Tuesday, August 10, 2004

Maternal Death

I had had that sucky hospital birth, then my UC with Meghann and, even though I had trouble (shoulder dystocia), I was still euphoric with the Perfection of Birth when I was pregnant with Aimee in Frankfurt, Germany. I was doula-ing for women regularly at the Frankfurt Army Regional Medical Center... sitting happily with CNMs, RNs, and even some of the docs... asking a zillion questions about birth. I was more than a dry and parched sponge; I simply could not learn enough even with the 10 books I read a week on birth (no Net or tv or videos back then!).

One of the nurses called and told me a woman needed some help, could I come and help her out. Sure!

I got up there and worked with her for a few hours... it was really nice. She had some nubain, so was dozing and I was out talking at the nurse's station and another nurse came and said a woman really needed a happy face for a minute... could I please come and talk to her. Absolutely.

I went in and spent about 10 minutes with a sweet couple... talking about their baby coming... helping her move from tears to smiles... and we had a couple three contractions together. I held her hand.

I was sitting at the nurse's station as she was wheeled to the Delivery Room and I went and stood outside the door to watch her have her baby.

As she began pushing, the usual scene unfolded... she was draped, she grabbed the hand grips, her man at her head (dressed head to toe in blue-green), and the nurse and doc were exhorting her to push.

Then, hell entered the room.

The woman passed out and she began bleeding. A nurse hit the button on the wall and a storm of green came from every orifice of the hospital. Within a blink, the father was shoved next to me, anesthesia was gassing the mom, and blood began pouring everywhere. Creeks, rivers, oceans of blood.

This mom still encased her baby and I could hear the docs screaming with confusion about what to do first... get her under anesthesia? was she already dead? just cut her open?

My head was swirling with horror and fear as I grasped the father's hand who was out of his body with fear.

I watched doctors I despised work until they fell down from exhaustion only to be replaced by other doctors I adored. I watched as the docs worked as they were trained to do; to save a life... it was their ultimate training and, for the first time ever, I respected that training.

I watched a choreography of bloody dancers, bagging and intubating the mom, doing CPR on her as she had heart failure, nurses who'd opened two more IV lines in her neck squeezing blood into her body... over and over... the anesthesiologist screaming to just get the baby OUT and the OB finally deciding it was time to get to the poor suffocating baby. 7 minutes hadn't passed since she entered the DR.

The floor was already puddled with red, but as the doc used his scalpel to open the abdomen, a waterfall of blood poured out of her body and over the table and I saw the mom begin bleeding from places I never imagined. Her nose, eyes, mouth, fingernails... her very skin turned red as she went into complete DIC (Disseminated Intravascular Coagulation). I thought I was going to vomit from the scene, but I prayed for the baby they pulled lifeless from her body.

Another team grabbed the baby and waded to the warming table and began working on the blood-covered baby. Wiping him with towels, they intubated and brought the baby to a groggy and brain-damaged life.

Dazed, dad went with the baby to the nursery and I went to sit against the wall across from the DR. I began crying and could not stop. The nurses and docs who filed past me gave me no notice whatsoever; they were in their own pain.

I had my other mom still in labor and she was going to be delivering in her labor room (highly unusual) so no one had to go down to the DRs until things were tended to and cleaned up. From down the hall, I watched as the mom, under a clean white blanket, was wheeled down to the morgue... and I walked into my client's room, held her hand, breathed with her, and watched as her precious... oh so precious... baby was born.

They both lived.


Anonymous said...

This...is....the saddest...
brought me to tears.
So amazing what we do to give birth, the risk. To live.
All of us, y'know? How are you going to live you life - knowing that THAT is right there...none of us are immune.

Thank you for this.

Navelgazing Midwife said...

It's so odd how embarrassed I am to share this story sometimes. I feel it is important in my evolution as a midwife, but it is also a terrifying possibilty for pregnant women to face. The California Association of Midwives newsletter editor, after hearing the story, asked me to write it down for the newsletter. I told her I'd already done that and, as I edited it for print, I felt more and more secretive about the contents of the story. I am so afraid people will think that I am tainted somehow... being able to "see" the ultimate worst in birth. I know differently. I know that, while I am a product of my experiences, I am also in a place of resignation to reality and able to forego allowing fear (in most cases) to control my thoughts and certainly, in every case, my behavior.

I asked the editor of the newsletter to be very careful in deciding whether to use the piece or not because during all these years of sharing the story, it never fails to bring a hefty backlash of disbelief; until amniotic embolism/DIC are explored and seen as the truth, not any fiction I, nor anyone else, could ever make up.

Thank you, anonymous poster, for being touched. I re-read the piece through your eyes even though I just edited it and re-read it a couple of days ago, and I, too, wept. That baby is 18 years old now. I wonder how he is.

Anonymous said...

There is a line in "the Red Tent" (have your read it? oh my, of course you have!) something like: "It takes courage to get up on the bricks."
Whether a woman knows it or not.

It takes courage to get up on the bricks.

Keep writing.
Love, Lesley

Navelgazing Midwife said...

I shall! I shall keep writing.

I printed out your short note and made it HUGE and will put it up here and at the office.

It is voices like yours, Lesley, that keep me writing, even in the face of anger and resentment at what I have to say.

Thank you.

So, so much.

oursonend said...

I have peeked into your blog more than once, and this is the second time I read this birth story, but this time, something struck me funny. Why were the hospital staff doing CPR on the mother before doing a c-section? The success rate for CPR is so, so very low, and as soon as the mother's heart stops beating, the baby is without oxygen... and a true emergency c-section can happen very quickly. Was it a matter of it all just happening too fast? What a haunting story this is.

Anonymous said...

I read your other blog a lot. I haven't read this one before, but I too have witnessed an amniotic embolism.

It was like hell on earth Barb. I wanted to die myself. I stood at the resuscitaire, for 11 minutes while we resuscitated the baby, 3 of us, begging & begging & begging him to 'wake up'

8 weeks later & mother & baby are well. The baby seems normal, the mother has no idea how close they came. No idea.