Parents envisage who the child might look like and whether it will be a boy or a girl.
There may be a baby shower or blessingway.
There are discussions (and perhaps arguments!) about baby names.
Baby clothes are purchased.
Dreams are dreamt of all sorts of possibilities for this precious little life in the days, months and years ahead…..
For some of us, sadly, what we end up with is death.
It is the furthest thing from the mind of most expectant parents. “Do you want a boy or a girl?” we are asked. “Oh, so long as it’s healthy”. No one thinks to say, “Oh, so long as it lives.” The truth is, in our modern, westernised society, the majority of babies DO live. This is a great thing! But it also sets us up for the shock of our life when the opposite happens.
We expect: “Congratulations! It’s a girl!”
We get: “I’m sorry. Your baby is dead.”
In my previous post, I wanted to celebrate the life and existence of Cody Luke, because he did live. Not for long. And it certainly wasn’t an easy nine hours for him. Or us. But live he did. Both before he was born, and for a short time afterwards.
The headstone on his grave reads:
Nine months to know you
Nine hours to be with you
A lifetime to miss you
Eternity to be together
When he died, we received many many cards of sympathy, one of which congratulated us on his birth. I must admit I would never think of sending such a card, but the truth is, it really blessed us! It was an acknowledgement of his life when what we were facing was his death.
Here is the story of his transition from the womb, to our arms, to the neonatal ward and a helicopter, and then to the grave.
Early Hours After The Birth
When I was pregnant with Cody (precious memories, those ones!), I was declared to be “low risk” and “perfectly suited” to a Birth Centre delivery. How quickly those predictions can change, like the toss of a coin, or flick of a light switch.
Cody’s triumphant moment of entry to the big wide world was accompanied by a strange sound. A kind of thud. It was the sound of his ruptured umbilical cord dropping to the floor (I was standing up). It was so random and unexpected that even the midwife didn’t notice and we had to bring it to her attention. (This was the first of her many mistakes.)
One of the failings of the Birth Centre where Cody was born was that, if a delivery occurred during the night, there would be only one midwife in the entire unit and no one else would be called in to assist at the moment of birth. One midwife can only observe and deal with so much. (This is one policy we fought hard to have changed after Cody died.)
When we brought the ruptured umbilical cord to our midwife’s attention and she noticed the large volume of blood on the floor (sorry, this might be a messy blog post!), she suddenly started barking orders at my husband, Geoff, instructing him on how to provide medical care for his baby while she attended to me. Mistake number two. Unless the birth had occurred out in the bush or some such, she should never have expected the father of the baby to carry out any medical procedures on his own baby.
She did not call for help from any of the trained staff that were readily available in the delivery suite upstairs, or in the postnatal or antenatal wards. Pressing the buzzer that was attached to the belt of her pants, or pushing the emergency buzzer on the wall was a simple thing to do, really. Yet she didn’t do it. Not at the moment of birth, nor at any stage during the next two hours. Mistake number three.
She busied herself massaging my abdomen, fearing that the massive blood loss indicated a haemorrhage. Meanwhile she shot rapid instructions at my husband, telling him where to find the resuscitation equipment in the bedside table and how to use it, to enhance our son’s oxygen intake. (He was breathing but needed help.) When she glanced over to see if he was doing it correctly, she seemed quite angry, and raced over there showing him how to press the oxygen mask down over Cody’s nose and mouth to force air entry into his lungs, rather than just holding the mask above his face as my husband had been doing. Mistake number four.
It was this act of forced air entry, without having first cleared his upper airways of possible meconium, that was ultimately a major contributor to Cody’s death. And it was Geoff’s participation in this act, following the exact instructions of the midwife, that has caused him so much distress over the years, due to strong feelings of guilt. Even if guilt is completely unfounded and illogical to an outsider, it can eat someone up from the inside, displacing logic and rationality, and in their wake leaving fear, regret, shame and despair. I feel so sad that he still blames himself for following the instructions of the midwife, trusting in her competence and instructions, and blaming himself for not somehow knowing better than a midwife with 25 years of experience.
……. Pause to collect myself and settle my shaking fingers ……
After awhile, Cody was given to me with the excited proclamation that he was a massive 5150 grams (11 pounds 6 ounces). It seemed that the midwife was very proud of our successful and comparatively simple birth process, considering his size! I felt quite proud too!
