Rose A. Devasia, MD, MPH

University of Louisville, Kentucky, United States

 

A silent birth

Photography by Salihan Laugesen

As a physician married to another physician, I tried to do everything right during my first pregnancy. I took prenatal vitamins and folic acid before trying to conceive. I avoided any substance that could harm my baby. Caffeine, sushi, deli meat, wine—gone. I went to prenatal yoga (another name for a 30-minute nap) and took water aerobics. I was expecting an uneventful, normal pregnancy with a healthy baby being born at the end of it. I was certainly not expecting the lessons we would learn from a stillbirth at 35 weeks. Almost like yesterday, I remember the clean bill of health my obstetrician gave me just a day before our fortunes, and lives, changed.

“We usually have some sort of hiccup with a pregnant doctor, but you’re doing beautifully,” my obstetrician observes, closing up an uneventful appointment.

“So far so good,” I reply.

It is Wednesday, and after water aerobics Jeff suggests Indian food. I order my usual chicken biryani, but it is lackluster. After dinner we walk hand in hand through the parking lot. I have a strong but fleeting feeling—I am no longer pregnant. 

Like every woman, I have had a thousand different feelings during pregnancy. Since this is my first pregnancy, it is hard to know what to take seriously and what to disregard. I do not want to be an overanxious patient. Should I call the doctor, complaining that “I feel weird”? I would not know what to say to a patient with such a complaint. But the feeling passes, and I hope for the best.

That evening my baby, Micah, continues to kick intermittently. I wake up in middle of the night. He had not moved as much usual, so, half asleep, I tell him, “Mommy really needs to feel you kick, buddy.” He complies, giving the weakest of kicks as I fall back asleep.

Missing Micah’s usual routine of kicking me awake, I awake at 7:30 a.m. And after showering, eating breakfast, and drinking orange juice—hoping the sugar will get him active—I still feel nothing. I call the doctor, hoping merely this act will get Micah moving.

Called into the obstetrician’s office, I sit calmly. I text Jeff as the nurse struggles to pick up Micah’s heartbeat. I know the strong thud I am hearing is my pulse, not his. 

“He’s moving around so much we’re having a hard time picking up his heartbeat,” the nurse says.

“Well that’s good,” I say. “At least he’s moving.”

But the nurse remains silent. I realize she is lying to me. 

Walking across the hallway to ultrasound, I tell myself not to panic. As the tech moves the wand over my belly, I see Micah on the screen lying on his back without a visible heartbeat, but I still hope. My heart is pounding, and I start to feel cold. 

“I’m sorry.” I hold my breath as the tech continues, “Your baby is dead.”

“Oh God. Okay. Oh God.”

As I sit up, the door flies open. Almost running through the door, Jeff is still in his white coat, his face full of worry and concern. “What’s wrong?” he asks.

“He’s gone, Jeff. He’s dead. Micah’s dead.” I start to cry.

Faced with such an unexpected event, we see the obstetrician who gives us options: I take medicine to induce labor, go home, and return when we are closer to delivery, or remain in the hospital.

Stunned that we have to endure labor and delivery after such a loss, we choose option two. I want this nightmare to disappear. I cannot imagine going home and waiting, knowing we will have to return to the hospital to deliver our dead son. I regain my composure. I have a goal: deliver Micah. For the next 36 hours, that is what I do. Quickly admitted to the labor and delivery floor, I am tucked away in a corner room, out of earshot of all the happy couples in labor. Thankfully each nurse that enters my room to start an IV, to give me medication, or to check on me tells me they are sorry for my loss, occasionally recounting their own miscarriage or death of a child. Grateful for their kindness, I feel less alone. 

Soon after admission, we are visited by the hospital chaplain, who explains her services should I desire them. Then, pulling out a stuffed teddy bear with a T-shirt, she tells me, “We know you were expecting to go home with a child, but many mothers who suffer this type of loss find comfort in having a teddy bear to take home with them.” Without a word I stare at her blankly, hoping that my face conveys my anger. She persists, “Would you like to hold him?”

“No,” I reply coldly and put the bear aside knowing it cannot replace Micah.

She gives me a puzzled look and leaves.

After 12 hours, my back is sore and tight. I am told that I am contracting, but I cannot differentiate between the back pain and contractions. It all hurts. The pain keeps me from sleeping. Afraid of the epidural needle, I persist without pain meds, but eventually the epidural needle seems like the lesser of two painful options. The physician arrives to perform the procedure. I breathe as I bury my face into the attending nurse’s neck. With the prick of the needle, the pain finally dissolves away, and I can finally rest.

