My First Daughter

It took me a good number of years to be able to feel like it was appropriate for me to say I had a daughter. All that remains of her are the memories of what might have been, a fading ultrasound picture, a souvenior birth record, a tiny outfit, and a blanket the size of a hand towel. And then of course, there's the autopsy report.



Rachel Anne. That's her name. You won't find it engraved on a headstone or find a jar of her ashes. The only place you'll find her now is forever in my heart. But she deserves to be remembered for what she was - my first daughter.

My health care had been at the direction of a family practice clinic for a couple of years. It was my primary physician (Dr. S) who had pronounced me pregnant the first time and who cried when she told me that the tissue I had passed a few days later was indeed a blastocyst. She was excited for me when she found out I was pregnant again soon after. Unfortunately, because it was a family practice clinic, OB care was handled by whichever physician had an opening for pre-natal care. Her schedule was full at that time and so I was passed off to one of her teammates.

I never did hit it off with the new doc. I thought she was dismissive and downright mean spirited. Whether or not my perception was correct is a matter of opinion but I saw her for 3 monthly checks before insisting I be transferred to another doc or given a referral to an OB/GYN outside of the clinic. The proverbial straw that broke this camel's back was at my 3rd appointment with her. The baby was at 19 weeks 1 day and at the time I was chubby - about 200 pounds on a 5'4" frame. [I say chubby simply because it's been a long time since I've seen weight that low and it helps me keep things in perspective.] When asked if I felt the baby move yet, I responded no. She also had trouble but did find a faint heart beat at that visit. I asked if this was normal - the previous visit there was a good strong heartbeat. I also told her I was worried because I had been continuing to lose weight even though according to all of the books I should have started gaining some by that time. Her response? "If you weren't so heavy to begin with we would be worried." Apparently having a weight issue makes you a second class citizen with some physicians. I went to the counter to schedule my next appointment and informed them that I would not be returning to visit "that woman". My husband, ever the peacemaker, had not been at the appointment with me but did everything in his power to try and convince me it was all a misunderstanding and that I should just forget about it. So I did... try anyway.

My next appointment had been delayed until the 24 week mark. Dr. M had the same difficulty in locating a fetal heartbeat and was very alarmed that I still had not recognized fetal movement and was continuing to lose weight. He called an associate into the room who also could not locate a heartbeat and I was immediately sent next door to the hospital for an ultrasound. For some reason, I kept thinking about what the previous doc had said: "if you weren't so heavy..." Perhaps that's all it was. There really was no cause for alarm. I was just too heavy and this ultrasound was going to show them all that I was just a difficult patient and there was nothing wrong. That wasn't reality, however. The ultrasound tech wouldn't say a thing. I lay there praying for any sign of life, for any words of reassurance and got nothing. After making sure that the images had recorded properly for the radiologist, I was sent back to the clinic where I was put in a room to wait. I knew - my head did anyway - that the pregancy was over. All of the grim faces with no words confirmed my worst fears. And when Dr. M brought Dr. S into the room with him to break the news, no words were needed for me to understand.

Arrangements were made for me to be transferred to OB/GYN care and an appointment made for 2 days later. In the meantime, if I had any severe cramping or bleeding I was to report to labor and delivery. I've never been a very patient person. And one of my biggest pet peeves is having an appointment and still having to wait. I didn't care that someone else was having a baby and need the assistance of the doctor I was scheduled to see, I was simply pissed off that I was kept waiting for over 2 hours past my appointment time. I had taken several trips up and down the elevator on my walks in the courtyard - trying to keep myself busy. Sitting there in a room full of pregnant women was just too overwhelming. On the last trip up, I encountered a gentleman who inquired about my obviously agitated state. I told him I hated having to wait for people who were too inconsiderate to keep their appointments. Opps. Turns out that was actually my doc. He was understanding of my abruptness and set about tending to my concerns. He laid out the options: schedule for a D&E or schedule for induction. He told me that it would be easier on my body to have the D&E but that he would go along with whatever I wanted.