As she handed him to me, she commented that he was a bit cold and needed to warm up a bit, so she wrapped us both in a warmed blanket with skin to skin contact, and made me a cup of tea! She then left us to relax and enjoy our new baby. Mistake number five. A baby who is born in anything less than normal circumstances needs careful monitoring. This cannot be done from a separate room, relying on inexperienced parental observations only.
I was oblivious as to what was “normal” for a newborn, because I slept through the first hour of my first son’s life (in fact, I also slept for the fifteen minutes between the delivery of his head and the rest of him!). So to me, the fact that Cody was pale, whimpering occasionally, and very floppy, was not as much of an alarm bell as it should have been. When my third son was born 11 months later I suddenly realised what a healthy newborn looks like! Cody did NOT look healthy.
The midwife came back into the room once or twice to check up on us. I informed her that he was quite floppy in my arms and just grunted if I tried to move him or scoop his legs back into my embrace, because they kept flopping down. Our midwife simply gave me a freshly warmed blanket and another cup of tea. Was she British perhaps? No, a cup of tea really doesn’t fix everything!
She said that he would have to be taken to the intensive care nursery at some stage because he was over 10 pounds and asked us what we wanted to do about that. We deferred the decision back to her, saying that she could decide because she was the midwife, but that if it was important for his health then of course we wanted him to go now. She declared that it was “A silly hospital rule” and left him with us.
After quite awhile, she took Cody from my arms to perform the Apgar tests, which should be done at 1 minute and 5 minutes after delivery. This had obviously not been possible, due to the fact that he was having air pumped into his lungs at that time, and the midwife was busy with me. When the Apgar results were written in his notes, it was stated that they were in fact performed at 1 minute and 5 minutes, which they were not. He was also given a rating of 8 out of 10 for his 1 minute Apgar, and 9 out of 10 for his 5 minute Apgar. She rated him 2 out of 2 for “respiratory”, even though he was being given oxygen at the time the tests were supposedly carried out! I’ve lost count of the number of mistakes.
At the time of performing the Apgar tests, the midwife called us over to the bed and specifically pointed out the “signs of respiratory distress” present in our baby. She showed us his chest recession and the nostril flaring and the grunting sound he was making with every breath, as he struggled to get enough air to survive.
She gave Cody back to me for some more “bonding time”, and again removed herself from the room. I will not bother trying to keep count of her mistakes.
During this time, as day was now dawning, Geoff began making what should have been excited phone calls, but they were tinged with a sense of tension, using words such as, “He is apparently a little bit stressed from the delivery” and “Please pray”.
After awhile, the midwife returned to our room, felt Cody’s skin and decided that he was still a bit cool and needed to be helped along a little bit. She took Cody from me and I decided to have a much-needed shower. My wonderful husband helped to clean me up, which took quite awhile, due to the messy nature of the delivery and the length of time since. It felt good to be clean!
I needed some supplies from the car, so Geoff went out to get them, surprisingly discovering our midwife outside smoking a cigarette and writing up Cody’s medical notes (one long entry of what she could remember from the last two hours since he was born)!! Geoff asked her where our baby was, assuming he was in the intensive care nursery upstairs, but she replied, “Oh no, he’s in the utilities room.” Up the hallway. Alone.
Geoff was shocked! He quickly came back inside to where I was waiting for him, gave me my things, and then went to get Cody from where he had been left ….. alone ….. under the warming trolley, surrounded not by professionals or loving parents, but by empty urinals and other medical equipment.
Geoff, with his heart full of love for his son, asked if he could carry Cody up to the nursery, rather than having him wheeled along in a trolley, and the first thing he did was to bring him to me so I could see him once more.
Okay, now this is very hard to write, but write it I must. When I saw Cody I was shocked. He looked…. grey. His mouth was sort of hanging open, as he gasped for intermittent breaths. It seemed very odd to me, and I commented on it to Geoff. We were both VERY concerned by this time, and very angry that he had been left alone.
The Neonatal Intensive Care Unit
As we made our way to the Neonatal Intensive Care Unit, with Geoff holding Cody, he mentioned to the midwife on more than one occasion that Cody seemed to be “gasping for breath”, to which she replied glibly, “Oh you’d be a bit stressed too, if you’d just been born”…. ????
Upon entry to NICU, the midwife did something that she had only done a couple of times in the past hours. She laid him down, fully removed his blanket covering and actually looked intently at him.
“OH MY GOD! HE’S NOT BREATHING!!!!”
Those words haunted me for years to come.
The staff at NICU were absolutely and completely amazing. They literally RAN to Cody’s aid. With lightning speed they had his blood tested, and his poor body prodded and poked and hooked up to life support equipment. They immediately summonsed the on-call paediatrician, whose Sunday morning plans no longer mattered. A life was at stake.
