Two things are certain in this existence, birth and death. We are all born, and we all die. Some of us are here for a long time, and some a very short time. When expecting a baby, there is most often a great deal of joy and anticipation. Much dreaming and wondering what this little life will bring, look like, be like, what will they do, who will they become. But for some, this will not eventuate.
Another midwife once told me, ‘You must always remember, in every birth, death is in the corner’. This is by no means meant to detract from the amazing journey birth is for women, or how giving birth is one of the most “normal” things a woman can do. But it is a reminder that some babies, and mothers, happen upon birth and death in one breath… or less. I write this piece as I have been the midwife for three couples who have lost their baby at term in the last four months. All very different circumstances, causes and all in healthy, low risk women.
As the care provider for these families on a path so much bigger than what we all first imagined, some key aspects came to light as to how I could assist them to experience this with the least trauma, regret and pain as possible. And in doing so, initiating a healing process.
In one of the cases, the couple was planning a homebirth. At 37 weeks mum could no longer feel movements from her little one. There was no heartbeat. Due to other factors, this then became a hospital birth and an induction. The most important conversation I had with this couple was that this was still their birth, and we were going to do it their way. Prior to the labour commencing, the Doctors would talk about epidurals, and any pain relief she may need, she could have. She did not need to suffer, they would say. At this point I initiated a discussion about how important it is that she BIRTH this baby. To bring this baby earthside, and to feel the power of her body in doing so. To feel the emotions as they rise throughout the labour, to allow that process to happen. Being an incredible woman, she looked at me and said ‘that would be best for my emotional wellbeing wouldn’t it?’
This couple then laboured quietly and privately, and together birthed their first baby, still, in water. I could see the impact this had on their grief. The processing had begun, as well as the healing and the letting go. Later the father was thanking me, and he said ‘this day was amazing and perfect, except he didn’t breathe’.
Time was another key factor for all these couples. Being given the time to think, ask questions, process and to feel into what is right for them. Just because their baby was no longer with us, did not mean we had to rush things, or hand their bodies over to the medical system. With time, all couples were able to comprehend, and make informed decisions, and birth and grieve their way.
Informed choice of birth place does not create higher risk. Death comes at home and in hospital. We live in a society where death is not accepted, and when it occurs, there must have been fault. We have a great attachment to life, and with the medical technology of today, there is often a common misconception that death is avoidable, in all circumstances. I am not writing to scare women or families, but to shed a little light and awareness on what some families face when on the journey of pregnancy.
As a midwife and woman myself, walking beside these couples has challenged my core beliefs about birth, homebirth, life and most of all my philosophy as a midwife. It has made me examine the very core of what I believe about birth. Under all the tears, anger, grief, frustration and fear, I realised I do not only believe that birth is normal, but I know women are made to birth. And I am here to support them in doing so. Taking the responsibility of being care provider into my hands is not easy. Being fully present with women on their journey is crucial to woman centred care, however this does not mean it won’t be challenged. But as I have witnessed, these challenges make us stronger. They shape our practice, our care and our lives. Being with women in pregnancy, and birth, and death is a journey like no other.
Birth is yours, regardless of the circumstances. Yours to make the decisions, ask the questions, take the time, and yours to do your way. This is what births empowered women and mothers.