Hey Jude — Ending a Chapter

Today, Jude is two years and 10 months old. In exactly eight weeks, we’ll (okay, I’ll because let’s be honest about who’s doing the ‘heavy lifting’ here) hopefully deliver our fourth and final baby via scheduled C-section on December 21 at approximately 37 weeks.

I don’t know if it’s the sleep deprivation that’s –this time—come from excess work or the reality that this is it, but I’ve been so much more emotional in the past few months than I have been in the past year when I think about and talk about my Jude.

If you’ve ever lost someone, first, I’m very sorry. Second, you know that most of the time…you’re okay. You mourn privately and usually on anniversary days, perhaps their birthday or the day they passed away, but otherwise, you don’t walk around with your emotions bubbling below the surface (that’s not to say you’re not always thinking about your that you don’t still love the person you lost, of course).

I’ll admit that I thought I was past the point of spontaneous tears, but it seems I’m not. Because we don’t know the gender of this “mystery baby”, I ordered a very cute “Baby’s First Christmas” outfit in the newborn size. As soon as I did, I thought about the what ifs…a great thing for when I’m writing fiction; not so much for when I’m thinking about what could happen between now and December 21 and even afterward (I’m very anxious about delivering at 37ish weeks and about possibly having to have a steroid shot to develop the baby’s lungs prior to; I’m also anxious about the baby having medical complications due to being delivered so early.).

But, the what ifs…they come whether you want them to or not. Before I could hit stop and eject on the thought process, my mind was at Jude’s funeral, and I was standing in front of that little teeny satin box, and his teeny body was in it and dressed in his little blue outfit, and he was there, but he wasn’t, and …just thinking about it, it makes me cry. I miss him so much. I’m so afraid of going through that again. The thing is, it’s okay that no one can say anything to make it ‘okay’ because it’s just not okay.

There are some things, some circumstances in life that are too complicated for words to make right. I think about my friend who brought coffee the next day at like, 6:00 in the morning before her shift at the hospital. It was coffee. That stuff most of us drink every day so our facial muscles function properly (I might be over-sharing here.) But, you know, it was so much more than coffee. It was just…showing up and wanting to help and bringing that one little comfort that I couldn’t get. It was her tact in not trying to say the “right” thing because there really is no right thing you can say.

I’ve observed more and more people put their foot in it trying to say the right thing instead of just keeping their mouth shut. I’m still a member of the Pregnancy after Loss group, and what some of these women endure is surreal. One pregnant “friend” asked a mom two months after her loss if she could buy or have her baby things since she wouldn’t need them. Other times, people suggest that the women can always have more babies, or they suggest that if they already have one child, “At least you have (first child / children).” They don’t understand why the women don’t celebrate when and if they can / do get pregnant again.

I know I’m not as sensitive to some stimuli as other PALs, but I get being pregnant again not necessarily being a cause to celebrate. It’s like walking across one of those broken wooden rope bridges in an Indiana Jones film. Maybe you’ve made it once, maybe you haven’t, but there was that one time where the board beneath your feet broke and you fell. You almost died, and it took every ounce of hope and humanity that you possessed to get up and to climb back to the top of the cliff and to start walking again. The walk is never the same. Every step, every board looks nefarious. It doesn’t matter that a team of engineers are encouraging you and assuring you that everything looks great with this bridge. There’s no reason for you to not make it to the other side. You want to believe them. You want to enjoy the scenery on the walk, but there’s no foregoing the trauma from “the fall.”

Eight weeks, especially the last eight weeks are the most treacherous part of my pregnancy journey. I’m trying really hard to hold it together as I cross the bridge, but I’m scared of heights, and I don’t like pain if I can avoid it.

I don’t want to fall again. I want to make it to the other side just one more time because this is the last time. No matter what happens on this journey, this is it. It’s not that I couldn’t try “one more time” if the unthinkable what if happens. It’s just…I don’t want to. It’s too much on me and on Sean and on our family. Being able to have children is and has been a blessing to us, but the emotional and physical burden isn’t healthy.

At the same time, closing this door somehow causes me to feel like I’ll lose a little piece of Jude. I can’t tell you how many times I’ve felt kicks or had headaches or experienced some other nuance that reminded me of Jude’s pregnancy. I’m going to miss that. I don’t want to let go of feelings that make me feel more connected to him, even if those are the same feelings that make me cry uncontrollably when I hear about someone else’s trauma or when I think about the “what ifs”.

Like all endings, this will be bittersweet. Right now, the hope of just having a healthy baby in eight weeks fully overshadows the gravity of this life transition, but I know that once it sinks in, I’ll (hopefully) be complete in a sense and can celebrate starting a new chapter while reflecting more meaningfully on the one that I’m about to turn the page on.