Upon arrival to NICU the fantastic paediatrician immediately set to work. The first words I heard him utter were, “WHO THE HELL DID THESE APGARS??!” He was looking at a baby in full respiratory arrest, with blood tests that were incompatible with life, and he was reading test results that showed he had scored 2 out of 2 for the respiratory part of the Apgar test. He later told us that the only rational reason he could think of for the inconsistency was a rare medical condition that can cause a respiratory shut down after two hours. But this was not the case.
The next few hours are a bit of a blur. I remember asking for a lady from our church who I knew worked at the hospital as a midwife, and she was thankfully just coming on for a shift. She came straight to us and was literally a tower of strength for which I am still thoroughly thankful. I remember telling her a bit of the story, and mentioning something about the broken umbilical cord, which really shocked her! There had been nothing written in Cody’s notes about this very important fact. She rushed down to the birthing unit and discovered (in the rubbish bin!) the discarded cord, which she retrieved and sent away for pathological testing.
….. Pause Breathe Cry …..
I remember a blur of people coming and going. Friends. Family. Medical staff. I remember the paediatrician asking if we wanted to have our baby baptised, the suggestion of which made me angry. Or perhaps shocked. I was in such denial at the reality of what was going on, and this suggestion was like a slap in the face, trying to wake me up. I did not want to be woken.
We were informed that Cody would need to be airlifted to the major children’s hospital in Sydney, and that the Newborn Emergency Transport Service (NETS) team would soon be arriving by helicopter. Reality was beginning to sink in.
Airlifted to the Children’s Hospital
The team that came to help our baby were so wonderful. They were competent and professional, which helped us trust them, and compassionate, which helped us feel cared for. The nurse, whose name was Karen, was particularly supportive to us.
I was surprised how long it took them to do their thing. I thought they would rush in, grab him on a trolley, and rush back out the door to the helipad. It took almost over five hours for them to stabilise him enough for transport!
I remember being informed that by this stage, with his blood levels severely acidotic after extensive oxygen deprivation, if he lived (IF??!), he would almost certainly be severely brain damaged and require major ongoing medical care for his entire life. Again, I was angry at the assumption that this somehow seemed to diminish his worth! I told everyone that I would love him, no matter what, and do whatever it took to care for him. Of course I would have preferred that “healthy baby” we all wish for, but I knew that I could and would love my baby in any condition. I just wanted him to live.
The thought that he might not live was still far, far from my mind.
Thank God for the numbing benefits of shock!
We had to make a very, very difficult decision regarding his helicopter trip to the hospital. The number of staff required to provide his care during transportation meant that there was only one spare seat on the helicopter. This meant that only Geoff or I could accompany him. At this stage we did not think we could cope with being apart, so we decided to travel together by car to the hospital, desperately needing each other’s support to get through this. I still regret that choice to this day.
When Cody was finally prepared for transportation, we were able to say goodbye to him. It was gut wrenching to see him with so many cords attached to his (not so little) body. I managed to stand up to get closer to him, and said the words I didn’t want to say: “Good bye Cody. I love you.” I still assumed that I would see him soon. Now some may think it is my wishful imagination, but I am absolutely sure he opened his eyes just a little bit at that time. It was the last time I would be able to look into those deep, beautiful, soulful eyes.
I felt so connected to him in that moment, as though all the life-giving cords, the resuscitation equipment, and medical teams were not even in the room.
Time stood still.
The Final Moments
We prepared ourselves to leave for the Sydney Children’s Hospital at Camperdown, but before we were able to depart we received the phone call that no parent EVER wants to receive.
“I am so sorry. We have done all that we can do. Cody suffered seven more cardiac arrests during the twelve minute flight. We are keeping him alive artificially and need to know what you want us to do.”
It was my husband that took the call and gave them permission to turn off Cody’s life support. If it had been me, I may never have been able to make that choice. When I allow myself to think of it, I still feel a deep, deep sadness that I was not with my son when he died. That I did not have the courage to go in that helicopter with him, so that he could die in my arms.
The midwife who had come with the NETS Team was called Karen and she had been so lovely to us, so it was a small consolation to know that she held Cody in her arms while the life support cords were removed, and she poured into him some of the love that I desperately wanted to give, as he breathed his final breath.
I’ve left the photos until last, because they may be upsetting to some people.
My next posts will talk about the early days of grief, forgiveness, and life after loss. They may be awhile in coming!