Coping with a stillbirth – Rhoda’s experience

Last year I lost my first baby when I was eight months pregnant. It all started with very many complications. I bled during the first three months. I was not just spotting, but bleeding. It would stop for a while, then at other times I would wake up and find my bedding soaked in blood. I was given medication to stop the bleeding. At other times the doctor would prescribe injections, three times a week.

I do not recall feeling the baby kick. At the clinic, the doctor did not advise me to monitor the movement of the baby, which I think I should have done. The clinic I attended is in my neighbourhood. The doctor would simply touch my belly and tell me that everything was fine.

I went into labour at eight months

In August 2006 I requested for an ultrasound scan since my baby was due in September. Unfortunately the scan was overtaken by events: I went into labour at eight months.

I began feeling pain while I was in the office and I decided to go home to pick my clinic card and then go to the hospital.

On arrival at the hospital. I was taken to the labour ward where the doctor examined me with a fetoscope. He then told me my baby would have to be delivered prematurely and they did not have facilities to deliver pre-term babies. He therefore referred me to another hospital.

I was received well at the new hospital and rushed to the examination room. The first doctor examined the foetal heartbeat. She called another doctor who did the same and then they called in four others.

I learnt that they could not trace the baby’s heartbeat. I was devastated! After some vaginal examinations, the doctor told me that since my cervix had already opened up, I could go through a normal delivery. I was induced.

I sent a message to my husband to the effect that I had been admitted. By the time he came. I was in a lot of pain. When I told him what the doctors had said he told me that we should hope for the best.

I delivered a stillborn baby

After the induction, I stayed for about an hour and then delivered a stillborn baby. It was a baby girl, and the nurse who was conducting the delivery told me that it was not a fresh stillbirth: the baby had died about three days before!

I was taken to the maternity ward and I got encouraged to learn that there were other women who had gone through the same. The next day. I was discharged and advised to go back to the hospital after six weeks. It was not easy. My breasts were full with milk and though I had been given some medicine to stop the milk production, but my breasts continued producing milk for another two weeks. I would express the milk and discard it: sometimes my husband would help me do it.

My world had collapsed

I felt my world had collapsed because it was our first baby. I had bought a lot of things for the baby. All I would say is that God knows why it had to happen.

When I went for review after six weeks, the doctor did some tests for blood sugar level and bilharzia and the results were negative. He told me that I could try getting another baby.

There was no need for me to go for pre-conception clinic. I conceived again in October: that was a month after delivery. A friend of ours had advised us that the only way to heal after such an incidence was to get another baby as fast as we could. I decided this time round, I should lake a lot of caution and make sure the doctor who is attending to me is a gynaecologist.

I continued to receive congratulatory messages

Back to the house, we were very low and we would cry a lot. I continued to receive congratulatory messages from friends who heard I had been admitted to hospital for delivery but did not know what had happened. Recently, I met with a friend who was pregnant at the same time as myself and she was shocked to see me pregnant again. She asked me why I got pregnant that soon and yet the other baby was still young.

I began attending antenatal clinics at three months and my gynaecologist was attended to me very well. It was exciting to feel the baby kicking every day and I had a lot faith in God. I did not know that one has to monitor the kicks but now I know. I went for a scan and found out that I was carrying a girl. Somehow I felt it was a replacement and I was very happy, the pregnancy was normal: no morning sickness and no cravings.

I began my leave a week before my expected due date, which was 17th July, but my doctor advised me to check in at the hospital on 4th July. Owing to the previous delivery which was a stillbirth, the doctor did not want me to labour. On 3rd July, I went to town, and then passed by my aunt’s office for lunch. At around 3:00pm, while still at her office, I noticed some spotting. However, I was not alarmed and decided to go home where I cleaned the dishes, prepared supper and then went to take a shower at around 7:00pm.

