Expecting the unexpected

Sebastian was a surprise pregnancy. Ovum and spermatazoon meeting clandestinely when their parents least suspected.

Upon losing him, it was inevitable that I would go back and remember the little things that suddenly seem big. I feel awful for that moment, however brief, when I knew for sure I was pregnant and panicked a little bit – I’m pretty sure I even said a bad word. I felt sorry at the time, too, remembering how purely excited I’d been for my first two positive pregnancy tests. We rapidly readjusted our family plan and began to anticipate with joy… almost immediately.

Then there was the moment when we found out he was a boy, and I can’t deny I had a ripple of disappointment. Neither Sean nor I was sure we wanted more than two children, and suddenly the possibility of never having a daughter seemed very real. I tried hard to prefer the idea of a boy, but didn’t truly succeed until a few weeks ago, watching E play with some other kids and realizing how much fun it would be for him to have a brother. Now, I yearn for that boy – that specific boy – and wonder, how could I not have realized how much I wanted him?

I know I made some uncharitable remarks about him as he stubbornly sat in my womb, bum and feet both tucked down by my cervix, head poking my right side, day in and day out for over six weeks. Now that I know his extraordinary situation in there, I’m just praying that he was comfortable and happy… since that’s all he got.

He was given his name on Canada Day, on the drive to our friends’ house in Hamilton. We had narrowed it down to two names and asked E which one he preferred. He said flat-out No to the first, and yes to the second: “I like Sebastogen.” We even came to a decision on a second name – Sean has always wanted to name a son after a British king, and Sebastian Edward rolled off the tongue the best.

On Wednesday, July 6th, I drove half an hour to Kitchener first thing in the morning to have an ultrasound test. Normally you only get one at 20 weeks, but my 20-week test had shown something called echogenic bowel, a “soft marker” for Downs syndrome. Although most of the time this turns out to be nothing, they offer a follow-up ultrasound if you want it. I got to the clinic to check in, and was regretfully told that my health card had expired (one of the many “small” things that escaped my mushy pregnant brain) – I would need to pay up front, not to be reimbursed, or reschedule. I was exhausted (as always, it seemed) and feeling overwhelmed, and found myself suddenly, embarrassingly, shedding tears right there at the desk. What a pregnant cliché I must have looked. But the receptionists were very kind: they double-checked to see if there was another option for me (nope), and then found me directions to the nearest place I could renew my card. They never batted an eye at my silly tears.

Maybe they weren’t silly – my body just knew something was amiss. That night in bed, it occurred to me that I wasn’t sure when was the last time I’d felt this baby kick. I thought, What’s wrong with me? What kind of mom doesn’t notice when her baby’s not moving? The possibility that something was truly wrong… didn’t bear thinking about. I lay there poking him, barely breathing, waiting for him to do something – and eventually, he did.

As it turned out, I was able to get another appointment the very next morning. It was quicker than I expected – under half and hour. The tech showed me the face, spine, limbs, and the flashing heartbeat. She confirmed his breech position, and agreed this was probably why I wasn’t feeling as much movement.

I was supposed to have an 11:30 midwife appointment, but it also got moved because that particular midwife had been up all night at a delivery. I could go in at 4:30 to see a different member of the team.

Sean was off that day, and we decided that he would bring E and attend the appointment, for the first time this pregnancy. It just seemed to work out. (Had it been 11:30, it would have been nap time and they would have stayed home.) Thank God for this, because it was not a normal appointment.

Our midwife, B, said the results of the ultrasound were very puzzling to her. They indicated that arterial blood flow was normal, suggesting that the placenta was working fine, but the amniotic fluid was measuring zero. They also said the baby was measuring 3-4 weeks too small, even though my abdominal measurement was normal and B said the baby felt like a normal size, upon palpation. It just didn’t add up.

She sent us to the hospital for a non-stress test, warning us that if it showed the baby was under stress, we might be having this baby today. We might even go to Mac for delivery, since they are much more experienced with undersized babies. This was big enough news to take in: a baby now would definitely rearrange the whole summer’s plans!

We called Auntie Beth, who graciously came to look after E while we went to the hospital. We were looked after by a couple of different nurses, as well as the doctor on call. Our midwife had been happy to hear which doctor it was, saying he was a very level-headed man who would not rush us into anything. I was at the hospital for over two hours; Sean arrived partway through with snacks, and read to me from Steinbeck’s Travels with Charley (I couldn’t read my own book because a lot of the time I was holding onto the heart monitor to help keep it in the proper place).

