on Thanksgiving on the third anniversary of the only time we held her in our arms.

                I wasn't surprised to go past my due date.  I tried all of the usual tricks for bringing on labor naturally to avoid another induction, but they didn't work.  We'd been seen several times on and after my due date to make sure she was still doing well in my tummy.  She looked absolutely perfect for each biophysical profile and non-stress test.  There were no concerns.  She was always healthy and active.  I had no health problems and took all precautions to ensure a healthy pregnancy.  My only risk factor was just barely qualifying to be considered "advanced maternal age".  During my 20-week anatomy scan there was a concern raised about the cord--marginal cord insertion-- but that was later ruled out and followed by multiple in-depth ultrasounds to  ensure that baby's growth was on target.  This was a closely monitored pregnancy.  I never considered the possibility that anything might go wrong.   A week past my due date, I was scheduled to be admitted on Sunday, November 24th for an induction and the baby would be born sometime on Monday the 25th.  I was given the option of coming in sooner to give us a little more time in between baby's birthday and Thanksgiving later in the week.  But, we wanted to give her all the time she needed.  We were also looking forward to one last weekend as a family of three, so I declined.  Choosing to wait when I could have been induced sooner will haunt me forever.

                That last Saturday morning, I headed out for my usual four-mile walk.  It was a route that we enjoyed at least twice a week since we moved here this summer.  I looked forward to admiring the sunrise over the hills above the Hudson River and always considered  the early morning my special time with her, so it was bittersweet knowing that this would be our final outing together like this.  The rest of the morning was a flurry of activity.  I was frantically cleaning the house one last time and preparing to go to Caroline's little friend's birthday party in the afternoon.  Greg was spending the day at a volunteer event so us girls were enjoying an afternoon alone together.
Hudson River on the morning of November 23rd


                At the party, the next day's scheduled induction was the topic of conversation with my friends.  Was I nervous?  Was I ready?  I joked that childbirth is "no fun", so putting it off for one more day was just fine with me.  The kids had a great time and I helped myself to a couple of slices of pizza (I was eating for two!) and cake.  Knowing that my life was about to become much more complicated, I was happy to spend a little easy time with friends.

                A few minutes into the drive home, I realized that I couldn't recall the last time the baby moved.  This wouldn't have been too unusual as I'd been busy and on my feet all morning, but it was strange to not feel  the familiar kicks and jabs to my right hip while sitting still in the car--especially after all of that sugar.  I poked at her little hip the whole way home.  No response.  

                Back home, I bribed Caroline with television and ice cream and told her that I needed to lay still in bed alone for a little while.  Thankfully, she complied.  I stared out the window as I lay motionless--barely even breathing and praying for a kick.  "Kick, little one.  PLEASE kick.  You're making me nervous..."  An hour passed with no movement.  Greg came home and we agreed that it would be best to just call the doctor.  I questioned whether or not my concern was valid.  Wasn't it normal to have periods of time when she'd just sleep and not move much?  But something just didn't seem right.  I was instructed to go to L&D to get checked out.  The doctor didn't sound too concerned.  I figured that I was going to end up being embarrassed about having wasted everyone's time because the baby was going to be just fine.  We dropped Caroline off with some friends, telling them that we were a little worried, but probably overreacting.  We'd be back for her soon.  On the drive to the hospital, we prayed.  I told Greg about all of the stories I'd read online about full-term stillbirths and near misses.  Maybe there was a knot in the cord and I'd have an emergency c-section like some of the women I'd read about?  Maybe everything was okay?  Silently, I pleaded with God to keep this baby safe.

                At the hospital, I was escorted to a room and the nurse said, "Before we do anything, let's just check the baby's heartbeat".  So I laid down and held my breath.  Cold gel on my belly.  Scratchy static from the monitor.  More gel.  Searching.  Nothing.  "Let me see if someone else can try".  I started to panic.  My legs started shaking .  This is bad.  Is this really happening?  I'm supposed to be induced tomorrow!  The next nurse went through the same process with no change.  I asked her,  "I'm a nurse so I understand that you can't say much, but could you tell me what's going through your mind right now?".  She said, "Would we like to have heard the heartbeat?  Yes.  But let's wait for the ultrasound and see what's going on."   She promised that someone would be in soon.  The nurse later told me that after calling for the ultrasound and being told that I was in line behind other patients in the hospital, her response was, "There is absolutely NOTHING more important than you getting up here to her room right now".   The ultrasound tech was by my side within minutes.

                It seemed like an eternity before the machine was up and running.  Greg and two nurses stood by my bed.  All of us stared at the screen--hoping and praying.  An image popped up.  It was our daughter's face.  The screen blurred and then another image of her tiny chest.  The tech looked at the nurses and pointed at the screen and said, "See here?  This is the diaphragm".  I stared at my sweet baby's motionless chest while blinking away tears.  I said, "So there's no heartbeat".  She responded, "I'm not a doctor, so I can't tell you that". 

