Things you might like to know
Monday, January 9, 2012
Gratitude
Dear Jane,
On 25th November you met me at the Royal Women’s Hospital when you came to photograph by newborn son, Max, who had sadly died the night before after being born at only 23 weeks gestation. I am so sorry it has taken me so long to write this email. As you can imagine, my life has been turned absolutely upside down. Sometimes I don’t even know what day it is or how much time is passing; everything is such a blur.
I was in shock that day, and still very groggy from the drugs they had given me, and I hadn’t slept for about two days. I barely remember you coming, and I have no idea how you ended up there, but I will be eternally grateful for the precious images of my baby that I now have to keep because you were there. It must be a very difficult thing to do and I admire your courage in walking into a room full of strangers that have just experienced the worst day of their lives. You must havea very special heart.
I would like you to know that your heart has touched mine. Those images are all I have of my only child. I can’t tell you how many times they have been pawed over and passed around and cried upon. I can’t bear to look at them but at the same time I can’t stop looking at them as they express Max’s beauty and peacefulness so honestly. I will treasure them until the day I die - they are truly my most prized possessions. My labour was sudden and I did not even have a change of clothes let alone a camera with me so I don’t have any of my own photos. For some strange reason we didn’t even think of using our phones to take pictures and I really regret that now. I wish I had a million pictures of him, but I know that no matter how many I had it would never be enough.
Tell me, what is your connection to the hospital, and how did you end up in my room that morning?
I wish I could thank you, some how, for everything you did for us.
I notice on your website that you normally photograph happy occasions - weddings and parties. Some day in the future, if our family is blessed to experience a happier occasion - I know where I will come to have my memories recorded, and I’ll be a very lucky customer.
With much gratitude, and best wishes,
Janelle
Sunday, January 8, 2012
I cannot sleep
My eyes are hanging out of my head, I feel sick from exhaustion, but still I cannot sleep. I’ve read, I’ve had warm showers, I’ve practiced my mindful meditation techniques. Nothing seems to work. The golden standard treatment for folk like me - the old Temazepam pill - cannot even provide me with any relief right now. My eyelids no longer become heavy as it winds its way through my blood.
I don’t know what to do when I cannot sleep. Lying in bed waiting for sleep to come has proven a painful practice as I get angrier, lonelier and more upset with each passing moment. I feel bad for keeping Leslie awake or waking him up so I go out to the living room but its even lonelier out there. Sometimes Peppy follows me and I love him for that. Mostly, Leslie is sleeping blissfully unaware that I’m up feeling the saddest I’ve ever felt and it feels cruel to wake him and make him experience it with me. After all, he can’t really help, no matter how earnestly he tries. He needs his sleep for work tomorrow - the ‘real’ world crashed his bereavement party much sooner than it has mine.
I google ‘I can’t sleep’ - because that’s the kind of thing I do when left to my own devices - and I come across this creepy song from the nineties:
This doesn’t help as that song always made me feel uneasy. What was I even doing in 1995? Completing Year 11, I think, though I can’t be sure of the dates at this hour of the night. At any rate, I wasn’t Max’s mum then. I would not have even guessed in a million years that I would one day give birth to the world’s most perfect little boy.
It seems like so long ago that Max was here that it seems absurd that he is not even supposed to be here yet. Even after all these weeks it should be a couple more months until he arrived. What was he thinking? Did he get a ‘choice’ at all, or was he a victim as much as I was?
I can’t help but wonder if he knew what was going on to him. I know there are many philosophical debates to be had about what moment a person attains consciousness. I have trouble reconciling the fact, for example, that 23 weeks gestation is considered the threshold of viability, but at the same time doctors will perform late-term abortions at this stage in exceptional circumstances, so clearly in some respects a baby of this age is considered somewhat expendable and not a life within its own right. I spoke to my psychiatrist about her understanding of what a baby in the womb perceives or is aware of. She said that we don’t really know the answer, but that we do know they can hear things and that they dream little baby dreams of some kind. Despite everything I know to the contrary, I can’t help but imagine Max inside me as being like little Mikey in the Look Who’s Talking movies. Was he in there going ‘whoa, mamma! What’s happening! I’m not supposed to be going anywhere yet!’
God, I have so many questions, and just when I think I have the answer to them, I find that the answer is no longer satisfactory to me and I want to re-think it or re-know it, and I’m finding that impossible to do. No one can tell me where my son is, what he felt or experienced when he was here, if he was aware of me or knew that I was his mother. For some reason I am still surprised by all this, as if somehow I expected someone to pop up with all the answers, just for me.
Goodnight Max, wherever you are. Send mummy some peaceful sleeping magic if you can. xox
Remember
Remember me when I am gone away,
Gone far away into the silent land;
When you can no more hold me by the hand,
Nor I half turn to go yet turning stay.
Remember me when no more day by day
You tell me of our future that you planned:
Only remember me; you understand
It will be late to counsel then or pray.
Yet if you should forget me for a while
And afterwards remember, do not grieve:
For if the darkness and corruption leave
A vestige of the thoughts that once I had,
Better by far you should forget and smile
Than that you should remember and be sad.
