Monday, November 17, 2008

Into the storm: The Loss of Duncan

My husband and I had been planning a homebirth this pregnancy and we were ecstatic about it. Before learning about Duncan's passing I was counting down the days to his impending birth. I ordered last minute things for the birth and was in good spirits. Much of that changed when after ordering some stuff for the birth I noticed I hadn't felt him move or his hiccups in the last day or two. In the back of my head I thought everything was fine. I have a doppler (the kind some midwives and OBs use) that I had since my first pregnancy and thought to use it to reassure myself. I don't like using it, but I thought it would give me peace of mind and reassure me everything was okay. The doppler was on its last leg and was a hassle trying to get heart tones because it kept dying out. After maybe five minutes I pick up a what I thought was his heart beat which read 136. I found it low and in front. I thought everything was good.

As the day progressed I didn't feel him move at all. Something just didn't seem right. I first checked for his heart tones around 9:00 am. I checked again at around 2:30 pm. This time after trying for 10 minutes I just knew something wasn't right. I tried every place I could think of. Another 30 minutes went by and still nothing. Being almost 35 weeks I should have been able to pick up his heart beat anywhere, but I wasn't getting anything above 108, which was mine. I decided to rest and see if I could feel any movements. I thought if I took it easy then maybe he'll wake up. In the back of my head I just knew that wasn't the case. I decided to get up and go search for a 9v battery to replace the dying one. I replaced it and still nothing. I was getting a ton of feedback, though. Very annoying. By this time Mark came home from work and asked how long I had been trying. I said, "Too long. Over an hour." He had a feeling, but wanted to remain optimistic.

After not getting anything back I called my midwife to tell her what was going on and she got worried. She wasn't as worried about me not feeling as much movement because I had the excess fluid and that can sometimes muffle the baby's movement. She was concerned about not being able to pick up his heart beat. She asked if I wanted her to come to the house and check to hopefully reassure me that all was okay. She arrived and noted how huge my stomach was. I was approaching 35 weeks and my fundus measured 47 cm (equivalent to 47 weeks). I had so much fluid. It was now her turn to try and she tried and tried for about 30 minutes and didn't get anything. We were set to go to the hospital. I called and spoke to a nurse and she transferred me to a CNM and I told her what was going on. I wanted to bypass triage and head straight for an ultrasound. During this whole time I knew he was gone, but it hadn't hit me yet.

Mark stayed home with the kids while my midwife and I headed to the hospital. I was going to call him as soon as it was confirmed. We get to L&D and the NM greeted us at the front desk. I made sure to tell her that I was really just about 35 weeks. I'm sure she was thinking there's no way, simply because of how big I was. Now it was time for the ultrasound. It didn't take her long to tell me that she wasn't seeing what she wanted to. She went ahead and got the OB on duty that night and he confirmed that Duncan had passed. I already knew he was gone. I knew since the beginning of the day. Seeing him still on the ultrasound was when reality hit me. He was really gone. So many things were whirling about in my head. He noted the abnormalities he saw -- my fluid level and there looked to be some calcification on the placenta, which isn't normal at this point. I honestly didn't think anything was wrong with my placenta.

The OB and NM left to give me some privacy and said they'd have the chaplain come up to talk with me. The tears started to flood and I started to feel really numb. I called Mark to tell him of the news and I could tell he wanted to stay strong for me. My midwife was so kind to ask a doula friend of hers to watch the girls since we don't have family here. My husband arrived with the girls and I was so relieved to see Eve was asleep. I wasn't sure how they'd handle being up since it was getting late. I called my mom and some friends to let them know what was going on. That was rough. Having to break the news to family and friends. Mark had a hard time telling his family.

After we had some time to ourselves the OB and chaplain came in to talk to us about what our plans were with inducing labor and when. He suggested not to wait longer than two weeks. I wanted to be induced ASAP. He told us that they can induce that night. Since it was already around 10:00 pm, we figured it would be in the morning. We left to go pack my things and meet with the lady that was going to watch the girls. My midwife had another client in labor that she was going to check up on. She was going to come back to the hospital in the morning.

We got home and I packed my things and took a shower. Still completely numb and in shock. It was my worst nightmare come true. Ann showed up and we left. I'm so grateful for her watching the girls. She was so sweet and kind.

