At Peace

I started the day with morning mass..

Thank you for your prayers, I had my 6 week ( well 5 week ) follow up, with my doctor, following the stillbirth , full term at 37 weeks, of our son David.
The following will help with my longer explanation, further below. 

1 in 160 births end in stillbirth.  Approximately 26,000 stillbirths a year in the US. When you narrow it down, to hear that only 500 stillbirths happened,  in the state of Michigan last year. It doesn't sound like a lot,  but then also 500 too many. About 50% of stillbirths can be avoided,  by better care on the mothers part ( not smoking, better disease management)

What are the causes of stillbirth?

There are a number of known causes of stillbirth. Sometimes more than one of these causes may contribute to the baby’s death. Common causes include:

• Birth defects: About 15 to 20 percent of stillborn babies have one or more birth defects (1). At least, 20 percent of these have chromosomal disorders, such as Down syndrome (1). Others have other birth defects resulting from genetic, environmental or unknown causes.
• Placental problems: Placental problems cause about 25 percent of stillbirths (3). One of the most common placental problems is placental abruption. In this condition, the placenta peels away, partly to almost completely, from the uterine wall before delivery. It results in heavy bleeding that can threaten the life of mother and baby. Sometimes it can cause the fetus to die from lack of oxygen. Women who smoke cigarettes or use cocaine during pregnancy are at increased risk of placental abruption.
• Poor fetal growth: Fetuses who are growing too slowly are at increased risk of stillbirth. About 40 percent of stillborn babies have poor growth (2). Women who smoke cigarettes or have high blood pressure are at increased risk of having a baby that grows too slowly. An ultrasound examination during pregnancy can show that the fetus is growing poorly, allowing health care providers to carefully monitor the pregnancy.
• Infections: Infections involving the mother, fetus or placenta appear to cause about 10 to 25 percent of stillbirths (4, 5). Infections are an important cause of fetal deaths before 28 weeks of pregnancy (4). Some infections may cause no symptoms in the pregnant woman. These include genital and urinary tract infections and certain viruses, such as fifth disease (parvovirus infection). These infections may go undiagnosed until they cause serious complications, such as fetal death or preterm birth (before 37 weeks of pregnancy).
• Chronic health conditions in the pregnant woman: About 10 percent of stillbirths are related to chronic health conditions in the mother, such as high blood pressure, diabetes, kidney disease and thrombophilias (blood clotting disorders) (5). These conditions may contribute to poor fetal growth or placental abruption. Pregnancy-induced forms of high blood pressure (such as preeclampsia) also may increase the risk, especially when they recur in a second or later pregnancy (6).
• Umbilical cord accidents: Accidents involving the umbilical cord may contribute to about 2 to 4 percent of stillbirths (3). These include a knot in the cord or abnormal placement of the cord into the placenta. These can deprive the fetus of oxygen.
• UNKNOWN

Other causes of stillbirth include trauma (such as car accidents), postdate pregnancy (a pregnancy that lasts longer than 42 weeks), Rh disease (an incompatibility between the blood of mother and baby), and lack of oxygen (asphyxia) during a difficult delivery. These causes are uncommon.
Certain risk factors also are associated with stillbirth. Some of these include (1, 4, 5):

• Maternal age over 35
• Maternal obesity
• Multiple gestation (twins or more)
• African-American ancestry

A recent study found that African-American women had a two-fold increased risk of stillbirth compared to white women (7). It is not known why African-American women are at higher risk. The risk for Hispanic women was similar to that of non-Hispanic white women (7).

information courtesy of  the March of Dimes

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So the main purpose of a 6 week follow up is to see how the mother is physically doing. I passed all that stuff with flying colors. He said my episiotomy has healed near perfect. He said I can expect to see my return of fertility in 4-8 weeks. I should continue to monitor my NFP signs ( mucus ) to see when it returns.