Christina Rosetti
When I am dead
Sing no sad songs for me;
Plant thou no roses at my head,
Nor shady cypress tree:
With showers and dewdrops wet;
And if thou wilt, remember,
And if thou wilt, forget.
I shall not see the shadows,
I shall not feel the rain;
I shall not hear the nightingale
Sing on, as if in pain;
And dreaming through the twilight
That doth not rise nor set,
Haply I may remember
And haply may forget.
Christina Rossetti
If I should die
If I should die and
Leave you here awhile
Be not like others sore undone,
Who keep long vigils
By the silent dust and weep.
For my sake turn again
To life and smile
Nerving thy heart
And trembling hand to do
Something to comfort
Other hearts than thine.
Complete these dear
Unfinished Tasks of mine,
And I, perchance
May therein comfort you.
Mary Lee Hall
Death is nothing at all
I have only slipped away into the next room.
Nothing has happened.
Everything remains exactly as it was.
I am I, and you are you, and the old life
that we lived so fondly together is untouched,
unchanged.
Whatever we were to each other, that we are still.
Call me by the old familiar name.
Speak of me in the easy way which you always used.
Put no difference into your tone.
Wear no forced air of solemnity or sorrow.
Laugh as we always laughed at the little jokes
that we enjoyed together.
Play, smile, think of me, pray for me.
Let my name be ever the household word
that it always was.
Let it be spoken without an effort,
without the ghost of a shadow upon it.
Life means all that it ever meant.
It is the same as it ever was.
There is absolute and unbroken continuity.
What is this death but a negligible accident?
Why should I be out of mind
because I am out of sight?
I am but waiting for you,
for an interval,
somewhere very near,
just round the corner.
All is well.
Nothing is hurt; nothing is lost.
One brief moment and all will be as it was before.
How we shall laugh at the trouble of parting when we meet again!
Saturday, January 7, 2012
Dear Max
I miss you so, so much today that I’m afraid to even say it for fear of what might flow forth if I begin to give expression to such longing. When I write to you I feel connected to you somehow, although this makes no sense to me as I know you are not here. What I knew of you is burned up and inside a cardboard box in the next room. The photos I have of you are as still as you were: there’s none of your life in them.
The truth is there are many parts to your mummy - parts that don’t fit together all that well sometimes. There’s the educated, rational, pragmatic part of me that believes when a person dies they just ‘stop’. This part gave up all belief of god’s will, heaven or an afterlife long ago, and I’ve been getting really angry at all the people who’ve told me that you are in god’s hands or working in his garden or whatever the hell weird imagery that’s come to them at the time.
Then there’s the hopeful, wondering, confused part that secretly wishes I am wrong and that there are things we don’t understand. I want to believe you are somewhere better, or somewhere within my reach. I want to believe that your spirit lives on and that you still exist in some form or another. I feel like a mad hypocrite who denounces all of that on the one hand but who still finds herself wanting to go sit in a church to feel closer to you. Someone as mixed up as I am is ripe for the picking if you were an evangelist or cult leader. They like to get people at their most confused and vulnerable and when they are looking for answers like I am.
Since you left me I haven’t known what to believe. I spend all day with my thoughts going to and fro between a million extremes. It comforts me to think that perhaps you are somewhere in the ether around me where I can connect to you on some kind of cosmic wavelength. Sometimes I’d like to believe, as some have suggested, that there’s some kind of heavenly playground where you are see-sawing to your heart’s delight and never growing old or sad. Have you been reincarnated as a cat or a butterfly? Will your soul return to me in another form some time? Is there a ‘higher’ reason why you were called away or is everything that happens just as random and pointless as it often seems?
I guess if I got an answer from you I’d at least be able to narrow it down. I don’t even know what language to speak to you in, though. When you were inside me I spoke to you in something like morse code, I think, through the beating of my heart, but I don’t know how to translate that to a language that lives outside my body. This is hard as there is so much my heart had left to say to you that is now just bottled up inside my chest making it hard to breathe. I have no way of getting it out and sending it to you. I wish that I could just hold you close against my chest so you could hear my heart’s familiar voice for yourself. Then you could say ‘I know exactly how you feel, mum’ and I’d feel understood.
I spend so much time looking at your photos, Max, and still cannot bring myself to believe that little baby is really you. There is part of me that still believes that day was all a dream and that you are still safe inside me where you belong. As the days tick over I still find myself looking forward to March as the month of your birth. What will I do when I get there and you do not materialise? I fear it is going to be like you have died all over again, and I’m not at all sure I can bear that. There’s only so much your little mum can take.
In case there is a chance you are coming back in another body, at another time (yeah I know I’m hedging my spiritual bets) I’ve kept all of your things for you. I don’t know if you need baby grow suits in the metaphysical world but I wanted to give you the option. Can you call the home phone and mysteriously hang up? Or can you rattle the pans in my cupboard? I wouldn’t mind having you around as a ghost - it’s got to be better than just am empty echo of who you were that surrounds me everywhere I go.
