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One year ago today, we discovered that you were gone. I can still remember the ultrasound technician trying to find you. You were supposed to be 14 weeks gestation that day…but you’d stopped growing at 11 weeks and 5 days gestation. And your heart had stopped beating.

I don’t know how to reconcile all of these new anniversaries and birthdays — days that were supposed to bring us so much joy, but instead make the grief feel unbearably heavy. Today’s anniversary, and your birthday, make three dates that I absolutely dread and cherish all at the same time. I cherish them because they are moments that remind me you were here. You are real, and I will always be your proud mama! I dread them because you could not stay, and the shadows of what should have been bring me to my knees.

The other day, your gramma told me about your sister playing with a little boy at the park. He is two-and-a-half years old, and your big sister played with him the way she would’ve played with Ezra. That thought made me want to cry, and it’s the reason I avoid parks as much as possible. They are filled with physical representations of the things I can never have. Right now, I have a five-year-old, a two-and-a-half-year-old, and a seven-month-old, but only one of you is visible to the other people of this world.

I wish there were more I could say to you…other than, “I miss you.” The truth, though, is that I struggle to shake off the constant melancholy. And, until the day I draw my last breath, I will miss you, Fletcher, and your sweet big brother, with every piece of my broken heart.

Love Letter

Two years. You have been gone for two years. Ezra, I still am completely baffled by the fact that two years can simultaneously feel like eons ago, and yesterday. The last two years have brought with them so much heartache, and it has truly been a painful process to learn how to exist without you here.

Global climate change has progressed, war is raging, genocide happening, and we’ve lost your little brother and your last living great-grandparent on your papa’s side of the family. The pandemic had plateaued, but the numbers seem to be rising again. It’s a scary world, and a very small part of me is honestly grateful that you were spared the pain the world offers. But most of me selfishly wishes you were here…making a mess of your clothes, and helping your big sister to turn the whole of the house upside-down every day.

I was so looking forward to washing extra tiny clothes again, all of the little socks getting stuck in our shirts and pants. You were supposed to be my snuggle buddy when your sister was either in her “Papa” phase, or completely disinterested in snuggling at all. My heart aches when I think about all of the things we’ll never be able to do together.

Even so, I feel you in everything I do. When I’m down, one of the songs I associate with you will come on the radio, or I’ll notice it’s 11:11 on the clock. I feel you in the warmth of spring sunshine, and your love is carried to me on the wind. Regardless of how long it has been, I will always love you, my sweet boy.

Happy second birthday, precious one! How I wish I could hold you and cover every inch of your face in kisses.

Love, your brokenhearted mama

Ghosts

Three years ago, we traveled to Washington to meet my brand new nephew. While we were there, we also picked up a minivan — a 2006 Toyota Sienna, which would replace our 2004 Toyota Corolla. At the time, we had a little girl who hadn’t even turned two, yet, but we were planning for a larger family and all of the adventures that might entail. Today, we still have that minivan, but now it’s a painful, lasting reminder of what life should, but cannot possibly, look like.

I will be the first to admit that my life was charmed. Only in my wildest nightmares could I ever have imagined losing a child to stillbirth, followed in quick succession by a miscarriage at 14 weeks and the death of a grandparent. And that’s just what’s happened, so far. I know sweet families who have experienced loss after loss — children, spouses, parents, siblings…Who’s to say that the next boogeyman isn’t still out there? My days are filled with melancholy, and the color palette of my world is in varying shades of gray. The sun constantly feels too bright. I much prefer rain, snow, and windy conditions to warm, tranquil summer days. It’s things like these that that make me feel like I’m surrounded by ghosts — shadows of what might have been if I weren’t so incredibly unlucky.

At one point, my husband looked at me when we were discussing what to do with the cars we currently own, and said, ”We planned to fill up that van with car seats. Instead, we’re filling it up with ghosts.” I’ve felt like giving up a lot since first losing Ezra, but I so badly wanted to throw my hands up and quit when he said that.

