The Birth That Changed My Life: Part II

This week in our Delmarva Community Birth Stories series, we're doing something a little different.  This story is shared by Thrive owner and doula, Maria Mengel.

If you haven't read Part I yet, hop on over and check it out now.

I received the worst message that you could ever receive as a friend/doula:

"Amniotic fluid is basically zero.  They can't find any kidneys or bladder.  Without kidneys, the baby will die after birth.  We're going to AAMC for induction.  You should come now."

Then it was followed by:

"worst nightmare"

I was completely in shock and "respond" mode.  I was in the shower, so I jumped out, toweled off, texted my husband to come upstairs now, and started getting ready.  I was in the car within minutes.  I was nervous, scared, worried about my friends and their baby, and in a real hurry to get there.  On my way, I called and talked to my mom and my doula/mentor to keep my mind from racing too much.  They both promised to pray and reassured me that I would be able to support my friends no matter what.  I told them that it wasn't fair that my first bereavement birth after receiving my certification was for my best friends.  I was still feeling pretty raw from the sudden death of my little brother just months before, and I truly didn't know if I could do it.

I didn't waste any time, but I didn't speed either.  While I was alone in the car, I tried to think about everything that I learned about babies who passed after birth.  I would need to be strong enough to explain to my friends what to expect and yet compassionate enough to support them through a potentially long induction and birth.  Two hours later, I pulled into the hospital parking garage.  I practically ran to the elevators, through the Labor and Delivery doors and down to the room where the nurse told they would be.  I quietly opened the door to my friends sitting on a couch together talking with their midwife.

I was breathing heavily from running and when I walked in it was completely silent.  

Without speaking, I walked across the room and sat down with my friends when Wes said "Well, the induction is not until Monday".  Apparently Labor and Delivery was really busy that day (Friday), so they decided to wait until Monday for the induction.  Their baby had been surviving with extremely low amniotic fluid levels and seemed to be doing fine for some time (they estimated up to 6 weeks or so), so they figured a few more days probably wouldn't make a difference.  Everyone seemed so relieved.

It was kind of awkward because we were all in shock, sad, relieved, and scared at the same time.  The midwife came back with a specialist on the phone from Children's National Health System in DC.  He expressed his apologies about their situation but offered them a pretty innovative opportunity.  He told them that he could see them early Monday morning for a fetal MRI to get a closer look at baby's renal system and lungs.  He told them that he would hopefully be able to get a more concrete diagnosis before the induction that morning so that they would know how to prepare for their baby's treatment after birth.   They decided to accept the offer and scheduled an MRI in Washington D.C. at 7:30am and an induction in Annapolis at 9am. 

We spent the next hour or so on the phone making appointments and then made the two hour trip back home to the Eastern shore.  Meghan's parents were on their way from upstate New York and they needed to stop at the grocery store to stock their fridge for guests.  Wes took my husband to the store with him while Meghan and I stayed at my house with the girls.  Meghan and I talked about how it all seemed so strange and so awkward that we just found out that her baby might die and we were doing normal things like grocery shopping and watching my kids play.   When they went home that night, I promised to stay in touch.

Guys, thank God for texting.  

We spent the time between her diagnosis and her birth texting constantly.  It was so much easier for Meghan to express her thoughts and feelings through texts than saying it all out loud.  Our relationship as friends grew leaps and bounds through those messages, many of which I saved so that I wouldn't forget.  The good and bad feelings, the fears, the worries, the logistics,etc.  It was like having a diary to process our thoughts together.  And it was so much easier to text our thoughts than say them out loud.