I wish you were making me fat and uncomfortable right now. That was your job, and to be honest you were pretty slack in that department. I barely even got to look pregnant before you shipped out for your next adventure.
Talk to me in my dreams tonight, will you? Say anything you want. I’ll wait for you there.
Love your mummy xox
Beanacht Blessing
The weight deadens
On your shoulders
And you stumble,
May the day dance
To balance you.
And when your eyes
Freeze behind the grey window
And the ghost of loss
Gets unto you
May a flocks of colours
Indigo, red, green and azure blue
Come to awaken in you
A meadow of delight
When the canvas frays
In the church of thought
And a stain of ocean
Blackens beneath you
May there come across the waters
A path of yellow moonlight
To bring you home
May the nourishment of the earth be yours
May the clarity of light be yours
May the fluency of ocean be yours
May the protection of the ancestors be yours
And so may a slow
Wind work these words of love around you
An invisible cloak
To mind your life.
John O’Donohue
Your joy is your sorrow unmasked
Your joy is your sorrow unmasked
And the selfsame well
From which your laughter rises
Was often times filled with your tears
And how else can it be?
The deeper that sorrow carves into your being
The more joy you can contain
When you are joyous look deep into your heart
And you shall find it is only your sorrow
That is giving you joy
When you are sorrowful look again into your heart
And you shall see that in truth you are weeping
For that which has been your delight
Kahlil Gibran
Mourning
There is a legendary, strange belief
That Romans kept
Their tears within a bottle when they wept
To hold their grief;
Tangible proof of mourning for the dead.
Don’t sigh for her.
Don’t store up sorrow, cry for her.
Don’t lock all your lamenting in your head.
Bring buttercups and gorse, till her grave glows.
Mourn her in gold.
Broadcast your thoughts in brightness; make them bold.
A yellow rose.
Give daffodils to her. Mourn her if you must
With flowered grass.
But it’s enough to picture, as you pass,
Her golden dust.
Margaret Callaway
Friday, January 6, 2012
A dawn dream
It was just like a snippet of a dream, but it seemed like it went on forever, too. I woke up and was instantly filled with the most empty feeling when I realised that none of it was true. It seemed so real, I had named her and everything, and that name came out of the blue. It’s not one that was ever on my list of names. Who is Amber, I wonder? I can’t shake it from my mind today, or the feeling that I may never get to experience holding my own baby in my arms ever again.
Sleep has been pretty weird for me since Max died. I either can’t get enough of it and need to sleep the afternoon away as well, or I can’t sleep at all and lie awake for hours with my head whirring. I have sleeping tablets to help, but when I take them I end up really groggy the next day, which makes me really tired again so I sleep for hours in the afternoon and then can’t sleep again that night. It’s a vicious circle.
I have been having a lot of vivid dreams though. This was happening throughout my pregnancy as well, though a lot of the ones I had then were nightmares. I can’t remember the last time I had a dream that stuck with for hours afterwards like this one, though.
Wednesday, January 4, 2012
More questions...but the type with no answers
If what happened to me is just one of billions of examples of stupid tiny things that can go wrong then I just don’t understand how anyone gets to take a baby home, let alone the fact that most people do. When so many things can go wrong, how does anything ever go right? Who chooses which people get to keep their babies and which people don’t? In a similar vein, how come so many people who deliberately take known risks don’t have bad things happen to them? When I arrived at the hospital yesterday the first thing I saw was a couple of heavily pregnant rough-looking women smoking ciggies out the front. Smoking is a known risk factor for premature labour, amongst other things, but it has not happened to them even though I cannot help but think they deserve it.
Though the hospital were encouraging about our chances of having a successful future pregnancy I just can’t imagine, no matter how hard I try, how that will ever be the case, when I know of so many things that can go wrong. Having my baby die has in fact made it really hard to believe that other people’s babies live. When I hear people say when their baby is due now, or debate what type of mother they’re going to be, or whether they’re going to use cloth nappies, or send their child to private schools I just want to stop them and say ‘how can you be so sure your baby will be alive? How can you be so confident that your pregnancy will end with you taking your bundle of joy home with you?’
I will never get to be one of those smug pregnant women who talk of how blissful and calm they felt when they were pregnant or what a wonderful experience it is to let their body do what it is made to do. I won’t get to be one of those women that do this five times because they love the feeling of being pregnant. How can I ever make any plans for a baby that’s inside of me when all I will be thinking about is whether it is going to die? For this reason, as much as I say I eventually want to try again, I just don’t know how I ever could. I have heard horrible stories of women who have experienced the death of subsequent babies and I don’t know how they endure it. I simply don’t know.
I have a very vivid imagination, which has always worked very well for me up until now. It makes me a good writer and an entertaining story teller. It gives me a rich and fulfilling inner life that I would never want to give up. Right now, though, it is working in overdrive and sending my anxious thoughts into a cascade of fear. I imagine myself giving birth to a baby who survives for a second, and soon afterwards I think ‘well, that doesn’t mean anything - the baby could die of SIDS in its sleep at 12mths old, my next door neighbour could run over it and kill it in the driveway, it could get cancer or leukaemia…’ the list goes on. In every scenario my child dies. I think these thoughts constantly. There is no relief from them, even in my dreams.