Two years ago today, I left for work thinking I was so incredibly lucky to have such a beautiful, healthy family. I came home from work with fears that I tried so hard to push away — fears that were confirmed four short hours later. All around me swirl constant ”what if” scenarios. They play out in my head much the same way that normal people experience daydreams. Some of the ”ghosts” I sense come in the form of beautiful reminders of the love and light that Ezra brought to my life, despite it being so heartbreakingly short. It’s not all inherently bad, but everything does elicit a twinge of pain in its own way, all the same.

How to Proceed When the World Feels Unbearably Inhospitable

*Trigger warning: Personal accounts of stillbirth/miscarriage/child loss and grief are mentioned in this post.*

Eight days. That is how long I have to figure out how I will tolerate being back in the workplace after my miscarriage, and I am terrified. I can still remember going back to work after Ezra died, and the moment I put my badge on I felt like an imposter. There I was, so broken, both inside and out, and I was educating my patients’ parents like my whole world hadn’t just gone up in flames. And, in eight days (a mere 21 days from the loss of my son, Fletcher), I am going to have to do it again.

For those who don’t know, I am a registered nurse in a level III neonatal ICU. It was my dream job before I graduated from nursing school a little over nine years ago. It was always exactly where I wanted to be. Then, my baby died. Suddenly, everything about my job was overwhelming. I can still remember overhearing conversations between a couple of the moms at the bedside that made me want to disappear. One mother’s little girl had been in the NICU for a very long time, and she said that her older daughter said that she had a baby sister, but it felt like she didn’t. Soon after that, they proceeded to talk about how the most traumatic thing either of them ever had to do was leave the hospital without their babies. I excused myself to cry in the stairwell as I remembered telling my then two-year-old daughter that her baby brother was not coming home. The memory of what it felt like to drive away from the hospital, knowing that my son was still in the hospital morgue, will forever elicit tears. Unfortunately, conversations like that are common where I work. It’s a proverbial field of landmines.

There is never a moment where my sons aren’t on my mind. Everything else I do or think about is secondary, and it requires a truly colossal amount of effort and emotional energy to get myself through the most basic of human interactions. When those interactions are filled with words or images that trigger painful memories of my sons’ deaths, all of my executive functions go out the window. At this point, I am certain that all of the new faces at work (there’s been a lot of turnover, exacerbated by the COVID-19 pandemic) probably think I’m an aloof jerk who has no interest in anyone else’s life other than my own. The truth is that I struggle listening to all of these young women of childbearing age talk about trying to conceive and their pregnancies/births/newborns at home, hearing about some of my coworkers’ brand new grandchildren, or even something as mundane as their weekend plans. For as much as I adore those with whom I work, it hurts to think about the life I can no longer have.

I long for the days when my worries and responsibilities didn’t weigh so much. Sure, they felt so heavy at the time, but 19-year-old Angelica couldn’t possibly have expected the metaphorical weight of the life I now lead at the age of 33. I, like all of the other bereaved parents around me, carry this grief everywhere I go, and it is a lifelong sentence. If I work at it, I will experience moments of joy again. But nothing in my life will ever resemble what it was before I was told that my sons’ hearts were no longer beating.

So…where do I go from here? I don’t know the answer to that question. It isn’t likely to be straightforward, and there is nowhere on this planet where I won’t feel the sting of child loss. Very personal (sometimes downright insensitive) questions will still be considered small talk, even though the answers will forever bring me to my knees:

“How many children do you have?”

“Do you think you’ll try for a boy?”

“You want a ‘replacement baby’, right?”

During the morning huddle, lunchtime, and between cares/assessments, I will still hear those around me talking about the joys of pregnancy, birth, and early parenthood. I am certain to see those who have young babies taking a break every four hours or so to go to the lactation rooms. The reminders are everywhere, and impossible to avoid. I will always think about how I was supposed to be among their ranks, and how I’ve been unceremoniously kicked out of the club. Again.