***

Dear Jude,

I don’t know what to say other than I love you, and I miss you. I wish I could remember you better. A PAL was asking if other moms looked at their baby’s tummy or patted their little bottoms, the kinds of things that moms do when their baby is alive. I’m sorry that I never saw what color eyes you had or changed your little diaper or gave you a bath. I remember your feet and hands; I love your feet and hands. I love the way it kind of felt like you held our hands. There’s a part of me that’s not in this world because you’re not here. I appreciate that you make me a stronger, better person in so many ways. I wouldn’t be who or where I am if not for you, and that’s not something I can necessarily say to your sisters or to mystery baby, so you’re very special to me. I just miss you, and there’s a selfish part of me who wishes she could have you here. I wish I was planning a little third birthday party right now and perhaps complaining about how hard it is to plan a birthday party at Christmas time and just be completely unaware of how nice it is to have that problem. I don’t mean that people who have that take their precious babies for granted because I know that they don’t, but I just wish…that was the most of my problems.

Anyway, I love you so much my beautiful boy. I’ll see you one day –sooner than later in the grand scheme of things.

You’re in my heart.

Love,
Mommy

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Hey Jude – Somewhere Over the Rainbow

I’ve always liked the expression that life is stranger than fiction because it is. In fiction, scenarios are contrived. If you want it to, love conquers all; the boy gets the girl; the bad guy gets what’s coming to him, and the good guy wins in the end. In reality, life is dirtier and messier. Bad things happen to good people; some bad people never get their just desserts. Life can seem unfocused and random at times, which is why many people believe that events in life are purposeless.

Without saying that everything happens for a reason, I believe it’s possible to find meaning in most things. Losing a baby, losing Jude, wasn’t one of those things I was going to try to find meaning in beyond what joy Jude had, has, and continues to bring to my life. You see, when someone suggests to a grieving mother that she lost her baby for a reason, there are very few conclusions she can and will arrive at that don’t lead her to conclude that she’s a terrible person.

After we lost Jude, some very well-intended people suggested that perhaps it was a wake-up call for us, which I reasoned if I needed such a powerful “wake-up” call as losing a baby that I must be a terrible, horrible human being completely unfit to so much as breathe the same air as everyone else; however, I realized that though well-intended the suggestion (as it aimed to give some purpose to the nightmare of suddenly and without explanation losing Jude), it wasn’t accurate. Pain and punishment aren’t doled out to bad people just like riches and rewards aren’t doled out to good ones; this was something that our priest talked about during church on Sunday and is something that we –humans—struggle to understand.

Thus, I was content to accept that no special meaning or greater purpose had to be attached to Jude’s perfect life. He was pure, innocent, and he was love; there didn’t need to be more to it.

When we became pregnant with Eilie five months after losing Jude, I knew their due dates (Jude and Eilie’s) would be close; you’d think it would’ve been difficult when I found out that Eilie’s gestational due date was February 11, 2016 one day and one year off of Jude’s gestational due date of February 12, 2015. It was even more ironic since Jude’s scheduled C-section would have been February 11 as it’s my mom’s birthday. I took the situational irony with a raised eyebrow and a grain of salt.

After all, Eilie and Jude wouldn’t come close to sharing an actual birthday; Jude was born still on December 26, 2014; Eilie would hopefully spend at least six more weeks in utero to be born on February 4, 2016 at 39 weeks.

Like her brother, Eilie was scheduled to be delivered via C-section. Other than my copious anxiety during her pregnancy, everything relative to Eilie’s development and pregnancy was perfect (this is the actual word that my doctors used). I did a weekly non-stress test with my regular OB and a weekly biophysical profile with my high-risk doctor. Toward the end of the pregnancy, I sheepishly told Dr. B. that, “I felt bad seeing a high-risk doctor with such a healthy pregnancy when there were women out there (with losses) with real problems (in their pregnancies).” He kindly told me I was right where I needed to be.

On Tuesday, January 26, 2016, thirteen months after losing Jude, I wrote my monthly letter to Jude. That afternoon, I went to see my regular OB. Like clockwork, I was hooked up for the non-stress test. After a while, my doctor’s nurse came in and said, “Now, I don’t want you to freak out….”

“I know,” I cut in. I smiled wryly. I’d had a feeling something wasn’t right; Eilie hadn’t done her usual gymnastics during the non-stress test. So, just like I’d done with Jude, 13 months and almost to the hour before, I allowed myself to be escorted to ultrasound for a biophysical profile of my baby. I was surprisingly calm. I texted my mother who would call my aunt who was watching Lillianne to tell them I’d probably be late and to have my dad pick up Lillianne when it was time for my aunt to leave. I called Sean who was leaving work an hour out of town right to tell him not to panic or to rush but that we were doing a biophysical profile…that I was sure everything was fine (even though I wasn’t completely sure).

My doctor, Dr. T., sat through the biophysical profile with me. Everything was gradually checking off of the list of requisite things for them to observe. Fluid levels and Eilie taking a breath were the two things I was most concerned about; those were two abnormalities in Jude’s biophysical profile. It felt like an eternity, but Eilie finally took a breath. And after roughly 20 minutes, the BBP concluded with Eilie hitting all of her points. During the test, I tried to envision myself going home that night, going to bed, and sleeping. It was so conceptually absurd. I mean, there was just no way I’d sleep.

We walked back to the office, and instead of being checked for dilation (typical at 37-38 weeks) as we were planning, Dr. T took me into her private office. “So, I don’t know how you feel about this, but I’d like to send you to the hospital for a couple of hours to sit on the monitor. It would just make me feel better.”