I feel like the magic has gone from my understanding of life. I no longer trust that the universe is looking out for us and ensuring we get what we deserve. I now know for a fact that bad things happen to good people. I know that some people endure more suffering in their lives than is fair, and that others always seem to get off scot free. And I don’t mean to make myself sound like the person who is worst off of all. Much of the pain I feel is due to the sudden realisation that some people suffer so many worse fates than mine, and that there is just so much suffering, and so many people enduring unimaginable pain. I’ve joined a couple of online support groups for people whose babies have died and whilst it has been very helpful to talk to people who truly ‘get it’, it is also overwhelming to witness so many other people’s immense and unbearable suffering.
Most of all I feel that everything I’ve ever done in my life has been pointless up until now. So many hours spent thinking my life was worthless if I could not finish my PhD, for example. The things I thought were a big deal are almost laughable to me now and I feel like mocking the girl who at times was so consumed by fear that she couldn’t even open her own mail or answer her own phone. What a fool she was to think her life was hard then! If only she’d known what she was in store for!
Yeah, so I guess I’m angry at my old self for not having the presence of mind to see this coming; for being so naive; for thinking things mattered when they didn’t. But paradoxically I’m also angry that she had to change into whoever I am now - the person who has to see life for what it really is - cold, unfair, often pointless and painful. I don’t know how to be this girl and I’m not sure that all the people who loved the old one are going to ‘get’ or even like this one or, indeed, if I even care.
Tuesday, January 3, 2012
Answers
I reported to reception at the pregnancy clinics and within two minutes my obstetrician had come out to collect us so that we did not have to sit with everyone else in the waiting room. I was so bloody relieved as even just walking in there and seeing everyone and their pregnant bellies sitting around was enough to make me lose my breath in a panic. Dr Fiona Cullinane is the obstetrician who saw me on the ward, and who saw me today. She will also be the doctor who looks after me through any future pregnancies, even though we now live out of The Women’s catchment area - she said that she will pull strings to do so for us. She is an Irish doctor, with a lovely lilting accent and a kind, expressive face. She has shown us nothing but kindness and compassion, whilst at the same time delivering horrible news. She is a specialist in the area of pre-term birth, having set up the Preterm Labour Clinic at the hospital. I’ll write more about that later.
We spent a full hour with her going through the results of all the blood tests, placental analysis and the post mortem results (we did not consent to a full post-mortem, believing Max had been through enough, but we allowed them to conduct an external examination and a chromosomal analysis which required only a skin sample). She really seemed to ‘get’ what we’d been going through and was able to pre-empt a lot of our questions before I even had a chance to ask them. She began by asking me if I’d recovered physically, if the bleeding had stopped, and if I had any pain or discomfort. Everything settled down very quickly after the birth so I had nothing to report. She also made the effort to ask Leslie how he had been coping which I thought was very good of her.
She was very thorough going through all the reports with me. They were very clinical and full of terms and descriptions I had never heard of so she explained it all to me the best she could. The good news is that Max himself had no abnormalities and was a perfect little boy, as I already knew. He was a ‘well preserved male infant with body weight and measurements consistent with 23 weeks gestation…no abnormalities identified’. In fact, Max was a fantastic size for his age. He was 682g and the 50th percentile for his gestational age is 578.2g and the 95th percentile is 731.7g. Must be all the bananas I ate giving him lots of energy for growing big and strong! His cause of death was determined to be as a result of ‘extreme prematurity’, which of course was no surprise.
I say that this was good news in the respect that it meant there were no obvious abnormalities which may have indicated more sinister problems in my ability to grow and carry a baby. In another way it was heartbreaking to hear that there was nothing wrong with him as it makes it so much more difficult to make sense of why he had to die. In some ways, if he’d had a chromosomal problem or disability I would be able to understand that what happened was my body’s way of ‘righting a wrong’ or whatever it is people say. I would have been able to reason with myself that perhaps he would have had a hard, painful life and so it was for the best. Now, though, I have to come to terms with the fact that I had a perfectly healthy, perfectly developing baby boy who would have arrived safely had something in my body not triggered pre-term labour. In short, I guess, I feel like my body failed him. I know people will tell me this is not true, and maybe I know that it’s not, but I can’t shake the feeling.
I was very anxious that there would be no answer as to why I started contracting. The doctors told me that in 50% of cases their is no attributable cause. It turns out there was a reason though there is still much uncertainty associated with the diagnosis. Basically, the report found that ‘it is likely that preterm labour and delivery have been precipitated by infection and/or haemorrhage although the exact contribution of each of these factors is unknown’. The placenta showed what is called Early Acute Chorioamnionitis and a recent Marginal Haematoma.