We Make Plans, and God Laughs

*Trigger warning: Personal accounts of stillbirth/miscarriage/child loss and grief are mentioned in this post.*

I grew up in the state of Idaho. Contrary to popular thought, our largest export is not potatoes, but salmon (farmed salmon, to be specific). When I was seven or eight years old, there was a “Salmon Days” event at one of our local parks adjacent the Boise River. A bunch of us were bussed to the park for a day in the sun, learning about salmon. On one side of the park, nearest the parking lot (and, subsequently, the firetruck/EMTs), was a table with cross-sections of actual salmon. At that particular station, the other kids screamed and swatted away the wasps and yellow jackets attempting to make off with pieces of the salmon as they came near. I very calmly told them to step away, leave the insects alone, and they wouldn’t get stung/bit. As fate would have it, I was THE ONLY ONE who got stung that day. The title of this post is religious, in a way, even though I haven’t attended church in the better part of a decade. It is appropriate for what I feel right now, however.

It has been 20 months and 17 days since my son, Ezra, was stillborn. He was planned, and very much wanted/loved. After he died, we weren’t sure what we were going to do. Then, last year my husband told me he was ready to put his heart out there again. He asked me if we could plan for another baby — a living sibling for our four-year-old little girl. Despite my trepidation, I relented. In November, we discovered that we were expecting again, and we greeted this baby with very cautious optimism, and so much love.

In December, I started to bleed, and had my first ultrasound just prior to six weeks gestation. There was one perfect, blinking heartbeat, and what the sonographer thought might be two gestational sacs. In January, I began to bleed again, landing us in the emergency room because I was certain I was miscarrying. We then were told that the second gestational sac was actually a pocket of free blood — a subchorionic hemorrhage that had passed and now left us with an otherwise healthy baby, and no impending risk of loss. My OB suggested non-invasive prenatal testing (NIPT), which yielded negative results for T-13, T-18, and T-21, and revealed to us that we were having another baby boy, who we were, up to that point, calling “Grogu”. I left that appointment with so many feelings, but was just beginning to feel like hope was an appropriate thing to feel for this tiny growing being.

On February 10th, I began to bleed again. It was a small amount, but I’m so anxious and hyper-alert that I called with my concerns, anyway. They were kind enough to get me in for an ultrasound the following day. I was so sure it would be a routine scan — an opportunity for us to look in on our little boy and see his beautiful, tiny heart beating away. But, alas, the wasps were back.

On Friday, 11 February 2022, we heard those words again…those earth-shattering, life-altering words: “I’m sorry, but I don’t see a heartbeat.” Another baby was gone. At 14 weeks exactly, he was only measuring 11 weeks and 5 days gestation. Yet again, my body was a tomb. Yet again, I would be forced to give birth to death. Once more, my body had failed.

It was my mother’s 60th birthday, which we had soundly ruined. My younger brother and sister-in-law had also delivered a healthy baby boy just three days prior, and Nick’s younger sister has a perfect five-month-old boy at home. At this point, I feel like my timing is superb, and there is something I must be doing horribly wrong. After all, if I did it once before, why can I no longer safely bring a living baby into this world?

I made plans, and God laughed. It doesn’t feel like a good-natured laugh, where some supreme being above me is telling me that something better lies beyond all of my hopes and dreams. Instead, it feels like someone is laughing AT me; like the universe is telling me I was never meant to be a mother, and is now trying to even the score. I tried so hard to keep my babies safe. I asked all of the right questions, took all the right vitamins, ate all the right food, read all of the articles, counted kicks, slept on my side…and the wasps still came for me. Not once, but twice.

I had a D&C on Tuesday, and the reality of our predicament still sends me reeling in the quiet moments I have to myself. I have cried what feels like millions of tears, and not a one will bring either of my sons back. We decided to name our second baby boy Fletcher Atlas Kovach. His middle name was meant to imbue him with all of the strength it would take for him to carry the weight of the world. And oh, how we miss him…

Somewhere Only We Know

*Trigger warning: Personal accounts of stillbirth/child loss and grief are mentioned in this post.*

The other day, I ventured into our attic for the first time in over a year. My sister-in-law will be delivering their second baby very soon, and I was looking for the MamaRoo infant swing she had lent us before we lost Ezra. It turns out that my parents placed it in the basement of their house in the days after his death, so I couldn’t find it. What I could find, however, were all of the things that were supposed to be handed down to my son — the things that I had pushed out of my mind over the last 16 months: a different baby swing, a bouncer, a car seat base, three strollers, a pink bathtub, a play mat, two baby walkers, a box of clean bottles and breast pump equipment, and several boxes of clean baby clothes (split ever so painstakingly into different sizes and separated into “boy” and “girl” clothing boxes).

