Monday, 4 May 2015

Keira's Song

Valerie is sharing her story with Sands with the aim of opening a window into the experience of stillbirth.  Her precious daughter, Kiera was born 2 years ago on May 4th and she wanted this to be a gift to her.

"Your body slipped into this world at
6.10 am Saturday the 4th of May 2013 
just as the birds were waking.
The silence upon your arrival was deafening  
but your birth was beautiful."

We were always going to have 3.  I've never been surer of anything.  From writing our wedding vows  and even during my labour with your second sister Isla ( who must have known also because right from a toddler she often talked about a baby sibling)  I just knew our family wasn't complete without you – our number 3.

I knew right from the moment of conception - from the first  flicker of your earth song, you were finally joining us, I didn't really even need to take a test but I did anyway just to see those two pink lines one final time.  I was Happy! Excited and nervous too - but so so happy... to  greet my final pregnancy journey, and babyhood - with you.

My pregnancy with you felt different to both your sisters right from the very beginning.

Perhaps because I was older this time? Perhaps because we had so recently been through a very stressful period of our lives with the Christchurch earthquakes, and the upheaval and transition of moving to Western Australia?  Or maybe just maybe you were sending me little warning signs all along - that our journey would be brief?

Sometime around 10 weeks I began to feel your first tiny fluttering's, the primitive beginnings of your own unique language through which I began to know you. Your patterns of wakefulness, positions you liked and disliked, sounds and people that soothed you, music that you liked, loud noises, ultrasounds and other monitoring that scared or distressed you. Whenever I spoke directly to you - you ALWAYS without fail answered with a reassuring kick or bump.

 At 12 weeks Daddy and I were so excited to see you on our very first ultrasound scan – there you were on the screen so infinitesimally small yet perfectly formed!  We marvelled at your tiny perfect fingers and toes, and your little heart pulsing so fast. 3 days later the Dr asked to see us, it was disquieting when the receptionist refused to divulge why.

We learned at that appointment that you were considered high risk for Down Syndrome. 1:132 - were your statistical odds.  Daddy and I were shocked and surprised, which led us to research, question and deliberate on the statistics, the syndrome and further testing procedures.  Ultimately we decided it didn't matter to us if you had DS, we just wanted to know one way or the other to prepare ourselves. So four weeks later at 16 weeks gestation we had an amniocentesis performed at King Edward Memorial Hospital.   The Specialist obstetrician who expertly singlehandedly carried out the procedure told me you were bouncing up and down on your head the whole time!!!  24 hours later  preliminary test results showed you were a chromosomally perfect little girl!  Finally we felt we could relax and enjoy the rest of our pregnancy and prepare for your arrival earthside.

Christmas Eve 2012  I saw you again  - a routine anatomy scan showed you to be a busy robust healthy little baby.  Santa came and left your first Christmas present - the softest sweetest little bunny with silk edged blanket. Your big sisters loved that!

You were very aware of your sisters - particularly Alena. Whenever she rested her hand or head on my belly and spoke to you - you always kicked and wriggled right back - every single time!  Whenever they put the Swan Lake Ballet DVD on and danced - you danced too. At swimming lessons you even seemed to swim when they did!  Often it seemed their noise and chaos would lull you off to sleep.  Both of them were so excited you were on your way, they made so many plans for you...

We began to make a physical space for you in our lives - a nursery of sorts.  I really relished the experience, and knowing it would be my last, chose carefully.  Bizarrely a series of strange incidents ensued over the selection, purchase and construction of your cot -  which eventually (out of pure frustration) had me ask Daddy if the Universe was trying to tell us something?  The fact that I even said that gives me chills now.

Also at about this same time I was carefully considering how and what I needed to birth you in the closest possible manner -  to that of your sisters - which were both for the most part calm ,natural, and empowering births.  The public system here in WA does not utilize an LMC model of maternity care - rather teams of Drs and Midwives in very busy scheduled clinics.  This effectively means there is no personalised care - and you see someone different each visit. We were ineligible for private maternity care as we hadn't been here long enough. I was looking to establish a partnership/relationship in lieu of an LMC  and was very fortunate to cross paths with an exceptional Trainee Midwife  Steph. A mother herself, in her third year of midwifery and nursing training looking for expectant mothers to share their pregnancy and delivery journeys to help fulfil her course obligations.  I am eternally grateful for whatever force bought us together, because she was to become our rock, my port in the storm and a very special friend for life.

At 29 weeks I was diagnosed with borderline gestational diabetes.  This meant I had to tweak my diet a little and prick test my blood sugars 4 x day to make sure we were keeping healthy.  At 34 weeks we had another scan to check your growth and well-being. You were doing great - apart from an usually large chest measurement calculation which potentially meant you might be very big - or macrocosmic - which can occur with Gestational Diabetes. I never believed you were a big baby, my weight gain was minimal and tho I felt I was carrying bigger than Isla , I felt I was either the same as or slightly smaller than with Alena. I learned later I was bang on, and the scan was well out...  Another scan was booked for 38 weeks. I suppose you could say this was the beginning of the end...

