This last week of work has been really hard on me, so I am sorry I have not posted sooner. Whenever someone hears that I am a labor and delivery nurse, they say,"Awe, that must be so much fun, you must love it!" Well, yes, I do love my job, but what no one else but a labor and delivery nurse thinks about is that sometimes things don't go as well as everyone would hope. In every job there are frustrating parts and my job is no different. It is frustrating when you see mother's who do not take proper care of themselves or their unborn child. It is frustrating when you see a mother that cannot possibly care for or provide for this child because they are so young or have so many or both. Those beautiful scenes that you are picturing are rare. You know, the one where the couple love this baby even before he is conceived and now they are here having the perfect labor and delivery. They are both crying tears of joy as is both of their whole families in the waiting room. The mother looks down at her beautiful (yet a little goopy and bloody) baby and says, "Hello, my love." (i actually had a patient who said this once, i cried). These are the scenes we live for, because they do not happen that often really. Then, the absolute hardest part of my job, when the baby dies, either before they get to me in Labor and Delivery or because of a labor complication or because they are so preterm.
It seems that every 6 months since I had Matthew I have a patient that has a placental abruption (or abruptio placenta). When the placenta tears away from the uterus before birth. If the placenta detaches there is no blood flood to the baby. The babies do not always die, if we can get the baby out before the placenta completely detaches. When I put the mother in the bed and try to find they heart beat and I can't, and I look and look and after about 5 min start to get a sick feeling in my stomach, I think, "Please, Lord let me find this heartbeat." When, I have to look into the mother and father's eyes and say," Well, I am going to call the doctor so he can look with ultrasound, and they see in my eyes what I already know. When, the doctor comes in and with tear filled eyes tries to explain to them what happened, it's not their fault, etc. Then, instead of sitting down and crying, we have to get back to business, we have to get the baby out before the mother's bleeds out. While, we are explaining (usually a cesarean section at this point with a close to term abruption) what must be done with tears streaming down our cheeks and our noses running, we try to hold it together. When the doctor hands me the lifeless baby in the OR, then I usually let go and cry. I hold the baby before the mother does and cry and hold him and cry. Cry for this couple who now will ache for this baby until their dying breath, cry for their families who cannot understand what happened, and cry for myself and my own memories and what might have happened.....
These situations are hard on every labor and delivery nurse, but I especially have a hard time and thank goodness all my co-workers know why and try to be strong for me......
When i was in labor with Matthew it started out similarly to Avery's in that it was back labor and was long. Both my kids were occiput posterior or face up, which causes you to feel the contractions in your back and lower pelvic region. These labors and long and more painful than if the baby was positioned face down. The doctors say,"it's like trying to fit a round peg in a square hole, you can do it, but it's hard." lol. Anyway, things were progressing slowly and I was at home. (I did not use epidurals for my kids, just my preference). After about 10 hours and still not much change, I was in the bathtub waiting for a friend of mine who was coming by to check on me. I felt some fluid come out in the tub, it was bloody. Sometimes, it is a little bloody, so I wasn't worried, but then my contractions were coming back to back. I was like, ok, my water broke this thing is on finally! By the time Nicola got to my house I was feeling pressure and really moaning during the contractions. She said,"It's time for you to go." She stayed with Avery until my mother and mother in law got there, so Shaw and I could go ahead and go to the hospital. Nicola noticed the blood and told Shaw to hurry there was too much blood. After we left, she called the hospital to tell them we were on our way. Then, she went upstairs to my bathroom to clean up a little and saw blood all over the bathroom, the carpet, a couple towels. She knew then, this was not ok. She called to labor and delivery and talked to my doctor, Dr Kent. She told him about all the blood and he said, ok he was waiting on me they were ready.