I carefully sifted through the items, thinking about how ready we were for our baby boy to arrive. Everything was covered in a layer of dust. No parent expects to be left with an attic full of their dead child’s unused personal effects when they find out they’re expecting a baby. But, alas, here I am. After failing to find the one thing I went up there to get, I descended the rickety ladder, closed the attic door, washed my hands, and sat down on my bed. And then, I cried.

There is a video from the Star Legacy Foundation (https://www.facebook.com/StarLegacyFoundation/videos/110104136545239/) that I stumbled upon about one month after Ezra’s death. Just an FYI, do not watch it if you are not in a good place, emotionally. It nearly broke me the first time I saw it. In it, a mother and father exit a hospital. The mother is in a wheelchair, pushed by a hospital employee, and the father is carrying a car seat. They drive home in silence. When the couple gets out of the car, the father collects the car seat, they pause to look at one another, and they proceed into their house. It is quiet. They then walk over to the nursery, the father puts down the car seat (which we can now see is empty), and the mother begins to sob. She drops a pink baby blanket on the floor, melts into her husband, and they both crumple to the floor in tears in the doorway of their child’s silent nursery.

We never had a nursery set up for our son. He was going to share his big sister’s room and hand-me-downs. If anything, we were just doing our best to make room for him in our home, and in our lives. And we were trying to do it safely in the midst of the pandemic. To this day, we still feel the void left by our son. It’s hard to ignore, and, honestly, I wouldn’t dream of ignoring it. Compared to other bereaved parents, those who have no other living children, we have a home that is filled with noise. Our four-year-old does a pretty good job of making sure we don’t have too much time to over-analyze the dark thoughts floating through our heads (and I cannot adequately express with words how grateful I am for her), but there is still an uncomfortable silence. It both makes me desperately want to fill it, and, simultaneously, slip into the noiseless void and disappear.

When I was pregnant with my son, I can recall noticing pregnant people all the time. It’s the kind of phenomenon that everyone experiences at one point or another. If you buy a certain kind of car, you suddenly begin to see that car everywhere. After Ezra’s death, pregnant people continue to be ubiquitous. Only, now, the mere sight of them sends me into a full-blown panic. I am part of this dreaded club, and some days it seems like death is all I can see. It is a big, black, billowing cloud hanging above my head, and it grows every day as we get further and further away from the day Ezra was born still.

Add to this the fact that COVID-19 stands like an ominous shadow in every alleyway. At times, I wonder if I’m going insane. I’m sure I must be. I wasn’t exactly considered “normal” even before losing my son. Despite that, I am told that what I feel is not, in any way, unusual. Super encouraging, right?

I don’t really know where I was going with this blog entry. It started with a pile of untouched baby items in my attic, somewhere in the middle is the image of me sobbing and obsessively poring over/editing my old baby registry for my sister-in-law who is due in February, and it ends with the pile of messed up thoughts and feelings festering in my head. Over a year after losing my son. I guess today is National Son’s Day, too, and I’m feeling his absence so keenly this week…

Despite Knowing the Journey and Where it Leads…

“Despite knowing the journey and where it leads…I embrace it. And I welcome every moment of it.”

– Louise Banks’s monologue, Arrival

*Trigger warning: Personal accounts of stillbirth/child loss and grief are mentioned in this post.*

My sweet Ezra,

Today is your first birthday. A part of me marvels at the idea that it’s already been one whole year. Then, another part of me thinks, “How can it have only been one year?!” Time stopped for me, but I remain an observer to the ever rapidly-moving world around me. I remember sitting with you, singing and talking to you that final Sunday in May. In the mirror, I could see myself growing, and was only made excited by the prospect of becoming more planetary by the moment. I can even remember telling you about the pastel lights, in a long row of lanterns in front of a neighborhood just down the street from ours, turning on as I drove home from work that same day. Honestly, it stings to think of the moments before your death…to consider how normal and blissful everything was before my whole world was turned upside-down.