Now, D&E may have it's place in the medical world but I could not fathom anyone ripping apart the life I was carrying in my body and sucking it out like some kind of waste. My head knew the baby was dead, but my heart did not. And what if they were all wrong? What if by some miracle my baby was still alive and by having a D&E I was in essence aborting it? At least if I forced the baby to leave my body with induction there would be a chance, however grim, that it could survive at 24 weeks.

True to his word, OB doc did support my decision to have an induction and inserted absorbant dilators to begin the process since my cervix was still closed tight. This was Wednesday afternoon. I had to report back to his office if there were any "problems" otherwise Labor & Delivery would be expecting me at 6am on Friday to start the pitocin drip.

Those of you who have experienced pitocin know this was no cake walk. My best friend was there for me (ok and yes, my husband was sitting in the corner of the room participating in his own scared way). She made sure I had the things I needed as my world collapsed around me and the gravity of what I was doing set in. At some point early in the process one of the L&D nurses brought in the little outfit you see in the picture. I was told that when the baby was born I would be allowed to dress it, spend time with it, take pictures if I wanted - otherwise the hospital would take some for me for later. There was still a matter of gestational age to be considered as I was laboring in a Catholic hospital. Any baby over 20 weeks gestation must be dealt with as a dead child and would have to have its remains handled by the family.

The long and the short of it is that I labored for only 12 hours. When the baby was finally delivered it was anticlimactic. After having been up and down for the restroom a number of times, I again felt a strong urge to empty my bladder. The nurses were paged but I honestly thought I was going to loose control of my bladder before they could get there [average nursing response time was 5 minutes from time of page] and my dear friend provided me with a bedpan and the support to use it. My baby was born, delivered into a bedpan, at 7:40pm on October 9, 1992.

The L&D nurse said it was a good thing for the baby to be delivered as it was - encapsulated in an intact amniotic sac along with the placenta - it might give a better clue during autopsy as to why the baby died. And that was the last I saw of my baby: something that looked akin to a giant blood clot. No dressing the baby, no holding the baby, no photographs of the baby by me or by hospital staff. Instead my baby was sent off to autopsy to determine its gestational age.

In retrospect, I don't know why they did it, but they declared gestational age to be 19 weeks, 2 days - the day after the appointment where "that woman" had trouble finding a heartbeat. The autopsy report shows measurements consistent with a fetus at 22-23 weeks gestation.

I left the hospital the next afternoon after spending a night on the maternity ward. Thankfully I was able to have a private room and not have to share with a new mother. But apparently the word had not been passed to all as during the night the traditional "welcome basket" the hospital provided to all new parents as well as several of those freebie packets - the ones with diaper samples and all sorts of ads and coupons - were placed in my room.

On Monday my husband left for Air Force Basic Training and I was left alone to deal with the loss. I really don't know how I made it through those days that followed. By the grace of God and the care of some very dear friends, I survived the hurt and anger, the depression, the grief, the guilt. And at my post-natal check up, thankfully scheduled with Dr. S, we cried. She asked if there was anything she could do and I said yes. Please. I don't even know if I had a boy or a girl. She immediately got on the phone and got the answer. I had a daughter. She asked if we had a name picked out for a daughter and then made a second call to arrange that the hospital send me a souvenior certificate of birth, complete with her name. She also made arrangements for a copy of the autopsy to be mailed to me.

That was the beginning of the healing. I had a daughter. And her name is Rachel Anne.

There are many things I could write about the lack of grief counseling and support that was available to us at that time. I read the blogs of various women who are or have been dealing with their own losses and hope that they feel the love and support of those of us who have been in their shoes. What I know is that we have to stick together in this world. We have to know that it's ok to grieve for our dead babies. Most importantly, it's ok for us to proclaim them as our children. And any woman (or any man) who needs my help in going through their own loss is going to get it.

It's the least I can do because of my first daughter.