(This is long…probably too long. It’s also pretty detailed, and extremely sad, so it might not be right for everyone to read. I just needed to get this week down in words.)
It’s been one week. I can’t quite get my head around that fact, though, because it feels like time has done its strange work of making long and short of life this week. I know that friends and family want to understand what happened, and I think that we may need to look back to understand what has happened, so I’ll try to write. Write what I know. If you go back and look at the three posts below, you can get an idea of what was happening two weeks ago. Renee had been diagnosed with t3 hyperthyroidism, she was experiencing intermittent bleeding and cramping, and she had been diagnosed with a (possibly hpv) lesion on her cervix. Concomitant to all of this scary medical stuff, though, we had gotten a really good ultrasound (complete with thumb-sucking, kicking, and hiccupping). Our baby seemed to be growing normally to the day. He had a strong, consistent heartbeat, Renee’s cervix was long and closed, and her placenta and amniotic sac were normal and intact. We just knew that something wasn’t right (parental intuition, perhaps?), but all of the medical professionals that we encountered (our midwives and the doctors at the high-risk pregnancy clinic) all assured us that everything was okay.
On Monday morning, we heard strong fetal heart tones and R had a good pelvic exam. That night, R passed a huge blood clot, which we now suspect may have been her mucus plug. Concerned that she could be having a uterine blood clot, we rushed to the ER parking lot while calling the on-call midwives. Prior to going into the ER, though, we were called back by our midwife, L, who calmly assured us that, since we had just heard the baby’s heartbeat and R’s cervix was totally closed, the clot was probably the by-product of R’s engorged cervix and to try to relax. Again, we were assured that we had a less than 1% chance of having a miscarriage in the second trimester. We went home, but I can tell you that (for about the fifth night in a row), we didn’t sleep.
By Tuesday, R and I had pretty much decided that we were crazy. She was still cramping and bleeding, but since everyone we had talked to had said that we were okay, we decided to try to cope with the intense anxiety that we were feeling. We called a medical counselor to try to start therapy, we called R’s mom (who lives about an hour and a half away) to come and stay with us for a night or two, and we tried to have a normal day. R’s mom graciously drove up that day, and our friend M came over to the house with dinner that evening. M and I had class until 9pm, and then she dropped me back at the house. Part of the point of R’s mom, C, coming to stay with us was that I might be able to get some sleep. Neither of us had had a full night’s sleep in six days, and I thought that I would be a better caretaker for R if I could rest for a little while. R and I had been very firm with C that she would have to be super stoic and supportive if she came up, because we knew that it would be hard for her to see R in pain and not do anything. But R and I were already feeling like the boy who cried wolf, so we were pretty committed to not calling the on-call midwives in the middle of the night for the sixth night in a row. I tried my best to make R comfortable (with Tylenol and a hot water bottle), and then I went upstairs to take a bath and try to sleep. C was under strict orders to be reassuring to R that everything was going to be okay. Barring a real increase in R’s bleeding, we had been assured that everything would be okay. So I took my bath, but absolutely could not fall asleep. There was something about the way R was standing, moving, bouncing, and breathing. I had seen this before, last summer, when our friend J was in labor with her little girl. I knew it. I knew it on a gut level, that R was in labor, but I was too terrified to say it out loud. I knew that if I said it aloud that it would make R’s anxieties so much worse, and, after all, everyone had said that we would be okay. Renee was, though, in labor. She had contractions for about five hours before transitioning around midnight. Her mom was with us that whole time, and she was amazing. She had to watch her only daughter in immense pain, and she helped to deliver her grandchild, who came way too early. R and I are both beyond grateful that she was with us that night. I don’t know how we would have made it through without her. I can’t really get into Emmett’s birth. It’s too hard to talk about. I’ll just say that Emmett was born at home at 1am on Wednesday, January 19th, 2011. He was too small to take a breath outside of the womb.
By the time we understood just what was happening, I called 911 immediately. After Emmett was born, R began losing a lot of blood. In addition to the blood loss, we were obviously very scared about R’s uncontrolled hyperthyroidism. Just five days earlier, a doctor had explained how the threat of thyroid storm made R a poor candidate for surgery or labor and delivery. Now we had an emergency, unmedicated, unsupervised labor and delivery. I think we were all holding our breath fearing that R would have a heart attack. The paramedics were very helpful. They stabilized R and dropped an 18-gauge needle in her arm, so that they could transfuse quickly, if needed. They checked Emmett’s vitals, but, obviously, he was gone. I rode in the ambulance with R and her mom followed behind us.
Once in the ER, R had the biggest panic attack I’ve ever seen her have. It was really scary because it was hard to tell the difference between the panic and cardiac trouble. Her whole body was shaking from head to toe and she couldn’t catch her breath. Her pulse was racing and her vitals yo-yoed quite a bit, but none of her vitals ever got into the danger zone. The ER was a blur. They gave R ativan for the panic, zofram for the nausea, and lots of IV fluids to stabilize her pressure after the blood loss. We had to have an ultrasound to make sure that she had birthed the placenta in tact. It was the most heartbreaking ultrasound. Everything was just quiet and empty. Just a few days earlier our little boy had been swimming around in there. R also had to have what I know was the most painful pelvic exam imaginable to make sure that her cervix was closing normally. The ER was awful. Really Really Really awful. We were finally discharged at about 6am. Our friend M drove us back to the house. We were just in so much shock. They gave R xanax and pain meds to help her deal with the panic and pain.