On Sunday, we scheduled our prenatal meeting together.  It was supposed to be a meeting where we discussed their dreams and desires for their beautiful water birth.  But instead, I got my first taste of what it was like to be a bereavement doula.  I met with Meghan and Wes and we discussed their options.  If the MRI the next day confirmed their worst fears, and baby truly did not have a bladder or kidneys, and severely underdeveloped lungs, they would have a few choices.  The staff at their hospital informed them that they could continue with the induction the next day, with the understanding that the baby might not make it through the stress of labor and die before birth.  Or they could wait for spontaneous labor, knowing that the baby may pass before labor begins, and then definitely deliver a stillborn baby.  Or, they could schedule a cesarean to guarantee that Meghan and Wes would have a chance to meet and hold their baby still alive, and then know that baby would probably pass in her arms shortly after.  

We talked about what to expect with all of the options, including the details that I didn't ever want to have to share with my friends.

They were aware that funeral arrangements would have to be made, but weren't ready to talk about it yet, so Meghan's mother and I talked through their options and I contacted a funeral home, asked questions about their options in terms of transportation of the baby's physical form and services.  I gathered all of that information and placed it in a folder in my birth bag.  They decided to wait until after the MRI in the morning to make a final decision about their birth plans.

The next morning, I knew that it would likely take a long time before the MRI was finished and they were able to talk with all of the necessary specialists in DC, so I did the only thing I could think of to pass time.  I feverishly cleaned my house.  I literally was scrubbing the freaking baseboards because if I sat still too long, I started getting sick thinking about what might happen later that day.  I had a knot in the pit of my stomach and every once in a while, I had to sit down and mentally tell myself that what they were about to go through was much harder than my role in the process, and that I could support them 100%.  I knew that there would be a lot of processing and healing time afterward for everyone and I planned to give myself the energy and space for that after the birth.  

When Meghan finally called, she told me that the news wasn't good.  They were unable to find any bladder or kidneys still.  They told her that her baby's lungs were severely underdeveloped (as a result of the low amniotic fluid) and that her worst nightmares were confirmed.  Life outside of the womb for their baby was highly unlikely.  They weren't going through with the induction. They were coming home and waiting for their baby to decide when it was time to be born.  They were aware that there was a risk of stillbirth, but they wanted to respect their baby's timing. 

Baby Rice's diagnosis:
• Bilateral Renal Agenesis
• Pulmonary Hypoplasia
• Anhydramnios
• Potential slight spinal malformation

I was absolutely heartbroken for my friends.  And I was so relieved to know that today wasn't the day.  

We didn't know it at the time, but we still had another two whole weeks before their baby was born.  They decided after the MRI to find out the sex of their baby so that at least for a short while alive, their baby could have a name.  Here is the MRI photo of Charlotte Catherine Rice.

**Click here to continue to Part III**

***Of course, I have received full permission from Meghan and Wes to share my version of this story and use their real names***

The Birth That Changed My Life: Part I

This week in our Delmarva Community Birth Stories series, we're doing something a little different.  This story is shared by Thrive owner and doula, Maria Mengel.

I don't normally share birth stories as the doula.  The stories belong to the families!  But this story is one that I couldn't keep in.  Because while it is always all about my clients, and while it is my intention during a birth to make them feel like the most important people in the world, this story had a big impact on me and my life, too.  

This is the story of the birth that changed my life.

I met Meghan and Wes nine years ago in college.  We were all studying music at West Virginia University when we met each other and our spouses.  We were in the same classes, went to the same parties, and played in the same ensembles.  We were in each other's weddings and vowed to stay in touch.  The year after my husband and I received music jobs on the Eastern Shore, Meghan got one, too!  We were so excited to be close again and for Wes to bring his clarinet business to the Eastern Shore.  

Naturally, we all became best friends again.  We shared dinners on the weekends and even lived together one weekend when their home was evacuated for a hurricane.  They were the first people we told when we had our girls.  And they have been there to watch my girls grow up and see all of their "firsts".  

Last December, Meghan and I were taking my girls to the Salisbury Christmas Parade when Meghan shared the fabulous news that they were expecting!  I knew that they had been trying for a while, and I was equally happy for them and excited to meet their new baby that would get to grow up with my girls!  

