Elegy for Amy

Amy’s Story April 4, 2012

Filed under: Uncategorized — elegyforamy @ 8:42 am

On April 3rd, 2012, our daughter Amy was stillborn at 23 weeks and 5 days into our pregnancy, 5 days after I went into preterm labor and mostly ruptured my membranes. Up until Friday, we had a completely normal, complication-free pregnancy. And then everything went horribly wrong.

On Tuesday I had this odd bout of intestinal cramping that in hindsight might have been the beginning of all of this, but it wasn’t anything particularly unusual. I noticed when I went to bed that my lower back ached for a minute or two, like maybe I had a UTI, but I changed positions and it went away and never came back.

Wednesday, I was grocery shopping and suddenly just felt overwhelming tired and kind of weak, but I came home and laid down for a bit and drank a lot of water and was fine.

Thursday afternoon, 23 weeks exactly, I started feeling badly again, went home and had a fever. Took some Tylenol, fever dipped, but I was kind of feverish the rest of the evening. Around 11, I had what I know now was a contraction but at the time I just thought it was a random pregnancy pain. It wasn’t severe and it didn’t happen again. Fell asleep, had maybe two or three more of these episodes throughout the night. It didn’t seem particularly out of the ordinary until about 6 AM, when these cramping pains started happening every 25 minutes or so, and they kind of hurt, and I went online and read that Braxton-Hicks contractions are “typically painless,” but also not to be alarmed unless you were having for than four an hour. I was alarmed anyway, so around 8 AM I called the doctor and they told me to come in in an hour.

At this point, I knew there was a reasonable chance something was kind of wrong, but I had no idea it could be something this bad. I suspected they might admit me and packed an overnight bag, but I thought, like, regular bedrest. Possibly for a long time. As soon as the doctor went to examine me, all hell kind of broke loose. I was already dilated 2 cm and my bag of waters was bulging through my cervix, complete with baby’s head. They had me get dressed and wheeled me straight to labor and delivery. I did not fully realize it then, but they were fairly certain at that point that I would deliver in the next 12 hours.

The hospital staff was truly excellent – no one pulled any punches or sugar coated this for us, but they also always said, we don’t know what could happen, people come in and stay this way for weeks, this is not over yet. Dan and I focused on positive thoughts, and the doctors put me on a drug called Indocen to try to get the baby up away from my cervix. I was also put in something I can not pronounce (Trendelenburg?) that basically amounts to being upside down in the bed at a 15 degree tilt, essentially attempting to use gravity to our advantage. They started an IV drip of magnesium sulfate which stopped the contractions almost immediately with the side effect of making me feel like a drunken mental patient. Not that we really cared – we would have done anything, absolutely anything, they told us to do if there was even a chance it would help.

The neonatalogist came in and gave us the grave statistics about viability at this stage – even at the magic 24 week point, where survivability is more than 50%, the odds of the baby having a “moderate to severe neurological defect” before 26 weeks is close to 80%. The odds of her having none at all were basically zero. He explained to us that we need to fill out a form indicating whether or not we wanted to resuscitate the baby in case of delivery. I want with every fiber of my being not to know what it is like to have to have a conversation with your husband about whether or not you want to let your beloved child die, or write on a form, do not resuscitate my baby. But I do. And I wouldn’t wish it on anyone.

At that point, we basically began playing wait and see. We knew the situation was not good, that the odds of making it to 26 weeks were not good, but the odds of 24 weren’t totally off the table. They gave me steroid shots to improve Amy’s chances if we could make it that far, and her odds were better than normal because she was measuring sizably for her gestational age (about 1 lb 2 oz on Friday, 1 lb 6 oz at birth) and apparently girls survive more often. I was having some kind of bloody discharge, but tests for amniotic fluid came back negative and the bleeding eased up over the course of the day so they thought it was likely from the exam earlier.

Dan held my hand through the entire ordeal. He changed my bedpans – the man who has never even seen me pee, in 9 years together, without hesitation. Got me food. Brought me anything he could think of from home that I might want for the next three months, because we were hoping against hope that I was going to have a ridiculously long hospital stay. We loved each other through Friday and Saturday, and when the discharge let up and the contractions had been gone for more than 24 hours, we started to hope things might really be okay.

Then… things went pretty clearly downhill. Early Sunday morning, I began leaking so much fluid they called in the doctor. Again though, tested negative for amniotic fluid, which was good. Bad was that she could still see my bag of waters bulging in my cervix, which meant the medications and the lying upside down weren’t helping with the biggest threat to delivering imminently. They decided to keep me on the magnesium and wait and see, and later that night there was even more fluid. Which again tested negative for amniotic fluid. At this point, they also did a quick ultrasound and baby Amy was fine, floating around happily. She had a consistent 155 bpm heart rate for our entire stay.

The doctor told us she didn’t think there was any way we’d make it to 26 weeks and actually stayed overnight at the hospital because of the likelihood I’d deliver. Which I didn’t, miraculously, but neither Dan or I slept much at all that night, terrified I’d go into labor.

