Due date

Dale Michael Both

That is the name of my first born son. I haven't talked a lot about him, as sometimes it is quite painful. He was born at 14 weeks and 3 days gestation, far too small and early to survive on his own. He was due on January 8th, 2019. It has now been almost 6 months since his death, and I have been preparing for this day ever since.

    I knew I wanted to post something about it. I wanted to be able to post the video from when we first told my family I was pregnant on Mother's Day. I had hoped to share it in late July, after a planned trip to Gabon, but by then he was gone, and so I never posted it. But the joy and excitement were there, and I wanted to be able to share it in some fashion. I wanted to be able to share his story and mine, with the hopes that it may help other women who have lost children due to miscarriage to know they are not alone. Initially I thought I would write just about the announcements to family and then what I found helpful or not helpful after I miscarried. However, this turned into a much longer post, but I think I needed to write it. 

     I first discovered I was pregnant in April. I just knew something was different, and that I was pregnant, but it seemed forever for me to have a positive test. When I did, it was faintly positive. Luigi had me take a few more tests just to be sure. I did so over the course of the next week, and they were all positive. At about 6 weeks gestation I started to have some morning sickness. Most of it was tolerable with some ginger or crackers. On the rare occasion it caused horrible stomach pain, but it resolved with some Zofran. We discussed about when to tell family, but since my parents were leaving on a 3 week trip to Europe, we thought we would tell them before they left (just in case something happened). My grandma and my dad's siblings/spouse and all my siblings and nieces and nephews were there as well, so we enjoyed getting to share the news with them as well. I still remember the tears of joy in my aunts eyes. Here is the video: 

Shortly after that, we told Luigi's family. Here's the video of Juliana learning about it:

First glimpse at our little one

     We had my first ultrasound when I was 8 weeks along. We could see his heart beat flickering on the screen. Things continued to go well, and I managed to keep my nausea from affecting work (all though at times waves came at me and I had to step outside a room). My staff at work kept asking me if I was pregnant or had taken a pregnancy test (I'm not sure why, but they did). I didn't tell them it was because I was already pregnant that I didn't take any more tests. When I was a little over 9 weeks, I told them. Mae about fell out of her chair with excitement. 

     We had a family reunion (for my mom's side) in June last summer, and though I was only about 10-11 weeks, I wanted to share the excitement with my family, and I told them as well. They were all quite excited! Some may argue that we told people too early and should have waited until the 2nd trimester. In my opinion, it was easier for me to go through everything knowing I had their support and prayers than to smile and nod and pretend nothing happened. I want people to know I have a son and I love him very much. 

     I had an ultrasound shortly after the reunion, I would have been about 11 weeks here. You can see him putting his hand to his face. He had been moving around a lot before I started recording, but then slowed down. 

     On June 30th, I went to Michigan to visit some college friends. I awoke July 1st to some bleeding. I called my doctor about it, because even though I answer those phone calls for my patients, sometimes it is just better to hear the same words from someone else. I had little bleeding the rest of the day, but was sure to check to hear heart tones when I got home that day-he was still alive, with a heart rate of 150's. I saw my doctor the next day, and he did a short ultrasound and checked to see if there was any reason for the bleeding. He diagnosed BV (an overgrowth of bacteria, common in pregnancy) and treated it accordingly. I still had bleeding during the night after that, but it did improve and was gone for several days. I did some gardening July 4th and had some heavier bleeding. I ran upstairs as I could feel the blood, and after cleaning myself up, laid on the floor crying, almost hysterically, as I was so afraid I might lose the pregnancy. The bleeding stopped and we checked his heart rate again-150's, still alive. I called my doctor and we did a more formal ultrasound to evaluate for signs of bleeding around the placenta. There was none, and he was moving around and active. I was amazed to see him and how much development there was already (even though I know it mentally, it's still amazing to see) and also just in awe that this baby was inside me-those pictures on the screen were of my baby, not someone else's. It's been 16 years of caring for other women and their pregnancy, and finally I was getting to experience it myself. I was so thankful. 

     Rocco (Luigi's brother) and his family came to visit the weekend after that (July 7-8). We went swimming in our neighbor's pool. Gianni shouted to us across the pool that he "had a 'gina" (His parents have been teaching him proper names of body parts, but he was a little confused at who had which part). We all laughed quite a bit at his remark. 