As I understand it, chorioamnionitis is a general term for bacterial infection of the amniotic fluid, membranes or placenta. Bacteria ascent from the vagina and break through the normal barrier at the cervix to gain access to the amniotic cavity. It is the most common cause of premature labour, causing approximately 25% of preterm births. It is often caused by treatable conditions such as bacterial vaginosis or group b streptococcus. The problem is that in some cases (such as mine) it is a subclinical or ‘silent’ infection that has no symptoms therefore you do not see it coming and do not have the chance to treat it with antibiotics.
It is diagnosed in three stages. I had Stage 1 Early Acute Chorioamnionitis which means that the infection was still probably in its first 12 hours and was confined to the decidua, which I think she said was the maternal side of the placenta (trying to decipher her notes!) At any rate, it had not yet spread to Max. They found ‘a heavy infiltrate of neutrophils’ (white blood cells) at the ‘chorio-decidual junction’. In response to infection, these white blood cells migrate up through the chorion and amnion, which are placental membranes, and infiltrate the placenta.
I was incredibly relieved to find out that I had not caused this to happen. I have spent many sleepless nights since Max’s death obsessing over things I think might have caused it. I remembered accidentally eating some pre-prepared salad at my sister-in-law’s house. Maybe I gave myself listeria. There were one or two times that Les was not home and I had to change the kitty litter. Maybe I got toxoplasmosis from my beloved cat. I took two medications regularly during my pregnancy. Maybe I poisoned my own baby in trying to make myself feel better.
At the same time, I’m so angry that my baby died because of something as ordinary-seeming as a bacterial infection - something that is entirely treatable. It seems so senseless and such a waste. In an ideal world, the obstetrician said, they would screen all pregnant women for these bacteria much earlier in pregnancy, but they can’t screen every low-risk woman for every single thing that could possibly go wrong. I understand this, but it still hurts. My baby didn’t have to die. This didn’t have to happen.
Because it is preventable, though, and they now know that I am at risk of preterm labour, hopes for a future successful pregnancy are relatively high. There is no reason to suggest that it would recur, and I would be under careful monitoring to ensure that it did not. Speaking odds-wise, I now have a 15-20% chance of having another premature labour, which is higher than a normal woman’s chances (which are 5%). I asked her that if you had to experience a premature labour what would be the ‘ideal’ time to have one (ha ha, as if there is one!) and she said that anything after 26 weeks would be good as baby’s lungs are much more developed then.
In a future pregnancy I would be managed, as I mentioned, by the Preterm Labour Clinic. Here, they see you weekly from 14 weeks gestation. Each appointment you have a transvaginal ultrasound and a swab to test for the bacteria. They are also chemical ‘markers’ that are released into your body when your cervix starts to thin or dilate. They are able to pick these up and predict with great accuracy whether you are likely to go into labour in the next two weeks. If your cervix does start to shorten or change, they treat you with progesterone pessaries which have apparently revolutionised the treatment of premature labour. They don’t know exactly how it works but it is thought that progesterone helps to ‘quieten’ the cervix and discourage it from getting up to no good.
Fiona said that this clinic have really good results and that she has high hopes that she will see me get to take home a healthy baby in the future. I now have private health insurance and I asked her if there was any specialist I should see, or if I’d be better off under private care. She said absolutely not and that the Preterm Labour Clinic is the place to be as no other hospital is as equipped to deal with complicated pregnancies. I felt happy about this as throughout my whole pregnancy and labour I experienced such wonderful care from the doctors and midwives there. Admittedly, the admin staff could do with some customer service training, but those things aren’t as important.
She said there is no ‘ideal’ time to have another baby - that there are no physical reasons to wait, but just if and when you feel courageous enough to try again. I am terrified of ever being pregnant again but I know that we will want to try again at some point. I want a baby more than ever since I held Max in my arms and felt what it was like to be a mother. In fact, I want a million babies and this is saying something as I was always sure I just wanted one!
That’s a consideration for a much later time, though. Right now it’s still early days and my arms still physically ache from the pain of not being able to hold Max in my arms. Right now I don’t want any other baby except the one that is already rightfully mine, and I think I have still not really come to terms with the fact that I’m not pregnant anymore and that he will not be coming in March. It is so easy to convince myself that what happened in November was a bad dream and that everything is still OK. I should be on the homeward stretch of pregnancy now. I should be attending my antenatal classes on the 15th January. I should be finishing up work a month after that. So many plans that will not come to fruition. So much more that needs to be planned to take their place. What I do with myself and expect of myself in 2012 is still to be decided and I could use with some direction; some kind of sign from the gentle hand of ‘fate’, if such a thing exists, of how to go on with my life in the absence of my son, because I certainly cannot see a way right now.
Monday, January 2, 2012
So many questions
Questions about the future
- If I get pregnant again could I return to the Royal Women’s Hospital even though I now live out of its catchment area?
- Could you still be my obstetrician at this hospital or could I see you privately?
- In a future pregnancy would there be any benefit to having a private obstetrician for more frequent monitoring?
- I have heard of women at risk of premature labour being given progesterone injections throughout the pregnancy with good results. Would this be appropriate for me?