Tues April 31st 2013  38 weeks and 1 day old, at 1pm was the last time we saw you alive.

It was school holidays and during the morning I had felt really anxious about having this scan - so anxious in fact I asked Daddy to drive us.  I am so incredibly glad I did now, because it was the first time we all went – Me, Daddy and your sisters. They were so excited to see you, and there you were happy and healthy and wriggling around non stop!!!

The following day I had an appointment at the antenatal clinic for a routine check up and to discuss the ultrasound.  Unfortunately neither Steph nor Daddy were able to come so I was alone. It was crazy busy and a long wait after seeing the midwife and physio but eventually I got to see the Dr - yet another different one and she was by far the kindest and most attentive. She was happy with how we were both doing until she saw the scan report.  After consultation with one of her superiors it was decided it was better for you and for me to birth you sooner rather than later as there was a strong possibility you could get stuck during delivery. If you had measured only 4mm bigger they would have scheduled a caesarean. On that basis I was scheduled for an induction in 4 days time.  The Dr then proceeded to outline all the possibilities of birthing a big baby - shoulder dystocia and all the awful things they might have to do to get you out if you got stuck.  The descriptions  made me feel quite sick and very very anxious for both of us.  Before I left the Dr asked to examine my cervix - presumably to check its readiness for induction. She also offered a membrane stretch and sweep to help get labour started. She felt sure that it would, given you were my third baby and my body was was now well versed in labour and birth.  I agreed to both simply because,  my beautiful girl, I wanted you to have the safest, smoothest, most natural entry into this world possible - and that seemed at the time like the best alternative I had.   I  was alone, afraid and not thinking clearly.

I will regret that decision for the rest of my life.

Afterwards I was put in a monitoring room blowing the most freezing cold air.  A staff member told me someone was menopausal and needed it that cold. I sat in that antartic room for 45 minutes on my own shaking uncontrollably.  You did not like that CTG machine and kept moving away from the probe, no matter where it was placed.  You probably didn't appreciate my shaking either.  Nearly 4 hours after arriving at the clinic I went home cold and stressed to make preparations for your sisters for sunday night as Daddy would be staying with me at the hospital.

The next day was Thursday. You were flipping around quite happily but I was feeling a bit off. I wanted to stay close to home, feeling labour would be imminent and still feeling unsettled and anxious, such a  contrast to how I had been at the end of my previous pregnancy with Isla.  Thursday evening I asked Daddy to give me a reflexology foot rub - with the hopes of stimulating labour.  We slept peacefully till 4 am when my waters broke! I was SO relieved  - you were on your way without needing the induction! How clever of us both! 

The hospital asked us to come in for a check up as soon as we were able.  9.30 am we arrived and they did another CTG - and checked my vitals. Your readings were textbook perfect!!! Mine were also good, so we chose to go home and wait for labour to begin with strict instructions to return at 4am even if it hadn't for IV antibiotics.  About  an hour after that we decided to go for a walk in a bid to get things moving. Such a nice walk (waddle) with your Daddy down to the jetty and back. I vividly remember walking back up the street towards home and feeling you moving -  I thought it strange because you usually moved most when I was still.  I didn't know it then but that would be the last time I ever felt you move.

The walk had worked!!! Soon after I was getting contractions – regularly. Long strong ones - every 10 minutes for about 45 - 50 minutes. Then everything stopped.  Frustrated by this I tried to keep moving and spent loads of time on the edge of the couch, on my knees on the floor etc to encourage you into the best possible position. You seemed 'quiet' but I felt quite  sure you were just getting ready for your big entrance into the world.   Alena wasn't home to ask me if you were moving either - she was at the zoo with Grandad Mikey .

By the middle of the afternoon I was really tired - and a little bit concerned that labour wasn't progressing so decided to rest in bed and slept. I woke when your sisters came home and Daddy was making dinner. I wasn't hungry and still felt a bit off but ate a light dinner.  By now I was growing more concerned about your inactivity. Something felt different. I went back to my bedroom for a quiet chat with you.  My belly felt different, quiet and heavy, I quietly begged for you to move for me, I told you how excited we were to meet you, how safe you were, how loved you were - I poked and prodded and poked and eventually exhaled with relief when I felt you respond. In hindsight this wasn't you - it was gravity. The reality was this is when you left us, you were already returning to source... your light, your song was ending... the autopsy told us that.  Somewhere somehow I think I knew - but not consciously. 