“Yes, I think that’s a good idea,” I concurred without hesitation.

Soon, I was on the monitor, and Sean was there. “Did you know you’re having contractions?” a nurse who fluttered in asked.

“Really? No, I had no idea,” I said, amused at the phantom contractions. I’d had some great inner thigh cramps because of how low Eilie sat in my uterus throughout the pregnancy, but I certainly hadn’t had any contractions I was aware of (other than Braxton-Hicks). Because Eilie had resumed her usual level of movement, I was at ease.

A few hours after we’d been checked in, there was no indication we were leaving anytime soon. Dr. T came back to the hospital and checked me. I was 2-3 cm dilated…something else I wasn’t aware of. The “wait and see” game was thus extended to morning.

Given that we were one day away from being full term (38 weeks), I rationalized that Dr. T would want to wait until at least Thursday if we were going to deliver early…maybe longer because women dilate all of the time and aren’t necessarily in labor. I mean, I wasn’t in labor; I had labor contractions with Lillianne, and believe me, I know what labor feels like. So, needless to say, it felt like the air had been sucked out of my lungs when Dr. T came into our room, sat down, and candidly said, “I think we’re going to have a baby today.”

For the first time in the past 24 hours, I was so flooded with emotion that I nearly cried. “Are you okay?” she asked.

“Yeah, just a little shocked…and overwhelmed. Why now? Why today?”

“You’re having contractions that are about 7-10 minutes apart, so rather than send you home knowing you’ll be back, I’d rather go ahead and deliver you.”

Having lost Jude, I wasn’t up for taking risks; I trusted Dr. T implicitly, so the next question was, “When?”

Half an hour later, I was in the OR getting the spinal tap while nurses and other medical staff requisitely prepped for a C-section delivery. I laid down; the partition was raised, and Sean came in wearing his yellow “husband scrubs”. Unlike Lillianne’s C-section, I was attentive to every detail of this delivery. I was aware of the cover over me. I was aware of the numbing sensation that was gradually overtaking my lower extremities. I was aware that the procedure was starting. I must’ve been oddly quiet because the anesthesiologist kept asking if I was okay. I was fine. I was occasionally vacillating between wanting to burst in to tears and to laugh out loud…but mostly to cry…but I was fine.

“Oh wow, you can see her face,” someone said. I looked up at Sean who was peering over the partition with a look of absolute wonderment.

“You can see her face,” he confirmed. I wasn’t quite sure what was so impressive about this other than the fact that Eilie had been sitting incredibly low in the birth position for the better part of the last two and a half months, so perhaps they were marveling that the face was the first thing they saw in lieu of a back end or something like that.

As the procedure progressed, I overheard a few whispered words among the medical team on the other side of the partition, “…that was really thin….” Were they talking about my c-section scar? Because Jude and Eilie were so close, I worried constantly that I would experience dehiscence or rupture.

Finally, the unmistakable sputtering wail of a newborn pierced the air. And suddenly, there she was. At 7 lbs, 71/2 oz, Eilie Colette was born…one year, one month, and one day after Jude.

The next day, Dr. T came to check my recovery, and I inquired about the procedure, “I overheard someone say something was thin. Was it the scar?”

“Actually, it was the area below the previous scar; it was like a window.”

Oh. “Do you think that if we’d have proceeded with waiting the outcome might have been different?”

“It’s a possibility.”

“I know you know we want to maybe try to have one more….”

The uterus, she explained, will thicken as it heals. She believed that this thinning most likely occurred because Eilie was sitting so low and because I’d been having contractions for such a long period of time (during a “panic” visit in later November, I was told while hooked up to the monitors at the high risk hospital that I’d had a couple of contractions; I couldn’t feel them either.).

I was unable to ignore the fact that had it not been for Jude, Dr. T most likely never would’ve chosen to deliver when she did. After all, had it not been for Jude, Eilie’s pregnancy wouldn’t have been regarded as high risk. I never would’ve had a non-stress test that day; had it not been for Jude, Dr. T wouldn’t have made the cautious call to get on the hospital’s monitor after a normal BBP. We would’ve never known about the contractions, and well, the outcome may have been very different for Eilie.

When I recounted this story to another mom, she suggested that the outcome could’ve been different for me, too. “You could’ve died,” she said. “He was looking you, so you could be here for your family.” While I agreed, as maternal morbidity is a possibility with uterine rupture, I never felt like my life was in danger (ignorance is bliss?). I have more than once looked at Eilie and seen Jude. Especially when she’s sleeping, she looks like Jude when we buried him, and it’s absolutely jarring.

After all of this transpired, I recalled a much earlier conversation with a friend in that I pointed out that without having lost Jude, I wouldn’t have (then been expecting) Eilie. Had Jude survived or made it to his due date, Sean and I would’ve never conceived another baby in May of the following year. My friend said she felt that her babies were her babies and would be no matter when she had them. While I understand what she means, technically, that’s impossible. The genetic material that created each of my babies was unique and wouldn’t have been in existence at another time of conception; that baby would be and is a different person entirely than Jude or Eilie.