Every day since you died, you have been at the forefront of my brain. Doing anything is a struggle, and requires what feels like a herculean amount of focus and intent. I find myself constantly bargaining. While I know time won’t magically turn back the moment the clock strikes 6:42AM on June 1st, I keep hoping it will. Hoping that this year was a nightmarish test of some kind, and that one day I’ll wake up to find you sleeping soundly in a bassinet by my bed after I’ve learned the appropriate lesson.

I have this image in my head of you at about two years of age, coming up behind me and wrapping yourself around my neck in a tight hug. At work, I stare longingly at brand new 33-weekers sleeping soundly in their isolettes. More and more, I wonder who you would be today. It’s a miserable exercise, honestly, pondering the things that will never be. But all of the love I have for you has to go somewhere, so I find myself daydreaming about the incredible person you’d be if you were still here with us.

For as sad as I am on this day, I want you to know that I love you. And, despite the pain of this year…even if I had known what was going to happen, I would not trade the 33 weeks and four days of your life for anything else. You are my mine, and I am yours. Forever.

Happy birthday, my sweet, precious boy…

Ezra Wilde Kovach, 1 June 2020

4 East

The last child I held

was dead for at least twelve hours.

Sometimes life has a way of coming to the end

before it’s even started.

The hall was quiet with the deafness of

mourning, but there was a peace in your room

I never want to understand.

And your sweet husband was holding your boy

on his skin like a prayer

and I thought

Oh, to be loved like that.

I did my best to memorize him,

take in the slight fingers and the

soft brown hair,

but I didn’t see the color of his eyes

or the tiny little hairs on his tiny little legs.

I never got a chance to hear him say mama

or watch as he

lifted his head for her voice,

but I did hold his body at the same

precise moment as

God.

I still hate when people say things like

He would’ve started kindergarten this fall

but he would’ve turned one this winter

and two the next, which feels like

a mounting hurdle as opposed to

the healing of time.

And this whole thing is preposterous

because he’s not my son

and there’s no way I could understand.

I guess I just wanted to tell you

I miss his slight fingers and

soft brown hair

and I also mourn

for the things we will never know.

-Megan Ulrich, Return Unto Me

Nobody Prepared Me for Life After Your Death

*Trigger warning: Personal accounts of stillbirth/child loss are mentioned in this post.*

The day you left, I wasn’t prepared. Then again, who could possibly anticipate how to feel or respond when told that their child’s heartbeat has inexplicably stopped? I was alone that day — driving myself to the hospital in the wee hours of the morning because I was sure I must be overreacting. There was no way that something serious could be wrong. I’d inevitably be discharged and home again later that morning…right?

No. Not in the least.

The doctor simply looked at me with tears in his eyes, almost whispering, “I am so sorry.” I don’t think I ever heard either of us use the words “no heartbeat”, “dead”, “lost”, or “gone” in that moment, because they were superfluous. I knew what he meant. It was 2:15 in the morning. When I called your papa to ask him to come to the hospital, I simply asked if he could find someone else to look after your sister. He was positive he knew what had happened as I sobbed between sentences. I should’ve been more straightforward, though; told him exactly what happened instead of leaving him to wonder, perhaps with a false sense of hope. But I couldn’t bring myself to say it out loud. That would mean that it was real.

My first thoughts were those of utter disbelief. I did everything I could to take care of myself for your sake. Especially during a pandemic. Not only am I your mother, but I am a nurse. I had been working just down the hall five hours earlier. How could any of this possibly be real? What did I miss? What did I do to have lost you like this? Then, I imagined my name appearing on the L&D grease board — the reason for my admission no longer reading “decreased fetal movement”, and so cruelly screaming “fetal demise”. I believe my coworkers must have known the true nature of what had happened before your own father did. I waited for him as I clutched my abdomen, rocked back and forth, and said “I’m sorry” over and over again.