After an evening walk with Daddy, and your sisters, I spent the evening trying to keep warm, I was so cold and unable to identify or shake a deep feeling of unease, anticipation - something I still can't properly explain.

By 10 O'clock I was ready for bed. Once settled contractions began again frequently and rhythmically. I was so glad - it felt like we had dodged another bullet. You were not moving, I assumed because you had tucked yourself well in, in preparation for birth. I decided not to wake your Daddy sleeping so peacefully until the contractions got closer. I was still cold and began to shake - anxiety does this to me, as does a woman's labouring body. I remembered it well when labouring with Isla.  Deep breathing usually subsided it quickly but this time it wasn't working, in fact it was getting worse. My mouth was very dry despite drinking cupful's of water. By 11.30 pm Daddy insisted we get to the hospital.  For a brief moment I was overwhelmed by the feeling I couldn't move, get out of bed.  Like I was this great impossible weight.   The truth  was I was actually very sick but I didn't know it just yet...

I remember just before leaving the house I had another drink of water, my mouth felt like sand, I could hardly hold onto the glass my hand was shaking so badly and my teeth were clattering hard on its rim. I turned the heater on full in the car I felt so frozen.

A midwife was waiting for us, at first she looked cheerful, calm and relaxed - but her demeanour began to change when she noted I was unable to provide a urine sample and was shaking so violently. I was covered with a warm blanket, and she proceeded to strap the CTG monitor around us.  She seemed to keep moving it around and told me our heartbeats were mirroring. Maybe if I hadn't been so ill at that point I would have understood what that really meant?

My student midwife Steph arrived right about then.

She immediately knew from the midwifes movements, my high temperature, racing pulse and declining kidney function that things were very very wrong, I had no idea she knew this though - because she kept smiling, holding my hand and both offering words of encouragement and answering mine and the midwifes questions without hesitation.  An intern Dr came to see me and then we were moved to a delivery room, where the atmosphere suddenly swung from a quiet business like manner to an intense, strained and hurried one, I knew right then things were not good for us my darling. Time seemed to warp into alternating slow motion and fast forward all  at the same time.

There were now 2 midwives, the intern, and an obstetrician with me. I was having blood drawn and an IV iline inserted, still contracting regularly all the while. I remember a parade of tense and anxious faces, even a murmured argument between staff on the other side of the room, Daddy and Steph were my 2 constants and where I  tried to keep my focus, to concentrate, to try and think through a head full of hazy cotton wool. I was there but I wasn't - acutely aware of the increasing contractions yet emotionally and mentally detached – far far away. Maybe sepsis does that to you - or maybe it is natures protective mechanism? 

Next they needed to insert a special probe into your head to read your pulse, a horrible but essential procedure. I'm oddly  grateful you never had to feel that stress and trauma - it was agony, through a swollen infected cervix.  They made 3 attempts - changing probes to rule out mechanical failure. I distinctly remember seeing one of the midwives stand back after reattaching the cables, hands folded, smiling a little... fading quickly when there were no reassuring beeps... and it was then I knew for sure, way down deep,  Her face, my heart and soul all told me the cruel unjust truth.  The consultant arrived to conduct an ultrasound scan  - first with one machine - and then a second one.

The whole room was so still and quiet, just as you were when the probe moved over you that one last time.  My whole world shattered in the second it took for me to register your still heart. The silence broken by the consultant softly uttering that sentence I will never forget - in the most gentle way he could. "I'm so sorry but your baby has died" followed by Daddy's deep distraught sobs...

I have no idea what I said or did right then - I was in pieces, someplace far away, feeling so utterly hopeless because my womb that was so supposed to have been your safe place  had betrayed us, I couldn't save you, couldn't take away Daddy's pain or even comfort him because I was still labouring... trying to absorb the enormity of the situation,  with every contraction starkly reminding me that although you were gone, our dream smashed into tiny pieces, your physical entry to this world was still happening – Your body still needed mine to complete that.  I waited for , and fully expected them to say they would take me to theatre, they didn't. It felt like such a cruel joke that they expected me to birth you naturally, until Steph gently explained that it was actually better for the grief and healing  processes in the long term. Somehow – I was able to process that and feel grateful that was at least one thing  - the only thing I could still do for you - just as I had for your sisters.  I'm so very proud and glad I could and did.  I begged for pain relief - an epidural, anything to make it all go away. They declined explaining with the infection I had it was too dangerous to put a needle into  my spine. They gave me morphine instead.

We were transferred by ambulance to King Edward Memorial Hospital where I would be able to be monitored more carefully in the adult special care unit. Steph drove Daddy in her car. I do not know what we would have done without her!

The ride seemed quick - the morphine was taking the edge off and I felt very numb and sleepy. A delivery room was waiting for us. Such a lovely peaceful room - dimly lit, and so very quiet.  Such a welcome contrast from the bright, busy stressful room we had just left.