When we got there, they were waiting on me on the ramp. It's nice to know everybody in a situation like this. Another friend, Jen, was waiting with the wheelchair. She said, ok when this one is over let's get in the wheelchair. They waited and waited, and waited some more. She felt my belly and it was staying firm, no breaks. She said, "Shaw, help my get her in this chair, we need to go!" I remember being flown back to my room and saying, "OH! I wanted room 5, where Avery was born!" They were like TOUGH! get in the bed. My actual nurse was Kim. She put me on the monitor and the baby looked ok. Kim said (knowing i did not want pain meds),"do you want the monitors off? I said,"no, they are fine." i really didn't want anyone touching me to be honest about it. Dr. Kent checked my cervix and I was 8-9 cm's., but my water was not broken yet. ( it was just blood that I had felt and saw).I remember Dr. Kent saying something about I needed something for pain, I was having to hard of a time. Kim, said, "No, Dr. Kent. that's not what Gretchen wants." The baby was having variables (decelerations with contractions) then, i saw them on the monitor. Well, that sometimes happens at the end of labor, but they started an IV then. Then, Dr.Kent wanted to put a scalp electrode on to monitor the heartbeat better and to break my water. So, he did. That's when everything happened. When he broke my water and put the monitor on his head, blood poured out and his heart rate went straight to 40(normal is 120-160). I was so out of it, I didn't even realize what was going on. The said turn to your side, I didn't comprehend. Shaw finally went over to me realizing something was wrong and turned me. I heard Dr. Kent say," It's time to go girls, NOW!" Kim still trying to help me have my natural labor said, "Well, maybe she can push, it is her second baby. They let me try once, but he was still so high, i didn't feel the urge to push. Dr. Kent said after i tried once,"NO, let's go now, let's go. Gretchen, I will see you in the OR!" I still didn't comprehend until I looked over at the fetal monitor and I SAW the 40, 40, 40, 40. The baby wasn't even trying to come up, usually they at least try. Then, I got it. I stood up and walked over to the stretcher to get on. Jen said,"Wait, i will help you." but now I got it and I understood- I might LOSE this baby, he might DIE!!!! let's go now, 10 min ago!!!! NOW! I looked at Shaw and said, "this is bad, babe. You need to pray!" He said, I will , i love you." And then we went, no catheter, no preop meds, no IV fluids (I did have a heplock at this point). No anything, let's just go! On my way to the OR it was surreal. I remember thinking,"This is not happening, there must be a quicker way to get the baby out than THIS! I cannot have a c-section." But then, reality kicked in, this was the best way. When I got into the OR Dr.Kent was waiting on me already scrubbed and sterile. He said, "Shug, get on the table, quick!" I did. I lay down and saw more familiar faces. I wanted to say, "Please, save my baby's life! What will we do if we lose this child!? We have waited so long for him, all of us, even Avery. (we had 2 miscarriages after Avery, before Matthew). PLEASE, LORD,PLEASE!!!!!! Finally, I cannot lose MY Matthew!" but that's now what came out. Guess what came out? I told the anesthesiologist Dr James, I need some Zofran!" He said ok later.... Then, Dr.Kent said, "Have you peed lately, Shug?" Remember, no catheter. I saw him hold the scalpel over my belly and watched it come down (no drape either) to my belly and then I was out... When I woke up in PACU, my baby was alive and surprise surprise, it WAS another boy! He was still sick and getting a blood transfusion. Later, I found out that I bled and bled and poor Dr. Kent, who is more like family after 8 years of working together and taking care of me with Avery and my miscarriages, was talking to me when I was asleep, "Now, Gretchen, you cannot do this to me, you have got to stop bleeding, you cannot do this!" I finally did stop after losing 2 liters or more. My friend Nicola made it just in time and was met with the admissions clerk saying, " You need to hurry, your friend is in trouble!" She made it to the OR and was then met with Shaw in the dressing room connected to the OR on his knees, crying and praying to save our baby's life! She said when she saw me with the ET tube in my throat and my eyes taped shut, she lost it. She said all she could do was cry and pray (well that was enough after all). She was their when I woke up in the PACU. Shaw was not allowed in there. Shaw had taken a picture of Matthew and as soon as my eyes opened, she put in my face and said,"it's a boy, he's ok, he's ok." Shaw wrote me a note on the back of it that was so sweet. I said, "Where is my husband?" and "why did this happen?" Of course, i knew the answer, there is no answer, because it just does sometimes. The recovery was hard for both of us, but I will not do into that, since that is not the point of this story. Thank you, Lord for saving my baby's life and giving Matthew to us!
Matthew's first picture
Matthew getting blood
Sleeping peacefully
Bath time with Big Brother
This experience affected not only me as a labor and delivery nurse, but my coworkers as well. Everyone was crying and praying for me that day, everyone was in a fog for the rest of the day. So, when I have a patient who has an abruption whether we save the baby's life or not, it is very hard on me. I usually get a migraine, one time my whole mouth was filled with canker sores for a week, after a particularly stressful one. I usually have a hard time holding it together especially when the doctor hands me this lifeless beautiful baby, this could have been my Matthew! I know that the Lord saved my baby for a particular purpose and this was his plan for Matthew. I know that it was the Lord's plan not to save this other baby's life. I know, I must trust that He knows what he is doing and this was not an accident that He could not have prevented. He could have prevented it, if it was in His plan. I also, know that just because we have faith in the Lord's plan, that doesn't mean we ought naught to grieve. Grieving is biblical, and so grieve I do for these parents. I cry without shame, hold the baby and cry, hold them and cry, hold their family and cry. I only hope as a nurse, that in some way can make such an awful thing a little better by truly grieving with them. I know this is long, so I will close, but I do want to say one more thing about the girls that I work with at night. We have become so close over the last 10 years, that we finish each others sentences, don't have to ask before they are already doing it, and if it were not for these people, I could not make it through these hard times at work. I know they understand me and I understand each of them. We are not ashamed to cry together, pray together. I know that their faith in our Lord is strong and together we will get through these truly hard times at work.
Matthew 5 months old and Avery 31/2
