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Prior Birth Complications and Trauma

My first pregnancy was relatively uneventful, but we were shocked when I delivered a full-term baby at barely 5 lb. He ended up needing to be transferred to another hospital for NICU care. My doctors said it was probably a fluke. In my second pregnancy, they monitored me a little bit closer, and unfortunately, our baby girl was already measuring small at 16 weeks and I was diagnosed with IUGR (intrauterine growth restriction) and placental insufficiency. The whole pregnancy she continued only growing half what she should have. I was monitored extremely closely with twice a week fetal surveillance starting at 25 weeks, and eventually at 33 weeks I had to be hospitalized for full-time monitoring as the umbilical cord was barely flowing. The doctors induced me at 35 weeks and she was only 3 lb, about the size of a 30-week baby. During that whole ordeal, the thought never crossed my mind that she could have died – that they were doing so much monitoring on her because of that risk. I naively was only worried about how long we would have to stay in the NICU. Thankfully we were able to get her earthside. Looking back on this experience, I can see now with clarity that I was surviving through the trauma of these complications through dissociation and avoidance practices. I never allowed myself to process any of what happened to me. And in hindsight of everything that followed after, I now see that the avoidance of processing this initial trauma only made future trauma more compounded.

 After she was born, my doctors finally admitted that there must be a problem and ran a bunch of tests on me. The tests came back positive for Lupus and a rare blood clotting disorder called Antiphospholipid Antibody Syndrome, which can cause severe pregnancy complications due to placental insufficiency. I was told if we wanted another child, if I took daily blood thinner injections and Lupus treatments then it would take care of the problem and we could have a healthy baby. It felt great to have answers and I felt so confident. I did everything I could to make the next pregnancy successful – I lost weight, was exercising, and we did preconception counseling with our OB plus two specialists to plan out what medications I should use. We were excited.

 Olivia’s Pregnancy – Antenatal Complications

 We conceived quickly, and for the whole beginning of the pregnancy I was thrilled. I took the injections every day – I was excited imagining what it would be like to take a baby home right away and not have to go to the NICU. I was so naive taking for granted that this treatment would work. Unfortunately, again at 14 weeks, our baby girl was showing signs of IUGR. I still never thought anything would happen to her – my second child made it! No one really explicitly told us that IUGR was a leading cause of stillbirth or that we should be worried. At a 17 week scan, her growth was even farther behind. She was literally measuring at less than zero percentile, which I didn’t even know was possible. But her heartbeat was strong, and the umbilical cord flow was still in the healthy range, so I had great hopes for her and big dreams about bringing her home to our family. I started to have doubts when I joined an IUGR support group online- it seemed like every story I could find that talked of a baby as small as her at this early in the pregnancy ended in stillbirth. It was then that I began to fear. My continued trauma had me living constantly in a state of hypervigilance and anxiety. I know now that my traumatized mind was never allowed a moment of rest. And at the time, without awareness and knowledge of trauma and how it was affecting me that spaces like The Birth Trauma Mama has provided me, I didn’t know to seek help. I thought what I was experiencing was normal.

 Olivia’s Birth

At 18 weeks, we went on vacation to visit my husband’s parents in Michigan. I was just sure everything was going to be fine. Our baby girl was really active, and I felt her moving around all the time, including the night before we left. Unfortunately on the plane, I started to bleed, and I realized I hadn’t felt her move most of the day. I hoped against all hope that I just hadn’t felt her because we woke up so early and were running around getting ready to leave. The spotting got heavier, and I started cramping too. In my heart right then I knew something was wrong and I think in my heart I knew she was gone.

My husband’s parents picked us up at the airport and I told them right there in the parking lot that I needed to go to the hospital, that I thought I was miscarrying. Here I was, in another state, away from all my doctors who knew my medical condition and would take great care of me – I knew this was going to be bad. On the way to the hospital, I started having regular contractions.

Hospital Trauma

When we walked into the ER, they asked me my due date. They said I was ONE DAY before their cutoff to be able to go straight to labor and delivery, that instead I had to go to the ER. I started crying profusely right then. Somehow I just KNEW that the ER was not going to be the place I would get the best care. I begged them to let me go to labor and delivery and they said no. I was SO mad at myself for not asking the cutoff first – I could have just said my due date was one day different and had a much better experience. But no, I was faced with no compassion and sent to the ER, in a room with no private bathroom, while in labor. I had heard horror stories of women miscarrying in the ER – I saw myself becoming one of those statistics before my eyes, and with a fully developed baby so agonizingly close to viability. I couldn’t believe we were not given the grace to give birth to our baby in an actual birthing space.  I waited for what seemed like an eternity in that non-private ER room with just a curtain and no door, having full-on regular labor contractions, in excruciating pain with the refusal of pain medication. I had to wait for an ultrasound tech to come pick us up, which took forever. They told me my husband couldn’t even go with us to get the ultrasound – I put my foot down and INSISTED that he go with me or I wouldn’t go, so they finally let him. I had to sit there getting this ultrasound, where they wouldn’t even let us see the screen. But I heard the complete static in the place where I knew her heartbeat should have been. And it was over way too fast – two minutes and we were done. I knew it then and the devastation was already kicking in. But I prayed against all odds that maybe I was wrong. Maybe she was still there. Maybe.

