In Utero

Photo Credit: Wade Wilson

In Utero

👤Melissa Sawatsky 🕔Feb 17, 2018

This story begins with an ending.

The meat cooler at Safeway has been picked over. The half-filled rack of steaks reveals a piece of cardboard at the bottom of the cooler, stained with drips from leaky packages of raw meat. I’m back in the hospital bed staring at the blood-soaked protective pad that just caught my dead son. Trauma is like that. The visceral experience gives way to snapshots of sensory memories that take root in dim corners of the body, and every now and then, it pounces into the present moment and induces paralysis. I don’t recall how that particular grocery trip played out—whether I fled from the oppressive, fluorescent lights and fended off a panic attack in my car, or steeled myself and continued to march through the task of collecting food for the week. I’ve reacted in both ways when some innocuous image, comment, or sensation triggers a phantom return to the experience of losing my first baby.

My son succumbed to osteogenesis imperfecta 20 weeks into my first pregnancy. I have since given birth to a healthy child and am often asked, “Is this your first?” The answer to this question is complicated and problematic: yes and no. If I say yes, I feel as though I am denying and dishonouring the experience of losing my son. If I say no and provide a brief explanation, the inquirer is often uncomfortable, apologetic, or dismissive. Miscarriages, fetal deaths, stillbirths, and infant deaths represent varying degrees of an invisible loss that society in general doesn’t have sufficient vocabulary for. It has proven difficult for me to find words to fill this particular kind of silence.

Ultrasound I hold each side of my belly, a seed of doubt branching out as the ultrasound technician remains quiet. She is taking far too many photo stills. Finally, she says, “Wait here while I call your midwife.”

My husband distracts himself by studying posters of the skeletal and nervous systems in the waiting area, trying to ignore my incessant chatter. “Why would she call Bobbie if it wasn’t something serious? Wade? I’m kind of freaking out here. Why don’t you seem concerned? Did the baby look normal to you?” Not that we’d know what to look for.

We’re taken into a private room. I somehow already know what we’re going to hear and try in vain to breathe through my constricted throat as my heart rate accelerates. Wade refuses the proffered chair.

Bobbie is clear and forthright. There is something severely wrong with our baby, and even if it survives to term, it will not survive beyond birth. Something about broken bones and underdeveloped limbs. I tune her out and focus on catching my breath; my lungs feel as though they’ve collapsed. I glance around for a wastebasket, certain I’m going to throw up. I look at Wade and he isn’t ready to meet my gaze, his expression hard and unreadable. He asks practical questions I can’t find the words for. Bobbie will give us time to digest the news and come by our house in a couple of hours when she has more details from the radiologist.

Wade wraps his arm around my shoulders as we leave the hospital and make our way to the car. He starts to sputter and the tears come as he struggles to unlock the passenger side door. It’s my turn to take care of him. I guide him to a small field of grass just beyond our car and we sit there for a long time. The peaks of Hudson Bay Mountain loom bare, its ski runs out of season.

A few hours later, Bobbie comes by with a report from the radiologist. The fetus is obviously grossly abnormal...severely dysmorphic limbs...only bud-like contours present. I focus on the good news: A view of the heart shows four apparent chambers with a heart rate of 176 bpm.

What is this sound that escapes us? A new, instinctual language—something perhaps called keening. I tell myself: “You’re still a mother—will still have been a mother to this fragile being, no matter the fractured bones and bud-like limbs.” In the background, Bobbie explains the options, which include inducing labour, a dilation and evacuation procedure, or simply letting the pregnancy take its course.

Wade and I continue to seek out patches of green. The yard at home is dry and needles into our skin as the cat sits sentinel, taking care of her parents. It is a stolen afternoon of disbelief—perhaps they are mistaken and our child will defy the odds.

“At this moment,” I think, “my baby still has a heartbeat.”

Waiting Room The twenty-something couple across from me curl into each other in the Fetal Diagnostic Service waiting area, touching foreheads. Another woman is here alone, her expression as unreadable as a passport photo. Three more women arrive, the youngest talking over the white noise of the BC Women’s Hospital lobby.

“My baby has a hole in its stomach. How am I not supposed to panic?”