Monday, they sent me up to perinatalogy for an ultrasound which is when we learned there was no longer any fluid around the baby, meaning it was almost certain my water had broken despite the negative tests. We kind of broke down in the office, but again, the doctors were very supportive, not pulling any punches but they said they have patients in the hospital right now who have had their water broken for weeks and they’re still pregnant, so again, this wasn’t necessarily over yet. But between the bleeding the the fluids, it was not likely we’d make it long. I think at that point we just started praying for the two more days to get to 24 weeks and a really hearty baby. They pulled me off the magnesium and knew we’d find out in the next 24 hours or so which way this might go.

Monday night, I just didn’t feel right at all. We hardly slept, we were both scared. I still can’t exactly when things went totally awry, but it happened fast. I was having some weird twinges in the early morning hours, that were not actually cramping and felt not at all like the contractions I was apparently having on Friday. they started to hurt a smidge and come more often, but here is the thing – when you have spent 4 days hanging upside down in a magnesium haze clinging to desperate hope that you can keep your baby alive, acknowledging that you might actually be having cramping feels like giving up. Admitting that it was starting to hurt felt like I was betraying my daughter, like if I could just pretend that it didn’t really hurt, that it wasn’t really that often, then maybe we could still make it.

Called the nurse to tell her about the pains just before 5:30 AM, called my mom who was sleeping at our house so Dan could stay with me. Nurse went to call the doctor and by the time she came back, it was pretty clear to me and everyone that This Was Happening. The cramps weren’t bad, but they were every 3-4 minutes.

I remember asking Dan, alone in the dark, if our baby was going to die. He held my hand and said yes, but that we’d done everything we could, that we would somehow be okay. The nurses had gone to transfer me to labor & delivery and by the time they came back, I was having full on contractions every couple of minutes, crying in pain and feeling guilty for admitting how much it fucking hurt. Which was a lot. Dan stood over me, rubbing my back, telling me how great I was doing, the entire time. In the midst of it all, the nurses had to draw my blood and I will remember for the rest of my life my husband asking them if there was any chance they would need to do a clotting time check and that if there was to please take the blood now so I wouldn’t have to get stuck again later.

From there everything happened so quickly that the doctor almost missed the birth. I think they got me into L&D around 6:30 and Amy was born at 7:07. Even though it was obvious what was happening, the nurses aren’t authorized to simply start confirming labor or handing out drugs, so I ended up accidentally having a natural, unmedicated delivery, save for an IV shot of some narcotic they managed to scrounge up in the final minutes before delivery and inject into my IV. By the time the doctor arrived, I was already dilated to 8 cm and two contractions later, Amy was born.

She died at some point before or during the delivery process, we don’t know which, but it was almost a relief not to have to decide, don’t try to save my daughter. Don’t resuscitate my baby. She was perfect. She wasn’t at all like the 24 week preemies we’d seen on TV, clearly not ready for the world – she was perfectly formed, like any other baby, just far too small for this world. She was so pretty. She had Dan’s eyebrows and forehead and my mouth and the slightest bit of dark brown hair, and she looked so peaceful. We loved her so much. We held her and looked at her and the nurses told us to take our time and let them know when we were ready for them to take her to the morgue.

How do you decide, when you are ready to have someone take your baby daughter to the goddamn morgue?

Again the hospital staff was incredible, though, with so much kindness and respect and compassion. They gave her a tiny hat and a tiny bear and we have them in a box they gave us with photos of her and her tiny ankle ID bracelets. Several of the nurses who’d cared for us over the weekend even stopped by to express their condolences, which seemed above and beyond the call of duty.

And then we began life after our daughter died. After the birth, Dan and I were both suddenly, ravenously hungry, which made us feel callous and guilty. I was relieved beyond all measure to be allowed to actually get up out of the bed and actually go to the bathroom on the actual toilet after lying prone in bed not even allowed to prop up on an elbow for 5 entire days. After 4 nights of waking up every 20-30 minutes worrying we’d go into labor, we both fell into a dead sleep within hours. We were both so, so tired.

I gave birth to our daughter,  just like any other mom, except my daughter never lived outside the womb, and I don’t get to bring her home. I don’t feel like I’m a mom, except that she was my daughter and always will be and that makes me a mom.

We had a high-risk pregnancy because of my clotting disorder. I had been on daily Lovenox injections since November 14th. I was at risk for a lot of things as a result, and so I never counted my chickens. But at a certain point, you have to be pregnant. You have to allow yourself to think about the child you’re hoping to have, to raise, to love. We’d only done the smallest of things – bought a couple of books, a Care Bear, and just in the last couple of weeks I’d knit 3 tiny baby sweaters. Unbelievably tiny clothing that our daughter would have been swimming in had she survived, and they’re all over my house, and it’s awful. I can’t do anything without bursting into tears.

And then there is the topic of trying again. I am pretty sure that I want to, eventually. But I don’t know how I will ever do this again without living in abject terror every single day. Without going to the doctor 3 times a week. There were really no good signs, no indication, no warning. No one knows why this happened. All of the things I was at high risk for – this wasn’t one of them. And does it really even matter? Because even if we try again, and we have another child, it won’t be this one. It won’t bring her back, or change that this happened.


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