    July 12th was my 38th birthday. My friend Melissa Raymond had come the night before to pick up a trumpet for her daughter (long story but it was too broke to fix for use) and hang out for a while. She sat while I finished my packing for my planned two week trip to Gabon. I had been quite nervous about this trip with the recent bleeding, and had conveyed to the team that if there were any complications that came up, I wouldn't come. I kept praying about it, and had discussed it several times with Luigi. My biggest concern was if something happened while I was there, how he would respond (he was not going with me this time). In retrospect, he should have been coming with me, and I won't go without him in the future. I awoke that morning feeling so thankful: my dreams had come true. I had a loving husband, and a baby growing in my belly. I have wonderful friends, a great place to work, and a wonderful home to live in. I had everything. I even had one of my closets friends here to visit me. It was a wonderful birthday! I don't recall what gifts I was given by my husband, but I do recall laying in bed trying to see if I could feel our baby move. (I'm still not sure if it was him or just me moving from breathing). 

    Then I awoke July 13th to more bleeding. It was still about the same as usual, but a little more cramping with it than previously. We had a staff meeting that morning, so I left early while Luigi was still sleeping. I had awoken him to tell him of the bleeding and cramping, and we prayed together. I had had some mild cramping before with the bleeding but it always went away. Today, however, I noticed the cramping was worse as I drove to the hospital for the meeting. It was enough to put me in tears from the pain and fear. I still believed the cramping would go away. Rather than going to the staff meeting, I went to the OB floor. Sue Bettcher was there and I told her everything that was going on. She helped me to the triage room, we checked fetal heart tones, still 150's, got me a hot pack and some Tylenol, and I called Luigi, and then my doctor. He said the same thing I knew: either the cramping would stop and go away, or it would get worse and I would miscarriage. I still believed it would go away. I couldn't possibly have a miscarriage. It's not supposed to happen that way. Not when I've waited all this time. Not when I've already made plans-I've not added any OB patients due near me, and told a few that were due while I would be on maternity leave. I started making plans at work for how patients would be cared for while I was gone. So the cramps were going to go away. Lindy stopped by as she noted I wasn't at the med staff meeting and had asked where I was. She did a bedside ultrasound, and there he was, moving all around! No signs of bleeding around him, all looked good. I wasn't having any more bleeding either. The cramps seemed to improve and so I went home for the day, and the office took care of rescheduling my patients or having Lindy see them if needed.      On the way home the cramping increased. I kept using the word cramp because contraction would mean something more serious. I was crying on the way home as it hurt and I was scared. Luigi made me breakfast and a hot pack from rice and a pair of his socks. He had never made one before so it took a bit of explaining (including NOT to cook the rice) but we got them made. They helped for a while, but then the pain went from tolerable to intolerable in about 3 minutes. From that point on it was excruciating pain. I could tell my blood pressure had dropped by the way I felt. I tried to stand but almost passed out. Luigi was a bit frozen as to what to do: does he follow his instincts as an EMT, or listen to his physician wife? I didn't know what the best thing was at that point. I wanted to melt through the floor, or pass out, or die. Anything that would tale away the pain. I knew I needed medical care but I wasn't sure the fastest way to get it, or get relief.  It turns out the best way was to have Luigi take me. We have since found out the local EMT's have a BLS ambulance, and wouldn't have been able to provide any relief to me. Luigi called the ER on the way to the hospital to inform them we were on our way and why.  

     On arrival, my blood pressure was extremely low (70/50 or so) so I got a large IV in my arm and fluids. I begged for pain medicine. It turns out Dilaudid IS a wonderful pain medication and helped tremendously. Within ten minutes of arriving, Dale was born. He was born en cul, meaning the amniotic sac was still intact. It was also attached to the placenta. As soon as he was born, the physical pain subsided, but the emotional pain really began. I moved him around first to see if he was still alive. There was no movement. I opened the sac and you could see he was a boy. His little hands, his tiny feet-they were all there, all fingers and toes. His eyes were still fused shut but he was able to open his mouth. He was likely sucking his thumb or fingers in the ultrasound I saw previously. Luigi was there the whole time, I think in shock too. The nurse put Dale in a little washcloth with a little lace thing beneath him. Luigi held him while I got cleaned up. I held him again and took pictures. I wish I had taken more. I wish I had one of his hand in mine (or on my hand). I wish I had him up near my face, or of me holding him. I have ones of his feet-those are precious to me. I have a few of his whole body. His umbilical cord was so interesting as it had three vessels, but they looked like old typewriter ribbons (where there were black and red ribbons), without all the wharton's jelly or twists and turns a term umbilical cord has (the wharton's jelly is the rubbery/jelly like substance around the vessels). I remember looking at him and the placenta both as a physician looking for a cause, and a mother, looking at every detail of her child. 

