content notice: fetal and neonatal death, genocide in Gaza and Palestine, grief, unconsented pelvic examinations under anesthesia
Many of the first births I ever attended were fetal demises. The first few were observations in other countries while working abroad. Another was shortly after I began attending birth as a student midwife, and it’s one of the births I remember with my entire being. In my nine years in clinical practice, I diagnosed many, many fetal demises in the clinic or in triage. Family, patients, friends, and colleagues have all lost desperately wanted and loved babies to miscarriage, second trimester rupture of membranes, or rare and unpredictable events during pregnancy and birth. Countless others have spent endless days and nights in the neonatal ICU with their very sick babies in the first days, weeks, and months of life, holding hope in life and trust in care that their newest family member would come home with them soon, healthy and thriving. Still others have lost children.
Fetal and neonatal death are devastating. The weight of such a loss is indescribable, one I will never know personally but will hold space for in my heart and memories for the rest of my life. There is no normalizing nor adjusting to the significance of fetal and neonatal loss, for me and for every birth worker I know. Delivering a fetal loss, no matter the age, is a privilege and a sadness, an honor and a heartbreak, a duty and a sorrow. Caring for patients and loved ones grieving the loss of a fetus or neonate is one of the heaviest and hardest experiences of my care provider life. Worse still is the loss of a child, no matter the age, beyond the first days and weeks of life, and I lost count early in my career how many experienced this agony.
What I remember most in the moments after breathing in the reality of a fetal, neonatal, or child loss is the depth of grief. The fracture of time and space. The abyss between the now and the moments before. The stillness, the quiet, the vacuum of sound. And yet. I still hear parents crying, screaming, falling to their knees, turning away from us and in toward themselves. I remember the sharp and immediate entry into the stages of grief, questions and anger and shock. For those of us who have, as midwives, as birth workers, as people who provide the tendrils and safety of care when caring is all that might be left to offer, there is no forgetting this feeling. Perhaps what I remember most of all is how tightly my hand has been held in those moments. Tighter than in any birth, tighter than in any hemorrhage, tighter than in any epidural placement while contracting and experiencing more pain than can be contained in screams. Hands clasped while falling into the gulf of suffering is something I still feel, viscerally, because of this lifetime of holding space and holding hands and holding someone with everything I have while they hold onto anything that remains around them.
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