                Greg held me close and we broke down together.  I couldn't catch my breath.  Hot tears poured down my cheeks.   There just aren't words to adequately describe the wretched, disgusting, unfathomable horror of being told that the baby you've dreamed of for years and fallen in love with over forty-one weeks  is now dead.

                Because her death was so sudden and unexpected, the doctor wanted to go ahead with the induction that night.  Whatever took her life could affect me too if we didn't act right away.  We'd arrived at the hospital with only our wallets and phones, so Greg helped me make a list of things he'd collect from home and bring back for our overnight stay.  Our nurse advised us, "You're going to have a full-term baby.  It would be a good idea to get her clothing so that you can dress her after she is born.  And bring your camera or allow us to take some pictures for you".  If it weren't for her suggestion, I probably would have told Greg to not bother bringing the diaper bag with the baby's things.

                Greg left, the nurse left and I went to work preparing for what was going to happen next.  I texted as many people as I could--too weak to say the words out loud on the phone, but wanting as many loved ones and close friends as possible to hear the news from us.  I also thought about pictures.  Getting a photo session was a priority.  I'd been a part of the pregnancy loss community for over a year because of my previous miscarriages, so I knew that photos--good  photos--would be important.  I first emailed Elizabeth Shaw who we'd hired to take our newborn photos the following week.  We'd never met in person, but I hoped that she would agree to come.  While waiting to hear back from Beth, I contacted a local representative from "Now I Lay Me Down to Sleep", an organization which provides professional "remembrance" photography free of charge.  They would try to find someone to come out after the birth, but in the meantime Beth wrote back to me and said that she would be here for us in the morning.  We hadn't yet met in person, but because her work is so beautiful and because she expressed to us that she wanted to be there for us--her words to me were "I can't think of anything I'd rather do. Honestly"--we were thrilled that she would be the one to take the photos of our daughter. 

                After Greg returned with our bags, he crawled into bed next to me.  For one last time, the three of us would snuggle together.  Greg made a few final phone calls and we laid in bed staring at a picture on the wall.  What to do now?  Watch TV?  Sleep?  I wasn't sure how I'd even be able to continue breathing, much less get some rest.

                We agreed that our little girl would be named "Bella Joy" .  It was a nickname that our 5-year-old daughter had chosen so we'd always referred to the baby as "Bella".  We had a completely different name picked out, but we'd planned to keep it a secret until after the baby was born.  (Not even our daughter knew the name we'd agreed upon for her new sibling.)  Considering we'd known her as "Bella" her whole life,  it seemed wrong to consider naming her anything else.  It's exciting to imagine how Caroline will feel when she's older and realizes that she was given the honor of naming her baby sister.

                Part of the nightmare of losing a full-term baby is that you still have to give birth to your child's body.  I was told that they'd give me an epidural and load me up with pain medication, but I didn't see this as a solution to this "problem" of getting the baby out.  My plan all along was to avoid an epidural as I had with Caroline.  It didn't matter that she was dead.  Labor and delivery was still going to happen and I knew that my plan was right for my safety and my sanity.  The chance to parent this baby had been taken from me; I didn't want to also be robbed of giving birth to her the way I'd planned.  On top of that, I didn't want to be distracted from focusing on the labor process and spending time with my daughter after she was born.  I believed that the physical limitation associated with an epidural would only add more trauma to the situation.
Last belly photo


                My induction with Caroline was easy, so the plan was to use the same medications.  Cervidil and then pitocin in the morning to get active labor started.  The first medication was given around 9 p.m.  I spent the next three hours online researching  topics like "Stillbirth" and "How to tell a preschooler about the death of a baby".  I wanted to make sure that our hearts were somewhat prepared for what was about to happen--especially Caroline's.  How would we tell our sweet girl that her baby sister died and wasn't coming home with us?  How were WE going to handle the birth and going home with no baby?  The three of us cuddled in the hospital bed.  The storm of worries in my mind was only quieted by the effects of the strong sleeping pill I took around midnight.

                I started to feel uncomfortable around 3:30 a.m.  I couldn't shake the urge to sit up in bed occasionally because of the pressure in my lower back.  I'd sit forward, stretch out a bit and then lay back down.  This started happening frequently around 4 a.m.--the pressure quickly turned into pain.  My constant shifting woke Greg and I started hearing the beeping of his watch as he timed my contractions.  This went on for about an hour.  I was restless, so I'd walk around the room and sometimes find myself squatting on the floor because a wave would swallow me up and prevent me from taking another step.  At 4:30, my nurse removed the cervidil and gave me some medicine for the pain through my IV.  It took the edge off, but  left me feeling incredibly drowsy.  Greg later told me that I'd fall asleep in between contractions--sometimes even snoring!  At about 5:30, I'd just returned from a trip to the bathroom and as I sat down in bed, my water broke.  The next ninety minutes were a blur.  Suddenly waking, the painful squeezing, the beeping of my husband's watch, drifting back to sleep.  My nurse was sitting on the edge of the bed most of the time.  The overwhelming grip of a contraction would come back, but in my mind I'd imagine myself sprinting at full speed up my favorite hill in my neighborhood back in California.  Good pain.  Lungs and legs on fire.  The pressure would subside as I reached the top of the hill and turned around to head back down again, proud of getting through it and ready for the next one.  I was going to see her soon!

