** TRIGGER WARNING This post is about miscarriage, babyloss, stillbirth, and the fallout from it. It is about negligent care from midwives, and more. Please do not read this if these topics may cause you emotional stress, that is never my aim. **
I can’t remember what the weather was like that day. I can’t remember what I was wearing, or what I ate for breakfast. I do remember, in great detail, the searing pain of loss I felt, though, when I heard those words
There is no heartbeat, your baby has passed away.
I have written about my experience with late-term miscarriage a number of times. Here, on my own blog, I recounted my story. I talked about how my daughter named her dead sibling Marshmallow, and how we still remember that baby many years later. I even shared my experience with the readers over at Yummy Mummy Club. I talk openly about my experience, the feelings and the aftermath because I think that we need to discuss these things. We need to know there are others out there who suffer these losses, too, and that we can lean on one another for support.
What I have not discussed (only alluded to) was my experience with the midwives I had placed my trust in during that pregnancy.
My first pregnancy was uneventful. Though Story was 13 days “overdue” and I was induced to deliver her, nothing was very remarkable. I was under the care of an absolutely incredible OB/GYN, but we moved out to the ‘burbs and seeing her in downtown Toronto was no longer reasonable with my second pregnancy. I decided to take the advice of some friends and use the local midwifery practice. They came with rave reviews about how warm and inviting their practice was, and how natural and supportive the entire process of growing my baby and birthing it would be. I was pretty excited.
I’m a fairly crunchy sort, and practiced extended breastfeeding and many attachment parenting practices. I felt like midwives fit into my belief structure about how pregnancy and birth should be. I wasn’t really on board with them pushing home birth so hard, and I didn’t love that the secondary midwife was very anti-Western medicine in general, but I’m a confident patient able to speak up for myself, and I drew my lines where I felt comfortable.
At approximately 16 weeks, the secondary midwife tried to find my baby’s heartbeat but was unable. She tried different angles, had me roll to different positions, and was still unable to detect anything. When I questioned this, she said it was normal, and that it was “rare” to hear a heartbeat at that stage of pregnancy. I don’t carry much belly fat to cushion the sound, and I had an anterior placenta with Story and had still heard her heartbeat at 13 weeks, so I found that comment suspicious.
When I said I was planning to have the 18 week ultrasound done, the secondary midwife was extremely unhappy. She told me it wasn’t necessary, and pushed me to not have it done. But I wanted those tests done, and we also wanted to see if we could find out the sex of our baby. The midwife was adamant that it was a bad idea. I told her I wasn’t comfortable with her not being able to find the heartbeat, and that I wanted confirmation that everything was ok. She was very indignant, and I felt like a child being tsk-tsked for ill judgment.
At just over 19 weeks, I had the ultrasound done, and you know how it ended up. My baby was dead. For almost a month, I had carried a dead fetus in my womb, because a midwife made a bad choice and was so against Western medicine that she allowed it to cloud her judgment.
Lying on that ultrasound table was torture. I knew something was terribly wrong, but had no confirmation until my primary midwife returned the call of the lab tech. They sent her an emergency page, and she responded 45 minutes later. They made me wait in a gown, on a table, for 45 minutes. Alone. Cold. Afraid. She was kind enough to break the news to me over the phone, though we still had to drive to her office to speak with her in person.
When we walked into her office, I couldn’t feel anything. I was hugely pregnant, and scared to death of what I was going to hear. I told her that the secondary midwife hadn’t detected a heartbeat weeks ago, and she merely shrugged. There was nothing they could do. She explained that because my baby died before the half-way point (20 weeks) of my pregnancy, I was automatically passed onto the OB/GYN on duty at the hospital where they would decide if I should have a D&C or if I’d have to deliver. She wouldn’t be coming with me. This was good-bye.
Since my ultrasound clearly showed a fetus at approximately 16 weeks gestation, she should have known there was no choice but to deliver. There was no way a fetus of that size could be removed via D&C yet she either didn’t know this fact, or chose not to tell me. Negligence.
When I went to the hospital, I was in the care of a kind OB who stayed with me during my labour and delivery. My husband and daughter were there, too, although not in the room when I was ready to deliver. They ran into my primary care midwife in the halls of the hospital. Note that she never once popped in to say hello despite being just down the hall from me. She never offered to hold my hand or see how I was doing. She said to my husband, “How’s Alexandria?” and he replied, “Well, not good, obviously” and she said, “Well, give her my best.”
Her best. That was her best? Where was the compassionate care? The over-and-above concern and warmth? People talk about the cold care of OBs but my midwives were like ice. The OB who had just met me that day looked at me with tears in her eyes and hugged me tight, but my midwife couldn’t look me in the eye, and wouldn’t visit me while I laboured because she wasn’t getting paid anymore for my care.
In the weeks to follow, I received an email from that primary care midwife, asking if they could drop some books off to me about grief. I said sure. I declined a visit from her, while she defended the choices of her second-in-command. Later, in an official letter, I was notified that never again would an undetectable heartbeat go without further investigation so at least my experience was not in vain.
I still have the letters I wrote the week after my miscarriage. I wrote one to the Head of Obstetrics at the hospital, and one to the midwifery practice, but sent neither. It made me sick to my stomach to have to open the wounds again, when I was (and am) so desperate to let them heal.
But whenever I read about people bashing obstetricians, or offering blanket praise to midwives, I want to scream about my horrible experience. The doctors in the hospital were shocked at how long I had been carrying the deceased baby, because generally, the mother’s body would either reject the fetus, or go into septic shock from infection as a result of carrying something deceased inside the womb. I could have died. I could have died because this woman made a decision against Western medicine.
There are good midwives and bad. There are good obstetricians and bad. This is my experience. This is why I would never recommend the midwifery practice of which I was a patient, and why I would probably never recommend midwives, either. There are always other sides to the stories, nothing is quite as clear-cut as we may wish it were.