So the big elephant in the room was the cause..
They did an autopsy, placenta and cord analysis but we have to leave this one to God. There was nothing found abnormal. We fall into the "Unknown" category.  I'll just call him one in a million. I'm not a math person, but million sounds like a good number to me.

I need to look up something call CVS.. ( mild-mild infection in David) .. treatment of it.. what it is.. nothing major to be concerned with. Explained to me as something that sets in after the baby dies..

I shared our pictures of David with Dr. G, it also allowed me to ask some questions. The reason  we could not bathe him? What I thought was vernix, was actually his skin peeling off. Had we bathed him, it could have got pretty bloody. He used a technical term, emaciated.  He said that also can give them an idea of how long he had been deceased. We didn't go into that. I guess there are plusses and minuses to delivering sooner than waiting, when you find out. We chose to wait a day and come back when we found out he had no heartbeat.

So what did we talk about for the rest of the hour.. ( yes he gave me an uninterrupted hour of his day ) 

We talked about the research I've done.. Dr. Toth for infections.. ( he had heard of him)  and Dr. Jason Collins -- Stillbirth research in Louisiana. 

We then talked about if to try again.. ( ultimately hubs & I need to discern ) no medical reason why we can't.  Then the next conversation: how long to wait to try again..  he listed the medical data, supporting waiting a year, 6 months ,and then 3  months.  Ultimately, we can't try until my cycle returns. After that it is truly up to us. He said I am in good health, so with our IF  history, and age, he doesn't recommend waiting a year.

We then talked about a next pregnancy and what to expect, having already dealt with a "high" risk pregnancy, I know most what to expect. I asked what might change from David to the next. At the suggestion of the Maternal Fetal Med Specialist. (MFM). She would recommend, and Dr. G supports,  steroids to mature the lungs early. careful monitoring. ( maybe even daily NST) looking into the Dr. Collins daily NST program.. and likely delivering at 34 or 35 weeks. 

We talked about logistics of all this. ( factors hubs & I have to consider) .  The hospital Dr. G is at (Crittenton for those local), was just bought, by a larger Catholic hospital organization ( Ascension Health Care). The effects of it, won't go into effect until the summer. The unknown, is who the hospital will be referring us to for MFM services. The current MFM is with a different hospital,( St. Joseph) who is on loan to the hospital Dr. G is at.   The unknown is who we will be referred to for MFM services. Time will tell, the other good news, is a hospital much closer to me, is a part of the network( St.John/Providence )  Dr. G's hospital is joining, Dr. G won't have privileges at the close hospital to us, but if we can do MFM care there, it will save on the driving.. We would have to see MFM & Dr. G alternating weeks again.

Other good news, doc gave me his e-mail, to send him some of my research, and for any questions, i may have. So no filtering thru nurses. Love Love Love...

He teared up when I showed him the pictures of David, so did the nurse & receptionist. The nurse said, he had shared with the office David's funeral arrangements, she said she couldn't come, because her son had hockey tournament, doctor wasn't there, because he was on call. It was kind, that they even thought of coming.

Last thing we talked about, was how I was treated. He wanted to know the doctor that delivered me, was truly honored to be there, and that he is changed ( in a good way ) after being there. 

I mentioned research I've done & found something called a Cuddle Cot. There is a Campaign to get one in every hospital. He sounded like he would genuinely look into it & see if the hospital could get one. He seemed very receptive to making the time you have with your child matter.

With out going into a lot of detail we talked about babies/people dying being saints vs. angels, I found an excellent article/blog post that I printed for him, so he could share with his staff, to explain why Catholics believe this way.

When I left, he said he can tell I'm at Peace. He was happy, that I'm at Peace. I do feel at Peace. I know we did everything , medically asked of us. I know we didn't do anything to put David in danger. I know I've become a healthier person because of this. I know that David's death has been hard for some to understand, and for others it's drawn them closer to God. 

We know God has a plan for our children.