Almost right away, they hired me to be their doula.  They were planning a natural birth at the same birth center that I birthed my first daughter. I was excited to be going back and so thrilled to witness the birth of this baby, who I already loved.  Meghan and Wes were some of the first participants of the class I worked so hard to design, Thrive Childbirth Education.  They were so excited and adamant about their natural birth plan, and I had planned to support them in whatever they needed and wanted.  

While they were pregnant, I had decided to study through Stillbirthday to become a certified Birth and Bereavement Doula.  I was unlike many of my class members, as I had never experienced a pregnancy or infant loss before.  To be completely honest, I had no clue what motivated me to take this training.  But I was completely committed to it and finished the program in March.  I wasn't yet sure if I would ever put myself out there as a bereavement doula, but knew that I had learned some valuable information, should I ever need it.

As their due date drew nearer, Meghan began telling me that she was measuring small (the measurement in centimeters that they take from your pubic bone to your fundus at OB/midwife appointments).  However, both Meghan and Wes are small people, and nothing seemed too concerning.  But when her belly wasn't growing at all after 3 or 4 appointments, her midwives recommended a biophysical profile to take a closer look at baby... just to be sure.  Meghan and Wes originally wanted to decline the ultrasound, as they had declined other ultrasounds in their pregnancy.  They weren't sure whether the potential risks of a long ultrasound at 38 weeks would be worth it to find out that everything was perfectly normal in the first place.  

They decided to go ahead with one biophysical profile, just to be sure baby was still growing normally.  I went with Meghan while Wes was working on Thursday, July 21st.  It was really cute to see their baby up on the big screen.  The ultrasound tech seemed like she knew what she was doing and was busy chatting a bit, while taking measurements and snapping pictures.  After it was all over, the tech said she'd be right back.  She was supposed to report back to Meghan's midwives with information.  When she came back she said that they were busy, and as soon as they were able to connect, her midwives would give Meghan a call.  She seemed perfectly happy and didn't look concerned to me at that point (although I now know that she was).

When I got home, I had to teach some private music lessons almost immediately.  I was in my first lesson when Meghan called back.  I didn't answer since I was teaching and instead texted "Hey I'm teaching. Everything okay?".  I waited a minute and got a reply, "No.".  

When I stepped out and called, Meghan was crying.  She told me that the midwives called and told her that there was basically zero amniotic fluid with her baby.  This could be life threatening to her baby, so they wanted her to drive immediately to our local hospital for a non-stress test and possibly a cesarean that very night.  I was, of course, completely shocked.   Since Meghan lived about 30 minutes away and she was still in town, I told her to come to my house and that Wes could meet us here.  

We hugged and talked for a little bit.  She was scared, of course, but wanted to be sure that her baby was as safe as possible, so we were just calm and hanging out with my two toddlers while we waited for Wes.  He brought the whole birth bag just in case they would be having a baby tonight!

At the hospital, the midwife and nurses did a non-stress test, which showed that baby seemed perfectly fine and healthy.  The care providers at PRMC told them that low amniotic fluid alone wasn't a clear indicator for induction.  They advised them to go home and rest.  Of course, after the providers at our hospital told the midwives at the birth center, and after the birth center consulted their maternal fetal medicine (high-risk) specialists about her case, they recommended that Meghan and Wes made the 2 hour drive that very moment for an induction that night.  And they politely declined, but agreed to come in the morning for a second biophysical profile with the specialists, just to be sure.

We had dinner together that evening at my home.  We talked about the crazy day we had and how they really didn't think anything was wrong.  We were all surprised at how insistent the "holistic" midwives were that the baby come out tonight, when our doctors at our local practice told her that her baby seemed perfectly healthy on the non-stress test.