- I have also heard of women being recommended bed rest at 20 weeks. What about this?
- What about a cervical stitch?
- What are the chances of having a full term baby in the future after a premature birth?
- How do you manage anxiety in the weeks of a new pregnancy knowing that nothing is ever really safe anymore?
- How long do I have to wait before getting pregnant again? Is there an optimum gap?
- Do I have to worry about my increasing age causing more potential problems?
- Is there anything I can do to better prepare my body for next time? Eg. get fitter, eat different things, etc.
- What monitoring would you do next time? Extra visits? More scans? More bloods or swabs?
Questions about causes
- In your opinion, what are the chances that my antidepressant caused this? Would you agree with my psychiatrist on maintaining this treatment in a future pregnancy?
- Could it have been the drug I took for hyperemesis (severe morning sickness). How could hyperemesis be treated differently in a future pregnancy as this also caused significant depression that could have been avoided
- I heard of a condition called an incompetent cervix. Could it be this?
- Was there any evidence of an infection that could have caused it?
Questions about our experience
- What did our baby experience during labour and at what point did he actually die? What is his official cause of death?
- Do you know any other babies that have had better outcomes at 23 weeks. Do most people choose not to resuscitate? What would you have done?
- How many babies are born at 23 weeks?
- If I’d recognised signs of labour earlier would this have made a difference to the outcome?
- When do you think my labour would have started? Did I mistake the signs for normal pregnancy aches and pains?
- Why was Max so much bigger than expected? Did this mean he was older than we thought, and that therefore he should have been resuscitated? Could I have had gestational diabetes that made him bigger than his actual age?
- Why did no one ask me if I wanted to bath him? I did not realise this was an option but have since found out from others that I should have had the option.
- Why was I not put in touch with any of the support organisations or given one of their bereavement packs before I left hospital? I left with empty arms.
- Why was the social worker so inept and why did she give us no information apart from a list of funeral homes we could ring?
Waiting for answers
These situations are, obviously, my greatest fears. In my imagination, I react with anger - pure fury - in the doctor’s office and start yelling and screaming. In the scenario where they tell me there was no obvious answer for why this happened I am also yelling and screaming and losing the plot. I think this is indicative of my whole emotional state at the moment. I’m fucking angry. So angry that I did not think this amount of anger was possible. I do not deal well with anger at the best of times, preferring to internalise it, suppress it, and turn it against myself. At the moment it’s all but destroying me as I cannot get the feelings out no matter how much I try.
A friend suggested I put an old computer out in the backyard and take to it with a cricket bat. Others have suggested a punching bag or some vigorous exercise, but I can’t seem to bring myself to attempt any such thing, so instead I constantly feel like I’m about to be eaten alive by the anger; swallowed whole. Instead, I imagine myself expressing it in less than socially-acceptable ways. In my head I have gouged pregnant women’s eyes out in cafes, pummelled my obstetrician in the guts, cut babies out of their mother’s tummies and ran away with them, and drowned other people’s babies so they, too, can know what this feels like.
I hear what you’re saying - somebody get this woman a psychiatrist - but in truth I already have one. Worst than that, she’s telling me that all these feelings are normal. That I’m allowed to think malicious thoughts and wish people ill-will. I’m finding this ‘new’ me to be rather confronting. I don’t want to admit that there’s a new side of myself that is so jealous and bitter and angry. But at the same time I feel that this part of me is here to stay - that the old Janelle is gone forever.
I’m scared of how I am going to react going back to the hospital tomorrow. Not just because of the trauma that occurred there, but because I am going to have to sit in a waiting room full of about a hundred pregnant women who are there blissfully ignorant of the things that can go wrong; of the tragedies that can befall. Is it wrong to want to shake them and tell them that their baby could die when they least expect it? Is it cruel to go around telling them that I’m there because my baby died, making them deal with the awkwardness of the situation? Is it selfish to expect that they make for me a special space that’s immune from all of these potential confrontations and from the excruciatingly painful reminder that everyone else gets to take their babies home after they’ve been pregnant with them all those months? I feel like all sorts of exceptions should be made for me now that my baby is dead. Haven’t I suffered enough?
Anyway, back to tomorrow… when we were in the hospital they told us that there is only an identifiable cause in about 50% of cases. The rest of the time things happen for no apparent reason, which is so hard to comprehend. I desperately want there to be a reason so that if I am brave enough to try for another baby I will have the knowledge to be able to prevent this from happening again. At the same time I am terrified of finding out the reason in case it is my fault - something I did or didn’t do - as I don’t think I would be able to live with myself. It doesn’t matter how many people tell me that no matter what, it wasn’t my fault, it still already feels like it was no matter the reason. It was my job to keep him safe and my body failed me, and as a result I failed him. In giving birth to my son I also killed him and I go to sleep at night and wake up in the morning with that thought as a constant whirring in my head.
