A recent study published this week reveals that most hospitals, maternity care staff and physicians are insensitive in dealing with women experiencing pregnancy loss – probably not an unexpected finding to anyone who has lost a child through miscarriage, stillbirth or perinatal death. The study was conducted by the Association for Improvements in the Maternity Services – Ireland (AIMSI) and focused on women having miscarriages. Those surveyed reported receiving care for their miscarriage on the labor and delivery floor, right next to women at the end of a long pregnancy about to give birth to a living child, God willing. One of the respondents reported being traumatized by hearing the sounds of a busy delivery room as she was dealt the news she would lose her tiny baby to miscarriage.

Although the subject of the article centers on the mishandling of miscarriages, it brings back nightmarish memories of my own labor and delivery story – the silent birth of my first child, Nicolas, one week after his due date. After waiting patiently for 41 weeks, convinced we were out of the “danger zone,” i.e., the first trimester (oh, how naïve I was then), we went to the hospital on February 28, 2006, excited that labor had finally started, only to be told our son had “no heartbeat.” Lying next to me in the same room were two other laboring women, hooked up to Dopplers, the strong swoosh, swoosh, swoosh of their babies’ heartbeats echoing along with my sobs. I was finally taken to a private room and given Pitocin as my labor slowed. I was told my contractions stopped because usually babies help progress labor, but in my case… I wanted to tell them Nicolas wasn’t being difficult – he was dead.

I labored for about 23 hours, thankfully much of that time lost in a fog of pain and shock. But every now and then, from another room down the hall, the sweet, mocking sound of a newborn cry and the cheers of nurses would creep into my consciousness. Every now and then I would hear that strong swoosh next door and realize my nurses didn’t even bother to put a heartbeat monitor on me. The following day, in my recovery room, a nursing assistant came in with an sunny smile on his face and told me it was time to take my prenatal vitamin. I had just given my son’s body back to the nurse for the final time and was in no mood for false cheer. As he left the room with that damn pill still in the little Dixie cup, I glimpsed just outside my door a new mom and dad with their breathing baby bundled in an infant carrier, ready to go home. I could take no more and demanded to be released. I was given a prescription for Motrin for the physical pain and two anxiety pills for the emotional trauma that lie ahead (they were concerned I would take all the pills at once, so I only got two). The pharmacist congratulated me on the birth of my baby as she handed me my prescriptions, and all I could choke out was, “thank you.” My husband pulled the car around, and I climbed in, Nicolas’ empty car seat in the back. We went home and shut the door to Nicolas’ waiting nursery.

I wonder now if my experience would have been better if I were quietly taken to a room far enough away from the “normal” labor and delivery floor so I wouldn’t have heard those Doppler heartbeats and newborn cries, so I wouldn’t have seen living babies next to my dead son. I wonder if it’s asking too much to be treated respectfully but separately from other laboring women, to be handled a bit more sensitively and to be spared those painful reminders of what I would never have with Nicolas.

There is a saying, though few have probably heard it, that expresses an oversight of the English language — a missing word to describe a pain and a grief that should never be: “a wife who loses a husband is a widow; a child who loses a parent is an orphan. But there is no word for a parent who loses a child.” As malleable and ever-changing as our language is, why is there no word for us? The tragedy of a child’s death is nothing new — too many parents throughout time have buried their babies, their toddlers, their teenagers, their adult children years before their own deaths. Since Nicolas died, it seems I hear about a mother who has just buried her child almost daily — not because these deaths are happening more often but because I pay attention now, having survived my own son. It is a commonly agreed upon truth in our society that no death is as tragic as a child’s, no grief as deep as a parent’s. So, again, why is there no word for us?

A child who precedes her parents to the grave goes against the natural order of things — it shatters our illusions of what is fair and what is right. A baby should not lose his life before his first breath. The young should not die before the old. I struggled with these truths for a long time after Nicolas died, struggled with the knowledge that I had already received the gift of three decades of life — thirty years of sunrises and sunsets, holidays with my family, swimming in a cool river on a hot day, traveling to new places, experiencing first and second and third loves — while my infant son received nothing. It is not natural, it is not fair, it is not right. Is this the reason there is no word for us — because burying a child is so unnatural, so appalling, that we cannot name it?