The next morning, they made the trip to Annapolis for a second opinion on the biophysical profile.  I had my bags packed to join them just in case they ended up with a baby that day, but I didn't really think it would happen.  I spent the morning pulling weeds and working outside while thinking about them and how it was going.  As I jumped in the shower after working in the August sun, I finally got a text message from Meghan:

"Amniotic fluid is basically zero.  They can't find any kidneys or bladder.  Without kidneys, the baby will die after birth.  We're going to AAMC for induction.  You should come now."

**Click here to continue to Part II**

***Of course, I have received full permission from Meghan and Wes to share my version of this story and use their real names***

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If you're living on the Eastern Shore and would like to share your positive and empowering birth story with our community, please email me at maria@thrivebirth.org.

Birth and Death

Birth and Death are opposites, right?  A new life enters.  Another exits.  I've birthed two babies in the last three years.   I lost my little brother in April 2016.  I was shocked by how similar my "recovery" experiences were in each situation.   Maybe because I'm so involved with birth every day as a doula and birth worker, but I couldn't stop noticing similarities to the way I experienced the two life events.  

In March of 2016, I finished my bereavement doula training.  I learned a lot about loss, grief, what the experience of losing a loved one might feel or look like, and how to support others who are in that space (specifically pregnancy loss).  I was surprised, though, that I didn't grieve the loss of my brother in the ways that I thought I would.  Each loss is different, of course.  But one thing has been clear: bringing in new life and saying goodbye to another are monumental moments that shape your mind, your soul, and your relationships.

Birth and Death...

1. ...ARE ALL CONSUMING.  I couldn't think about anything else.  I replayed every detail over and over in my head.  For the first few weeks after the births of my daughters, I thought day and night about their births, my labor, how they were handling life, when they needed to eat, how much they were sleeping and peeing and pooping, and if I was doing everything right.  My brain literally could not focus on one other thing.  For the first few weeks after the death of my brother, all I could think about was his life, his death circumstances, the "what-if" questions, how my life would be different, how his children and my family were coping, and my memories with him.  Other than attempting to care for my children, absolutely nothing else got priority.
2. ...REQUIRE CONVERSATIONAL PROCESSING.  At least for me.  As a doula, I recognize the importance of creating a safe space for the new mother to share her birth story and how she felt during that process.  I understood after my own births how it was ingrained in my soul to share my story and talk about it to reflect and process the events.  After the death of my brother, it seemed that the only thing worth talking about was him.  In the same way that I needed to process the monumental event of birth and new life, I needed to process the monumental event of the death.
3. ...ARE A HORMONAL ROLLER COASTER.  With both, I cry one minute, experience happiness the next, and then guilt about what I could have done differently.  Granted, the overlying feelings of sadness with death and happiness with the birth of your child are inevitable and normal.  But both situations elicited a wide range of emotions that seemed to come and go without explanation.
4. ...CHANGE YOUR LIFE FOREVER.  The path of your future is carved the moment your baby is born or the moment your loved one leaves. You know immediately that your life is changed.  Things will be different.  You'll never be the same person and your life will never feel or look the same.
5. ...REQUIRE A RECOVERY PERIOD AND TRANSITION.  Thank God for maternity leave, right?  Our bodies and our hearts need time to readjust.  We need to experience life with a new human and transition from life without this new baby to life with this new baby.  And that takes time, patience, and sometimes the road is rocky.  We require and deserve some time to figure it out.  The death of a loved one requires a recovery and transition, as well.  Life is not the same and won't ever be the same again.  Your family dynamic, your relationships, your energy and motivation all need to transition from life with this family member to life without.  

Of course, my experience with the loss of my brother may or may not be similar to yours.  If you've lost a pregnancy/child, parent, sibling, close friend, or spouse, your emotional, mental, and physical responses to loss may have felt completely different.  Bereavement is a multi-layered subject, but I think it's safe to say that everyone who is grieving deserves to feel heard, validated, supported, and know their options for moving forward.  

Have you experienced the death of a loved one?  How was your experience similar or different?