Acacia's Story

Today’s post is a guest post from a loss mom. This is Jenny’s story (in her words) of the birth and death of her daughter, Acacia.

"I've been deliberately vague about the complication that my daughter suffered because some people have been unable to resist the urge to pick over the details of her birth and suggest that if we'd had "better" paramedics, or a midwife, something could have gone differently. This is both unhelpful and unrealistic. The paramedics' quick thinking meant we had a chance to get to know her before she died. But no matter what anyone tells you, paramedics do not have operating rooms, surgical teams, anesthesiologists, blood transfusions, neonatalogists, neonatal nurses, or respiratory therapists hidden away on that ambulance.  They just don't.  And neither do midwives.  The best, most experienced homebirth CNM in our area transfers at the drop of a hat exactly because she hopes to avoid injuries like the one my daughter suffered. 

Unfortunately, what happened to my daughter was something no one could have predicted.  My daughter's complication is one of those events every OB and midwife fears.  The only thing that could have made a substantial difference to her outcome was a change in our location prior to the event - if we'd been in the hospital instead of in my kitchen. 

~

Before I had my first child, I was terrified of doctors.  I had unrelated trauma that made trusting anyone an ordeal.  What I read and heard about natural childbirth left me believing that in a hospital, I would be medically battered, strapped to a bed, shamed, touched without my consent, and bullied into accepting interventions I did not want.  Nevertheless, when my time came, I asked my boyfriend to drive us to the hospital - "why" would be too big of a story to go into here.  Imagine my relief when I was treated with kindness, dignity and respect.  We brought our firstborn daughter home at three days old.

When I was pregnant with our second child, I felt that my previous experience in the hospital had been decent enough to repeat. Many of my peers had or were having home births and I eagerly listened to their stories. But as nice as they sounded, I decided that three days in the hospital would allow me to rest up before launching into the challenge of being a mother of two. Planning a second hospital birth was a housekeeping decision. I was not particularly worried about safety because through playground chats and reading about natural childbirth on the internet, I'd come to accept the notion that "birth without interventions is best," and that women should "trust birth." Underneath it all was a belief that birth is basically safe. When I talked about birth with other moms, we sometimes wondered if this intervention or that intervention had really been necessary. But we seldom, if ever, talked about death as though it were a real possibility.

Then my daughter, my second child, died because one of those "rare" split-second, every minute counts birth emergencies. Despite living just minutes from two hospitals (mine, and the one with the best NICU in the area), we did not make it in time. My labor was irregular then suddenly intensified. Just as I was putting on my shoes to go to the hospital, I started involuntarily pushing and my water broke.  I couldn't make it down the stairs, so my boyfriend called 911.

The paramedics arrived promptly and by the time they did, she was crowning. They did all they could while I gave birth there on my kitchen floor, paralyzed by labor and unable to speak. But as close to the hospital as we were, we might as well have been an hour away. 

We didn't know at the time, but moments before our 911 call, she experienced a complication. Because of that complication, she did not breathe at birth, and was in need of some very specialized help - the kind of help you can only get from a well-oiled pediatric team in a hospital. The paramedics attempted to start her breathing, gave her oxygen, cut her cord, took her, called ahead in the ambulance, and were met by NICU staff at the entrance of the ER. My boyfriend says a a swarm of people began treating her the moment she arrived, and she was not yet ten minutes old.  

My daughter lived four days, and despite being treated with a cooling blanket, she suffered total brain damage and the breakdown of her body following the long oxygen deprivation. Together with her care team, we chose to have her healing supported by technology as long as there was a possibility she could actually heal. However, as the days went on, we learned that her kidneys and her gut were destroyed. Her other organs were following close behind and her body could not recover. We brought family and friends to meet her, and then we chose to discontinue any intervention that did not add to her comfort.  Her dad and I got to spend several hours holding her and watching the sunset with her.  These were some of the most beautiful and holy hours of my life.

After I came home without my daughter, I searched for stories similar to what had happened to her and was horrified to find that they mostly happened to women and babies who'd had planned home births.  Getting out of the house always took longer than anyone would have imagined, and devastating brain damage was always the result. Women who happened to be in a hospital when similar birth accidents occurred generally got scary crash c-sections and mostly - though not always - took their living children home.  I met a mother in the NICU whose baby was born in the hospital, didn't breathe for eight minutes, and received the same cooling blanket treatment my daughter would receive. Her daughter was going home healthy and neurologically intact. What other differences there were between her daughter and mine, I can only guess, but any baby who doesn't breathe for eight minutes was almost certainly in trouble before birth too. It took eight minutes just to get my daughter to the place where she could receive the breathing help and blood transfusion she needed.

At one time, I had fervently believed that my body knew just what to do, but I came to resent every time I'd ever read "trust birth" or "birth is safe" or "our bodies were made to do this" or "all you need is instinct" and "interventions are what cause complications." Every time that I read, "If an emergency happens we will just go to the hospital." As if it were that easy. The paramedics had arrived to my house before we anyone suspected anything was wrong. I also resented the fact that I had feared a c-section more than I had feared my child dying. I resented the fact that I had worried about the "cascade of interventions" more than I had worried about brain damage. I had been worried about all the wrong things.

In the hospital, we were treated with more compassion than I have ever encountered in my life. From the moment we arrived in the emergency room to long after we left our daughter, newly dead and swaddled, they focused not just on the physical, not just on her health and mine, but our whole family system, our feelings, her comfort, our comfort, her humanity. Her essential value as a person was at the center of every decision, from the one to try to save her, to the one to let her go.

The doctors and hospital midwives were more than willing to admit that they didn't have all the answers, and that sometimes things happen that can't be prevented or fixed. They refused to speculate - if only I'd done this or that. All they would say is, "If you had been in the hospital, we could have done x, y, and z. We can give you percentages on how often that is successful, but we can't promise your outcome would have been different. I wish we could. I wish we could tell you this will never happen again. But we're not gods." And in a small way, that saved me because it was the truth. The truth is we never had a guarantee.

I'm not telling my daughter's story to say that women should not have home births - that's not my decision to make for others. But I am telling her story because I think that the notion that "birth is safe as life gets" is a shaky one. No decision should be made on that premise. Birth is not as safe as life gets. Mothers and babies can die and the human race will go on. Most of the time, people get lucky, and things go off well enough. When shit goes bad, it has the potential to go really, really bad. We cannot control whether our babies survive birth by eating a special diet, doing the right stretches, or with positive thinking. I was low risk as can be. My baby didn't die because I failed to trust birth or my body. She didn't die because unnecessary interventions interfered with her natural process. She died because sometimes, in the absence of the right kind of help, and sometimes even despite it, birth kills.

I miss her little face. Not a day goes by that I don't regret the fact that I never heard her cry, that I will never hear her cry, or that I never got to see her as the healthy baby she was before she was born.

My boyfriend lost his child. My older daughter lost her sister. Our brothers and sisters lost a niece. Our parents lost their grandchild. My friends lost a dear new baby to love and watch grow up.

She wasn't mine alone to lose.”

Baby Acacia after resuscitation

Click here to read more from Jenny's mother on her experiences and thoughts regarding birth - where they once were and where they are now, after their loss.