5/15/13 update: This post was cited on another blog, with the author assuming this story is about a midwife-attended homebirth. However, I would like to clarify that this was a PLANNED HOSPITAL BIRTH. It was not a homebirth or a homebirth transfer. This mother was attended by an obstetrician, not a midwife. This update isn’t meant to invite further dialogue but rather, in light of this confusion, to honor the family this happened to by ensuring the truth is known. My hope for the future is that readers and myself would be able to interact respectfully when we have differing viewpoints. Thank you.
Last fall I wrote the following article about a recent professional experience with maternal and neonatal mortality for Friends of Missouri Midwives‘ quarterly newsletter. After the publication of the newsletter, I finally stopped thinking about the loss of that mother and baby 24/7. I had to let go of them, mentally and emotionally, for numerous reasons, but mostly because I was pregnant myself and could not continue to function if I lived every day terrified of death. It was necessary for me to “forget” about this for a while, and thankfully, I went on to have a normal, safe birth: healthy mama, healthy baby. But the other day, I stumbled upon my article anew as I was shuffling through my documents on my laptop. And I read it. And it was hard. It still hurts and I think it should. I also think it should be shared with a larger audience. This is real and it matters. Thank you for reading…
As legendary midwife Ina May Gaskin has put it, maternal mortality is the last thing you expect when you are expecting. Virtually no mother goes into a pregnancy or birth thinking she might die – and no mother should have to think that. However, the horrible reality is that mothers sometimes DO die during pregnancy, birth, or the postpartum period. The really scary thing is that the U.S. loses more women than many other countries, and our national maternal mortality rate has gone from 6.6 [deaths per 100,000 live births] in 1987 to 12.7 in 2010. Although no one expects it, it does happen – all too frequently. And the trend is moving in the wrong direction.
I recently attended a birth as a doula in which the mother died. And making things even more horrific, the baby died as well. They had both been perfectly healthy the entire pregnancy and labor…until they weren’t. Of course, losing only the baby, or only the mother, would have been completely devastating on its own. But the fact that a dear man lost both his wife and his daughter at the same time, on what was supposed to be the most joyous of days, is utterly traumatizing and soul-debilitating. The fact that his two young stepsons lost both their mother and their baby sister in one night is absolutely wrong and un-reconcilable. There are no sufficient words to relay the devastation of the situation, nor the horror it was to witness as a doula and a pregnant woman myself.
And yet, I have had to do the impossible and come to terms with this grave reality the best I can. I have not done postpartum care for this family; I have done post-mortem care. I have not been able to talk to this beautiful mother – who I came to care about deeply –about the amazing job she did in labor and birth, and I will never be able to have that conversation with her. I will never be able to coo over her sweet newborn and comment on all the adorable things she does. Instead, I had the great but awful privilege of speaking at a motherbaby funeral. I had the incredibly hard job of doula-ing a broken man as we waited in an empty hospital room across the hall from motherbaby resuscitation efforts. I delivered dinner to this man a couple weeks later…dinner for one.
I hope and pray that I will never lose a baby and that I will make it through all of my pregnancies and births perfectly healthy. I hope and pray this for every woman…and I hate it that so many mothers have to encounter death on the road to giving life. I don’t believe this is the way the world was meant to be. And yet, we cannot escape stories of tragedy…they find us. If it is not our story, it belongs to someone we know and love…and I’d venture to say that does make it our story to some degree. We are along for the journey.
Greif and horror and unanswerable questions have become part of my pregnancy journey because of my stepping into my doula client’s journey. I started this pregnancy – my first – with a great deal of trust in the process. For years prior to conceiving this child, I have been “brought up” in the midwifery and homebirth community. As a result, my heart and mind have been continually washed with faith in the birthing woman’s abilities and the newborn babe’s resilience. Trust birth. Birth works. I’ve heard it all many times over. I believed it like a religion. And it’s not that I don’t believe in birth anymore…but it’s no longer so simple. Death does happen – even when it’s unfair and unthinkable. Sorrow may invade a birth uninvited. When my client and her baby died, I was in the room. I was tapping her arm and feeling for her pulse and calling out her name…and then I looked in her eyes and knew she was no longer inside looking back at me. I was a foot away when the doctor caught her baby girl, as purple as an eggplant in the face and white everywhere else. I was clutching the father’s arm when he was told the impossible news some 45 minutes later that neither mother nor baby could be saved. I was there. I tasted death.
I called my husband in hysterics at 1AM to come up to the hospital to be with me. I clutched my belly and begged my baby to move to reassure me that he or she was alive. Although I previously had no intention of having an ultrasound done, I leapt at a thoughtful resident’s offer to scan my 23 weeks baby in the aftermath of such trauma. (She printed a picture for us from the ultrasound machine, and I must say I treasure it). When my husband and I got home in the wee hours of the night, we stayed up watching sitcom reruns because I wanted to go numb, to go back, to pretend, to laugh. Sleep never greeted me that night although many tears did.
In the days and weeks afterwards, I did a lot of processing. I did a lot of healthy things. I spent a lot of time with understanding friends, telling the story when I needed to and not talking about it when I needed life to feel normal. I went to counseling. Some dear midwifery friends of mine held a lunch and intimate “peer review” for me, in which I was able to discuss the clinical aspects of what happened, of what might have happened “if this” and “if that.” I wrote a letter to the L&D staff at the hospital, thanking them for going above and beyond in their care and compassion. I attended five births with my midwifery preceptor, all of which were entirely normal.
I also drank numerous milkshakes. Cried a lot. Got mad at God. Felt helpless. Questioned whether or not I still wanted to have a homebirth. Wondered about everything over and over again – if my client had been sufficiently informed of the risks vs. benefits of various interventions, if the presumed cause of death was accurate, if I was a horrible doula/if I would be a horrible midwife, if I could regain trust in my baby and my body, and if that would be enough…
And amidst everything, my baby, my sweet little baby who previously had been relatively still in my womb, sensing my fears and I believe desiring to take care of me, started wiggling around more often inside my belly. ❤