The obstetrician that saw me was a lovely woman and I’m sure she will give us every comfort that she can. I’ve compiled a list of questions that I want to ask her. Some of them I know she won’t know the answer to, but I want to ask her anyway. I just hope that we are not rushed out of there too quickly and that we get the time to get the answers we need. Part of me wants to record the session as I know from experience now how hard it is to remember things that happened while you were stressed, upset or in shock.
Thursday, December 29, 2011
Don't wipe your tears away

Cameron M. Semmens - Through the Lover’s Window
don’t wipe your tears away
don’t smother them with tissues
let them streak and splash and soak in
wear them like jewels
don’t try to blink your tears away
let them sit in your eyes
let them sit in your eyes
and you will see the ocean
let them spill out naturally
waterfalling down your face
til they lap the shores of your lips
lick them
and you will taste the ocean!
but you won’t sink
you won’t drown
these tears will keep you afloat
lie back
lie right back
and let the trickling tears
tickle your ears
Monday, December 26, 2011
'One morn I left him in his bed'
One morn I left him in his bed;
A moment after some one said,
‘Your child is dying – he is dead.’
We made him ready for his rest,
Flowers in his hair, and on his breast
His little hands together prest.
We sailed by night across the sea;
So, floating from the world were we,
Apart from sympathy, we Three.
The wild sea moaned, the black clouds spread
Moving shadows on its bed,
But one of us lay midship dead.
I saw his coffin sliding down
The yellow sand in yonder town,
Where I put on my sorrow’s crown.
And we returned; in this drear place
Never to see him face to face,
I thrust aside the living race.
Mothers, who mourn with me today,
Oh, understand me, when I say,
I cannot weep, I cannot pray;
I gaze upon a hidden store,
His books, his toys, the clothes he wore,
And cry, ‘Once more, to me, once more!’
Then take, from me, this simple verse,
That you may know what I rehearse—
A grief – your and my Universe!
Wednesday, December 21, 2011
A letter to my baby
My dear baby,
I am writing you this letter to tell you how much I can’t wait to meet you, and how long I’ve waited for you to come. I’ve thought of you and imagined you into being for so many months that it feels as if you are already real even though you are at this time just a recurring dream; a gentle wish. There are so many people who love you already, and then there’s me, who I hope you’ll choose as your constant friend and most careful protector.
For as long as I can remember I have imagined a little son or daughter coming to me as though out of thin air; their arrival sparking an unexpected sense of remembering, like we might have met once before, not so far away, in a time that has only just slipped us by. That baby is you, and when I think of you you are tiny and blonde, with long, delicate fingers and a mysterious gaze turned towards the bigger people and the bright things that pass you by.
You’re a little like me, of course, in your quiet manner and easy disposition. But not too much. You have nothing of my melancholy. You are light and unencumbered by worry, by fear. You are quick to laugh and quick to love. You are a wonderful observer of the world around you, and a passionate participant in all of its wonders. You could be an adventurer with a restless spirit always urging you towards new things, or maybe you’ll be driven from an early age by just one particular longing. Either way, I will do my absolute best to help you follow your star, and I’ll always be there waiting when you come home again.
A wonderful home I will make for you - warm, welcoming, and full of your things and your spirit (which no doubt you’ll have in abundance). There’ll be animals to share your secrets and stories who’ll be devoted and loyal to you when you feel lonely or misunderstood. There’ll always be books within your reach to take you to whatever place and whatever time you can imagine, and music to afford you an escape from any cares you have upon your little shoulders. There’ll be warm baths and cosy cuddles, and as you grow there will always be room for you to share your home and your family with the friends you’ve carefully chosen - those who make you laugh and bring out your very best.
I can’t imagine what will be your favourite things to do. Perhaps you’ll surprise me with a penchant for tennis, or with strong shoulders that will lead you to the swimming pool - though no one would then believe you were a child of mine! I’ll leave those things for you to try, though I dearly hope you’ll love to dance and that cultural things afford you pleasure, so that we might share some quiet winter afternoons together, even when you are grown.
I’d like to think that I have chosen for you a caring, constant father who will adore you, even at your most awkward age and through your strangest interests! I know, right now, that he’s excited to meet you, though he is not quite as impatient as me, who has to learn to wait, to wait, to wait, and to give control of time over to you, for a little while at least, as you learn the funny ways of this world and prepare for your journey into our lives.
There is a place for you, little baby, when you are ready to come. It’s made out of fresh, soft air that will tenderly cushion your journey and shape itself to your particular form; that will become full with your particular grace - a sense that I hope will soon be as familiar to me as my own breath. Come soon, little one. I can hardly wait to look into your eyes and tell you that you’re home.
Your mummy xox
Monday, December 19, 2011
Back to the land of the living
Still, there are a number of ways in which this is cruel. Firstly, I deeply resent the allocation of an allotted bereavement time by workplaces, especially when this time is dismally short. I believe it’s normal to be allocated only a couple of days of bereavement leave in most corporations, which just seems offensive to me. Others I’ve heard will offer more leave ‘at your manager’s discretion’. Well, this is fine if you have a compassionate boss who exhibits evidence of human feeling, but what if your manager is an unfeeling ass-bag, or who is just not willing to fight for an extension of the policy on your behalf?