That said, I do believe that both of these babies were meant to be my babies. We chose both of their names –Eilie and Jude- when we were expecting Lillianne. Eilie was an uncommon Irish name. Jude was a name that we really liked. Lillianne ended up being Lillianne, but I already felt that I’d one day have a Jude and an Eilie. These babies were meant to be mine, and I think there’s a reason their tiny lives and beginnings have played out thusly.

While Jude’s purpose is far from through, I believe that part of his reason for being was to save his sister’s life. I support this belief with the unplannable “stranger than fiction” reality that they were due one year and one day apart (2/11/16 and 2/12/15) and were impossibly born one year, one month, and one day apart (12/26/14 & 1/27/16) after I was hospitalized under nearly identical conditions with both pregnancies (a non-stress test, a biophysical profile, hospitalized gestational monitoring, unscheduled Cesarean delivery).

Yes, life…it’s stranger than fiction, but it has purpose. Every drop of it, and it’s by no means random; rather, it’s being orchestrated in such a beautiful and fine way that we can’t always make sense of it; at times it’s like like jazz. Other times, such as in Jude and Eilie’s case, it’s a classical composition in which we can see how the notes connect and interact, and we can make sense of the music.

 

Hey Jude,

 I know that somewhere over my rainbow, there’s an angel looking down on us, and it’s you.

Thank you, my baby. I love you, and I miss you, and I keep you in my heart. Always.

(Left: Jude 12/26/14; Right: Eilie: 1/27/16)

Hey Jude — Everybody Hurts

Hi, Sweetie.

It’s really hard to believe that today and for four hours now, it’s been New Year’s Eve. Last year, I was also awake after a relatively sleepless night.

I remember waking up while the morning was still dark and finding your obituary online.

I remember deliberating for roughly an hour before deciding if and how to share it on social media.

I remember reading it and weeping.

I remember how beautiful and perfect you were because I look at your photo every day.

This year, I’m awake because the phantom monster that is prenatal anxiety came back. Your sister has moved her position or is moving differently, whichever; regardless, I haven’t been satisfied with her level of activity to allow myself to rest, so here we are. (Thankfully, we have a doctor’s appointment today.)

 

Everybody Hurts

After your funeral last year, your father and I talked as we both had different experiences during your wake and afterward at home with the family; we had different interactions and conversations. One thing that your daddy’s uncle said that still stands out and has resonated harder and harder lately is that, “There’s more than one way to lose a son.”

Some people might find this comment selfish given the circumstances, but I didn’t (particularly because I know his situation). After all, I find writing these love letters to you to be an inherently selfish and somewhat narcissistic activity…as though I’m the only person who’s suffered a painful loss. I cannot even begin to count the number of people who’ve suffered significant, life-changing losses –many harder to bear than mine—with a quieter dignity; however, we all cope differently (and I like to stay in touch with you).

What this comment and my reflection of it inspired is the realization that everybody hurts. Thus, I’ve started trying to take the journey others have endured.

Last night, I was thinking of my doctor who I know delivered a still baby on Mother’s Day last year. I wondered what it must be like to do that, to bring a non-living baby into the world, then to have to “do your job” at the same time. How taxing that must be on a person’s soul. I have another doctor friend who said that patients and patient families can be…well, not understanding. So, then I imagined the doctor who, while inwardly mourning an innocent loss, is simultaneously on the receiving end of a wounded person’s vitriol? The anger quickly becomes blame, and the doctor, who is certainly more than just someone doing their job, has to take it. Not only do they have to take it, they have to take it home; they internalize it; they analyze every step and moment to determine if and how the circumstances could’ve been different.

My doctor has told me numerous times how often she has revisited your life in her care in the hopes of finding something to answer the question of why or how…and there’s nothing. You –like your sisters—were perfect; you were perfect until you weren’t. None of her colleagues (including my high risk doctor) had answers either, which I hope eased her soul at least where we’re concerned; however, I know she hurt for us.

A week after your funeral last year, the bug guy came around to do his job. I kept the appointment on January 7 because…well, I just did. J arrived on time, and because we were in a fog and had forgotten the appointment, we were still in our pajamas and were rather unmade. J didn’t mind; he came in, and perhaps feeling it necessary to explain our appearances or all of the flowers, we told him about Jude.

J told us about his second baby, a little girl, born with a trifecta of genetic defects that meant she could cry but couldn’t produce sound, that she lacked the proper anatomical cavity for going to the bathroom, and that her heart had issues. For eight months, J and his wife endured…they endured surgeries, their baby’s quiet yet obvious suffering, and endless what-ifs and God-knows what else. At the end of eight long months, it became obvious that there was little more modern medicine could do to sustain their baby’s life, and they had to decide to allow their infant daughter’s suffering to end naturally.

His story filled me with sympathy and gratitude (I was appreciative that we never had to make those kinds of decisions for you, Jude…that you never knew Earthly pain and suffering or even the sensation of cold; I felt very blessed that my baby had only ever known warmth, love, and comfort). What J and his wife endured would have turned me into human road kill; I can’t fathom where my strength would’ve come from to be the people he and his wife had to be those eight months. In telling us this, he wasn’t trying to diminish the significance of our loss; rather, he was a person with pain sharing a story. But they survived; they had two more children after losing their second. J was among the first people who helped me to realize that everybody hurts.

