July 2, 2009

Another one year ago post... July 2nd, 2009, in the morning, I still had hope that Sierra was alive, that my ultrasound that day might even show that she had grown a bit.  She moved so little in those last couple weeks that I really was not certain if I'd felt her or not in the few days before July 2nd, but I thought I had.  The ultrasound was at 2:00 PM.  We went in and the sonographer said that the doctor didn't want a growth estimate this week, so she was just going to check for a heartbeat and look at the fluid level (which had been consistently very low).  I knew this was because my ultrasound the week before had shown a big decrease in placental function.  I protested, though, feeling like the doctor was giving up on my baby, and said I still wanted to know her size because we were still considering delivering her.  The sonographer's eyes were kind and slightly sad, and I caught myself then and said, "Well, let's just see if she's still alive, first."  The transducer was only on my belly a few seconds before she shook her head and said softly, "No, she's not.  I'm so sorry; there's no heartbeat."  As she pointed out Sierra's still heart, I told her, "It's okay; we were expecting that."  She responded, "I know, but it's still very sad," and that was when I started to cry.  I reached over to hold Tim's hand and we both wept silently as she finished the scan.  (Of course it wasn't okay, but for some reason I felt I needed to comfort her.  And alongside the heartbreak, I did also feel a bit of relief that it was over, although this wasn't in any way the ending I'd wanted.)

We went home to collect some stuff, and then went back to the hospital a few hours later.  Labor was induced that night and Sierra was born at 11:16 AM on July 3rd.

She was tiny, just 12.1 ounces and 10 inches long.  Her feet were about an inch and a quarter long.  She had probably been gone four or five days, the nurse told us gently, and her fragile little body had some indications of this.  But her feet were just lovely - perfect miniature replicates of Tim's, with the second toe longer than the first.  I'm starting to be able to look at her pictures now, and especially these footprints, with affection as well as sorrow and remorse.  This is my daughter and I love her.  But oh, how I wish she were alive in my arms right now.

June 2, 2009

The last ultrasound photo I have of Sierra is dated June 2, 2009 - exactly one month before the ultrasound that would show that her heart had stopped.  This photo is blurred because of the lack of amniotic fluid, and it's one of those frontal face "alien baby" shots, not a profile.  It made me cry when I showed it to a friend the day after it was taken.  I didn't like anything about it, but I kept it on my desk all of last June to remind myself she was still with me.  After her death and birth, I put her handprints on my desk in the same place that picture had been, and I put the picture at the very end of her photo album.  I still don't like it - the skeletal face, the fuzzy image that reminds me our placenta failed - but it will stay in the album.  It's the last picture I have of her alive.

More miscarriage memories

So the D&C was scheduled for April 17th, and on the 16th I went to the hospital to complete a bunch of paperwork.  As I sat in a small office near the front doors, filling out forms, a woman came into the lobby area with her newborn and several members of her family.  I was surprised at how painful it was to see this mother with her new baby while in the process of losing mine.

On the morning of the 17th, we went to the hospital.  I remember feeling very much alone as I left Tim and Austin in the waiting room and followed a nurse back to the pre-op area.  The first thing I had to do after undressing was get on the scale, and I noticed that I had lost 5 pounds in just a couple of days.  I guess it really is over, I thought.  The nurses were very gentle with me, holding my hands, bringing me kleenex, saying they were sorry.  The doctor came in at some point to explain the procedure, and when she said that she would "remove the contents of my uterus," I started to cry.  Those contents included my baby.

Eventually the anesthesiologist came in, and he greeted me with, "So you're having an abortion?"  I know "spontaneous abortion" is another term for miscarriage, but I responded, "No, I'm having a D&C to complete a miscarriage; I wanted this baby, but it died."  He immediately apologized, and then got down to business.  The drugs worked fast and the rest is very hazy.  I vaguely remember being wheeled into the OR, told to shift myself onto the table, the mask, counting backwards, and darkness.

The next thing I remember is hearing two nurses talking.
"Is she okay?"
"Oh, yes, fine.  But it's a very hard thing, and all that emotion has to come out at some point."
I can also hear someone crying - loud, harsh sobbing - and gradually I realize that I'm the one making that sound. (This was a really strange experience and I can't exactly describe it - I was awake before I realized I was awake - or something like that - it was just weird.)  The nurses I heard are on either side of me, wheeling my gurney to the recovery area.  There's a box of kleenex on my chest and the one who spoke second is looking at me with sadness and compassion in her eyes.  They get me situated and the first nurse leaves quickly.  The second one stays; she will care for me for the rest of the time I'm in recovery.  As soon as my conscious mind caught up and realized I was awake, I stopped crying, and now I just feel numb and sleepy.  The nurse gets Tim and Austin; they come to see me but Austin is afraid, clinging to Tim and peeking at me.  I realize I don't look like Mama - my face is swollen from the drugs and tears and I'm pretty spacey - and this makes me sad.  They stay a few minutes, then head back to the waiting room.  The nurse is wonderful, very compassionate.  I think I doze for a while longer, then wake up enough to go through the paces - have the IV removed, drink juice (she brings me crackers with peanut butter, too, noticing that my surgery was delayed and it has been almost 24 hours since I've eaten), stand up, walk to the bathroom, pee.  Then I can get dressed and go home.  A friend has left a casserole in our fridge - moussaka - it tastes marvelous.