Leslie has been lucky in that he was able to spend three weeks at home after I had Max. This is only because he was able to take two weeks ‘parenting’ leave also, because I gave birth to a live baby and the policy did not state this right was to be revoked upon the death of the baby. Even then, there was some confusion as to what he was entitled to. Is it not the job of HR professionals to iron these things out? I feel his work should have contacted him to tell him not to worry and that they would sort it out rather than making him chase it up himself. The last thing anyone wants to do when they are trying to organise the funeral of their baby is to worry about whether they have enough time off work to attend it.
Secondly, I resent that anyone gets to decide what is ‘enough’ time before we are expected to resume our old lives. At the moment, for example, it is very difficult for us to see or be around other small babies - every one of them is a stinging reminder of what we have lost and may never have again. People have been understanding and sensitive to this over the last couple of weeks, but I can’t help but worry how long it will be before we begin to be considered selfish for not attending other people’s baby showers, christenings or first birthday parties. How long before I’m expected to greet the news of friends babies with joy and happiness instead of bitter anger and jealousy?
It feels like forever will not be enough time for us to adjust to life without our baby; to let go of all the dreams and plans we had for our family’s future. I don’t believe we will ever resume our ‘old’ lives. How could we when we have changed, irrevocably, as people, and as a couple? Though I know there will come a time when our grief is not so raw, normal life for us can never again really be ‘normal’. I feel that life will be forever divided into two epochs - Before Max and After Max. On the one hand I would never want to go back to Before Max as I would not take back a second of the time I spent with him, nor the love he gave me. At the same time, life After Max seems like too much to bear in the long term. 40 or 50 more years of living without him? How do we manage that?
Despite my fears of being alone without Les today, it’s almost 6pm and I’m surprised to discover I’ve survived. I met up with a couple of friends - Leah and Yvette - for brunch, which I really enjoyed. We went to Porgie and Mr Jones in Hawthorn and listened to blissfully innocent Year 12 students talk animatedly about their ATAR scores and how their lives would never be the same again because they did/did not get the score they wanted. We watched Leah’s little girl experience a moment of the purest joy upon discovering that she’d be getting peanut butter on toast for brunch. We teased Yvette for ordering weak lattes because she can’t handle a full shot of espresso in one go. And we chatted about our plans for Christmas and the holidays, whose madness we agreed was about to descend upon us whether we were ready for it or not. In short, I did some living, whether I liked the idea or not.
Friday, December 16, 2011
All that remains
As I signed the register to acknowledge that I’d collected Max’s remains and checked that it was indeed his name on the container, I did feel, though. What came just wasn’t what I expected. There were the initial tears when I walked into the building and remembered this was where I saw him for the last time. There was nervousness when the lady who met me wasn’t the same one we’d dealt with for the funeral. There was confusion when she asked me if we’d decided what to do with his ashes, suggesting that we might consider placing him inside memorial teddy bear, a plant, or a locket. It didn’t feel traumatic, or significant, or distressing in itself, however. It just felt mundane. But perhaps that’s the wrong word. I mean to say that it just felt like life - or like what life becomes after you realise that you’re not immune from tragedy or suffering as you, until recently, assumed you were.
Here I was in the middle of busy Burgundy Street in Heidelberg, my ears assaulted by whiny carols blasting over the shopping strip’s public address system, dealing with death and its aftermath like it was an every day occurrence. How did this happen? Next door people were lunching. Out the front cars were slowing in the hope of finding a car park so they could duck into Australia Post in the least amount of time possible. I carried Max up the street in quality paper shopping bag - you know the exclusive-looking, waxy kind that you get from clothing stores, with two little handles. No one stopped to observe this procession. No one held my hand. My son and I were just another part of the streetscape; our moment gone as unmarked and unnoticed as any other.
In a way, I guess I’m lucky that I lived 33 innocent, ignorant years before I had to face the fact that death is just a part of life; that people will keep expecting me to go back to work, do the grocery shopping, or return my library books, despite the trauma I have endured. I’ve only just begun to realise that there’s no special dispensation for loss or suffering - at least not a long-term one. People everywhere, all around me, are carrying their own pain, and the world doesn’t stop for them anymore than it has for me. That’s perhaps the cruellest truth I’ve been confronted with yet, and I can’t stop thinking about the unfairness of it.
When people have asked how I’m going lately, I’ve often responded that I feel that I will never be the same again - that I will never know ‘normal’. The reply I expect is fervent denial. ‘No,’ they’d say, ‘time heals all wounds!’ But the reply I get is sad agreement. No, they say, you will never be the same. The pain will remain, always, you’ll just learn to accommodate it and get on with the business of living, whether you want to or not.
I put Max’s ashes under the Christmas tree alongside our other gifts. It seemed as good a place as any for now. I googled ‘infant cremation urns’ and browsed through hundreds of pages of ugly marble receptacles for the departed, where death was dealt with in perhaps the most prosaic form of all: an offer of free shipping for purchases totalling $75 or more.