Jack’s Story

By Beth

We may never know what caused my body to expel my little boy just 19 weeks into my pregnancy  All we know is that on Christmas Eve, 1999, as my husband and I left my sister's house and went home to open presents, I began to feel a slight, cramping backache, similar to a menstrual cramp. I'd just been in for a routine OB checkup three days before and still remembered the warning signs of premature labor. I felt apprehensive enough to check inside with my fingers--something which I hadn't done for weeks. What I felt in there shook me.

Instead of feeling a slippery, yielding cervix, I felt something large, round, turgid and "squeaky" filling the vault of the vagina like a water balloon.  I feared that I was feeling prolapsed membranes. Half in denial, I went downstairs, sat on the davenport and tried to think. Then a contraction hit me. I called the local hospital and spoke to an OB nurse, who told me to drink a lot of water and to come in if I bled. Well, bleeding started within minutes, so off to the hospital we went.

Things must have been happening rapidly; I had to almost lie flat in the car because it felt as though I were sitting on something, and my contractions came every two or three minutes. During a contraction, I couldn't talk, and grim fear kept me quiet the rest of the time. As the clerk took my information in the ER, I practically doubled over her desk with each contraction.

Finally a nurse showed us to a room. After a time she located the baby's heart tones with an ancient doppler and let my husband and me listen. My husband hadn't felt, seen or heard the baby up until then; he listened for a few seconds and took the ear pieces off without comment. "Will I lose my baby?"?" I asked the nurse. She said that she didn't think I would. The doctor who appeared some minutes later, however, didn't sugar coat anything, and a few minutes later he confirmed what I had feared; my membranes were bulging out of the uterus.

"You can't really reduce prolapsed membranes," he said, meaning push them back into the uterus. "They've been weakened and contaminated. The outcome would almost certainly be an intrauterine infection." Resigned to losing the baby, I asked for a painkiller, which they gave me. Then we were off to The o. ward, to wait for the inevitable.

After we were alone in the labor/delivery room for a minute, my husband broke down. Hearing the heartbeat had been too much, he said. How could his baby die?  I thought about it and could only imagine how awful it must be to first perceive one's own child just before its death. As for me, I was stunned and emotionless. I spent the next few hours in a narcotic twilight, waking with each new contraction and gripping the bars.

By six o'clock Christmas morning labor had stopped, and there I was, with the bag of waters in the vagina and the baby in the uterus, kicking now and then. I also had a bunch of people coming to my house for Christmas dinner, so I got on the phone and rearranged things. The day wore on and by noon the doctor on duty tried to get labor going again by hooking my membranes. The amniotic fluid gushed, he jumped back, and I cried as I felt all hope for my baby vanish. In fact it was then that the baby died, because the umbilical cord prolapsed, cutting off his source of oxygen.

The doctor finally tried inducing contractions with prostaglandins, but it took seven hours for that to finally work. The mini-labor was short and intense, and I expelled the baby in two or three pushes as I leaned on my sister. "It's a boy," the nurse said, as my sister and husband looked on.

There he lay, our little boy, half a pound and as small and still as a dol.  had large eyes, sealed shut like a kitten's, and amazing little features, down to every last detail: straight baby eyebrows, intricately coiled ear cartilage, even finger- and toenails. He had scratched his face at some point. He had been dead long enough for rigor mortis to set in and his head was molded from the squeezing of the cervix. The nurse pointed out how he had his mother's chin. In spite of all the awfulness, I allowed myself to feel a little joy at his perfection.

The placenta came out whole, much to everyone's relief. The doctor was afraid I'd need a D&C if the placenta didn't deliver right away. When he asked if I would like an autopsy I said no, but that I would like them to look at the placenta. They whisked the baby away, bringing him back presently, wearing a tiny cloth diaper secured with a single pin. I named him John Michael, memorized his face, kissed him and found him painfully cold. I wrapped him snugly in the tiny receiving blanket, laid him face down on my chest and we two took a nap together. The nurses found a sturdy white envelope box for him, which served as his coffin the next day--BoxingDay--when we laid him to rest in our back yard, along with some of his Christmas gifts and locks of our hair.

It's been nearly half a year since losing Jack. His due date, May 22nd, has come and gone. I've tried over the last three months to conceive again, but it  hasn't gone as smoothly as I'd hoped. Perhaps by the end of the summer I'll be pregnant again, and by the spring of 2001 we'll have a little one to love at last. When I do get pregnant again, I'll be seeing a high-riskspecialist, just to cover all the bases. After all, we don't really know if I had an incompetent cervix, an infection or premature labor. Given all the mystery, I am uncomfortable with simply seeing my regular OB/Gyn, although I do think a lot of his work. There simply is no substitute, though, for experience and extra monitoring.

As for Jack. . .well. . .not a day goes by that I don't hold his photograph close and think of how much I love him. I wish he could have known.

We Get an Answer.....

September 12, 2000 Now the answer is clear as to why I lost Jack: total uterus septus. That is, I have a dividing wall in my uterus that runs the entire length of the cavity, as revealed by a hysterosalpingogram.  A septum severely restricts available blood flow and space, which is why I seemed to have an incompetent cervix; Jack just levered himself out of my womb. Fortunately, the anomaly is easily corrected by a hysteroscopic septoplasty.  I hope to have it all done and be ready to try again by the anniversary of Jack's death.

I have been doing a lot of thinking about my own role in what has been happening. For starters, I decided to have a baby in the fall of 1998 and sought out my current OB/Gyn for it. He's a capital fellow, with good facilities to do testing and perform certain infertility procedures. I frequently butted up against his sense of orthodoxy, but in general I have had no complaints, and have appreciated the doctor's intelligence and flexibility.  I still believe that most of the choices I have made have been good. Except one, why didn't I insist on a hysterosalpingogram immediately after I lost my baby?  After all, I am not afraid to ask a doctor for what I want.  I refuse to speculate as to why the doctor did not insist, nor do I care, since I consider myself responsible for my own medical decisions.  It my responsibility to ask for an HSG and I shirked it. I'm sorry I did, because in so doing,  I just wasted 9 months of my time and several thousand of my dollars spent on fruitless IUIs and related expenses. What's worse, I could have lost another baby in exactly the same way as I did Jack. Uterine defects as severe as mine are so uncommon that it hardly occurred to me that one could have caused my problem. The lesson I learned?  When faced with an unexplained tragedy, try immediately and aggressively to find out why.

Jack was my fourth pregnancy and the first one to make it to the clinical stage. He was conceived by DIUI, due to male factor. My own problems are mild, mild PCOS and a complete uterine septum. If I get pregnant again after septoplasty, the party line maintains that I will not need a cerclage, however I am leaning toward requesting one. I can't stop wondering how much stress my cervix was under for weeks on end, as the pregnancy was forced down against it by my inelastic uterus.

If you would like to talk, or if you would like to see Jack's personal page, feel free to contact me at mickbeth@win.bright.net

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