When he arrived at the hospital, we held hands, cried, and asked, “What now?” We would utter those words through the rest of the day as we were guided step-by-step through every decision we had to make. Your papa looked at me solemnly and said, “At least the worst part is over.” Because he believed that learning you were gone would be the most painful part of this whole process. I began to sob again, and told him that the worst part wasn’t over…because now we had to deliver you.

I remember the cold, bright operating room and sitting upright as I moved onto the operating table from the gurney. My hard chart was in the corner, and it had a giant, purple butterfly taped to it. I was still hoping that this was all some horrible nightmare. Somehow, that butterfly was confirmation that my life had become the living embodiment of every worst-case scenario I had ever imagined.

I wasn’t prepared.

Nobody could have possibly prepared me for the silence as you were born, with the exception of my crying. I did not expect an acute feeling of emptiness to take hold as the doctor gently guided you out of my body, nor the wave of grief as a nurse said, through her tears, “He’s so beautiful.” The peace I so suddenly felt when I saw your face and felt your warm cheek against mine caught me off-guard. I could’ve been so easily fooled into thinking that you were still alive.

I wasn’t prepared.

I wasn’t ready for any of this.

But how could I have been?

How could anyone have been?

I wasn’t prepared.

When I was wheeled out of the hospital with a weighted teddy bear, the blanket in which you were swaddled, and a memory box in my lap, I didn’t realize it would hurt so much to leave you behind. To drive away, and never see your sweet face again. To see you nine days later in a tiny, sealed box carried by your papa from the hearse to the place where we would bury you.

Nobody ever told me I would ache with every thought of you, and that every aspect of daily life would become a constant reminder of your absence. Never could I envision a time when your big sister would ask to visit her baby brother, because you would never come home with us. It never occurred to me that my home would become my only refuge; that I would be reluctant to leave it for any reason at all.

I wasn’t prepared to lose my sense of self.

I didn’t know that a part of me would die with you.

I wasn’t ready to let go of the dreams and hopes I had for you, but they were already slipping away.

Dear God, I wasn’t prepared!

Before this, we owned one vase that frequently disappeared whenever we needed it. Now, flower arrangements were dispersed around the house. I would cry as I thinned them out when the flowers lost their color and shriveled. A large collection of vases would gather in a small corner as the flowers died. To this day, I almost cannot stand to have bouquets of flowers inside of the house.

Who could have told me that I would stare out of the window to the backyard for hours, hoping that the yellow butterflies and humming birds were a sign that you are okay? Wherever you are…

Who could have anticipated that I would want to talk about you every chance I got? I sought advice from support groups, feeling some semblance of peace for only a short time. I eagerly, and almost impatiently, looked forward to the next opportunity I had to talk with other bereaved mothers. It was the only way to keep myself from drowning in this deep, ubiquitous sorrow that stole all of the color from my world.

Not one person — not even another bereaved parent going through the exact same experience — could ever have prepared me for the dark, sinking, relentless pain that has devastated every aspect of my life. I can feel it in my bones.

As the days pass, the dark moments don’t feel all-consuming. They haven’t gone away completely, and, according to every article I have read and every bereaved parent I’ve ever met, they never will. Fewer days are entirely eclipsed by the overbearing cloud of grief. Nevertheless, despite however illogical and counterintuitive it may sound, I almost don’t want the pain to go away. I have photographs, your blanket, the hat you wore, your baby band from the hospital, etc. But none of that is you. The pain almost feels like the only thing I have left.

Recently, we watched Westworld. In it is a character who lost his son. He talks to his wife about his grief, and her words changed, in part, the way I thought about my life without your physical presence.

Bernard: I think about him every day…I turn expecting to see him. But he’s not there. He’s never there.

Laura: When he died, I remember thinking it was like the sun had gone down and it was never going to rise again. I walked in the dark for so long. I don’t know why people said [“if you love someone, let them go”]. If you love someone, why would you ever let them go? That’s what saved me. The only part of [him] I had left was his memory. And if I died, the darkness would take that, too. But if I kept moving, I could find the light again. And I could bring him with me.