The day passes with friends and family stopping by to see us. Most of the time we talk about mundane things—the work day, hospital food, difficulty finding a parking spot at the hospital. One friend stops by with my favorite ice cream in a cooler, and we eat. Occasionally someone makes a joke, and we laugh; I am glad for the diversion.

Late Friday night, the hospital is quiet. As Jeff sleeps on the cot beside me, I start to shake; I find it hard to breathe. When the nurse finds a 102.3 fever and blood pressure of 98/60, Jeff and I look at each other, both thinking the same thing. Am I going into septic shock? The on-call doctor arrives. Since he explains that fever is not unheard of during delivery of a stillborn, we assume it is due to one of the medications I am receiving.  

My body is pumped with intravenous fluids, and with time the fever subsides.  

It is quiet again.

I whisper to Jeff, “I sort of don’t want to deliver. Once Micah is out, it’s all over. Then it’s just the two of us again.” He nods his head and squeezes my hand. 

The two of us were great, but we were planning on three. I had washed all of Micah’s clothes. I had bought baby wipes in bulk and had acquired a portable crib for out-of-town trips. Jeff and I had put together a schedule to juggle both of our jobs and be with Micah. I had future plans about grade school, high school, and even college. I also did not realize how much I liked being pregnant, until it was suddenly taken away from me. There was no longer any point in wishing or planning. 

A few hours later I am pushing and pushing. Maybe everyone was wrong. Maybe by some miracle Micah will be born alive. 

He slides out, and all is quiet. They wrap him in a blanket. We hold him. We marvel at his big hands and feet, just like ours. We laugh about how he would have been a great swimmer like Jeff. He has a full head of black hair like me. He looks perfect.  

Ever the clinicians, we ask to look at the placenta. Normal.

“I shouldn’t have gone to water aerobics Wednesday,” I tell Jeff.

The OB who is still stitching me up pops her head up and looks me in the eye. “It breaks my heart to hear you say that. You did nothing wrong.” 

I weakly say, “I know.” But I cannot help but wonder.

The doctor decides to keep us through Saturday to make sure the fever has completely resolved. I am grateful to remain in the hospital. In the hospital I am busy; there are friends, family, nurses, doctors, and staff who come to my room. I am not ready to go home and feel the pain. I do not want to leave my child behind and all alone. What if the hospital loses him or he is transferred to the wrong funeral home?

Sunday we are discharged from the hospital. I ride in the wheelchair to the car with my eyes closed, not wanting to see the hallway lined with baby photos. The drive home is quiet and so different than we expected. Two driving home instead of three. 

We arrive to a house full of family. I remain in our bedroom. Jeff checks on me. I am sitting on the floor by our bed looking outside. He puts his arm around me. We suddenly hear a baby crying. We look at each other. It is our five-month-old niece from the bedroom beneath ours. “You have got to be kidding me,” Jeff mutters. I start to laugh. Jeff looks at me, puzzled and a little concerned. I keep laughing. “We can’t catch a break, can we?”

And for months that becomes the story of our lives.

My brother tells me to not sit at home, “Go back to work right away, you’ll drive yourself crazy thinking about this.” I do not take his advice. Several friends remind us that many couples get divorced after the death of a child. Day after day patients ask Jeff how his son is doing.

I get used to uncomfortable conversations. “I haven’t seen a picture of your baby.” “You must be excited about your baby’s first Thanksgiving.” I grow tired of saying, “My son died.”

Jeff receives a letter from a distant family member telling us that if we were “right” with God, Micah would not have died. Our God does not kill children. We shred the letter.

A couple of months pass.

“All I need is an email asking how we are doing,” I angrily tell Jeff. “Everyone acts like nothing happened.”

“Everyone wants us to move on, Rose,” Jeff replies.

A few friends do check on us, but most do not. Unsure what to say, they tell us about their children’s accomplishments, the day care they have chosen, the nursery plans. Then they seem puzzled and offended at our inability to share their excitement. I resort to drinking an extra glass of wine to get through painful dinners with friends and come home to cry. Other friends disappear, but somehow remember to send Christmas cards of their children.

Friendships we believed to be strong fall apart. It is easier to isolate ourselves from others than be hurt by their words. At home—just the two of us—we are safe.

Several months later I am driving from the funeral home after having Micah’s ashes transferred to a simple wooden urn. Micah sits in the front seat. “This is not what I imagined when I thought of driving around with you,” I say aloud. I place him on our bedroom dresser and kiss the top of the urn. There he sits.

 


ROSE A. DEVASIA, MD, MPH is an infectious disease physician. She is an assistant professor in the Department of Epidemiology and Population Health at the School of Public Health and Information Sciences at the University of Louisville. She now spends much of her time taking care of her six-month-old twins, Seth and Zoe.