     Besides taking more photos, there are other things I wish I had done differently. I wish we would have buried him. At the time, I didn't want him buried as I don't usually visit graves and I think the thought of having a tombstone to visit with my son's name on it was too much. I know some of that came from my own perceptions about how far along I was and how "real" he was (it might not make sense, and I know he was very real, but just not as developed. It seemed strange to me to bury a baby that was such an early gestational age. Now I wish I had buried him. I wish I would have held him longer. In all, we were in the ER less than 4 hours. However, I wish we had stayed and I had held him longer. I was at such a loss, and I felt like holding his body wasn't going to bring him back, so I might as well go. I still wish I stayed and held him longer. I do not regret the last thing I did before leaving the hospital-I kissed his head good bye. 

      Based on everything I know now, we believe it was some sort of infection around the amniotic sac (called chorioamnionitis), but we don't know the particular bacteria that caused it. I was septic when we arrived to the ER and though my vital signs improved after delivery, having those IV fluids helped significantly. The infection also resulted in abruption (separation of the placenta from the uterus)  as it came out with him and the sac.

      As we left that day, it was sunny. I wanted it to be anything by sunny. I wanted rainclouds and thunderstorms. I wanted something that matched my heartbreak inside. We went home and napped that afternoon. Then we had to start making phone calls-telling friends and family, canceling the travel plans, etc. I am thankful for friends and family willing to pass the word along so I didn't have to make all of those phone calls myself. It was important to me to call my immediate family. I called my Grandma, too. She had just called me the week before and told me she wanted me to name my child after someone on "her side of the family" (as opposed to my mom's side). I think she was happy to know he was named after her late husband, my grandfather. 

     I still had the two weeks of vacation time scheduled because of my trip. Lindy wouldn't let me come back to work early, and insisted I take the full time off. I am glad we did. I needed that time. We went to visit my family, then to Pigeon Forge for a few days just for ourselves, and then to Chicago to visit his family, and then home for a week. I remember noticing when we got to Pigeon Forge, I could feel an emptiness in my abdomen. I hadn't really noticed the fullness as it had been gradual as he had grown. I had been able to feel my uterus and knew where the top of it was before I miscarried. I could feel the difference without him, and I cried. Luigi held me so tenderly and lovingly during that time. He mourned the loss of his son, but he was also so grateful his wife was still alive. While I was in agony during the miscarriage, he feared I was dying before him. I can't imagine the fear and worry in his heart during that time. 

       I remember during those two weeks I thought for a while that I had to get through all my grief in that two week period before I returned to work. Then, in that second week, I realized that wasn't realistic, and actually harmful. That gave me a bit more freedom and relief. It was still hard to return to work, and there were many days I arrived crying, as the 15 minute drive gave me too much time to think. 

    There are things people did after I lost him that really helped: people brought us food and care packages. I had a few neighbors stop by as soon as they heard (Luigi had gone out to get something and she heard I was alone and came over immediately). At that time, sometimes the best thing to hear was "I'm sorry" followed by "there are no words".  I still think it is one of the best things I have heard. In that time of grief, I just needed people to be with me. I needed them to let me tell the story of what had happened. I needed them to be able to laugh and joke at times because I couldn't be in sorrow all the time. I am so thankful that I have friends and family that were able to provide that for me. 

     One of the hardest things to hear was "God has a plan." I do believe God is Sovereign, that He directs our paths, and that sometimes, he allows things to happen that are bad or sad. We don't always understand it, and sometimes we get mad when things don't go the way we planned it, but it doesn't change his Sovereignty nor his great love for us. We live in a fallen world, and therefore bad things will happen until this world is made anew. Knowing all of this didn't change the fact that I was mad at God for a while. I knew He could handle my anger, and still loved me, and knew I still loved him even though I was angry. I am no longer angry, though I will admit that I still have days or moments when I am mad or angry, but they are shorter, and I admit it to God when I feel angry, so that I can work past the anger. 

