do you ever stop feeling guilty? (death of baby)

[BettyFriedansLoveChild]

I've already got a thread going that deals with the specific issue of how to explain her sister's death to our toddler, and I've also had a look at the bereaved parents thread, but I just wanted to start a new one here to work through some of what happened in the lead-up to my baby's death last week.

Last Monday, at 35 weeks pregnant, I had mild to moderate pains in my abdomen and lower back from about 8am onwards. I thought that these were just possible Braxton Hicks / ligaments stretching / the body practicing for labour in some way, took paracetamol and got on with the day. By about 5pm the pains had got worse, so I thought that I would phone Triage just to be on the safe side. No-one answered the phone, so I took some more paracetamol and had a warm bath which didn't help, so I called Triage again; someone finally answered and I was advised to go in.

I was seen at about 7.15; the baby's heartbeat was monitored from around 7.30 onwards; they said that it didn't show any accelerations, which was cause for slight concern, but they didn't seem majorly worried and just said that I would have to stay in overnight for more monitoring. I sent my DP home to put our toddler to bed. Just after 8pm the doctor tried scanning me to work out where the baby's head was; as she was doing this the pains changed from manageable to horrific and I felt a kind of fever fall over me. The baby's heart plummeted and the doctor started shouting that I had to go to theatre straight away. I was raced down a corridor on the trolley to a theatre full of people masked up and waiting, I was given an GA, and that's all I remember. I came round a few hours later to be told that the baby was very ill, had been born without a heart-rate and only responded to resuscitation after 21 minutes. I was told that it was unlikely she would live, and if she did she would be severely brain damaged.

I understand that I had a severe placental abruption. I think that this must have been going on most of Monday while I was feeling pains. I feel as if I failed to care for my little girl by not going in to Triage immediately first thing in the morning. I keep thinking that if we had gone in earlier they might have been able to do the section earlier, and she might have been saved. I realise that this line of thinking is potentially toxic since there is nothing I can do to change things now, but how do you ever get past thinking that you might have been able to stop something like this happening, but failed to do so?

I haven't been through this, but read the toddler thread too and wanted to say I'm sorry you are going through this.

I think it's human nature to want a reason and to find a way to blame someone or ourselves. Those kind of niggles are so common in pregnancy. I think anyone us would have dealt with it exactly the same as you, many more would have put off even calling triage. I hope someone is along to offer you better advice soon.

The short answer is yes, or at least I have, although it took a while with it all going over and over in my mind.

I posted on your other thread - I had a placental abruption at 36wks with my 4th child. So much of what you said in your post is familiar. Again - I'll share what happened in case it helps. It might; I found reading other people's accounts of placental abruption helped, and the reactions of several health professionals afterwards really made it sink in for me that placental abruption is one of those thoroughly shit things that just comes out of nowhere and usually isn't possible to predict.

The abruption happened around midnight - the previous day or 2 I'd wondered about movements, but whenever I got chance to take it easy & lie down (not often, the dcs were off school & dh had a nasty tummy bug so I was busy), drink something cold etc he'd start moving again. That evening I felt uncomfortable - not painful, just uncomfy. I had a few strong braxtons & had a shower as I figured they'd either stop or carry on. I'd always had strong braxtons in previous pgs several times before actually going into labour. I didn't have any more & fell asleep. Shortly afterwards I woke up, thinking my waters had gone. It wasn't my waters, it was blood, which I covered the stairs with when going down to get dh before I realised. Dh called an ambulance, but there was no hb when we got to hospital.

When we met with the consultant for the results of the pm, there were a lot of details about the condition of the placenta, which showed the blood supply had been failing for about 6 hours prior to the abruption, but the abruption itself was a sudden event which was what caused our son's death.

I couldn't help asking, yet again - if I'd gone in when I was wondering about movements - would he be alive? If I'd gone in when I was having bh would he be alive? The honest answer is that no one knows, placental abruption is notorious for being difficult to predict. Even ultrasounds at the time aren't very reliable at showing up what's happening. For things to be enough of a problem that they can pick it up, it tends to mean its already a major problem with the placenta.