The next day is a Friday, but I don't go to work.  It's a gloriously sunny, blue-sky day.  Tim sets up the hammock in our yard and he, Austin, and I lie in it together.  I feel empty and sad and alive and loved, all at once.

Two years ago today...

I'm in an ultrasound room at the hospital, the little local hospital, not the big one where I would have all my ultrasounds with Sierra.  This hospital generally doesn't do maternity ultrasounds, but the sonographer at my regular practice across the street is out sick and I'm bleeding, so I've been sent to the hospital to have it checked out.  I've had to undress from the waist down and put on a gown and robe over my shirt; I've never had to do this for a pregnancy ultrasound and I feel awkward, hot, and anxious.  The sonographer who came to get me after I undressed looked almost as nervous as I felt, and she stammered when I asked her if Tim and Austin could come in with me.  Eventually she decided to allow it, retrieved them from the waiting room, and now here we are, all crowded into the small, darkened room.  I lie back on the table and try not to wince as she squirts cold gel on my belly and appologizes that the warmer isn't working.  Tim is tucked into a little chair by my knees, 19-month old Austin wide-eyed and quiet on his lap. 

She moves the wand across my belly and I crane my neck to see the image, to search for the flickering heartbeat that I saw on an ultrasound six weeks earlier and heard again just three weeks ago.  By this point it should look like a baby.  And it does, pretty much, but the image is small and I can't see any movement at all.  The sonographer takes some measurements quietly and without looking at me.  Finally she asks, "How far along are you, again?" 
"Thirteen weeks, two days." 
"Oh...ummm...the baby is measuring 11 weeks, 1 day."
Tim finally speaks up, "It isn't good, is it?"  She frowns at him, then finally admits she can't see a heartbeat, and I think yeah, I knew that already.  And then she gets a little agitated, tells us not to jump to conclusions, she isn't sure and she isn't supposed to say anything anyway and she needs to get a radiologist to confirm.  And Tim and Austin have to leave the room.  And then she shoos them out and walks out behind them before Tim or I can say anything more than, "But..."  The door shuts and I'm alone.  I don't cry; I am too shocked.  I just wait.

The sonographer comes back a few minutes later with the radiologist.  They put the wand back on my belly and peer at the screen.  It's turned so I can barely see it now.  They talk very quietly to each other.  After a minute they decide to do a transvaginal ultrasound.  The sonographer grabs that wand, and says, "You've had one of these before, right?"
"Actually, no, I haven't." And I'm scared and you made my husband leave.
"Oh, well, it's just like a tampon."  And in it goes.  More peering at the screen and talking in near-whispers.  Finally the radiologist tells me that there is no heartbeat but we should go across the street to the OB office and one of their doctors may want to confirm.  He says he's sorry, but his eyes just tell me that he is uncomfortable and can't wait for me to leave.  I think about how much I do NOT want to cry in front of these people, and I do manage to hold it together, get dressed, locate Tim and Austin.  Tim is angry and looks as shaken as I feel.  We walk across the street.

We are treated completely differently here; everyone is gentle and sympathetic - and unfortunately, all too familiar with this sort of thing.  The receptionist calls a nurse who immediately takes us to a room and alerts the on-call midwife.  She comes in a little while later, and it's the midwife I feel closest too, the one who delivered Austin.  She hugs us all and says "I'm so sorry.  This baby seemed fine just a couple weeks ago.  Tell me what happened.  When did your bleeding start?" And suddenly I begin to sob and can't answer.  She gives me tissues and another hug, sits and talks with us for a long time, assures me I did nothing to cause the miscarriage, tells me she has had miscarriages too and they are heartbreaking.  Austin flirts with her and smiles at Tim and me, playing peekaboo with Tim's hat.  "He sees your tears and knows you need him - and no, this experience will not hurt him."  We tell her about the ultrasound and she says she'll talk with the radiology department about how they treated us.  We decide I should have a D&C. 

To this day, I regret not asking for pictures from that ultrasound.

Seven months

After passing the six month mark, I actually had a string of pretty good days.  We flew across the country to visit my family, and while the plane trip was tough, being there was good.  Traveling as a family to go see family made me very aware of the fact that someone was missing, but beyond that it was really okay.  But then last weekend Tim and I had a silly argument and just that was enough to push me right back down into a really dark place.  Last week and the beginning of this week, I've really been struggling.  I miss her so much, I'm so sad, and I'm so frustrated that I was starting to feel better and now I'm back in a darker place than I've been in quite a while.  Last night I dreamed I was pregnant, full term, in labor, but I had barely any belly bump at all and I knew the baby was going to be born too tiny to survive.  People were asking me how I could go through a whole pregnancy without the baby growing.  I woke myself up before the baby was actually born. Today I was a weepy mess, fighting to concentrate at work, and now I'm exhausted.