                At seven o'clock sharp, I was given the green light to start pushing.  Finally!  To the surprise of everyone-- especially me--our little princess had turned while I was in labor and came out frank breech (bottom first and head last).  She was born at 7:07 a.m.  She weighed 7 pounds, 15 ounces and measured 21 inches long.   Despite the breech birth, I pushed her out six minutes faster than I did with Caroline and it was by far a much easier delivery.  After she was born, she was immediately placed in my arms and Greg cut the cord.  She was SO beautiful.  Lifeless, but otherwise perfect:  a different nose than Caroline's, chubbier cheeks, the same funny-looking toenails.  She was bigger and heavier than her older sister had been.  Unlike almost bald and blonde newborn Caroline, Bella had tons of dark hair.  We were offered care similar to that of a living baby's family.  Bella's feet were stamped on a certificate, she was given a warm bath, had her hair combed, a fresh diaper and brand new clothes before her baptism.  She was swaddled in a warm blanket that I'd purchased for her the day before.  Although we were heartbroken, we were also VERY proud new parents of this precious girl.


                Soon after Bella's birth, Beth arrived to take photos.  Not knowing her other than through exchange of emails, I was relieved to find her presence calming.  Aside from the hospital staff, she would be the only person to "meet" Bella.  Beth told us that she'd never photographed a baby like this before, but  I wouldn't have suspected it had she not told us.  She handled the situation with such tenderness and respect.  On top of that, we have amazing, beautiful photos of our sweet girl to cherish for a lifetime.  You only get that opportunity once and I am so grateful that we had the best of the best there to capture those moments.

                We spent nine hours with our little love.  I was exhausted from labor and lack of sleep, but didn't want to waste a second.  We took turns holding her, kissing her, examining every little detail from her soft eyelashes to the shape of her ears to the wrinkles in her tiny little fingers.  We absorbed her from head to toe.  We took SO many photos.  We sobbed.  We held and rocked her and sang lullabyes. 


  We snuggled her and drifted off to sleep here and there.  I'll never forget the feeling of her tiny little body on my chest and her forehead against my cheek.  Her skin was so soft.   I nuzzled against her brown hair and inhaled the smell of newborn baby.  How could I ever say that it was enough?  To accept that I'd kissed her chubby cheeks for the very last time?  That never again in my life would I see her sweet fingers wrapped around my thumb?   As the afternoon wore on, I began to feel like I wanted to both run like hell from that room and stay in there forever.   


At around 3:30 p.m., we decided that it was time.  We changed her diaper, tucked her "going home" outfit in my diaper bag, dressed her in a white cotton hospital t-shirt, swaddled her tight, tucked her into her bassinet and paged the nurse to come for her.  The nurse who had cared for us the evening before and all through that day was busy with a birth down the hall, so someone else came in around 4 p.m.  We each gave our newborn girl one last kiss before she was wheeled out of the room.  And that was it.

                We gathered our bags, took one last  look around the room and walked down the hall.  The sounds of a woman in active labor filled the hallway.  We'd heard the first cries of several new babies throughout the night and day.   It was still hard to believe that our story wouldn't end the same way.  Hardly anyone noticed us as we walked past the nursing station, down the elevator, through the hallway and out to the car.  Just the two of us.



As I write this, three months have passed since the day Bella was born.  We held a memorial service locally and laid her to rest in Arlington National Cemetery.  We were lucky to have these events captured in photographs by Elizabeth Shaw in a beautiful photo story you can see here.  Since we met Beth, we have found too many things in common for our acquaintance to be just a coincidence.  Surely the hand of God brought us together and I will always be grateful for her friendship and the enormous contribution she's made to our journey of healing. 


After learning that Bella died and I'd need an induction that night, I was convinced that she was going to be born with a knot in the cord or some other obvious accident.  We'd been so closely monitored due to a scare earlier in my pregnancy.  Just three days before she died, she had passed her biophysical profile with flying colors.  She should have been born healthy.  During the ultrasound which confirmed the lack of cardiac activity, we were told that the fluid levels were normal.  After she was born, we saw that the cord and placenta were normal.  She was normal.  They'd drawn numerous vials of blood for testing and we opted to have an autopsy performed.  Everything has come back completely normal. Furthermore, I have no chronic health problems and was proactive in making healthy choices during my pregnancy.  We will probably never know what went wrong.  Her cause death is a mystery.