I’m coming off of about five hours of restless sleep this
morning. A baby kept me up last night. But it wasn’t my baby. No. It was a baby
who had died in his mommy’s womb before I met either of them. I often find that
this blog becomes a place of therapy for my soul; somewhere where I can pour
out my heart during intense times like this. Therefore this will likely be a
longer post. So if you don’t feel like reading through to the end, no worries.
This morning I am writing for myself.
Last night we were hosting a back-to-school party at my
house for the youth in our life. We also had a few American volunteers over for
supper just before the party. As I was feeding my son and the visitors were
fixing their plates, someone came running to my back door saying that there was
an emergency at the clinic and the nurse on call was asking me to come. I know
that this particular nurse is super-capable and if she was calling for my help
it was probably bad.
She actually had three patients come in, in a very short
time. She was the only nurse on duty as it was after-hours. Two of the cases
she had under control, but one needed me to use my ultrasound skills. It was a
young, expectant couple who are not from our community. Just the two of them,
no support team of in-laws, friends etc. that you usually see during the birth
of a baby in our small community. The nurse explained to me that the mom was in
active labor, had been having pains for two days, and had not felt the baby
move since early morning. She couldn’t find a heartbeat with a Doppler so she
had already set up the ultrasound for me to use.
I am most certainly not a perinatologist, neither am I even
an OB/GYN doctor. I’m simply a nurse practitioner who has sought out some extra
training for times like this. And it did not take a specialist to see that this
full-term baby was not moving in the womb. I located the heart and did not see
any movement. I saw something that my non-specialist eyes felt was unusual. It
looked like there was a very wide aorta (blood vessel going away from the
heart, but I really wasn’t certain. Besides, the point was that the baby
appeared to have already died in the womb.
This couple was completely new to our clinic and had
received all of their prenatal care elsewhere. I stepped outside with the
clinic nurse, visiting nurse from America, and father of the baby. In times
like these you have to be so culturally sensitive even as you make medical judgments.
I shared with the father that I had some serious concerns about the baby; that
we would do everything we could but that I could not guarantee a positive
outcome. I asked him if he thought it was better for me to share this
information with the wife or to wait. We are in a rural location where getting
someone transferred for a c-section is a pretty big ordeal. I needed to know
that this mom could hold it together to deliver this baby so that her life was
not endangered. He told me that she is a very emotional woman and he felt it
would be better to wait and see the outcome before telling her our concerns. These
situations are always such a hard call. Whether or not I made the right
decision I do not know. But we did not tell the mom.
I recently read about a case in another place in Africa
where a woman was referred to a large medical center to deliver because the
smaller center had referred her for a fetal demise (same sort of case). In that
situation the baby was blue at birth and did not move so they put it to the
side and focused on mom. A few minutes later they went to move the baby’s body
and found it alive and moving. So I had resolved in my heart to hold on to hope
and do my best for this family.
It was not a particularly difficult delivery; her first
time, so of course not easy, but not particularly difficult from a medical
standpoint. The nurse and I decided that she would manage mom and I would
handle the baby. As the baby came through the birth canal I began to suction
and do all the things that I normally would during a delivery. But it looked
bad. I’ve done resuscitation on many babies, but this one was definitely beyond
resuscitation. I walked the baby away from the mom to another exam table. I
listened. No heartbeat. I attempted resuscitation for a few minutes all the
while knowing that the baby was already gone. I put my hands on the exam table
and leaned over this precious baby boy and asked God “What now?” I needed to know
that the mom was physically stable before going to see her with bad news.
The placenta came rather quickly and I knew it was time. I
knew that she already had to know something was wrong. I looked up to my
colleague and the visiting nurse and told them that I was going to talk to the
father and was coming. I shared the news with him. That I had tried, but that
the little boy was already with Jesus when he came out of his mommy. We went
back into the delivery room together and he wanted to hold the baby but was
afraid to at the same time. I helped him. We talked for a minute and then I
went to see the mom. She still needed post-partum care but I knew this
conversation could not wait any longer. I shared with her that her baby was not
breathing when he was born. That his heart was not beating. That I tried but I
could not get the baby to breathe or have a heartbeat. That her child was a boy
and that he had died.
Oh the anguish. She whispered “My Baby..” in Swahili and
then began to thrash and scream. She shouted all of the normal questions that
really have no answers. “Why my baby? Why me? I was not prepared for this! I
want to die too..” I wrapped my arms around her and cried with her. In a moment
like that, there really is nothing more that one can do. My heart broke with
this family.
In my life I have had many pains. One of those pains
included losing an unborn child myself.
I did not carry this child to term as this mommy did. I have no idea if
mine was a boy or a girl. But I do know the horror of having a doctor look you
in the eye and tell you that what you believed and all you had hoped for would
not be.
The passage in Second Corinthians, chapter 2 verses 3 to 4
comes to mind at a time like this. “All
praise to the God and Father of our Lord Jesus Christ. He is the source of
every mercy and the God who comforts us. He comforts us in all our troubles so
that we can comfort others. When others are troubled, we will be able to give
them the same comfort God has given us.” (NLT) I’ve always had mixed
feelings about this passage. I ask
myself why it is that any of us should need comfort in the first place? Why
this horrible, inexplicable, pain and suffering that some are asked to
endure? But in a moment like that moment
last night, I find great comfort in the fact that I can truly look these
parents in the eye and tell them “I know your pain. I know that it feels like
you will just die from it. I have been there. I’m so sorry.”
The job of washing a little body whose soul has left is such
a terrible, painful thing. But I did it.
I helped the mother hold her son as she told him goodbye while at the
same time hardly believing it could be possible. Her head to his forehead and
the tears falling unchecked. I prayed with the family. I asked that God would
be the God of all comfort and peace. That they would know His presence and have
the assurance that their baby is in the presence of God himself. I looked both
parents in the eye and said very clearly THIS IS NOT YOUR FAULT! I asked them
to comfort and hold each other as they walk through this unspeakable pain.
As I left them, extremely early this morning, they were
discussing where they would bury their son. In this area you bury your loved
ones in your backyard. They had recently moved to the area and are renting a
small house about twenty minutes away.
They don’t have their own property where they can lay their son to rest.
My short night was restless as I tossed and turned in my
bed. But when I came fully awake I was overwhelmed with thankfulness that I could
be there to weep with this family. That I have the honor and the privilege of
stepping into peoples lives during their most horrific and vulnerable times.
That God can use me as His instrument of peace during times of storms and
crises.
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