I was a bit worried. I had a little gizmo I was supposed to click every time I felt the baby move – and I was not feeling much movement. But then, the nurse would walk by and say, “I can hear that child moving!” (I guess it makes a certain sound on the monitor) so I would concentrate harder. Mostly slow, subtle movements. Finally one nurse gave me some orange juice, the magical beverage that’s supposed to wake babies up and make them jump around. Then I was definitely feeling movement, small but real, and soon we were allowed to go home. According to the test, this was not a baby under stress. Neither of us was very worried now – we would go for another ultrasound the next day, and we felt sure it would show that the other one was some kind of fluke. How could the baby show no distress if there was no amniotic fluid?

The next morning, Friday, July 8th, I felt Sebastian moving as I ate breakfast. I gave him a proud pat – attaboy. Then we returned to hospital for what we hoped would be the last ultrasound. (As I write this, it occurs to me that it was.) Sean dropped me off first and then took E to the babysitter’s – we weren’t sure how long this would take.

I waited barely a minute to get in. The technician was a middle-aged woman who left the room twice to check with someone (?) to see if she had all the data she needed. “I’ve been doing this a long time, but I’m new to this hospital,” she explained. It only took about ten minutes altogether. She asked if I was expecting my husband – “Because there’s a young man in the waiting area who looks about your age.”

Looking back, I hate to think how that must feel, to be the ultrasound tech who realizes she is looking at symptoms “consistent with fetal demise” and must not convey any inkling to the mother. No wonder she hoped it was my husband in the waiting room.

We headed back up to the birthing unit to have our follow-up non-stress test. The triage nurse told us our midwife was coming for that – surprising, but we took it in stride. We waited for quite a while. I was reading Outlander for book club; it is almost eerie to recall that as I sat there, I read the part about the baby that dies in the woods.

Suddenly B was there, and leading us to a birthing room. We were definitely confused by that – the night before, we’d spent the test in a triage bed, listening to a young mom in the next bed, accompanied by her husband and mother (in-law?), dilating four centimetres. (She did so well – sighing with the pain but not complaining – that the nurse who checked her was surprised at her progress.)

Our midwife sat us down, and said, with sympathy but so matter-of-factly that it didn’t register at first, “I’m afraid I have to be the bearer of bad news.” (First thoughts: they were right about the fluid – the baby needs to come out now – he might be in danger. If only.) “The ultrasound this morning showed there is no heartbeat.”

Totally dumbfounded. This doesn’t make sense. It can’t be right. It’s temporary…? We were speechless for a few moments. I said something like, “You mean – what does that mean – that’s it?” It was so inconceivable to us both that we had to ask to make sure she meant this: that our baby was no longer alive.

She told me we could do another Doppler to try to find the heartbeat, if it would make us feel better to hear it for ourselves. I wanted to – not expecting that the powerful ultrasound Doppler was wrong, but needing… something. Confirmation in my own ears, I guess. It seems many moms in this situation feel this way.

By the time B left to get the equipment, my tears had started. And at that moment I found myself witnessing, for the first time ever, my husband’s tears as well. We were still in shock, but the first layer of implications was starting to filter in. We were going to have our baby very soon – and he would not be alive. We would meet him, but he would not meet us. I remember Sean saying, “I don’t know if I want to see him.” I knew just what he meant – how awful would this experience be? – but at the same time felt an enormous yearning to see him, and replied, “But how can we not?” We held onto each other and cried, with nothing else to do.

Soon, we heard for ourselves the quiet space where the heartbeat should have been. Another midwife from our team, G, joined us for support. The ob-gyn on call (different from the night before), came to speak to us with a very sad face, offering his condolences and explaining about the prescription that would induce labour. At first I was confused – didn’t a breech baby mean I would need a C-section to get him out? No. When the baby is alive, it’s worried that the head will get stuck if the feet or bum come first, but when the baby has died, it is easier on the mother not to undergo surgery. Similarly, I was encouraged to get whatever pain management measures I needed – there are reasons to avoid drugs during childbirth, most of which are impertinent when the baby is dead.

It was up to me, they said, to decide when to take the pills that would induce labour. It might take two or three doses – twelve hours apart – to get things really going, since my body likely wasn’t planning to go into gear for another five-and-a-half weeks (or more)… but these people would all try to make it as easy as possible for me. No need to feel that pain on top of this.

Dear readers, if you’re still with me, I’m sorry to write such a huge post and then leave it here… but there it is. Thanks for being here.

Whew. I’ve been needing to write this for days. I still have a long way to go.

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