I study the faces of each strange sister-friend sitting in this circle of chairs and decide I have a head start. We came to Vancouver for an appointment with specialists here, and were just informed that our baby no longer has a heartbeat. I’ve had almost two weeks to process the news of this impending loss; the young woman beside me is in the throes of it.

My husband plays a game on his smartphone and I pace the hallway behind the seating area. We’ve been here for almost an hour, and some of the women were here before me. When an attendant approaches and calls my name, I see the other women sigh in frustration and I look at them apologetically. A dead fetus bumped me to the front of the line.

The attendant looks around and reads the energy of the group.

“I’m sorry we’re running behind everyone. We need to see people in order of priority.”  I place a hand on my belly and feel an uncomfortable sense of tragic privilege wash over me.

The young woman lets out a loud scoff. “And it’s not a priority that my baby has a hole in its stomach?”

I’m torn between the urge to slap her across the face or pull her into a tight embrace. The attendant leans over and speaks to her in hushed tones. The woman’s hands begin to shake and someone, perhaps her mother, wraps an arm around her shoulders.

I turn away and inhale, holding my hands steady. I have a head start.

Induction There is a profound isolation that comes with carrying a dead or dying fetus within your body for however long it takes to resolve (naturally, or through termination via induced labour or a surgical procedure). I was conflicted by the sense of feeling physically trapped in tragedy, yet reluctant to lose the only remaining link I still had to what would have been my first child.

With the guidance of our social worker, we decide that inducing labour is the right choice for us. Labour will give us a chance to be present and conscious as our baby leaves the womb, as well as afford us the chance to hold him and say goodbye. This feels particularly important for Wade, who would otherwise have no physical connection with his baby.

Barbara walks us through the administrative side of the process, which includes choices about what we want to happen during and after delivery, a potential autopsy to confirm the diagnosis, cremation services, and other options to assist us with the grieving process. We are given a pamphlet: Healing Together: For Couples Grieving the Death of their Baby.

I open it a few hours before the induction and read the first line: “Your baby has died.” For reasons only the mysteries of trauma can explain, I burst out laughing and it takes me several minutes to compose myself. Wade studies me as though concerned I’m having a breakdown and I have a hard time explaining why this blunt statement of fact strikes me as hilarious.

My baby has died.

It feels surreal and I momentarily disassociate from the reality of our situation and the ordeal we’re about to endure. Perhaps I’m experiencing a form of denial as I progress through the grieving process, but whatever the psychological implications of my laughter, it is helpful. These pamphlets begin to feel like film scripts, instructing me on how I’m meant to feel and process the death of my baby. I’m rehearsing for my role as the strong, stoic, bereft mother-that-would-have-been.

For a moment we both laugh at the tragicomedy of life and come up for air.

Death Canal This is the part of the story I can only relay as a montage of imagery:

Wade, sitting beside me all night for the 15 hours it takes to deliver our son’s remains.

Uncontrollable shaking for hours on end, partially due to the medication required to induce labour.

A nurse—one of many—appears during the worst period of mental and physical pain and guides me through a meditation.

In the end, the delivery is effortless—one body gusting from another. We are given the gentle suggestion to abstain from holding and viewing our son’s body. Then there is a mild commotion before I am wheeled into a room painted entirely royal blue and sedated for dilation and curettage.

The recovery nurse arrives with a few photos of our son’s hand. Knuckles that resemble his father’s. Fingernails just growing in.

The Beginning During the weeks and months following the loss of my son, I find myself searching for a way to give voice to a form of grief that seems to only be whispered inside private living rooms or behind closed office doors. I answer honestly when an acquaintance innocently asks, “How are you?” and talk through her obvious discomfort until she shares a similar story with me. Another woman states: “I’ve had two children and nine pregnancies.” A friend reaches out and shares the story of losing her son to a genetic condition several months after his birth. I am supported by this sisterhood as I learn to speak of my own experience.

My story ends with a beginning. After prolonged consultations with our geneticist, I am pregnant again the following year and fraught with ambivalence, fear, awe, and an acceptance of the fact I cannot control the outcome. A few weeks before my daughter is born, I write a poem for my children—to try to reconcile how my son’s death made room for my daughter to come out kicking.