 

Everybody Copes

Last year, just after we lost you I wrote what would be my first letter to you. I wrote about how we decided on your name, how during a tribute concert with friends where “Hey Jude” was played, I felt that was what I wanted your name to be because I wanted you to be able to make me a better person, to have a more open heart, and to be more hopeful. After a long couple of years of home renovations, struggles to advance financial, and marital and familial growing pains, I was rather guarded, which I didn’t like.

You, in your tiny and infinite perfection, have enabled me to let go of all of those burdens. One year later, because of you, the stresses of those damaging growing pains have been lessened. Your father and I are happier and healthier together; your sister is, well, she’s always been a little light, but she talks now. As you can see, I’ve just had the best year as a freelance writer and editor, and this was only year one.

It’s very odd to reflect and to say that so much about this past year has been good when it’s also been so painful, when missing you has been so hard; however, one emotion I couldn’t find relative to losing you was anger. I never got angry. You were and are too beautiful; you’re too perfect. Anger is ugly, negative, and generally ignorant as far as emotions go. You deserve better, and so I’ve only reserved the best for you.

I think this (or something similar) is whatever most who suffer a tragic loss comes around to…a pacifying acceptance that they can cope with and live with and maybe even grow from. Yes, they walk closer to the veil the separates life from death; they stop to look at it as they contemplate its larger significance. Somehow, seeing the veil flutter carelessly in the wind, walking alongside it, and realizing its significance, they find that life is too brief, too fragile, too precious to do anything less than to live (and what’s more, to live a little extra for those just beyond the veil).

I love you, sweet Jude. Thank you for everything this past year; you’ve given me so much…so much more than I could’ve anticipated when you and I started this unanticipated journey last year. Thank you for living through me and for giving me more to live for. You are and will always be my perfect middle child.

PS: I miss you.

Hey Jude – Flying Again

I am thankful; I’m more thankful than I’ve ever been in my life. You’d think that wouldn’t be the case considering my son, perhaps the only son I’ll ever have, isn’t here; he was only here for a fleeting 33 weeks before he was taken on December 26, 2014. Those weeks he spent kicking…he was so vital, so funny. It still doesn’t seem possible that he’s gone or that he was taken in a way that fragments the foundation of any confidences I ever had in anything.

 

Anxiety without Fear

After all, a seemingly perfectly healthy baby in a pain and issue-free pregnancy simply lost his heartbeat. I do have a theory on how that took place, but that theory does nothing to strengthen by belief in the probability that history won’t repeat itself. If anything it makes it that much worse. I won’t pretend I’m full of bravado, that I haven’t spent countless nights laying awake jostling a sleeping fetus so that she’ll kick me just to prove she’s alive for at least 10 more minutes. I won’t pretend I haven’t talked about it to my doctors like they’re therapists each and every time I visit. I won’t pretend I don’t think about it. I sleep with a teddy bear. I won’t pretend that I would much rather pretend that I’m not obviously pregnant. I won’t pretend that I want to talk about it. I’m sure people who don’t know or who think I should act more grateful think I’m a…well, it rhymes with peach, but I don’t care. Losing Jude wounded me to the core.

 

Flying Again

I have an ultrasound to see Ocean Baby every time I go see my high-risk specialist. I always start the visit very present, but I zone out quickly…I barely pay attention to the growing baby on the screen. Instead, I talk.

A disembodied hand moved a wand around on my jelly-coated abdomen while I stared unseeing at the screen. “It’s like being in a plane crash,” I said during a recent visit. “You’re in a plane that crashes on landing, and then the next time you fly again, everyone tells you just to be cool on the descent because it probably won’t happen again. I realize that statistically that’s unlikely, but that doesn’t make it any less anxious-making.”

My doctor nodded understandingly. We can all understand how terrified we’d be to fly again. Yet, here I am, exactly one year later; the plane is getting ready to make its descent. The gate knows we’re coming; we’re so close to the ground that if something were to go wrong, we should be able to salvage all of the passengers; of course, we should have been able to last time (perhaps); though, it’s hard to say what happened. We didn’t; there were casualties. I wasn’t one of them. I made it out. I was broken, bruised, burned, damaged, and changed forever, but I crawled away from the plane crash with my husband.

We never once considered not flying again. We knew we’d want to, but we were given a boarding pass and were taking our seats before we knew what was happening. This trip wasn’t planned. I’ve had some moments of anxiety including a recent visit to the Women’s & Children’s clinic because I felt a painful pea-sized lump under my arm that I thought might be a clot or something (an incident I shall henceforth remember as “The Preggo and the Pea”) (I should add that the doctors who inspected me did say they felt swelling, so I wasn’t being completely paranoid.).

That said, I’m not afraid of the crash even if I’m anticipating it. I’ve become unafraid of so much in the past year. Jude has given me so much strength and peace and courage…I can’t explain it. I truly don’t want to lose another baby ever, ever again. I pray with all of my heart that it never happens again, but I’m so proud of my baby boy for doing everything I ever could’ve asked him to do; he constantly makes me a better person.