The 15 minute drive seemed a lot longer than it was. I kept thinking I had 5 weeks to go and he just couldn't be gone. He seemed so active and well days prior. What went wrong. We arrived at the L&D floor and were met with very sad faces. The nurses were so wonderful and attentive. I knew it was going to be a long night. Nothing is ever quick in the hospital, at least not in my experience. The nurses attempted to start an IV and didn't have much success at first. After four tries the IV ended up going in the median cubital vein (elbow bend). I was stuck a total of nine times by the end of my hospital stay and over 20 vials of blood was taken.

The OB came in to talk about the induction process. He said what's most important to him was that I wasn't in any pain and that I rest. That in a normal situation he wouldn't stress a medicated birth, but in cases like this he doesn't want to see the patient in pain. I definitely understood what he was saying. He told us that given the situation it wouldn't be a normal induction. They were going to be more aggressive with the dosage they use to induce labor. I was hoping to just have my membranes ruptured and see if it could get things going. He wasn't at all convinced my cervix was doing anything at this point. He didn't even want to check until after I was medicated. He didn't want me to be in physical pain while trying to cope with the enormous emotional pain I was feeling.

But hell, an epidural was NOT what I wanted. I like to be in control. I like to move around. I didn't want my lower half being numb. I didn't want to feel paralyzed from the waist down and I sure as hell didn't want to be hooked up to a bunch of beepy annoying machines. I just wasn't sure what to expect with this kind of induction. He brought up Cytotec, which is an awful drug used to induce labor. I told him I wasn't comfortable with that drug. He said giving me pitocin if my cervix wasn't ready could backfire and make it a very long and painful process. The same and worse is said about Cytotec. I was nervous about this induction process. I was convinced I'd be starting with a closed, high and thick cervix. Still, I was not about to have Cytotec.

Much to my dismay I consented to the darn epidural. Hated the whole process. I felt the anesthesiologist threading the catheter down the epidural space and to the left side. I felt him pushing it in. Wonderful. I knew my left leg was going to be more numb than my right since that is where the catheter was threaded. A kink formed in the line and the anesthesiologist administered lidocaine to make sure it was working. Not cool at all. The epidural was placed at 5:30 am and the doctor came in to check my cervix for the first time at 6:15 am. Much to his surprise I was 4 cm dilated, but Duncan was of course floating around in all that fluid and I wasn't yet effaced, which was to be expected. It was this time he ruptured my membranes. His game plan was to induce with pitocin and it was administered at 6:45 am. Within 15 minutes the contractions started, but didn't register very strong on the monitor. They weren't regular at all. I so hated being numb, but I was mentally and emotionally exhausted and really needed some sleep. Mark passed out in the pull-out chair and I dosed off. I woke up in every so often to see what was going on, if anything. I remember waking up maybe close to 8:00 am and I freaked out when I couldn't move or feel my left leg. It just felt like a huge mass or heavy stump. I was getting very anxious and had Mark buzz the nurse two times to have the epidural turned off. I hated that feeling. I couldn't move my lower half to reposition myself at all.

The nurse called for the anesthesiologist, which was a different guy this time. He told me what I was feeling was the local block he initially inserted into the epidural catheter. He said it would wear off and wasn't permanent at all. I asked about having it turned off and he advised against it because the new OB on duty was going to up the pitocin to a much higher dose to really get things going. It was around this time the OB came in to check my progress. I was 5 cm and Duncan's head was at -1 station without a contraction and 0 station with one. I wasn't completely effaced yet because for so long he had been floating and wasn't able to put pressure on the cervix to thin it out. So, with the pitocin turned up he said it should get active labor going. Around this time my midwife showed up and was my labor companion during this whole process. My excess fluid really did show itself when the contractions started to come on strong. I don't think the nurses were expecting to see so much fluid. It leaked everywhere. There was a huge puddle behind the bed and my midwife was standing in a big puddle. It was like a non-stop gush of fluid. I had these leg cuffs on to stimulate the muscles so blood clots don't form. Interesting gadget.

