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** 

"Hesitating Sharing of the Joy"...or "The Fragility of Life"...or "How I Almost Died Giving Birth": Not Your Typical Birth Story

I almost died giving birth to my daughter Gabrielle on December 16th.  

There, now I've said it.

When my other daughters were born, I shared every detail.  I am a compulsive "over-sharer" on Facebook.  I have had this blog (and mostly written regularly) since 2009.  I am not one to keep my mouth shut (or, I guess it'd be keep my computer keys clickless or something).

But I have been very reluctant to talk about that day despite people asking (and being a bit bewildered by my recalcitrance, I suspect) because frankly I have never been more scared in my life.  Also, it feels wrong to talk about a day of such great joy as being terrible and scary.

Virtually all new mothers have that "first pic", the one where they are holding their baby for the first time.  I have one, too.  

The difference is that Gabrielle had been born some time before this picture was actually taken.  In fact, I'm pretty sure that my husband captured this moment--the first one of my newborn and I--just after her second bath.

I've been struggling with how to write this piece, grappling with whether I should do a play-by-play of Gab's birth or just focus on the strange and intense feelings the extremes of that day brought forward in me, which is of course the philosophical bend that I try to find in everything that happens.

Forgive me if I go too far one way or the other ...

My water broke around 2:30 a.m., and we headed to the hospital pretty quickly as it was almost an hour away and we already knew that I would need to have IV antibiotics during delivery.

The doctor decided to start pitocin right away because I was only 2 centimeters dilated.  I was very upfront about wanting an epidural as soon as possible; this was my third go-round with childbirth, after all, and I saw no reason to suffer agonizing pain needlessly.


The epidural started off okay, with the cold wash, the burning lidocaine, and the need to stay completely still. However, it started to hurt as the anesthesiologist moved the needle then the catheter around. A lot! She seemed to think I was being something of a drama queen as I got lectured on the difference between pain and pressure. I didn't care as long as the contractions stopped hurting.

All of a sudden, my bottom felt ridiculously hot, I couldn't move my feet, and my blood pressure started dropping. The anesthesiologist seemed to think I wasn't trying hard enough to move my feet at first, but I was too scared to be angry as my blood pressure continued to plummet...and Gabrielle's started to follow. I got dizzy and faint and started throwing up with an oxygen mask hooked onto my head...it was terrible.

The scariest part was that the nurses, the anesthesiologist, and my OB were clearly alarmed. I later learned, of course, that my blood pressure had dropped dangerously, had nearly disappeared for a moment or three, that I'm very lucky that ephedrine exists.  

They restarted the pitocin, and I was very quickly in agony.  If you've ever given birth, you know what "it's time to start pushing pain" feels like, and that's what I was feeling.  When the OB checked and I was only at 4 centimeters, I knew something was going on.  4 centimeters just didn't mesh with the frequency and intensity of my contractions, so she did a quick ultrasound. Turns out Gabrielle was facing outward (called "sunny side up" on birth boards), which explained the pain and the lack of quick progress.  (Not to put too fine a point on it, but the back of a head slides down the birth canal a lot more smoothly than a face)

I was kind of at the end of my rope (okay, I was about to scream in pain, with tons of dilating still ahead of me), so the OB said the only option for pain management was reattempting the epidural. Because of the epidural/blood pressure debacle, they did not want to give me narcotic pain medicine.  

The cause of the drama with the first epidural attempt was a bolus, and I was assured that it was incredibly rare and the odds of it happening again were astronomical.  In other words, there's no way I'd have another screwy reaction to an epidural.

Until it happened again...same dizziness, same blood pressure drop, same vomiting into the oxygen, and same fear.

When the OB reluctantly said a C-section was becoming increasingly likely, I was glad. I just wanted it over and the pain and fear to be gone.

This was my first C-section after having two pretty much uneventful vaginal births with my other two daughters. It was scary, to say the least. I was still freaking out over the two epidural attempts, and trusting that there would be no to minimal pain was hard to believe considering the way everything seemed to be going wrong.

They started the C-section, and my husband sat next to me and was very reassuring. I was dizzy and dozy from the medicine, and then my blood pressure dropped yet again and I had yet another round of puking into the oxygen mask.