     One of my patients has had multiple miscarriages between two full term pregnancies, and is now expecting again. She has been a comfort to me during this time, as she has gone through struggling with the loss of her children, and the "Why?" questions. One thing that she found to be frustrating is people's expectation for your time of grieving. They expect it to be done and over with, but don't always allow it to be a process that can take months, or even years. Each person mourns differently and in different lengths of time. So to those of you supporting women who have lost a child, be it through miscarriage or stillborn or after their birth, remember that grief comes at different times, in different ways. Sometimes it can be a seemingly innocent comment, sometimes it's just a thought, sometimes a reminder of what was supposed to be but isn't. Those times are sometimes managed with just a twinge of the heart, but other times with tears. My encouragement to you who are supporting such women or couples is to be there and support them no matter what. That could mean a hug or a listening ear. It doesn't always require a verbal response. 

     At her last visit, she reminded me that our days our numbered, and only God knows how long each one is. As she approaches her due date, she has her own fears about labor, delivery, and how the baby will do after delivery. We have all had friends or family have a child die near those times, and so it is scary. She takes comfort in knowing God is in control, and we are to be thankful for the time He gives us with each person on Earth. I am so thankful for the short 14 weeks I had with my son. But I'll be honest, I am also jealous to have had more time with him, to know his hair color and eye color, to know the sound of his cry and his laugh. It is something I won't know until Heaven.

      This year, the holidays were really rough for me. Luigi can tell you how much I cried as Thanksgiving and Christmas and the New Year approached. Each one was a reminder of where I thought I'd be in pregnancy-34 weeks, 38 weeks, and possibly delivered. I had imagined being with family at those holidays and they would get to feel the baby move. We would have his name picked out and a bedroom set up for him. There would be a baby shower somewhere in there too. But none of those were to be, not at least this year. 

     There are moments that Facebook is really hard for me to see. Friends posting photos of their babies, friends who had babies or are having babies around the time I was due are sometimes reminders of what I do not have. While I am so happy for them, there is at times a bit of grief for me. I do not want them to stop posting, I don't want them to stop being happy and loving their little one. But I hope they hug and kiss and snuggle their little one a little extra just for me. 

     Despite my sadness and grief, I have found things for which to be thankful. We bought a new house and haven't moved yet, and I would be stressed to have the baby's room ready or a place for him. I now have time to pack and move and not recover from a delivery. I was able to cover my office partner being gone for a month with some stress but not as much as if I was 34 weeks pregnant. I changed jobs at the end of December. Had I been pregnant, I probably would have just started my maternity leave then, and not returned to work for 3 months. Since I changed practice locations, this may have left some of my patients feeling at a loss of where to be seen or who would take care of them. I am thankful I can still see them and care for them, and help them in transitioning to a new office location. I have several patients who are due in February and March that I would not have gotten to deliver. They are dear to my heart and I'm so thankful I get to be a part of both their pregnancy, but also their labor and delivery. With the change in jobs comes a change in insurance, and my delivery would not have been covered by the new insurance. While we would have done a self-pay package, it is still a relief to know a future pregnancy will be covered by the new insurance. I am thankful for the additional time with Luigi just as husband and wife, to know each other deeper during this time. With all the changes in the last two months, I've been a bit irritable (to say the least) and he has loved me through it. 

    I was hoping by the time I wrote this I would be expecting again. However, it was not to be. It has been six months since I was pregnant. I still long for children, but will take whatever God has in store for me. It may be another pregnancy, it may be adoption, it may mean no children of our own. (Though I secretly pray it is not the latter). 

     As I close this long post, I will end it with these verses: a hope we are promised in Christ:

"Look! God's dwelling place is now among the people, and he will dwell with them. They will be his people, and God himself will be with them and be their God. 'He will wipe every tear from their eyes. There will be no more death' or mourning or crying or pain, for the old order of things has passed away." He who was seated on the throne said, "I am making everything new!"  

Revelation 21:3-5

PS I have started reading a book called 'It's Not Supposed To Be This Way".  I highly recommend it!