In an interesting article to mark Memorial Day, journalist Karla Holloway attempts to name our grief, to name the unspeakable loss of a child. After losing her child, Holloway searches the world’s languages and settles on a Sanskrit word, “vilomah,” which means “against the natural order.” While “vilomah” may never catch on, it would give some comfort to have our grief, our loss, openly named.

Parents deserve word to convey loss of a child

Evie’s Network, a non-profit organization based in the United States, is dedicated to providing information and resources to mothers, fathers, families, friends, coworkers and medical professionals on the tragedy of losing a much-loved baby to stillbirth. The organization’s primary purpose is to connect women who experienced stillbirth for direct, peer-to-peer support. As a mother who lost her first child to stillbirth at 41 weeks of pregnancy, I understand how vital it is to connect with other women who have also suffered the physical and emotional trauma of stillbirth. Giving birth, whether vaginally or by Cesarean section, to a baby you know has already died carries a lasting emotional impact unique to other forms of pregnancy and child loss. While fully realizing the devestation that a loss of a child at any age or stage of pregnancy brings to the surviving family, Evie’s Network has chosen to focus its limited resources solely on the tragedy of stillbirth and the accompanying physical and emotional trauma suffered by the birthing mother.

Evie’s Network was founded by Virginia Bertholet, who suffered the stillbirth of her only two children, Bigelow at 28 weeks gestation in 1995 from severe toxemia and Evie at 36 weeks gestation in 2000 from a placental abruption. If you are a recently bereaved mother looking for help with your grief, consider signing up for peer-to-peer support at Evie’s Network. Communicating with other mothers who understand first-hand what it means to leave the labor and delivery floor without their babies is tremendously healing. For those women who are a little further along in this life without their children, Evie’s Network offers an opportunity to share your story with newly bereaved mothers, giving them valuable support when they need it the most. More information can be found on the organization’s website at Evie’s Network

Earlier this month, the Arab Emirates 7Days newspaper reported on a case involving a young Lebanese mother who was found guilty by a Dubai court of causing the death of her full-term, unborn child. The mother was driving home one day in October 2008, just four days before her scheduled Cesarean section, when she unintentionally struck the vehicle in front of her. The drivers of the vehicles sustained minor injuries, but the baby’s umbilical cord was severed in the accident.

The head of Dubai Traffic Prosecution was quoted as saying the verdict would serve to protect unborn babies: “The mother is responsible because she didn’t protect her baby. She hurt her baby when she caused the accident. We want all pregnant women to avoid driving unless it is necessary, or it is an emergency situation. They need to protect their baby and sit in the back.”

When my son died at 41 weeks of pregnancy, I suffered with terrible bouts of guilt. After all, what is a mother’s primal purpose but to protect her unborn baby? I blamed myself for not sensing something was wrong, for trusting medical providers who turned out to be negligent, for not demanding my son be delivered before his due date, for studying almost every possible pregnancy complication but velamentous cord insertion, for not seeking a second detailed ultrasound, for forgetting to take my prenatal vitamin a few times, for not questioning my midwife when she told me it was perfectly normal to stop gaining weight at 32 weeks of pregnancy, for not asking what my fundal height was at each prenatal visit as I later learned Nicolas had intrauterine growth restriction, for believing my midwife when she said I couldn’t possibly have preeclampsia despite my dangerously high blood pressure, and for hundreds of other things.

Mostly, I blamed myself for living while my infant son died.

Every mother of a child who dies struggles with tremendous guilt. And to have your child die inside you – where he is supposed to be nourished and protected – brings a guilt and a grief like no other. I cannot imagine the torment this poor Lebanese mother is experiencing to be condemned by a court of law of failing to protect her baby and causing his death. As an American, it is easy for me to say that Dubai, like many Middle Eastern countries, is inherently misogynistic and is using this tragic event as a way of pushing women into the backseat, of reneging on the few hard-won rights granted to women in their country. But for this mother who lives everyday under these rules and culture, an official condemnation – official proof of her guilt — must be an impossible thing to live with.