One thing that struck me from your post,is that you did go in in time. You were checked out. And the people who know about these things far better than you or I do, didn't realise there was a problem either until it was too late. Unfortunately, that's so often the case with placental abruption. If you'd gone in even earlier (& you managed it much sooner than me - I bet you don't think I should've done more,I bet you only blame yourself - which is the natural effect of your grief) why would they have seen that there was a problem? It didn't appear urgent at 7.30.
I wonder whether you'll find out something similar to us in fact i.e. that what was happening during the day was a slightly failing blood supply, but then a clot causing a portion (or all of) the placenta to peel away (abrupt) suddenly just as the dr was scanning.

I found talking it all over with the bereavement mw very helpful - do you have that option? I also found the meeting with the consultant helpful as it did tell us what happened, although not why. Hearing other stories of abruption & how sudden they are helped - there are loads of posts all over the Internet. I realised I didn't blame any of them for not realising/doing something sooner, but judged myself more harshly. With time I realised that its such a normal reaction when people die - what if - if only - in hindsight. But we didn't have hindsight at the time. Forgive yourself - its not your fault. You made the best decisions you could at the time. Unfortunately, placental abruptions happen just like this, it's shit. But it's not your fault.

I hope that's some help - feel free to pm if you like, or keep posting. I think working it through & going over it with other people (rather than alone) are a big part of dealing with it all.

I'm so sorry for the loss of your daughter. It's devastating and the guilt thing is sadly a very normal part of the grief in these early days. You did nothing wrong. You did what you were supposed to do and you were very, very unlucky.

I lost my son at 39 weeks and I gave myself a very hard time about how long it took me to spot that something was wrong and get to the hospital. I still do sometimes. But to answer your question, the guilt does ease over time. I have learned to be a bit kinder to myself and to remind myself that I never would have knowingly done anything to harm my son in a million years.

I did get some counselling and it did help. I think when something so unexpected and terrible happens it's normal to look for someone to blame and all too often, when it's an unborn child, the mother blames herself. We feel as though it happened 'on our watch'. I can't offer much in the way of advice, only to say that you did nothing wrong, you were horribly unlucky, you're not alone, that what you feel is normal and that the terrible waves of guilt do ease over time. Please be kind to yourself.
xx

I don't think you can blame yourself for this. You did what pretty much anyone else would do. Its not your fault, it really isn't. But you won't stop feeling guilty until you can accept that.
I'm really sorry btw that this has happened to you.

Hello, I too am sorry for the loss of your daughter. As the others have said guilt is a huge part of the grief that we suffer after our baby dies. I lost my 4th baby at 37 weeks and the guilt was difficult to deal with for a while, I couldn't understand and forgive myself for not knowing that something was wrong or felt I must have done something to make him die.

It took quite a while but I did stop blaming myself for his death, I know I didn't cause it but I do still sometimes wonder why I didn't insist on a scan as I was measuring quite small - but I have accepted that I cannot change that.

This is so very very early for you and I hope you have good support around you, and just keep posting like BlySky says - it helps to get it down and for others to understand what you are going through.

I truly am sorry you are having to go through this.

I'm sorry to read your story. I think the guilt is something we all feel regardless of the circumstances. When I was very newly bereaved someone said to me to concentrate on trying to understand that it wasn't something I made happen but something that happened to me.

I didn't understand for a long time but they were right. I didn't make it happen and feeling guilty about it didn't help. What helped was being honest with myself and allowing myself time to grieve.

If you're not already using them can I recommend the Sands forums, they've been a lifeline for me. It really helps being able to talk to other parents who understand exactly what I'm saying, doing and feeling.

Thank you everyone, I'm having trouble getting up the energy to post a reply, but I am reading all your responses and they are helping a bit.

BlueSkyandRain, our stories sound so similar, would it be OK for me to pm you, perhaps when we get the results of the investigation back and I know exactly what happened with the placenta?

The hospital are taking this very seriously and holding an extensive enquiry, which helps a little. I've been reading placental abruption stories on here, and it seems that many people are lucky and get to go home with their babies because they get seen quick enough. I'm quite angry that no-one picked up the phone at the hospital when we first called, and wonder if that hour would have made any difference? - I will probably never know, but it is helping to shunt the blame onto someone other than myself.