 

A New Foundation of Faith

Ironically, losing Jude has made me realize just how much I have to be thankful for…I have so much love in my life. I have my incredible, beautiful little girl. I have my perfect angel boy. I have a good, faithful, hardworking husband who not only puts up with me but seems to genuinely like me most of the time. I have a safe, warm home. I have jobs that I love.

Most of all, I have faith that when the foundation of everything else was shaken, I was able to look to a higher power and let go. I was able to walk on air because I’d lost everything; there was nothing holding me to the ground any more. Suddenly, I was liberated by the reality that I can’t control anything. I finally understood what was meant by “I can do all things through Christ that strengthens me.”

Losing Jude by all accounts should’ve killed me. I’ve always said there are two things that would destroy me. One is my husband choosing to be unfaithful; the other –more terrifying prospect—is losing one of my children. In being forced to face my worst fear, I showed strength I never knew I possessed; I was surprised by my own faith. I truly had no idea who much of it I had in me; not once did I blame God or ask why (sure, I tried to find answers medically-speaking), but I never got angry…I never asked or wondered why. I just held fast to belief that there’s a reason and that perhaps I’m not meant to know that reason.

 

Jude’s Purpose

I know not everyone believes that events in life are purposeful. I am one of those people who believes there’s purpose. Jude’s already serving a great purpose; he’s helping me become a stronger, braver, and more fearless a person than I ever would or could’ve been without him.

I’ve imagined my life and marriage if we’d never lost Jude. Sean and I were in the midst of very stressful times. We’d recently moved into a house that we’d had fully renovated. Our finances were still tight but we were working on it; still, there was no excess. Our tense squabbles were typical of a working married couple with a young child: no personal time, no time to get things done, and money was tight as we worked to pay off student loans, pay our mortgage and other household expenses, etc. We both felt alienated and overworked and misunderstood for different yet equally valid reasons. Though some times were better than others, we were a structure under immense pressure and were a structure preparing to sustain more pressure. Jude was planned and we were excited about having him, but I think we both wondered just how much more we could take. Of course, we’ll never know.

The night we lost Jude and the nights after, Sean slept next to me in that hospital bed. I physically craved having him close to me; I felt things that I hadn’t felt toward him in a long time, which is sad to say considering how short of a time we’d been married. We lay intertwined, holding each other like human life preservers for two nights. We fell asleep here and there; I held him while he shook with sobs, and later when it was my turn, he cradled me as I broke apart. I never want to be without him, I thought. I never want to be away from the only other person who knows what this feels like. I never wanted to leave that hospital bed, our haven of security and intimacy away from the world alone with the pain of losing our son.

In much the same way having a living, healthy baby forges a bond between a couple, losing a baby does, too. In much the same way that raising a living, healthy baby can drive a wedge between a couple, losing a baby can, too. Of course, the stress of changing and adjusting to becoming a parent doesn’t have to be a wedge; a baby can also be a bookend.

I won’t say our sweet then-18-month-old Lillianne was a wedge because we’ve always both been involved and engaged parents; neither of us are selfish with our time (we were definitely both stressed to the nth degree more often than not, though, and very starved for personal time), but we were still adjusting to parenthood when we lost Jude.

Jude was a bookend; he slammed us back together and while we’ve had our moments this past year, Jude’s presence has been a quiet reminder that we’re in this together. My son’s life had and has purpose, which is why I’m not so afraid to fly or to land that I won’t ever stop boarding airplanes.

Hey Jude — Finding Answers without Solutions: How and Why We Lost You

For most of us becoming a mother forces a change of chemistry; we have a natural urge to protect and to nurture our children. Losing a child –no matter faultless we are—is also transformative and is damaging.

When Jude died, there were no early warning signs. Jude had been active like any health baby in utero should be. I didn’t have gestational diabetes. At our 20-week ultrasound, he measured fantastically. I’d been well on the way to deliver another healthy baby. In the afternoon of December 25, 2014 I noticed Jude wasn’t moving as much. After giving it some time and making every effort in the book to get him to start his usual patter of kicking, we went to the doctor on December 26.

Jude had a good, steady heartbeat; the only reason they checked me in for additional monitoring was because of slight polyhydraminos (25 cm instead of 24; women can have as much as 40-something centimeters of excess amniotic fluid and never know and everything be fine). The fact that our baby hadn’t taken a breath during the half-hour ultrasound that confirmed the poly was (or at least could be) considered not a cause for concern.

At around 6:30 p.m., we were led to the hospital where the baby and I would be monitored overnight, given a steroid shot, and monitored twice a week until we were due. It was all very standard and not a reason to be seriously worried. Within hours, Jude’s heart stopped and he couldn’t be saved.

The doctor on call and our nurses cried; they had no idea what happened. It didn’t make sense, this perfectly healthy woman with a perfectly health pregnancy to have suddenly lost her baby while she was being monitored (no less). Our efforts to save Jude (an emergency C-section) meant staying in the hospital for an additional few days during which time my regular OB came in to see us. She held me and cried with me and expressed her disbelief at our loss.