What seemed like hours of pain and contractions later, the nurse finally came and told us what I already knew – that she was gone. We cried together. I can’t believe how much I cried. But soon the tears stopped when the contractions got even stronger. I had to give birth to our sweet girl, who we named Olivia right there in the hospital.

The nurses and staff were completely dismissive of my emotions. I insisted on being taken to labor and delivery to give birth to her. I just knew that the nurses there would have training in how to help me with compassion and sensitivity to grief. But they kept saying they “paged an OB” and “he wasn’t answering.” They still couldn’t give me anything for the pain for that same reason. I kept asking them to page again – I was pacing around in so much pain from the labor. The PA who was waiting on the OB was clearly clueless – she at one point told me they might just send me home with drugs to “pass everything.” A quick Google search told me that protocols do not call for that when a patient is that far along in pregnancy, especially on blood thinners, as the risk of hemorrhage is way too high. I told the nurse “I shouldn’t be here – I should be in labor and delivery,” to which she replied “it’s really a gray area…” (presumably because my baby measured smaller than her gestational age), to which I replied – “MY LIFE IS NOT A GRAY AREA.” Losing your baby is traumatic no matter what the circumstances, but facing that in the midst of completely uncompassionate, uncaring, and unqualified providers and being at the mercy of a doctor “not answering his page” while facing the tragedy of your life – being in a non-private ER room while in full-on labor with a dead baby – that added a whole other layer of trauma that I can’t even begin to describe.

My contractions got much stronger and closer together, and I felt sure she was about to be born. I started panicking – I was NOT going to let this baby be born in this ER room. She deserved better than that. I deserved more than that. A thought popped into my head – I need to call labor and delivery myself. I grabbed my cell phone and dialed the same hospital I was sitting in, right there from the ER room, and explained what was going on. The nurse I talked to was appalled they had kept me there so long. She profusely apologized, and an OB was in my room within 5 minutes, I was given something for pain shortly after, and I was upstairs in a labor room in another 15 minutes. I was so thankful that the thought to call came to my mind, but wished I had thought of it sooner.

Upstairs, as I had hoped, the nurses and staff were so much more caring and compassionate. They walked me through everything that would happen and treated us with dignity. The room was much more peaceful and I had a private bathroom. I labored for another 30 minutes or so, and then she was born. I was standing and since she was so small, I didn’t have time to call anyone. I caught her myself which was terrifying, but something I’m so proud of looking back, that I was strong enough to do that in the midst of the pain and the screaming tears. We hit the call light and we had about 5 nurses and the doctor in our room in less than 30 seconds it seemed like – they were so attentive and caring. I can’t imagine if that had happened in the ER room – I probably would have had to hold her standing there bleeding for SO long before anyone came if we were still there. But instead, these sweet nurses took care of my Olivia with dignity and made sure I was safe and well with compassion.

I held her after. She was so very tiny from the growth restriction, but I could tell she had the same sweet facial features as her older siblings. She was beautiful. My biggest regret, one that will haunt me for a lifetime, is that I didn’t take any pictures of her. I thought I wouldn’t want to remember how small she was – that was, after all, what caused her death. I thought I would want to remember her by her ultrasound pictures when she was still alive. I had no idea that was something I would want later. So I didn’t, and I declined when the nurses offered to. The reality that I don’t have these pictures to remember her by is something that hurts me every day. They gave me another medication for the pain, and unfortunately, it made me extremely sick. I was vomiting and seeing double the whole time I had with her. Because I was so sick, I didn’t hold her as long as I wanted to. That’s another big regret I have. I have had to tell myself over and over “I did the best I could, in the time I had, with the support I was given.” I was not given the support to know what to do in this traumatic experience I knew nothing about. 

I asked the nurse to take her away way sooner than I should have because of the sickness. I spent that whole night crying in bed, wondering where she was – I knew she had to be in a fridge somewhere, but what did they put her in? These are haunting thoughts you never even imagine yourself thinking. I wish I knew it was okay to ask to see her again after I wasn’t throwing up anymore. I wish they had offered so I knew it was okay.

