The saddest moment of a pregnancy must certainly be when a woman hears that her baby has died. All of the hopes and dreams that she had for this unborn and unknown being lost like grains of sand slipping through ones fingers. Part of the psychological transition into motherhood comes when the woman feels the first flutters and twirls of the growing fetus within her womb. She identifies at once that this creature is of her, but is its own unique life coming to being. With this acknowledgment she begins to wonder, will she have my curly hair, will he bear the family nose, will she be kind, will he be funny...and just like that, before the child is even born the parents have cultivated a garden of hopes for their little one.
I can't begin to understand the sadness that my patient felt when she went to the clinic, concerned that her baby hadn't been kicking within her for the past two days and discovered that her baby had died. Surely the nurse or doctor applied cold gel to the plastic tip of the hand held doppler and searched in vain for the quick click-click-click of the baby's heartbeat. They probably told her that they were sorry, that it was too late, that her baby hadn't made it. After this heartbreaking news they must have informed her that she would need to go to the hospital to have her labor induced.
When I met her she was 5 centimetres dilated in labor with her first baby who had died. She was exhausted, her golden skin looked sallow, her eyes sunken with a far away look. Sweat beaded on her forehead and upper lip. She grasped her IV pole from which a bag dripped oxytocin into her veins. A cruel twist of fate this labor. Normally a labor of love and pain, women know that on the other side they will greet their long awaited baby. In a developed county this woman would be offered pain medication or an epidural to ease her through the difficult labor. Here it is not an option. With each contraction she reeled in pain. She moved from sitting to standing, to lying, lacking the strength or will to move gracefully between positions. She could not find comfort and cried out to God to see her through as each contraction surged through her. I sat with her and tried to calm her, knowing that her suffering was deep.
When her cervix was completely dilated we brought her to the delivery suite. She lay on the table, forlorn. She pushed bravely. I guided her, my hands fearful, never having delivered a baby that would not be alive. The delivery was difficult. Normally a baby rotates into the mother’s pelvis in a dance called the cardinal movements. The head flexes, then extends as it’s born, followed by a 45 degree turn at which time the shoulders align vertically before the rest of the body is expelled. But a baby that has died does not know the movements. The head does not gently extend, the shoulders do not rotate. The baby's body would not deliver. I found myself stepping aside as one of the doctors with more strength moved in to extract the baby. I had wanted so badly for the delivery to be gentle, to offer this woman just that small kindness after so much suffering, but it was not meant to be. I stood at her side as the baby was lifted to her abdomen. I wrapped her in the sterile green surgical drapes and carried her to the neonatal warmer, gently placing her onto the bed. It was overwhelming that she did not breath. Her right arm curled up towards her tiny mouth, left arm over her belly. Her small legs were pulled upwards in a tuck. She looked ready to take her first breath, ready to startle and fan her arms up and out into the world. She was perfect.
I moistened some gauze and began to wipe her face, eyes, hair, trying to make her as clean as possible given the conditions and lack of running water. She had been expecting a little girl. Her family passed back a rose pink princess dress with puffed sleeves and layers of sparkly tulle. After measuring and weighing her I fitted her white cloth diaper on. I smoothed the pink princess dress down over her little body, placed the pink hat over her moist black hair. I pressed her left foot onto an inkpad and placed a foot print on a piece of paper for the family to take home, then slipped on her pink socks. She looked like a newborn Cinderella.
One of the nurses brought her daughter over to her mother, whose eyes welled with tears. The baby was brought out to family waiting in the hall.
I wanted this blog to be a tribute to this brave woman. A remembrance for her daughter.
No comments:
Post a Comment