Thursday, August 14, 2008

Life Isn't Fair

I've been thinking a lot about our fetal demise yesterday. This wasn't my first demise that I've helped with, but it's the first one that has been anywhere near term, and the first one that was actually considered alive at delivery and then died later. I guess the technical term is "expired" but that to me sounds like a gallon of milk being past it's expiration date. This is a baby, not a gallon of milk.

When Mom and FOB walked in yesterday it just hits you "THIS ISN'T FAIR!" Mom was only 21, and her first baby and she looked so young and innocent, and yet so grown up and calm and collected. I know when she walked in she was still denying that her baby wasn't going to make it and she had this secret hope inside that everything was going to be ok. When we asked her the typical "why are you have a primary c/s" question, she didn't say it was because the baby was breech, or that the baby was going to die. She said "because the baby's head is too big to fit through my pelvis." Just like it was a normal problem that lots of babies had. I didn't see a tear or really hear her say much of anything the whole pre-op process. As her nurse, what was I supposed to say? I haven't decided if it's best to dive right into the whole "I'm sorry your baby's gonna die" speech, or if it's best to wait for them to talk about it first. If I don't say anything, then I feel like I'm just avoiding the subject, and I know that's not really the right thing to do either. But shoot, it's not an easy conversation or subject to bring up!

When the baby came out in the OR, the body came out and it looked totally normal. Baby was breech, so they got the legs, butt, arms, torso, shoulder out, and then the head kinda got stuck. From the US's we knew baby was going to have hydrocephaly (fluid on the brain so a swollen head), but it took lots of pulling and lots of fundal pressure to finally pop the head out. The head was very enlarged, and the body was limp and floppy. The eyes were wide open, but they never moved, never blinked, just started. There was never an attempt at breathing, but the heart beat for 2 hours. It's not fair.

I felt so sorry for the FOB in the OR. He totally broke down and just sobbed in the corner. Mom's dad was in there too and was taking pictures of the baby like any proud grandpa, and I never did see him cry. I was so proud of the FOB, he held the baby and sat by Mom and they cried together.

I remember when I didn't pass my boards and I felt totally empty inside, like everything I had worked so hard for was totally gone and nothing would ever be right with the world. Dad told me that maybe this was God's way of helping me to identify in just a small, small way with the Mom's I would work with who lost their babies. I didn't really think I'd be able to try out that theory so soon. I think he was right though.

I can't decide which of the horrible situations would be the "best" either. To know all through your pregnancy that your baby wasn't going to survive after they were born, or to go through your full pregnancy, or even part way through your pregnancy, go into labor, and then find out...I pray, pray, pray that I won't ever have to really find out. I just wish I knew what I could say to help those mom's in some small way. I know after boards, no matter what anyone said it didn't really help. Everyone was so kind and said the "right things" but there just isn't really anything you can say to make it better. But saying nothing isn't the right thing to do either.
This is the part of L&D nursing that just makes no sense. While there's nothing like seeing a baby come into this world, there's nothing like seeing one slip out either. I wish we could have one and not the other.

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