Monday, September 24, 2012

Delivering Chiara

I have finally been able to complete the story of Chiara's delivery. It is just a day shy of six weeks since we lost her. Mondays continue to be excruciating (the day we learned she was gone). Tuesdays are a challenge, too (the day I delivered her). Here is our story:

What a strange thing to wait around your house for the hospital to call, waiting for them to tell you it's time to come deliver your dead baby. In between the sobbing and the worried calls from friends and family and nebulizer treatments for your sick toddler you are sitting on your couch, in time that feels unreal. And then the call doesn't come. So you have to call them. Then you find out that the worst thing you'll ever have to do is scheduled for 1:30pm that day.

We said our goodbyes to our son and my Mom who would watch him for the night, packed our bags into the car, and left for Boston. We waited in the labor and delivery waiting room. The charge nurse came and got us and brought us into the delivery room. The sight of the baby warmer sent me immediately into tears, made it more real that our little girl would not need to be warmed. We were seen by the doctor from our practice and by a labor and delivery nurse who specializes in cases of infant loss. I was glad to have her with us to guide our way. Around 2pm I started the first round of Cytotec for induction. In the next hours we were visited many times by the doctor and nurse, by a social worker, and by the anesthesiologist. We confirmed our plans for an autopsy with cremation to follow. We discussed names for the baby. We settled on Chiara Astra. Chiara is the first part of my Grandmother's maiden name, Chiaravalotti. It means clear and bright. Astra means star. Her name means clear, bright star. We had thought of Chiara early on in my pregnancy, but had vetoed it because it felt very girly. For our daughter who will always be a baby, it was perfect.

After several more rounds of Cytotec, around 7pm, I started to feel heavy cramping. By 8pm I was in a lot of pain and asked for pain medication. I did not want an epidural. I'm a bit of a wimp when it comes to needles in the back. They gave me Nubain, which is pretty weird stuff. It dulled, but did not eliminate the pain. It also made me emotionless and a little out of it. After the Nubain, I was able to sleep a little.

I woke around 11:40pm to a different sensation in my belly, not so much pain as pressure and movement. Then my water broke. I had a c-section with my first pregnancy, so I wasn't prepared for what this felt like, for the warmth. Of course the fluid would be warm from my body, but I hadn't considered that, so it was a surprise. My husband called the nurse. The baby came easily. As the doctor examined her, she noted that the her umbilical cord was quite narrow as it entered her body, and that the cord was very twisted. The nurse went to untwist the cord, but the doctor said to leave it, as it would be important for them to look at it during the autopsy.

The nurse wrapped our baby in a blanket we had brought and we held her immediately. She was only 6.4 oz. and 7 inches long. She was fully formed. I loved her feet and was amazed at her long legs. I had been very afraid of how she would look, but it did not matter. She was my baby, and I wanted to hold her. We took photos, and I am glad we did. They are so sad, we look just devastated, but I am grateful to have them. On the days when I just can't believe what's happened to us, they are helpful. We sang to her, The Rainbow Connection, her big brother's favorite song. She had probably heard it every night that she grew inside me. The nurse took her to measure and dress her and then brought her back. She stayed with us all night in our room.

I woke in the morning around 6am and just wanted to get home. We were able to leave the hospital around 10am and we said our last goodbyes to Chiara immediately before leaving. I hated watching them wheel her away. I longed to have her back inside me.

Friday, September 21, 2012

Three States of Mind

I'm experiencing three states of mind these days, 5 and 1/2 weeks after losing Chiara. Here's what they feel like:

1) Primal screaming/sobbing: this is the vise-like grip around my chest, squeeze all the air out of me, Babylost Mama at her most alone. I scream or mumble, sob and cry. I am not really thinking, more just being overcome by the rushing tide of my own emotions. This is happening a couple of times a day. I walk for an hour every morning in the dark before work. Most of my walks are spent in this state. I wake to this state a few mornings a week. Other times it catches me off guard, in the middle or at the end of the day.

2) Functioning, with a backdrop: this is when I am functioning, but there a background story playing in my head. The first weeks it was a scrolling electronic marquee, "dead baby, dead baby, dead baby, " and on and on. These days it is more of a voice saying, "My baby, MY baby, MY baby,". I can do things, pay bills, answer emails, sit in a meeting, shuffle things around, but I am not very effective. This is the state I am in most often.

3) Functioning, no backdrop: I have the shortest snippets of this experience. For a few moments I am not sobbing, and there is no marquee scrolling, no voice reminding me. I am engaged in whatever task is at hand. It's a very small part of my daily experience right now.

I marvel at the different qualities of my grief. The first two weeks were just constant with re-working the entire experience of my pregnancy and loss over and over again. Any reminder of my pregnant days brought on the primal screaming/sobbing. Everything hurt, all the time. Now there is much more of the middle state, but the primal still sneaks in multiple times a day.