It has been over three years since I lost Nicolas, and on most days, I do not struggle with guilt or blame myself for his death. Although I still wish with every fiber of my being that Nicolas had lived, I understand now that I did my best for my son given the situation. None of us, including the Lebanese mother, intend for our babies to die – none of us would knowingly cause harm to our unborn children. It is a sad truth that we cannot protect our children in all situations. The unexpected and the catastrophic happen everyday, despite our best intentions. The guilt we feel when our children suffer from tragedies beyond our control is proof of the deep love and responsibility of motherhood. Guilt is part of being a mother.

Just over a month ago, Janet Fraser lost her full-term baby while giving birth at her home in Australia. A critic of modern OB/GYN care and a leading advocate of home births, Fraser opted to deliver her child in a “free birth,” a home birth unassisted by medical professionals. The irony of this tragic event — an outspoken advocate of home birth losing her baby during a home birth — has not been lost on the media, and the subject of home birth’s safety has received more attention in the last month than is usual.

It is easy to see the appeal of home birth to those suspicious of Western medicine. Many studies have reported that medical interventions, such as episiotomies, forceps delivery and Cesarean sections, are too readily used. However, it is medical advances such as these that have turned the single most dangerous event in a woman’s life — pregnancy and childbirth — into something routine. Not too long ago, it was common for women and their babies to die during the process.

A recent study presented at the annual meeting of the Pediatric Academic Societies reports that home births have more than double the risks of complications and infant mortality than do births at hospitals where access to medications, oxygen and trained pediatric specialists are available. While Western medicine has its shortcomings and is imperfect, the risk to mother and child is much lower in a medically-assisted birth at a certified hospital. In the end, it does not matter how your child gets here or where he was born –only that you’re both alive.

SF Sexual Health Examiner: New study indicates hospital delivery safer for babies than home birth

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Every year in the United States, hundreds of newborn infants die from undiagnosed – yet treatable – congenital heart defects. These children are sent home from the labor and delivery floor with a clean bill of health, only to return days or weeks later to the emergency room with difficulty breathing and blue-tinged lips, hands and feet. Some of these infants are fortunate enough to receive life-saving surgery to correct their heart defects. Many others do not survive. While prenatal screenings, in the form of ultrasound, can pick up some of these congenital heart defects, as many as three-quarters go undiagnosed during pregnancy. And, during newborn screenings, nearly half of serious heart defects are missed as well.

A simple, noninvasive test exists that can screen newborn babies for critical heart defects within hours of their births. It does not require any special equipment or training, according to Dr. Darshak Sanghavi, a pediatric cardiologist, and has been shown to have a high success rate in other countries. For whatever reason, most hospitals in the United States are not currently performing this screening test, which consists of placing a small sensor on the baby’s toe to measure oxygen saturation. If your hospital is one of the thousands not offering this simple, but vitally important, screening test, make sure you specifically request it. It is called “pulse oximetry.” For more information, please refer to the following article reported in the New York Times Health Blog.

Screening Babies for Broken Hearts
In the middle of one night in August, a seemingly healthy 1-week-old infant named Ryan Olson suddenly began gasping for breath at home in Massachusetts, and his frantic parents rushed him to the hospital. There, emergency room doctors noted the critically ill baby had bluish feet and — even more worrisome — no pulse in his lower body. That almost certainly meant the boy had a “coarctation,” or blockage of his aorta, which is the key pipeline supplying oxygen-rich blood to the body. As the on-call pediatric cardiologist, I was urgently called in to help out. Read more

Today is my fourth Mother’s Day. The holiday is meant to acknowledge all the work mothers do, the sacrifice of not only time and energy but self. Despite its lofty purpose, I have always considered Mother’s Day a slightly trifling holiday, promoted more by Hallmark and 1-800 Flowers than by any true tradition or feeling. While pregnant with my first baby, Nicolas, the thought of spending Mother’s Day with a child of my own flitted through my mind as a novelty. I imagined, briefly, what it would feel like to be on the receiving end on this day. After three decades of giving, this year I would open syrupy Hallmark cards and accept bunches of flowers from the 1-800 delivery guy – all because of the little heart beating inside my belly.

But then Nicolas died. And no Mother’s Day cards or flowers came.

