Archive for December 30, 2007

Jessica Michelle 12-28-2007

I avoided thinking of her as my child for so long.  She would be adopted – I had even chosen the family I wanted to give her, and it was easier on myself to not have to make the mental transition from “parent” to “birth mother” after the fact.

But now…she was my daughter.  She was only ever mine – I carried her, alone, for 9 months.  She only lived for 7 hours, and while I was never able to give her the kind of life I had planned, she changed my life forever. 

It all started on the 24th.  I had been having Braxton Hicks contractions for a while, these started to get a bit more painful.  I timed them, and while they lasted for about 12 hours, they were irregular and never intensified.  Late Wednesday night/Thursday morning, I lost my mucus plug, and knew that the time was getting close, but no contractions or anything but normal movement.  Friday morning, I woke up around 3 am needing to urinate, and it was uncomfortable – not burning like an infection, but a weird sense of pressure and soreness.  I went back to bed.  Around 7:30 that morning, I woke up with a sensation of intense fullness and pressure, mostly concentrated in my lower back.  It felt like I needed to have a bowel movement, but it wasn’t that.  Contractions began, but were difficult to time, and were irregular and different from the contractions I had been experiencing.  About an hour later, the contractions got seriously painful.  I started to get ready in case this was the time, which I had to do in between contractions, and was timing them.  They were still really irregular – sometimes 3 minutes apart, sometimes as much as 15.  I decided to take a short bath to get some pain relief while I called the doctor.  I never made it into the bathtub – the very next contraction was accompanied by an overwhelming physical need to push – I could NOT stop myself.  It was all I could do to crawl to the phone and call 911.  I was clothed only in a t-shirt, and crawled on my hands and knees to the front door just as the ambulance team arrived.  They got me strapped onto the cot and on the way to the hospital.  2 minutes from the ER, my daughter was born.

I had been immensely scared of the labor and delivery process.  I really only had an hour of painful contractions and gave birth with about half a dozen pushes, none of which I had control over.  I never, ever thought about there being problems afterwards, however.

She wasn’t breathing when I delivered her.  The EMTs immediately started trying to start her respiration, and they did manage to get some breath sounds.  She was immediately taken to another room when we arrived at the hospital, however, and I was surrounded by people trying to control my bleeding, deliver the placenta, and get me stitched up. 

The doctor in charge of working on Jessica came to see me quickly and tell me that she was in pretty bad shape, but she would do all she could.  All I can remember at that point is sobbing and apologizing for not being a good mother to anyone and everyone in the room.  I was in shock, literally and figuratively. 

A couple of hours later, I had to make the first really hard decision.  The doctor came to tell me that she wasn’t doing well – wasn’t spontaneously responding, her pupils weren’t adjusting, she wasn’t breathing on her own, and her blood gases looked pretty bad – she had metabolic acidosis, meaning her blood was too acidic.  There was a treatment that could help, but she would have to be airlifted to another hospital no later than 6 hours after the birth.  We decided to wait another hour and get another blood gas to see if it had improved.

The results came back amazingly good – she had started to respond, her pupils were adjusted, her blood gases looked significantly better, and she was responding to treatment.  The doctor made the necessary calls and the helicopter was called in to airlift her to another hospital.  At that point, they said she had about a 50-50 chance of survival.

Right before she left on the helicopter, I got to see her for the first time.  I couldn’t touch her, but it was hard to believe so much was going wrong with the tiny baby girl lying there.  I could do nothing but wait from there.

The doctors from the new hospital called to discuss my options and requests.  They needed my consent for a DNR order – if her heart stopped, or if her ventilation tube came out, they wanted to know if I wanted them to take “extraordinary measures” to save her life.  Ultimately, given how weak her organs were to begin with, and the stress that trying to bring her back would put on them, I elected to simply keep her comfortable in those circumstances.  But she would undergo the new treatment.  The plan was to drop her body temperature to 92 degrees by circulating cold water in tubes wrapped around her head for up to 72 hours.  This would hopefully minimize her brain damage while the sodium bicarbonate worked to buffer her blood. 

After more waiting, I got the information I had been dreading.  They had run an EEG scan of her brain – it showed nearly no activity.  Her responsiveness had been steadily worsening, as had her blood gases.  She had fairly extensive heart, lung, and kidney failure.  The doctors very gently told me that while she was still undergoing the hypothermic treatment, she probably wasn’t going to make it – but more importantly, they told me that she would almost certainly never be responsive.  Even if she was, she would never breathe, eat, walk, or talk on her own. 

My little girl had already undergone so much in just her first few hours.  She wasn’t gaining anything through her treatment.  I made the call to stop the treatment.  She died only a few minutes later.

I give all her doctors the utmost credit.  They did everything possible, kept me completely informed every step of the way, far more than they were required to, and most importantly, they held her as she died.  They made sure, even when I couldn’t, that she was comfortable and in peace.  They also took pictures and memories for me to come and pick up.

To give birth and death in a single day.  I only hope I made the right decision.

Rest in peace, little one.  I will always love you.

the road ends

One day soon, I will be able to type out the story of the worst day of my life.

I never knew how scary it would be to hear someone say that she wasn’t breathing.  I never knew how traumatic it would be to only be able to see my daughter in a box across a room, covered in tubes, right before they put her on a helicopter.  I never thought I would be the one in tears, on the phone, saying to stop the treatment.

Now I understand what the words rest in peace mean.