I am no stranger to grief. I lost my Dad when I was 31, he was 56. He had Alzheimer's. I've also lost all of my grandparents, two uncles, and several friends. I thought I knew something about grief. None of my previous experiences prepared me for this loss. I miss my little girl.

Saturday, September 1, 2012

Where a week can take you

Last week at this time I was peacefully sleeping, preparing to spend a Sunday with my husband and 2.5 year old son cleaning the house. It was a boring, mundane day in the life of our small family. Put away the toys, vacuum the dog hair, wash the floors, do the laundry. I was 21 weeks 5 days pregnant with our second child, a girl. It had not been an easy pregnancy, I had hyperemesis with my first, and while there was less actual throwing up this time, the nausea was pretty debilitating and my apetite had been poor since the start of the pregnancy. Anyway, back to last Sunday, which right now seems a million years ago. I can't even remember the final details of the day, but I know we ate corn on the cob, green beans and tomatoes for dinner. It was a lovely summer supper. Then we went to bed early.

The next day we had a follow-up ultrasound scheduled at 2pm. I worked in the morning and we drove to Boston together. We were nervous. At our last scan our baby, a girl, was measuring about 2 weeks behind normal growth for her gestational age. At the scan before that they had found a hyperechoic bowel. We had been referred by our obstetrician to the maternal fetal medicine practice at Brigham and Women's Hospital for a consult. We got in to see them as soon as possible and ended up doing an amnio at 19 weeks in order to test for CMV and for any chromosomal issues that might be causing the signs we were seeing. So we were nervous going the appointment, hoping our little girl had grown and that things were looking up. The ultrasound practice was very busy, and we had to wait over a half hour. We were then brought into an exam room and the technician started the scan. The room was completely quiet. My husband was holding my hand. We were very scared to hear anything. After only a moment, the doctor came in and within a minute of looking at the screen she said, "I'm sorry I don't have very good news for you, your baby has no heartbeat."

We fell apart. We were so afraid she wasn't growing right but we had just not considered that she wouldn't even be alive anymore. They let us have the room for a few moments to console each other and to prepare to make our way across the hall to our obstetrician's office. Once we got there, we were whisked into one of the doctor's offices and waited to hear about what would happen next. Our doctor was on vacation, so we met with one of her partners. She led us through our options. It was very important to us to deliver the baby so that she would be as intact as possible, and so that I wouldn't have to undergo any unnecessary surgery. We also wanted another ultrasound to confirm that her heart had stopped beating. I had still felt movement over the weekend and even that day, but the doctor explained that that is very common. I felt so foolish, having considered the movement such a positive thing. It gave me hope over the past weeks, even through the worry. How much I miss it now that my belly is empty.

We opted to go to the hospital to prepare for an induction the following day. We'd be able to go home and sleep for the night in our own bed, see our 2.5 year old son, and then come back in the morning. I desperately wanted to keep her inside me, I was not ready to let her go at all and would have considered letting it all happen naturally. I was so afraid that if we did that, we would jeopardize our chances of learning how she had died. A scheduled induction seemed the best of the terrible options: we would hopefully deliver her intact, avoid surgery, and get to hold our baby and say goodbye to her in a safe environment where help was near if we needed it. We left the hospital and headed home, stopping by the pharmacy to pick up my second dose of misoprostol and some ativan.

On the way home, I called my Mom, and a couple of friends to break the news. My husband phoned his parents.

My Mom brought our son home shortly after we'd arrived. She said she thought he had a temperature, so we took it. 104.5! A quick call to his doctor and we were back in the car and off to the the pediatric non-urgent care. An hour and a half later, after one nebulizing treatment, a prescription for amoxicillin, and some ibuprofen, we were on our way home. Five minutes into the drive home my Mom yelled "pull over!", so we did. Looking into the back seat, my son, who had been happily chattering away a moment before, was now frozen, his eyes rolled to one side, his hands jerking. A seizure. His first. On this night.

We all yelled, "call 911," but in our panic, no one was doing it. I was the most free, not driving or tending to our son, so I called. My Mom got my son out of his car seat to hold him. He was spitting stuff up. My husband turned and drove back to the non-urgent care and I called an ambulance. None of us knew what this was at first. I was afraid it was a reaction to the meds we'd just given him. We made it to the doctor and banged on the door to be let in. A janitor let us in and the one doctor left in the place looked after our son while we waited for the ambulance to arrive. At that point, my mind just stopped. I focused all my energy on our dear son, telling him that his Mommy was right there, and that we love him, that he didn't have to be afraid. I forgot for a few minutes that our other cherished child, our daughter, was lost forever in the sea inside me and would emerge tomorrow, not breathing. Our son slowly came to, was awake and watching, but still not speaking or responding. I boarded the ambulance and held his hand as we made our way to the emergency room.

Its taken me 2 week to get this post finished. It's only the beginning of our story, but it's enough for now.