The months after Jude’s death yielded many sleepless nights of wondering and searching. I laid in bed surfing Safari on my iPhone looking for answers. There were none to be had; each of my suggestions for what might have happened were rejected due to medical evidence that they weren’t viable scenarios.

There was a slight possibility I had a C-Protein deficiency, which could cause blood clots, but even that was proven unlikely when a follow-up blood test (though I was already pregnant again) yielded negative results. Ultimately, I accepted what happened and stopped looking for answers.

 

Finding Answers Part 1: Pieces to the Puzzle

Fast forward to August of 2015. We were getting close to being able to find out the gender of our third baby. I looked at a photo on our refrigerator of Lillianne revealing Jude’s gender at the exact same time one year before and felt very sad. Jude and his sister (yes, our third baby is going to be a girl) are one day apart on their gestational timeline. Jude’s gestational due date was February 12; his C-section was scheduled for February 11, my mom’s birthday. This baby, Ocean Baby, as Lillianne has nicknamed her, is due on February 11; her C-section delivery will be scheduled for February 3. We didn’t intend to have these pregnancies mirror one another or to be so close.

One night as we approached the gender reveal, I decided to Google some right side pain that came and went. It was in the area of my liver, but I didn’t have any signs of liver or gall bladder problems. I searched “causes of polyhydraminos” and high blood pressure was listed as a culprit. I made a note to look more into it the following day and headed to bed.

Halfway down the hall, I remembered that I didn’t have high blood pressure; I have low blood pressure, something I only recently found out because I spent the first couple of weeks of what technically counted as my third pregnancy’s first month in the hospital with pasteurella from a cat bite, and the doctor’s and nurses were concerned. “Is your blood pressure usually really low?” I didn’t have a clue; I called my OB’s office as they’d been the last group of healthcare professionals to monitor my BP and yes –I did have low BP.

I began searching low BP and polyhydraminos and soon found limited yet important research that validated that low blood pressure can be a factor leading to stillbirth.

 

Finding Answers Part II: How Low Blood Pressure Plays a Role in Stillbirth

The more I researched, the more convinced I became that my low BP was a critical factor in Jude’s death. Australian researcher Jane Warland has done some of the more recent studies that shows a relationship between a patient’s low or borderline low diastolic pressure and stillbirth. Warland’s studies remove systolic pressure as an indicator of risk of stillbirth.

Specifically, Warland’s studies show that stillbirth is more likely among women with “borderline” low pressure, which is diastolic pressure between 60 and 70; anything lower is considered hypotensive or extremely hypotensive. Warland also conducts a mean arterial pressure (MAP) calculation in one of her studies that shows that a MAP of 83 or less has a much higher likelihood of an occurrence of stillbirth.

Unlike a typical MAP, Warland’s MAP places double emphasis on the diastolic pressure. Warland’s MAP is calculated as thus: [(2x diastolic) + systolic] / 3. Per an article by Warland, a MAP of less than 83 carries “almost double the risk of stillbirth.”

It took a week and $165 to get my medical records from my entire hospitalization with Jude. I recovered my BPs from my pregnancy with Lillianne as well from the doctor’s office. I contacted Warland. While she didn’t respond to my inquiry regarding my MAPs, all of which were lower than 83 (the highest was 81; the lowest was 64), she did state that the rationale for assuming a borderline woman was at a higher risk is because “I THINK that this is probably related to what happens during sleep. The woman who has borderline BP during the day probably has a significant drop when she sleeps where as if it is already low during the day, it physical can’t actually drop much lower during sleep.”

While I understand this logic, I also tend to think that having a low BP can be problematic given that the issue with having low BP is that there’s not enough pressure to push nutrient-rich oxygenated blood through the placenta and to the baby.

I do concur with Warland in that there are –and must be—a variety of factors present for low BP to be a contributor to stillbirth. Warland strongly believes that back sleeping versus left side sleeping can be detrimental particularly if the woman already has low BP. Importantly, in a follow-up communication, Warland stated, “So, in my research women with borderline BP were at twice the risk. Let’s say the background risk for stillbirth is 1:100; this means that if your BP is borderline, your risk would be 1:50. That still means that 49 of 50 women with borderline BP are going to have a perfectly happy baby. Similarly with sleeping on your back, the risk for stillbirth is approximately doubled. That still means 49 of 50 mums who lie on their back will get away with doing that. This is where the triple risk model comes in as it shows what might happen with a number of converging risk factors and a vulnerable baby.”

What I infer this to mean is that a stillbirth with variables related to low BP is the perfect storm. What I also interpret this to mean is that if you can try to address one or more of those variables, it could make a difference in fetal outcomes.

 

A Medical Theory of What Happened to Jude

Looking at my BPs with Lillianne and those with Jude, Lillianne should have been the baby at a double risk of stillbirth as all of my BPs with her were borderline. While Warland said, “I don’t think we have any evidence that less exercise puts you at risk,” I disagree. If a pregnant woman with high BP is discouraged from exercise because it elevates her pressure, than a woman with low BP should exercise to keep her blood moving. When I was expecting Lillianne, more out of vanity than anything, I ran or walked 5 to 7 days a week. In the third trimester, when running with the extra weight became harder, I started doing leg lifts with ankle weights to strengthen my muscles. I did this before bed every night for the majority of the third trimester.