Processing the Trauma

In the weeks and months following her birth, I started having extreme panic attacks and anxiety. I couldn’t quit replaying the experience over and over in my head. The extreme desire to find answers and meaning for what happened to me was obsessive. At my darkest point, I stayed up all night long researching fetal autopsy and pathology reports trying to grasp at anything to explain what happened to her. Deep down I knew this behavior was not normal and I shouldn’t be doing this, but I was so shattered that it was all I could do. I stopped sleeping. I don’t even feel like I fully grieved her – I was too busy suffering from the symptoms of the trauma of her pregnancy and birth that I didn’t allow myself the luxury of grief.
I finally realized I needed help. I sought out a local counselor who specializes in both trauma and grief and began EMDR therapy. EMDR was so very hard. I found myself reliving her birth over and over. But as I pressed on in therapy, I found her birth becoming less traumatizing. I found clarity in being able to remember her birth and remember what happened to me without shattering. I realized so many new things about my experience and feeling new things. Realizing that the way I was treated at the hospital – being left alone and unsupported in the very place you came for help – was at the root of my trauma, and was something I didn’t deserve and couldn’t control. But I could take control in processing that trauma and moving towards healing from it.

Years later now, I still feel like I should get back into therapy to make more connections in the way my body processed the compounded trauma of my previous birth complications, and even to explore how unrelated childhood trauma ties into my experiences as a whole. I have much work to do and spaces like The Birth Trauma Mama make me realize that the work is valuable. 

Helping Minimize Trauma for Others, For Olivia

As I was processing my trauma after her birth, I felt a strong pull to do something tangible to prevent other women going through infant loss from facing as much hospital trauma as I did. I don’t want any other mom to have to process both the grief of losing their baby on top of unfair and unsupportive treatment from hospital staff. I want moms to be able to deliver in hospitals with well-trained staff, who are equipped with tangible ways to lessen the trauma for them. To support them in holding their baby and making memories so they’re not haunted by regrets for the rest of their life. To shatter the silence by bringing to light the taboo subject of stillbirth and infant loss that shouldn’t be taboo with how common it is. To give a voice to others. To give a voice to myself.

I read about a device called a Cuddle Cot or Caring Cradle. They are special bassinets for a stillborn baby to lay in that keep their body cool, to allow the family more time to grieve and process before they have to say goodbye to their baby forever. When a baby is stillborn, his or her body begins to change very quickly, and families usually only have a few hours with their baby before the nurses have to take the baby’s body away. The Caring Cradles allow a mother to keep the baby in-room with her for as long as she wishes, even up to days. Although the concept may seem morbid to those who haven’t experienced infant loss, being able to say goodbye to their baby on their own time, and to have plenty of time to make keepsakes such as photos and footprints without being rushed truly helps prevent some of the trauma. Having nurses who learn how to use the Caring Cradles and have candid discussions about how to implement them effectively makes for a more supportive staff. And there is a whole demographic of moms who, due to severe medical complications, may not even be awake when their baby is born. The Cradles are priceless for these cases- allowing mom time to recover medically and still know exactly where her baby is and/or having the baby in-room right away when she recovers. Although I know these devices cannot remove trauma from the infant loss equation, I truly believe deep in my heart that they can make a big difference in limiting that trauma in so many instances. 

Through sharing Olivia’s story and those of many others on social media, I raised $15,000 for a nonprofit whose mission is to purchase these cradles for hospitals. I was able to place three Caring Cradles with that money with her name on them for local hospitals in my state. It is an honor to know that her legacy is helping other families have a better experience. Losing their baby will still be traumatic, it will still be devastating to them, but I pray that it will be a little easier if they have access to a Caring Cradle.

Reaching Out to the Hospital

Afterward, I talked to the lead nurse in labor and delivery at the hospital where Olivia was born. I told her what happened and how traumatizing it was for me. She said it should not have been that way, and that I “slipped through the cracks” because I was from out of town and didn’t have a doctor there. That if I had a doctor there he would have told me to go straight to labor and delivery and called ahead for me. We talked about ways they could change their policies to avoid that in the future. I hope it makes a difference.

About The Author

Catie MacDonald is a mom of four, three on earth and one in heaven. She is an Oklahoma native and recent transplant to Georgia. Catie worked with The Jaxon Kade Foundation to facilitate the donation of the Caring Cradles. The Jaxon Kade Foundation is based on Oklahoma, with the mission of donating a cooling bassinet to every hospital in Oklahoma. You can find them at  jaxonkadefoundation.org and on Facebook and Instagram @thejaxonkadefoundation