I know that grief is not linear, that it's normal to feel like you're taking one step forward and three steps back at times, but I haven't really felt that yet - not until now - and it's just discouraging and frustrating.  I also feel like I'm just now grasping the fact that she's really gone - forever - and that at least some of this grief will be with me forever, and the weight of that thought is crushing me. 

Last week I stumbled onto a website with a list of babies born alive weighing less than a pound who survived their first year, and in several cases, went on to be relatively healthy teenagers or adults.  I'd seen this list before, but not since we were trying to decide if we should deliver Sierra, weighing an estimated 12 ounces, or not.  Not since Tim calmly and gently said, in response to me saying that some of these tiny babies do survive, "well, some people win the lottery, too."  Delivering her certainly would have been a huge gamble, one where the person with the most to lose would not have had the option not to play.  In the end it just seemed too risky to deliver her, and we chose to let her go relatively peacefully in my belly.  I thought I was working toward peace with that decision, but that damn website has me wondering again.

The word IF just keeps echoing in my head...if I hadn't continued to nurse Austin while I was pregnant with her...if I had gained more weight, eaten better despite the food aversions I had at first...if I had been as physically fit as I was when I got pregnant with Austin...if I had gone on complete bedrest instead of just restricted activity...if she had been just a few ounces heavier...if she had been just a few weeks farther along...if the placenta had been just a little less damaged...if we had delivered her anyway, at 27 weeks and 12 ounces...would she be here in my arms right now? would she be healthy?  I'll never know and I'll probably always wonder.  I don't know that I'll ever be completely at peace with our decision, although I hope, with time, I'll be more so than I am now.  We love you, baby girl, and we did the best we could.  I'm so sorry.

Six months

A year ago (give or take a day), despite being in a hotel room (with Austin) at a scientific meeting, Sierra was conceived.  Six months ago, she was born, having died a few days earlier.  January 3rd to July 3rd - her entire life, only six months, all of it in my womb.  July 3rd to January 3rd - my life without her, so far.  Six months.  She has now been gone for as long as she was here.  A year and a day or two ago, she didn't exist.  Her entire life was contained in 2009 - the first half spent growing her, and the second half spent mourning her loss.  Not the way it was supposed to be at all.  She never saw the world outside of my belly, but she was here and she was real and I miss her.

I find that I keep repeating that - she was here and she was real.  I say it to others, almost defiantly, but I'm trying to convince myself, too.  She was here for such an incredibly short time. 

As I lit her candle at the dinner table on Thanksgiving, I said I was doing it because it was our first Thanksgiving without her.  But as those words came out, I was thinking, but we never had a Thanksgiving with her.

Six complete months.  Twenty seven weeks and five days.  I always add the five days, or round up to twenty eight weeks, to make sure to count every day that she was with me.  Such a short time.  And if she feels like just a dream to me, how can I possibly expect her to be real to other people?  But she was here and she was real and I miss her.  And I love her.  And I always will.

Five Months

December 3, 2009

Dear Sierra,

I miss you so much, baby girl.  The darkness and coldness of winter - and the holidays - have only increased my longing for you.  I remember so clearly your brother's first Thanksgiving and Christmas, and I think of how you should be the same age he was at this time in 2006.  On Thanksgiving we lit a candle for you (and Uncle Todd and some others missing from the table) and it burned between Daddy and me for the whole meal.  But I kept imagining you sitting in my lap or in the infant carseat like Austin did his first Thanksgiving.  My mind adds you in everywhere - kicking happily on a blanket on the floor while I'm playing with your brother, in the backseat in your carseat when I'm driving, riding snuggly in your sling while I'm shopping.

Thanksgiving was sort of hard, but good too.  Austin was sick, and one of our friends had very definite ideas of how the cooking and everything should go and made me anxious.  And, of course, you were missing and I was sad.  But we did have a good, low key celebration with just a few friends in a very beautiful spot in Vermont.

I usually love the build up to Christmas.  This year I feel like I just don't have the energy or the heart for it.  But I'll do it for Austin.  I'm grateful for his enthusiasm.  He's so excited for it this year, making his list for Santa and planning what gifts he will give to Daddy, Grandma, his Aunties, and so on.  I will do it for him, and I'll think of you and how you would have loved the lights on the tree, the excitement of your brother, the motion of snowflakes in the wind, the sparkle of your first ornament.  I wish you were here, little one.

All my love,
Mama

***

I'm still thinking of ways to include Sierra at Christmas.  I want to get her a "baby's first Christmas" ornament with her name on it, and I'm trying to decide what to do with my Christmas cards.  I might put in a card with a picture of her footprints and her name and date - basically a birth/death announcement, which I never did formally.  Or I might just write an "In memory of..." line under our names when I sign the cards.  I'm going to include a picture of Austin, which is what made me think of including her footprints, but is that too sad for Christmas cards?  Any advice or suggestions?  How are you including your baby(ies) this holiday season?