With Jude, I’d never gotten back into shape; I walked some at the beginning of the pregnancy but after daylights savings time and when it got cold, I more or less stopped. I also started working more often at night, which meant I sat at a desk to work during the day and I sat to work at night. I was more or less sedentary. My BPs were what Warland’s research would classify as “hypotensive” or “extreme hypotensive”.

During my pregnancy with Jude, I wasn’t concerned about fitness. I also probably rolled onto my back during sleep more often than I should have; I’d been lulled into a false sense of security by the fact that many pregnancy advisories are overdramatized. For me, back sleeping during pregnancy is much more comfortable, so it happened sometimes. Whether or not that was a factor, we’ll never know.

My theory, which my high-risk specialist said had merit, is that Jude suffered from placental insufficiency and then failure. Placental insufficiency occurs during the late second and early third trimester. Typically, babies who suffer from placental insufficiency are small. Jude was born at a healthy 4 lb 2 oz; however, they don’t have to be (small).

I speculate that my low BP combined with other factors led to a diminished supply of oxygenated blood being pushed through the placenta over the course of several weeks. On December 25, Jude wasn’t moving as much; the following day, I was diagnosed with acute polyhydraminos and Jude didn’t take a breath on ultrasound.

Without oxygen, the brain cannot grow; with enough oxygen deprivation, the brain dies. If Jude had suffered from placental insufficiency, then this would explain why he still have a steady heartbeat when we went in for monitoring; it would also explain the slight polyhydraminos; he was neurologically no longer capable of breathing in the amniotic fluid critical for his development and survival. This is why, too, then, that within hours of being checked in for monitoring, Jude’s heart stopped.

 

Significance

Of course, this is all theory; even if we were able to prove beyond the shadow of a doubt that this is how Jude died, it would change nothing for my pregnancy with Jude’s little sister or any of his future siblings. Placental insufficiency isn’t visible; it’s only evident when the baby starts to show signs of troubled development.

No doctor is going to put a woman with low BP –even with BP as low as mine (my most recent was 80/50) on medication to raise BP.

Additionally, had I not had a loss, even if I presented this information to my doctors, they probably wouldn’t be very concerned as I don’t have any “trouble” signs of low BP. I don’t faint or get dizzy or have trouble concentrating. I do get headaches easily, and lately, I’ve noticed some tingling in my legs (occasionally) when I sit to work, but there’s no indication that being hypotensive causes me any distress. That’s not to say that it doesn’t; my BPs are definitely lower during pregnancy than normal.

So, all that we are doing is additional monitoring; I’m trying to walk at least 5 days a week, and I’ve started wearing compression socks to bed to keep my blood flow up at night. As I told my doctor, I realize that most of this is psychological; it helps me to feel like I’m in some modicum of control even though I recognize the reality of this predicament.

I allow myself to believe that there is nothing I could have done to help Jude; even if I’d been armed with more knowledge at the time, it’s highly likely we’d have had the same tragic and traumatic outcome. This, at the very least, means that I don’t blame myself or anyone else for what happened. On the other hand, it also means that I have no control over what happens with Ocean Baby, Jude’s sister. It’s a catch-22 of sorts because nothing changes…only the amount of knowledge that one has and that we now have a prospective theory of what happened to Jude.

Today marks 10 months since we lost Jude. He would have been 10 months old today. I don’t dwell on what he would have looked like or anything like that. I do think, sometimes, that he might be walking now and he’d be eating solids and following Lillianne around. I feel his presence all of the time; it’s like he’s just out of reach; he’s a warm shadow who stays close. I know he’s just beyond the veil and I know it will be a long time before I reach him. I know he knows I miss him, and even though I value every second of life here, I also appreciate that every second forward brings us closer.

 

Resource Links:

http://m.aje.oxfordjournals.org/content/153/7/642.full

https://books.google.com/books?id=5uB5DHPHwFwC&pg=PA205&lpg=PA205&dq=jane+warland+low+blood+pressure+stillbirth&source=bl&ots=LRR_f0YZIZ&sig=M4fAoawOtv5k8vONlZ6iLMWG_Q4&hl=en&sa=X&ved=0CCsQ6AEwA2oVChMIn-rP5enfxwIVCRceCh3T7QVk#v=onepage&q=jane%20warland%20low%20blood%20pressure%20stillbirth&f=false

http://www.starlegacyfoundation.org/files/Maternal%20Blood%20Pressure%20in%20Pregnancy%20and%20Stillbirth.PDF

http://starlegacyfoundation.org/wp-content/uploads/2012/09/Does-low-blood-pressure-increase-the-risk-of-stillbirth.pdf

http://www.biomedcentral.com/1471-2393/12/S1/A9

http://www.pubfacts.com/author/Jane+Warland

http://starlegacyfoundation.org/published-research/

http://lib.ajaums.ac.ir/booklist/American%20Journal%20of%20Obstetrics%20&%20Gynecology%20(%20AJOG%20)-Dec05.pdf