Of course Betty, please do, and whenever you want to.
I'm glad the hospital is taking it seriously & that it helps a bit. As far as other experiences of abruption go, I was told that the outcome depends a lot on how much of the placenta comes away in relation to how big it is - in my case it was already quite a small placenta, so what was left (it didn't come off entirely) wasn't enough to pass on sufficient oxygen. I think when the baby survives it not only requires an immediate response, but for it to only be a relatively small portion that has abrupted (essentially I'm saying there's luck involved too).
I should've said before - like matildawormwood did - be kind to yourself x

You were in hospital and being monitored. You couldn't have done any more. You relied on the judgment of others, why shouldn't you have done so?

xx

Hey Betty
Just to say I'm thinking of you xxx

You were at the hospital before the abruption, you had been scanned and their advice was going to be to just monitor.

If you'd gone in earlier, it sounds as if they would have done exactly the same. The clinical signs to indicate an emergency either simply weren't there or were misdiagnosed. When the abruption did happen, the response was immediate and even that wasn't enough.

Being completely practical and logical about the course of events, I don't think it sounds as if you could have done anything different which might have changed the outcome.

I'm so sorry about your baby.

Thanks everyone. I keep looking at the pictures of her lying in intensive care and feeling so sorry for her - she was basically born to spend three days wired up to machines, and then died. Her little body looks all bruised and battered - patches of her skin were burned off where they administered adrenaline shots to resuscitate her. We couldn't even really cuddle her properly at the end, just sort of hold her gingerly, because we were afraid of dislodging the IV line feeding her painkillers.

We had a very beautiful funeral for her last week, and I went out early in the morning to pick wildflowers for her coffin. I really enjoyed picking the flowers - it felt like the only positive thing I was able to do for her.

We're still waiting for some bereavement counselling - we want to know how it is possible to move past the sadness without forgetting her.

Hi OP, I am sorry for your loss.

for baby lost parents

So sorry for your loss, it's truly heartbreaking

Betty

I'm glad to hear the funeral went well. It's an unimaginable thing to do but I took great comfort in knowing that I'd made the day the best I could for my little man. Picking some wild flowers for her sounds like a lovely thing to do. I quite often go down and tidy up my little boys grave and I always end up decorating it with interesting stones I've found, pine cones, little flowers. It seems the right thing to do to me to use nature in that way.

I'm now 7 months in & I'm learning how to live with the sadness. To be honest with you I don't think it will ever 'go away' but I'm getting better at functioning around it if you see what I mean? Certainly the pain is less raw now so it does get 'better'.

Please feel free to keep talking to us here if it helps

Betty, I'm glad the funeral was beautiful and you were able to find some peace by picking the flowers. I was just thinking of you today and wondering how you're getting on

Betty - I went through something really similar to you. I had heavy bleeding at 39 + 3, called the midwife who told us to wait and see and concentrate on the baby's movements, went to hospital about 40 minutes later to find that what I thought was early labour was actually me haemorrhaging, and despite an emergency c section under general anaethetic, my son died 20 hours later.

They think it was either a velamentous cord insertion rupture, or a placental abruption. This was in late January, so I'm 4 and a half months out. I felt terrible guilt too. But this was not your fault, just like it wasn't mine. It's the nature of the mind to go round and round in painful circles.

There's a closed group on Facebook that I've found helpful - HIE loss support group. You might like to join - if you search for it, it should show up. Please PM me if you ever want to talk.

And you are a hero for getting through this. It's the hardest, most painful thing in the world, but you will be ok. Sending you love and courage.

I'm having good days and bad days. I'm back to work this week (work from home, so not as difficult as having to go into an office) but its slow going. I was fine this morning, and now this afternoon I can't stop thinking about her. Just before she died she opened her eyes and looked at us (her eyes had been shut up until this point) and a little tear rolled down her face - I keep worrying that she knew that she was going to die, and was sad about it, which is silly, she hadn't shown any sign of being able to respond to our touch or our voices up to that point, so how would she know something like that?

CritterPants, thanks for sharing your story. I was very moved by the picture of your son on your profile - he is so beautiful.

I wonder if I could ask a very personal question to everyone on this thread that has gone through this. How soon are you thinking of trying for another baby (if at all)? I feel immensely driven to get pregnant again as soon as possible (which is insane, because I hate being pregnant and really struggle with it). Obviously we will never be able to replace the daughter we have just lost, but the grand plan was always for two children close together in age, and we're both heading for 40, so really need to get on with it once we have had the medical ok from the consultant.