I noticed that the spotting had increased

At that time, I noticed that the spotting had increased. My husband and I decided to go to the hospital but before that, we passed by town for some shopping. I was not in a hurry because I was not in any pain. We arrived at the hospital at 9:00pm.

The doctor examined me and told me that I was in labour and had already dilated 4cm. She performed a vaginal examination and immediately thereafter my waters broke. She decided to augment labour and I laboured from 10:00pm to 4:00am. I would call the nurses to regularly examine the baby’s heartbeat. I was scared of history repeating itself.

The medical staff had to steady me by holding my hand while I signed the consent forms

During labour, I vomited everything I had eaten that day. When the doctor examined me to determine the progress of the baby, she told me that the baby was breech, lying longitudinally with the buttocks appearing first. She advised me that I would have to undergo a C section.

I was ready for the C-section because the pain was too much; the medical staff had to steady me by holding my hand while I signed the consent forms.

I was taken to theatre and before I was knocked out by anaesthesia I said a prayer.

I woke up at around 6:00am and was informed that my baby Mitchelle Nyambura was delivered at 4.42 am. She weighed 3.0 kilograms. I was happy because my baby did not have any problem, I thought the baby would be premature because I had delivered her before my EDD but she was fine.

My advice to all women who have had a stillbirth experience like mine is that, they should not view that as the end of the world. God has a reason for everything. As long as you still have your uterus, you can have another baby.

Coping with stillbirth

By Dr Blasio Omuga

Going through a stillbirth is not the best of experiences. A mother has been expecting and has willingly carried a pregnancy with all its challenges only to end up with a traumatic psychological and physical experience. Many of the cases of stillbirth can be avoided by closely monitoring complicated pregnancies, investigating and managing them effectively. Where necessary, patients should be administered carefully and given specialized care until they deliver. In some cases, delivery can be done earlier than the expected date and the newborn given support care in the nursery. In cases of complicated and high risk pregnancies, it is extremely important to listen to the patient’s views and complaints. It may be the only time to save a situation especially when there is excess bleeding, reduced or no foetal movement, as these are not good signs.

It is extremely traumatizing for a woman to carry a dead foetus without her knowledge, even more so when she has complained of no foetal movement or requested for investigations but not much has been done to address her concerns. A dead foetus can also cause excessive bleeding during pregnancy, labour and after delivery—a condition known as disseminated intravascular coagulopathy.

All first pregnancies should be given special care

In every clinic, service providers must examine their patients properly after taking detailed notes of the pregnant mum’s observations about her pregnancy. Missing a diagnosis or evaluation of a patient’s real problem can be extremely catastrophic and disappointing. The objective must always be to promote best practices in client care during pregnancy. If a woman expects a live baby and ends up with one that was long dead in the womb—especially after attending antenatal clinic—she may feel this is unforgivable. She definitely deserves an explanation. This is even worse when she has followed all the instructions given by the doctor to the letter.

Others might express sympathy instead of empathy

Peer grouping of mothers in wards can be supportive, such as in the case of Rhoda. When one discovers that she is not alone with the problems she has experienced, this eases negative reactions to her own situation. However, the first child has always had a special place in every woman’s life, hence it is virtually impossible to completely wipe out the trauma. Unfortunately, this is an experience the woman has to carry for the rest of her life. This is why all first pregnancies should be given special care.

In the family, such an experience can be hard to bear. The behaviour and reaction of other people, although innocent and well intentioned, can add trauma to the already badly wounded mother. Some might start blaming her for various imagined reasons. Others might express sympathy instead of empathy, with negative effects on the already distressed family. Women and families who have undergone such experiences need to be very strong and require every support possible in order to overcome their grief, especially where there is no other child around in the house to console them and the fate of future pregnancies looks bleak. At such times, the mother is not even sure whether she will ever be able to conceive or even sustain a normal pregnancy.

All service providers should thus take adequate care of their clients to avoid any accidents. Pregnant women and their spouses should also be informed of all danger signs in pregnancy.

END: PG09/51-53