 The midwife - Pauline,  whom met us there was exceptional. So gentle and respectful. Her eyes so full of care, concern, empathy.  With Daddy on one side of me and Steph on the other holding my hand, talking me through, never wavering in the slightest, they both gave me the strength and courage to birth you in my own way, in my own time. It was very peaceful, very sacred, it was ours. I couldn't wait to meet you - see you, hold you, surprisingly that anticipation was as great as it was with your sisters - maybe even greater mixed with the  tiny crazy silver of hope that maybe they were wrong, and I would wake up from this nightmare after all.   I reached down and touched your soft curly hair as you crowned - lots of hair just like your sisters -how very bittersweet.   The next thing we noticed was the cord wrapped very tightly twice around your neck (I knew you had been a busy little bee in there) but were later told this was not a factor in your demise.  Your body slipped into this world at 6.10 am Saturday the 4th of May 2013 just as the birds were waking. The silence upon your arrival was deafening  but your birth was beautiful. And uneventful. No darling you didn't even get stuck like they worried you would.  The midwife handled you so delicately, wrapped you and gently placed you in my arms, and for a moment there was only you and me my sweet baby girl. 7lbs 2oz - a little smaller than Alena and a little bigger than Isla.  For the briefest moment I marvelled at your absolute perfection, kissed your angelic face and felt the same enormous surge of pride as I had after the birth of your sisters, before the force of reality finally caught up and I caved into a heaving, sobbing mess.  How on earth could this have happened? What did we do to you? Why? Why? Why? 

I held you for the longest time - still so warm from my body.  I unwrapped you and studied you carefully from your soft golden curls , your chubby little cheeks, your pretty eyelashes, rosebud lips, delicate long fingers and toes - and big feet!!! They were a surprise!  You looked for all the world just like a peacefully sleeping baby.  That Keira, was a huge comfort to me, I hoped/believed it meant you hadn't suffered and your journey home was a peaceful one.  That and knowing on your short journey here on earth that you were never alone, never felt pain, or hunger, or fear, only ever knowing warmth, nourishment and love - so much love,  is what  got me through those first agonizing minutes, hours, days and beyond. My treacherous body did not seem to realise you had gone, my breasts became painfully engorged and leaking with milk for you, along with usual birth trauma and major bruising from IV's and so many blood tests.  My arms ached so much to hold you. I cannot imagine anything more incongruous and empty than a childless post partum mother...

We know now that the pathogen we were both infected with was Golden Staph. It is commonly found in hospitals and although harmless externally it is known as a super bug internally. We don't know where it came from, why we were susceptible or why it was so aggressive.  Clearly you became ill before I did, but I had no way of knowing that. A follow up review showed that your vital signs were textbook perfect at 9.30 am that Friday morning but according to the autopsy report you were gone just over 8 hours later.  It is extremely rare antenatally in the developed world affecting less than 2% of pregnancies.  There's a sort of strange irony that statically infection was the least of our worries throughout pregnancy yet it became our biggest?  Who would ever have imagined?

Your official due date was May 15 2013 - circled in my diary in excited anticipation, I never dreamed it would actually be the day we physically parted, but somehow it seemed right.

It was a beautiful sunny day. We gave you a beautiful send off. We set you free.

Thank you for the beautiful memories we made, for choosing me to grow, nurture and love you on this brief part of your soul journey. As much as my heart aches daily for you, for us all, I also feel strangely blessed  to have travelled this journey and met some very special people along the way who have become lifelong friends. Your life and death Keira - have woven your own unique pattern into the fabric of our family. You've made us stronger, wiser, more vulnerable, more intuitive, understanding, empathetic and more able to live and enjoy each moment. Maybe that is your legacy?
So my little precious on your Second Birthday in the stars - this is my gift to you.  Your story.  Your earth song. I hope I've done you justice.

                                                                                With all my love                  
Mummy XXxx
If you require support after reading this blog please contact
Sands on 13 000 72637

Valerie O'Connor

Valerie is a kiwi girl living in Perth, married to Neil and is a devoted Mama to her three beautiful girls - Alena and Isla earth side and her youngest Keira, her angel. She is a survivor of many things including anxiety and depression, earthquakes and stillbirth. These experiences have led her on a curious and empowering journey of self discovery which she hopes will inspire and encourage others on this crazy unpredictable ride called life! 

1 comment:

  1. Hi Valerie,
    A very beautifully written tribute to your daughter ! She knows how much you love her definitely !
    I lost my daughter 3 months back suddenly - no reasons given and coming to terms with it.. My son is keeping me busy which is helping me to a great extent !
    I wanted to know how did they give you the time of death ? We did not get any report here in Melbourne - nothing from the doctor - no mention of the time at all !