Tuesday, May 27, 2014

Stillbirths: What Nobody Wants to Talk About

When I read John Irving's The Cider House Rules, one of the lines that always stuck with me was when Wilbur Larch says, when arguing with his protege Homer Wells over the sanctity of life, "I give them what they want, an orphan or an abortion."

And really, it seems like there are three options when a child is conceived:
a) The child is born and raised by a loving family
b) The child is given up for adoption
c) The child is aborted (and I choose to add that this is almost always because the mother feels this is in the        best interest of the child)
d) The child is miscarried in early pregnancy

There is a silent e), though, that no one wants to think about, talk about, or otherwise mention. Those are the babies that are stillborn, that are either born just a little too early to survive or who have some sort of problem (I don't want to use the word deformity) that keeps the pregnancy from being viable.

With scenario a), which is obviously the best option, there is a child born, and children make most people happy.  The child is healthy and wanted and read to and tucked in at night, and it's a win/win for everybody involved.

Scenario b) is a bit stickier, as giving up a baby after carrying it for nine months would, I imagine, be tough.  I also know a couple of people very closely who were adopted as babies or young children, and it definitely plays a role in defining who you are.  With that being said, though, in most cases the child is healthy and wanted and read to and tucked in at night, and it's a win/win for everybody involved.

I will say that, when I had an accidental and unplanned pregnancy when I was seventeen, I considered giving my daughter up for adoption.  Once she started moving, though, I started to know her.  Now, I could never imagine life without having been bettered through being Emily's mother.  She is a treasure (she's the one playing the piano for her sisters here).

Scenario c) is stickier yet.  I think the idea of people running amok having abortions is frightening and disturbing.  That being said, there are times (rape and incest come to mind, or situations where a pregnant woman knows that she will be unable to care for the baby from the start) when I can see where abortions under, say, 8 weeks might be the best thing for both mother and baby.  I pontificate on this issue more here, but let me just say that it is sometimes best for both a fetus and its mother to not be born.  That sounds harsh, but I've seen enough abused kids whose parents blame their existence for all of their problems (and the damaging cloud those kids have been raised under, destroying every shred of self-esteem), enough women destroyed by family estrangement due to pregnancy, and so on.  I am not pro-abortion, I am pro-what's-best-for-everybody.

Scenario d) is quite sad, in large part because some women are prone to miscarriage, so they experience this over and over again.  I have a friend who tried for years to have a child, and she had miscarriage after miscarriage before finally carrying a baby long enough for her to survive.  I have had a miscarriage, and it is distressing, but it usually happens early enough that you haven't made big plans or bought clothes or had a baby shower or even told anybody.

Stillbirth, though, is the worst of all scenarios, in my opinion.

One day, I got a text from "Joanie", someone I am very close to.  It was very clearly an ultrasound picture, and I started jumping up and down with surprised joy.  Joanie already had a precious (and precocious) son, and while I'd speculated that she'd one day have another, this was a treat.

Joanie texted and called regularly as her pregnancy progressed, joyful tales of heartbeats on Doppler and plans for the baby, which Joanie and her husband learned was a girl.

And then one day, I got the news that the latest ultrasound showed a deformation in the baby girl's nuchal cord.  Poor Joanie, who is in the medical field, knew what that meant.  We all hoped and prayed that the next ultrasound would show better news, but instead, it was worse.  The pregnancy was not viable, and the baby would not live to term.

Joanie asked me to come be with her while she figured out if she should induce the birth or let it happen spontaneously.  I knew how serious this was because I do not fly.  My parents decided that it was easier to schlep three kids to Disney World in a station wagon than try to get me on a plane (the one time we did fly to Disney World, I evidently caused such a scene that we drove every time after).

Needless to say, I got on a plane.

When Joanie picked me up at the airport, I noticed that her hand was on her stomach.  It was caressing her stomach.  And as the weekend went on, her hand rarely left the gentle bump of her stomach.  She loved that baby, loved her dearly, and the fact that she knew the baby would  never reach viability was just terrible.  As I write this, I'm thinking about the gentle touch of a mother's hand on her baby, the being living within her, and I am crying like you cannot imagine.

Anyway, Joanie's baby was stillborn, and it was just as traumatic as you would expect.  She texted me a picture, and the baby was tiny and gray (she had died in utero before Joanie ever reached the hospital), but she was beautiful, absolutely beautiful.  In typical Joanie fashion, she noted that she had the same nose as her son.

The thing is, though, if you are visibly pregnant, you generally have a baby to show for it.  If you have an abortion, it's rare that you would show as anything more than a little fatter around the waistline, so no one would have to know.

A stillbirth, though ...

Everyone knows you are pregnant ... but then suddenly you aren't.  A lot of people, including Joanie and her husband, had bought stuff for their baby girl.  The baby's grandmothers had already gone nuts with shopping sprees.  I myself had bought at least two items (which, and this could be seen as either morbid or an honor, Gabrielle has worn.

I don't know how Joanie managed to survive the questions as her baby bump dissipated.  I know she cried a lot, that she was very sad and angry, but I do not know how she handled the issue with her colleagues (she was far enough along to have told her co-workers and superiors). I don't know what the neighbors thought, or her friends that lived close by.

I do know that I am closer to Joanie than almost anyone, and I had no idea how to handle it.  I mean, do you say, "I am so sorry!", or "What can I do to make this better?", or even "Wow, you look great, you've obviously lost some weight"?

There is no etiquette for stillbirths.  Instead the women who arguably need the most support are left with the greatest void.  I mean, sure, there's counseling, but the idea of paying someone to listen (and what are you going  to say, anyway ... "My baby died inside my womb and I'm freaking sad?") is kind of...I don't know, sterile, I guess.

I know that I talked to Joanie a lot, but I did not talk about the baby, who they named H.J., unless she broached the subject.  For a long time, this did not happen.

Then one day, Joanie had another baby.  Her son was born a couple of months before Gabrielle, and I spent some time in the hospital with her before her husband got there, and she was talking about the difference between her pregnancies with her older son and with H.J.  It hit me hard, that she had gotten to the point where she could talk about it as just any other event. I was very proud of her.

By some strange fluke that involves chlamydia (not either of us having it, but we sort of have an inside joke about it now), Joanie happened to be there when I was in labor with Gabrielle.  She was talking, again very comfortably, about the difference in the births of both of her sons and with H.J.  I should also note, in case you haven't read Gabrielle's birth story, that Joanie was the rock I leaned on when things got bad. Her strength is amazing.

The thing is, why do we avoid talking about stillbirths?  I think Joanie is an exception in that she is able to talk about H.J. in casual conversation without going to pieces.  People talk about abortions they've had, children they've given up for adoption, even early miscarriages without batting an eye; they just take this as a matter of course.

I guess I am curious about one thing.  How many people have had stillbirths that I am not aware of?  I mean, I'm sort of in Joanie's inner circle, so I know the whole story, but I wonder sometimes how many stillbirths I've been woefully unaware of?

What do you think?  Why is it that it's easier to talk about early miscarriages, children given up for adoption, children that have died young, and even abortions than stillbirths?

I would love to get your thoughts on this as I can't seem to wrap my head around it.

**This post is dedicated to H.J., a baby I love dearly and deeply and will never forget** 

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