That first Mother’s Day took on an unexpected significance for me. The lack of cards, the lack of calls – the lack of simple acknowledgement – was a silent testimony to the fact that I failed my son, that I failed to become a mother. I felt like an outsider. I had carried a baby for ten months and given birth to him, but I wasn’t a part of the mommy club. But neither was I a part of that group of women who have never been pregnant or had a child before. I was in limbo, not welcome in the mother group and kicked out of the singles club. So I spent my first Mother’s Day crying in bed, alone, my body still healing from 41 weeks of pregnancy and 23 hours of labor, my arms aching to hold my son.

The following year was different. I had given birth to my second son, Christopher Nicolas – a squirming, squealing, living child. With the birth of Christopher, I was brought into the mother fold. I received many calls – “how’s it feel to be a mother?” – received many cards – “Happy Mother’s Day” – and even received a bouquet or two of flowers from the 1-800 delivery guy. The change was distinct and real, the message even clearer. Now that I have a living child, I am allowed to acknowledge publicly that, yes, I am a mother.

Today is my fourth Mother’s Day, but none will ever hold the same significance and importance as my first. With the passage of time cushioning the pain of that first year, I understand now that a mother is not just someone who changes diapers, wipes noses, cheers at soccer games, or comforts a scraped knee. A mother is someone whose every thought is preoccupied with her child. A mother is someone who continues to love her child even after he dies. A mother is someone who mothers her son even in death. My heart aches for all the women I know who are going through their first Mother’s Day without their children. You are still a mother, and today is still your day. We don’t need Hallmark to tell us we’re mothers.

Governor Sarah Palin this week signed a bill into law enabling grieving parents in Alaska to apply for and receive an official birth certificate for their much-loved and much-wanted stillborn babies. This seemingly simple bill has, once again, ignited a firestorm of controversy among opposing sides of the abortion debate. Any mother who has labored for hours, often more than a full day, or had her uterus cut open in a last ditch effort to save her baby’s life — only to bring forth a dead child — has been through enough trauma without becoming the rope in a tug-of-war between the liberal left and the conservative right.

Pro-choicers vehemently oppose any language that would grant the status of “human being” on an unborn child, regardless of gestation — four weeks or forty weeks, it doesn’t matter. Until there is no longer those few inches of mom’s flesh between child and the outside world, pro-choice advocates need that baby to be called “fetus.” It’s a slippery slope of legal jargon. Admitting that a baby who makes it to 20 weeks gestation and beyond (the medical definition of stillbirth) is an actual human being may, over time, lead to the legal definition of a fertilized egg as a human being as well — thus effectively illegalizing abortion. I read a pro-choicer’s comment today who said, “one problem: you can’t be born if you’re dead.” I imagine he was speaking metaphorically because, as a mother who went through 41 weeks of pregnancy and 23 hours of a labor, only to push out a dead son, I can assure you it is quite possible for a baby to be born after he dies. In fact, the physical process of labor and delivery — the unrelenting contractions, the uncontrollable shaking and increase in blood pressure, the utter exhaustion from pushing your baby through the birth canal, the tearing and ripping of your flesh — they are the same whether the baby is alive or dead. I have given birth twice: once to a dead baby and once to a living baby. It was the same process both times.

The pro-lifers are no better than their antagonists on this issue. Rather than sponsor this type of legislation out of a legitimate concern for grieving parents, they use it as a poorly veiled attempt to further their political agenda. They see our tragedy as a vehicle for changing the legal definition of a fetus, which would, of course, hasten their goal of illegalizing abortion. Pro-lifers are announcing Palin’s signing of this Alaska state bill into law as a “respect for the sanctity of life.” While I would never argue that my stillborn son, Nicolas, is undeserving of such a description, I can’t help but be irritated by the pro-life advocates’ choice of words — the same words they use to argue against abortion. Their announcement smacks of a political poke at pro-choice advocates, which makes their seeming support of grieving parents insincere at best.

Something as simple as a birth certificate for stillborn babies to recognize the fact that the mother still gave birth and her child was real, even if it is termed a “Certificate of Birth Resulting in Stillbirth” in an effort to pacify the temper-tantrum-throwing political left and right, should not be such a controversy. I mean, really, who but the grieving parent should care?

This fight has nothing to do with us. Take your political agenda somewhere else.