Our midwife clinic seemed shocked at what had happened. They contacted us as soon as they opened, canceled several morning appointments, and told us that we would need to bring the baby in. We had made the choice to leave the baby at home when the paramedics took R to the hospital. We knew he was gone, and we weren’t sure that we would be given time with him at the ER, so R’s mom wrapped him up and put him in a small box until we came home. At the midwives clinic, our favorite nurse, C, met us at the lobby. She quickly escorted us back to an exam room. She took the baby, cleaned him up, wrapped him in a baby blanket that we brought with us, and brought him back in to us. We were able to spend a lot of time with our son. We named him Emmett Ever (our boy’s name that we had chosen, in honor of R’s father). We both had the chance to hold him, to kiss him, to touch him. He was so tiny. They were able to say pretty conclusively that he had a rare chromosomal abnormality. That because his heart was so strong and healthy, we had gotten such good results from ultrasound and the Doppler, but that since he was hitting such a growth spurt in the fourth month (he would have to have tripled in size over the next three weeks), he wouldn’t have been able to continue to physically sustain himself. Emmett had some visible abnormalities. He didn’t have feet, and his intestines were growing on the outside of his body. Otherwise, though, he was fine. The autopsy (which the medical examiner conducted later in the week) revealed that all of his skeleton and organs were present and normal except for those two problems. He was very sweet. He had a beautiful little face with a broad nose, small mouth, eyes, and ears. He had broad shoulders and perfect little hands with long fingers. I know that he wasn’t physically perfect (and that those imperfections meant that he couldn’t live outside of the womb), but he was our son and we were totally in love with him.
The midwives explained to us that it would be important to allow the medical examiner to do the autopsy, and that they would send a fetal tissue sample to the Mayo Clinic in order to conduct a comprehensive chromosomal study to understand what exactly happened. They explained that this information might prove very valuable in making our future fertility plans. They also directed us to a program that a local funeral home offers for miscarried and stillborn babies (or those who live less than 24 hours). The funeral home offers cremation services at a greatly reduced cost, and they would be able to work with the hospital to pick-up his body after the autopsy. We are grateful that such a service is available, as hospital disposition felt very disrespectful to us. We’ll be able to pick-up his ashes sometime later this week. I couldn’t really tell you much else about Wednesday. From the time they closed the lid on the box that Emmett was in, R and I both lost it. We had to sign a bunch of paperwork, including a certificate of stillbirth, on which we had to fill out the lines for parents of a deceased child. The midwives were kind in letting me fill in all of the requisite “father” lines. It was pretty heart wrenching that the first document that we signed as Emmett’s parents was the consent form for his autopsy. It makes me sick to think about it.
For the remainder of the week, R was put on a painful medication called cytotec, which made her uterus (and, by proxy, her stomach and intestines) contract in order to help expel any remaining pregnancy tissue. The OB surgeon was pretty on the fence about whether she would need a D&C or not, so we went back for follow-up ultrasounds on Thursday and Friday. On Friday, Dr. H felt pretty sure that she wasn’t going to need a D&C, but he told us to call him right away if R began to hemorrhage. Not the kind of bedside comfort that you want before heading into a long weekend of no medical supervision. Thank God, though, that we have an amazing support network of family and friends, so we were only left alone when we wanted to be, and even then, a kind voice was only a phone call away. R’s milk came in on Saturday, which was painful and upsetting. Especially since no one had thought to tell us that may happen. It was a very long weekend.
Through all of this, we have had an overwhelming outpouring of support. We do have such an amazing life. Our wonderful friends and family have been with us every step of the way (in person and over the phone). People have brought us flowers, cards, food, and gifts. We’ve received so many loving messages of support. And the influx of visitors has made the passage of time bearable. There are a lot of people who are carrying us through right now, until we can carry ourselves again. I will say that the rock that is our marriage feels like it’s made out of steel now. I cannot possibly imagine walking through this experience with anyone other than R. She is the person I was born to spend my life with and I know that more than ever before.
This week, R has had follow-up appointments on Monday and today (Wednesday). Her blood work today looks very good. Her hemoglobin is back up into a normal range. Her thyroid levels are stable, and her HcG is halving like it should be. We have an appointment with a grief counselor tomorrow, and an endocrinologist on Tuesday (to follow-up on the thyroid stuff). Our next appointment with the midwives is also next Tuesday. As the physical stuff abates, though, the emotional anguish of this whole week comes crashing down. I just can’t believe that our little boy is gone. Really gone. We had only begun to get to know him, to imagine our future with him. And now he’s just this missing piece of us. I cycle through feeling heartbroken, numb, sick, and exhausted. We have to start getting back to some normal activities now (work, school, appointments), so I have to get better at just pushing through the grief, but I feel eaten up with it. I know that R and I will have other children. I know that we will be amazing parents, but for the time being, I just want to grieve the fact that I’ll never get to watch Emmett grow, cry, walk, or talk. For now he’s this quiet weight in my heart that feels very heavy.