My husband & I agreed on the drive home from the hospital the day our little one died that we wanted to try again. That was 7 months ago & I'm still ttc but you just have to do what is right for you. It's absolutely fine to want to be trying again straight away, just as it is fine if you want to wait.

Thanks Spacefrog, that's reassuring to know. Good luck with TTC - I hope that you get a positive result soon x

Sorry for your loss.We lost dc1 neonatally. Slightly different circumstances in that she had an undisguised medical condition and died suddenly at 4 days old.

We knew that we wanted to start ttc as soon as possible. It took 7 months but dc2 is now 3 months old. She will ever replace her sister but has made it more bareable. Ttc is a very personal decision and only you will know when the right time for you is. However it's normal to really want to be pregnant again quickly.

Have you been on the Sands forum? There are ttc and next pregnancy groups. Kept me sane during this pregnancy as everyone knows what you are going through and has the same worries etc and can support each other.

Betty, our excellent consultant originally told me to wait 6 months to let my c section heal before trying again. He said that was to let the uterus repair and regenerate.

James was an IVF baby - we started trying to conceive him in April 2011, so that was more than 3 years ago - and like you, I was desperate to try again ASAP. I checked in with my consultant in mid May, four months out, because I wanted to start the ball rolling for a frozen embryo transfer (when we conceived James, we had five 'leftover' embryos from the same batch as him which were frozen). My consultant gave me the green light to go ahead whenever I was ready. So I'm in the early stages of an IVF cycle now (frozen, so much less intensive than fresh). When I do my transfer, I will be about 5 months post-partum. Another girl I know from the HIE loss Facebook group got pregnant 3 months after her post-c section loss, and her doctor was fine with it.

That's a very long way of saying - check with your doctor, but 3-4 months should be fine. They generally say 6 months after a c section, and after 9 months the risks associated with VBAC (which are very small anyway, but I know that doesn't mean much when you've been on the wrong side of the statistics) go down a bit more. If you don't plan on having a lot more children, you may well want a planned c section anyway, so the VBAC risk thing isn't an issue.

Another reason they tell women to wait is to give the body time to recover nutrients lost during pregnancy and breastfeeding - obviously the breastfeeding thing isn't an issue for us.

If you ever want to talk more about this - let me know. I am so damn sorry you're going through this. Massive hug.

One other thing - our IVF doctor did a saline infusion sonogram to check for scarring inside the uterus. It took about 30 seconds and didn't hurt at all and gave me peace of mind. That's something you could ask about, if you're worried.

Going back to work is rough. It's great that you're working from home, and just take all the time you need to recover and go slowly. This is a long process, but we are here for you.

Hi angelopal, sorry to hear about your loss. Thank you for your reply - its good to know that this is 'normal'. I haven't tried the Sands forum yet (spend too much time on mumsnet as it is), but I should really have a look at it.

Hi CritterPants, we were thinking of waiting six months - time for the uterus to heal, and for me to lose any pregnancy weight and to regain fitness. I can't imagine wanting a VBAC for a subsequent pregnancy - I just want the baby out in the safest way possible, and that's going to be a planned section (DD1 was a section too so VBAC after two sections unlikely anyway). Useful to know about the sonogram for scaring too - I will ask our consultant about that. I hope that this IVF cycle goes well for you x

Hang in there Betty and definitely talk it all through with your doctor. Having a doctor you trust makes a massive difference. You will be watched like a hawk next time I am sure. Not that it makes this gut wrenchingly awful immediate aftermath period any easier, but it helped me to have a future plan of action. Things I've found have helped are swimming (meditative and something I can do when I feel desperate and like I can't function at all), knitting things for James's as yet non-existent future brother or sister (combination of mindless activity and concentration/focus, plus it feels like a positive, hopeful thing to do, to welcome and prepare for another future child) reading PG Wodehouse (couldn't always concentrate but felt I needed something silly as a distraction) and spending time with my husband and talking it all through. If you can find someone in real life who has been through this too, that helps. Right after it happened I couldn't bear the though of being around anyone who was as sad as me, but now it helps to have that real life support. I was 'lucky' to have a mum who had a stillbirth at 36 weeks so she understood how I felt, and I also recently met up with another woman who went to the same antenatal class as me but 3 months earlier, who had a stillbirth at 41 weeks. It felt good to talk to someone who had been there.