It was only then that they realized that Gabrielle's shoulder was tightly lodged in my pelvic bone.  They could not get her out for awhile, and finally they had to get very aggressive.  As a result, my uterine wall tore and the OB had to call for backup and order blood for a transfusion...and everyone was very scared again, which of course freaked me out all over again.  I lost a lot of blood, and there was some concern that parts of my urinary system had been damaged.
Once Gabrielle was delivered, she was perfectly fine.  I heard her cry, and I wanted to see her more than anything, but they took her away while they tried to figure out how to solve the problem of me.  They called my husband over and gave Gabrielle to him.  He cut the cord, and they were ushered into a small room where they got to bond and hang out while my blood loss was figured out and remedied and I was stitched up.
It was only later that it occurred to me how serious the situation was as they literally left my husband alone with a newborn baby for an extended period of time.


This was over three weeks ago, and here is my beautiful baby next to me as I write this.

Trying to reconcile this beautiful miracle with the abject terror of that day is just ... well, difficult.  I feel like I should just forget it, get over it, say, "Well, that was interesting, guess she's going to be the kind of kid that keeps me on my toes", but I'm finding that it's not that easy.  

There is absolutely no connection between Gabrielle Rose, my surprise miracle baby, and the terrible events of that day.  But the events are still in my mind.  I have nightmares pretty much every night.  They just aren't connected to the baby.

Which I realize is a very good thing. 

What I can't figure out is where that space is.  Forgive me, I am having a very hard time articulating this, even to myself.  Basically, those hours of labor culminating in the C-section are lost in the Twilight Zone or something.  As soon as it was over, as soon as Gabrielle was okay and then I was okay, the fact that I almost died, almost disappeared from this world, could easily have left my other two daughters motherless ... it is just gone.  Except it's not.

I have these pics of my husband and older daughters with the baby.  We are all very happy.  It's a joyous occasion.  (And I am being 100% serious and non-sarcastic).

 Is it just that I have a better understanding of the fragility of life now?  Am I just struggling to get over an experience that was traumatic and suffering guilt because who wants to say, "The day my daughter was born was one of the scariest days of my life"?  

You see, the bottom line is that I was forced to gain a sudden awareness of how often that "almost" happens.  I think about my oldest daughter driving home from work late at night and just missing a tragic encounter with a drunk driver, my sweet 9-year-old getting into a car with a murderer, my husband getting attacked while walking downtown, and the zillions of other potential disasters the people I love encounter on a daily basis.

It's a scary world we live in, on so very many levels.

But I am so very, very fortunate to have this <3 div="">

The Octo-Mom

I find Nadya Suleman, also known as the Octo-Mom, to be utterly repulsive. If you don't know the details, here you go.

My main issue here is for the health and safety of these babies. They've been in the hospital for well over a month, and their release doesn't seem to be imminent, to say the least. They were born at just thirty weeks (a normal pregnancy is 38-40 weeks), and between their premature births and the strain of being one of eight inside a womb, they've got a long road ahead of them.

There are a couple of things that really boggle my mind here. First, these babies were conceived via in-vitro fertilization. Now, I know that this is the only option for some couples, and I completely respect that. The nature of in-vitro fertilization is such that frozen embryos are implanted in the mother's womb, and I guess the odds of success are increased the more embryos are implanted (I'm obviously not an expert in this). For some reason, a doctor implanted six embryos in this woman (two of the embryos ended up dividing into twins) ... a woman who already had six kids (yes, I said six--ages 7, 6, 5, 3, and 2-year-old twins). Am I crazy for questioning the legitimacy of this doctor ... and the sanity of this woman?

I have two children. Two is a good number for me, particularly when you consider the nine-year gap in their ages (they almost never fight, which is nice, and they don't clamor over the same toys ... Addie's attached to her laptop, Belle plays with Barbies). While I understand and appreciate that some people would rather have many kids and that some people leave the decision up to God (or whomever), I cannot fathom why a single mother receiving public assistance would choose to have more children (in a manner that she knew would more than likely be multiple births).

Further, I cannot imagine why a single mother receiving public assistance was permitted to have more children.

This does, of course, open a can of worms. For example, look at the popularity of "Jon and Kate Plus Eight." Did this crazy woman view her frozen embryos as a blank check made out by some sensationalized television network?

Who's to blame? The mother, for being nuts? The doctor who approved this? Society, for making single parenthood via public assistance acceptable? Science, for creating IVF? The media, for sensationalizing the biggest and most outlandish stories? Nadya Suleman's family, for her dubious morals? Other places? Other people?

I don't know the answer to that (I suspect it's like a pie chart, with varying pieces of blame going to different places), but what I do know is that my heart aches for those babies. Aches!