I was so hoping the whole induction process was going to be over soon. I was able to get a little bit of rest here and there and we all joked about the edema in my legs. Being pumped full of so much fluid really does it. Apparently, my left leg had massive swelling. My foot was huge. They got a good laugh. The mood was lightening up, but I knew that would change as soon as Duncan made his entrance. By 9:00 am I was beginning to feel the contractions, which was weird because my legs were still numb. Finally, I had some feeling and was able to get an idea of where I was at. Contractions actually weren't bad at all. I did feel them coming every 2 minutes and we could see on the monitor that I was getting close to transition. It was around 9:30 am when I told them I was feeling some pressure, like he was descending. My midwife said the contractions were beginning to come back to back. The nurse called for the OB and they began prepping. I started to feel the contractions getting a little stronger along with the pressure. The nurse turned off the epidural pump just in time, which was pointless since I was already capable of feeling the contractions and pressure. The pressure I was feeling at that time was a gush of water and then out slid tiny Duncan. He was so small. He was a little peanut compared to our girls. He was beautiful. Still covered in a lot of vernix. Mark and I both broke out in tears at the same time. Finally the whole induction process was over, but now reality hit us. Our son was gone. He wasn't the screaming pink and wide-eyed baby we so wanted. But gosh, he was just gorgeous. We couldn't give him a bath since they needed him to be "preserved" for the autopsy. Duncan Lewis Garibaldi Hines was born on 11/14/08 at 9:40 am. He was 5 lbs., 4 oz and 17 1/2 inches. He was born just under 3 hours after I was induced with pitocin with 1 hour and 40 minutes of active labor. He had blond hair like his dad and big feet like both of us.

Moments after his birth I inquired about the placenta. He said on appearance it look normal. Nice and big. Not shriveled or aged. He mentioned the ultrasound picking up some calcification and that the autopsy might reveal something he can't visibly see.

We got to spend over three hours with him. We cuddled and took pictures. The chaplain/bereavement counselor gave us a keepsake box to put pictures in. It came with an outfit, hat, a card for his footprints and a little baggy to put some hair in. He was dressed up in the little outfit and the nurse took his pictures. I loved the time we got to spend with him. I'll forever cherish the time we had together. We got to bond for just over 8 1/2 months and I will treasure every moment of that time. I could tell Mark was trying to stay strong, but it really hit him when he got to hold him. He said he looked like our youngest. One of the nurses said he looked like Mark and I agree.

When it was time to give him to the nurse I just broke down. It was so hard to give my son away. I would never get to see or hold him again. After he left I just wanted to sleep. I hadn't had but a couple hours of sleep in over 30 hours at this point. I couldn't wait to be discharged and go home. The OB came back in to check up on us and said 6 hours was the minimum stay. He wanted to make sure everything was alright with me before letting us go. He wanted to make sure I retained sensation in my legs and was able to walk and urinate. I couldn't wait to get out of that ugly and annoying hospital gown. And I wanted some food. Real food. The hospital food definitely wasn't the greatest. The bereavement counselor came in to talk to us about our plans for Duncan. We agreed on cremating him. We want to keep him with us. We were told it would take 3-4 weeks to get the pathology and autopsy results back and it's certainly one thing on my mind a lot. Even though I am anxious to get the report back, in the back of my head I have a feeling what went wrong.

It's been three days since his birth and each day is different. I think about what could have been and how much I miss him. Coming home without a baby was so hard. I want him with me. I want to smell him and cuddle him. My milk just came in today and I cry so hard knowing I can't nurse him. I want to smell the sweet milk on his breath. I want to wake up every two hours to feed him. But I can't. My baby is gone. Part of me is gone. I try to stay strong for our girls and put on a face and there are times that I tell myself I can get through this and be at peace. Mark has been a great support and I know he's going through the grieving process in his own way.

He will always live on in our hearts and memories. I miss him and love him dearly. I have to remind myself that it's going to be a long journey to recovery. The pain will never go away it just gets different.


Michelle said...

I found your blog on Mothering and wanted to read it.

I'm so sorry for you loss. How wonderful that the hospital treated you so kindly and supportively.

Thank you for sharing your story.

A n T said...

Clicked on Duncan's name after reading your response to the Kick counting post I started. I am so sorry for your loss. My heart was breaking into pieces as I read this. (((Hugs)))

Diane said...

I met you on FF. I am so sorry you lost your son. You handled it with such bravery. My thoughts are with you

Anonymous said...

Brittny, Thank you for sharing your story of your angel son Duncan. I am sorry for your loss, i know now just how it feels, as i am going through the same right now. We lost our daughter Stella Oct 28th 2010. She was born still at 37.4weeks. Reading other mothers' storys have been helping me cope greatly. Thank you again momma <3 God Bless.

Anonymous said...

Brittany, I cannot thank you enough for being so honest and genuine about the loss of your son. I lost my first child at 6 1/2 wks gestation, and although I never held or saw my child, reading your story and understanding your pain resonated deep within me. Sleep in heavenly peace, baby boy.

Love from a fellow mother of an angel baby <3

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