I don’t know what the path ahead of me looks like, or if I will ever fully succeed in finding the light again. Everything still feels so hopelessly dark, but I will try to keep moving forward for you, and everyone else I love. I will do my utmost to honor you and try to make you proud. I’ll bring you with me. Even if I never feel adequately prepared to face what lies ahead.

How to Save a Life

*Trigger warning: Personal accounts of stillbirth/child loss are mentioned in this post.*

At one point in my life, the world seemed to have something vaguely resembling order. With the passing of time, though, my rose-colored lenses have turned quite grey with every painful reminder that there are so many things over which we have very little control. In my case, it was the very unexpected loss of my son. It is heart-wrenching, and I am told I did everything I could for him in an impossible position. This does not, however, completely discourage my desire to decrease the odds of a tragedy like mine entering someone else’s world.

Almost three months ago, my son was stillborn. At 33 weeks and 5 days gestation, I went to the hospital concerned about decreased fetal movement. I just so happen to be an expert worrier, so I thought it was likely all in my head. Instead, while sitting by myself in a darkened exam room, I was told that my son’s heartbeat was gone. Since losing my son, I have heard stories like mine told time and time again. While completely horrible, I am not alone in this experience, and all of us are left wondering what happened.

Once a baby is born and ready to go home, nurses give discharge instructions for infant care, including how to prevent sudden infant death syndrome (SIDS). They teach parents how to properly install a car seat, and how to appropriately buckle their newborn into it to prevent injury should they be involved in a car accident. People know that children can die. Why, then, isn’t safeguarding against stillbirth more strongly emphasized in a pregnant woman’s prenatal education?

When most women find out that they’re expecting, they begin to plan. They imagine a life full of giggles and morning snuggles. One thing they also imagine is how their child will enter this world. In an ideal situation, every woman would experience an uncomplicated vaginal birth. In a perfect world, nobody would have to worry about hearing, “I’m so sorry…there is no heartbeat.” We wouldn’t have to make elaborate plans to prevent severe infant head trauma or cord compression during birth. Sadly, these things still happen, and I wonder how many mothers are aware that their giddy anticipation on or before delivery day can so easily disappear.

For centuries women have been giving birth without the assistance of medical devices like a fetal Doppler. But, as a NICU nurse, I have seen more than my share of neonatal injury and death as a result of hypoxia — following the birth of an unmonitored infant whose cord was unknowingly compressed. So many women make the decision to labor freely, without the constraints of fetal monitors, but, as a mother whose baby’s heart just…stopped without any plausible explanation, I have become a strong advocate for choosing to monitor a baby during delivery.

Birth plans vary widely depending on women’s personal experiences, birth stories told by friends and family members, family medical history, etc. There is no one-size-fits-all birth plan, but there are some recommendations:

1. The first is an intervention easily employed prior to an infant’s birth: kick counts/monitoring of a baby’s typical intrauterine activity (and immediately seeking help when there is any behavior outside of a baby’s norm).

2. Have a trained medical professional guiding each birth.

3. Whenever possible, monitor the baby’s heart rate during delivery.

Last week, I ordered some pamphlets from an organization that exists explicitly because its founder and staff have personally experienced loss. They are making a valiant effort to improve pregnancy outcomes. It was something I stumbled upon in my frantic attempt to understand why my son died, and to know if there was anything more that I could have done. When the pamphlets arrived in the mail yesterday, I sat on the couch reading through one entitled “Parenting in Pregnancy”. I started to think out loud while my daughter watched a children’s show and my husband read in a chair across the room.

The pamphlet said that babies don’t usually sleep for longer than 90 minutes in-utero. I had started to feel anxious that something was wrong at 9:00PM the night before we found out that our son was gone. I didn’t make it into the hospital until about 1:00AM. I started talking about how important it is for women to know this information. I almost began to rage about how pregnant mothers should be more strongly encouraged to advocate for their babies when they feel like something might be wrong. Because I dismissed my concerns as a product of my anxious brain. Because I doubted myself at a crucial time, and in a situation where an earlier intervention might have made all the difference.

My husband asked me to stop talking about it. I continued to think out loud, and he sternly told me that my son’s death was not my fault, and that I needed to stop what he perceives as destructive thinking. And, perhaps he’s right. I have heard so many times that any information for pregnant women directly addressing stillbirth can only cause undue stress. But I have always felt that knowledge is power. I will do whatever is necessary to spare someone else the visceral pain of holding their lifeless baby in their arms. I want to save others from the anguish of driving home from the hospital with a memory box in their lap and an empty car seat, walking into a quiet nursery, and burying a baby in a hopelessly tiny coffin. Complications arise, and, with appropriate prenatal care and education, some can be avoided altogether.

During pregnancy and labor, so many unexpected things can happen. I don’t say this to frighten pregnant women, but to desperately try to give mothers the tools to fervently advocate for themselves…because it could possibly save countless lives.

“It could always be worse…”

*Trigger Warning: This post includes personal accounts of infant loss/stillbirth.*

In nursing school, one of the first things to which I was introduced was Maslow’s hierarchy of needs. It is presented in a pyramid, very much like the food pyramid all of us learned as children. It is designed to reflect the general movement of human motivations. At its base are physiological needs (e.g. food, water, sleep), followed by safety needs, then, at its middle, belongingness and love needs. While the middle tier is important for maintenance of psychological health, the two tiers beneath it must be addressed first.

A while ago, my husband and I were watching an episode of John Oliver. In it, he discusses our country’s current dilemma regarding sending children back to school in the middle of a pandemic. He has segments that are broken up by relevant video montages. To keep us, or maybe John Oliver, from exploding, the topic is usually a little lighter, or more humorous. The montage that night, however, made my husband and I want to throw something at the television screen.

The video was a collection of television personalities talking about how desperate they are to send their children back to school (regardless of the risk the COVID-19 pandemic poses), both for their sanity and to prevent psychological harm to their children due to lack of socialization. Each of them have wide eyes and say, in exasperation, that their children are making them crazy. While I don’t want to minimize how someone else feels, my husband and I do not agree with this sentiment.

My mantra has always been “it could always be worse.” It usually reminds me to stop and check my first-world privilege at the door. But, sometimes, the worst thing one could imagine happening actually happens. In early June, I was told that my son had no heartbeat at 33 weeks and 5 days gestation. My pregnancy had been pretty routine up to that point, with the usual discomforts, but I tried so hard not to complain, because “it could always be worse,” right? We were heartbroken, and had to deliver our sleeping child into what has become a world of silence for us.

We have a two-year-old daughter, who often breaks silence pretty efficiently, but the past twelve weeks have provided us with plenty of quiet to sit with our agonizing thoughts about why we lost our son, and the fact that things are so still right now because we couldn’t bring our newborn home. For the remainder of our lives, there will always be someone missing at the dinner table. We will never be able to physically hold our son close again, know his smile, know what he wants to be when he grows up, nor see him get married and have a family of his own. My husband and I don’t even know the color of our son’s eyes. So, we sit in the uninterrupted “peace” of our home wondering who he would have been, and what it would be like to have brought him home with us.

The loss of a child is an excruciating experience I do not wish on any parent. While some parents simply don’t have a choice but to send their children to school for one valid reason or another, it comes as a huge shock to know that so many people are so willing to risk the lives of their children for a little bit of peace. I am a registered nurse. While I have not seen, first-hand, how COVID-19 impacts its victims, I do know that it has killed children and adults, alike. It also has proven to cause lasting damage to the heart and lungs. Without a solid plan for infection prevention in place, many schools are bringing children into the physical classroom far too early and inflicting an unprecedented amount of anxiety on the teachers of our country forced to teach these classes. It is their livelihood, and offers them no other option but to risk potential exposure to a frightening disease.

As a young adult, I never envisioned that I would one day have to bury my infant son. I did not lose him to a virus, and I am not an epidemiologist. But I do know that in the coming months, without carefully-considered plans to help protect our teachers and school children, many parents may also have to give up the dreams of their child’s unfulfilled future and purchase a burial plot. Because, after all, “it could always be worse…”