Delivery

We arrived in Wichita on Thursday, July 20th in the afternoon to begin our induction.  I knew what I'd seen in Philadelphia and that babies don't come back from the dead like that, but I still asked if we could verify with an ultrasound before we started for peace of mind.  That ultrasound was very brief in Philadelphia, God is capable of anything, and unexplained medical phenomena do (extremely rarely) occur; I wanted to make absolutely certain before we stepped into something we couldn't step back from.  The resident on staff was fine with that request and also thought it would be useful to see how the babies were positioned.  

Having gotten quite used to seeing Grace and Abigail alive and moving in ultrasounds and quickly identifying their parts and positions, this ultrasound was very clearly an image of death.  It was emotionally difficult to watch, but it gave me total peace of mind going into an induction.  Without a cycling bladder, the girls' fluid in each sac had greatly reduced, and they had clearly been still and dead for some time.  I don't know why, but the scene was so desolate that it made my heart hurt.  

After interactions with different staff, we met our doctor and found out that the plan was to go very slow with Laminaria insertion and then to use Cytotec the following morning.  I found it a bit ironic that Laminaria was the option since our OB in Hays had used it as an example of old ways of doing things that many women found uncomfortable and that had been improved on with more modern medicines.  That said, our doctor in Wichita was very experienced and clearly explained how what is essentially a seaweed stick that is inserted into the cervix can create a more even dilation that helps in cases of stillbirth.

They went ahead and did the Laminaria insertion procedure, which starts with a rather terrifyingly large needle for numbing; unfortunately, the new lights on the ceiling are reflective, so Tella could see that part and needed to look away.  I stood next to her as she jumped when the first poke from the needle occurred, but after that it seems that the numbing agents began to do their work.  Eventually, the procedure was done and we settled down to wait and to try and rest.  I actually went out to get us some food from a restaurant since limiting her to clear liquids didn't start until midnight, and we ate and tried to wind down.  That evening didn't involve terribly much or terribly great sleep for either of us.  We had come in not knowing what the game plan or timeline would be like, and the updated information had us starting Cytotec the next morning--possibly delivering right away and possibly not until 18 hours later.  Eventually, we both got some intermittent sleep.

The next morning, they came in to start the Cytotec and discussed epidurals.  By way of explanation, Simon, our firstborn son, was born without an epidural.  My wife originally didn't want one, but things were going slow enough that she was afraid she couldn't endure through and opted to get one.  However, the chemicals they were using to help her dilate suddenly caused her to move along so fast that they didn't have the time to do the epidural in the hour we waited on the anesthesiologists and she even was told to hold back on her urges to push.  As soon as she was allowed do so, it was only two pushes until Simon was born.  With that in mind, I asked about starting the epidural before the Cytotec just to be on the safe side.  We wanted/needed an epidural this time because there was a reasonable risk of needing a procedure called a D & C; if there is no epidural, this requires full general anesthesia and an operating room.  With an epidural, it can be accomplished right after the birth without additional anesthesia or needing to go to an operating room.  The resident felt that it wouldn't be necessary to do early, especially since it could take more than one round of Cytotec.  Tella also wasn't concerned.  They said they would ask anesthesia to come by 30 minutes after the start of Cytotec since it couldn't even take effect until then.  Anesthesia didn't get their orders in time, so by the time they came in 15 minutes late, Tella was having to try not to push and was already quite far along.  It was very reminiscent of Simon's birth.  The nurse said to go ahead and try to do it, but she looked concerned.  The anesthesiologist started his work not realizing how close Tella was, but when I explained it he rapidly sped up and got everything in.  They had me holding onto Tella's feet, and then they had her lay down and had me move to the far side of the bed.  She was trying to go slowly as she got down to prevent a contraction from starting, but 30 seconds after the epidural she coughed, which caused a contraction, and Grace's body was born.  With parts of the placenta and umbilical cord also being birthed, I didn't get a clear look, but I did see them take a tiny body over to the heat lamps and wrap it up.  Within two minutes, Abigail's body was also born.

I felt a wave of sorrow on each birth, and I wanted to go look at the girls, but I also felt it was best to comfort the living, so I hung out next to Tella holding her hands as we handled some of the cleanup and as they waited for the placenta to be birthed.  Once things calmed down, I asked if I could see the girls, and they said 'of course.'  Walking up to them, I saw Grace lying face down and somewhat contorted with a few of her organs sticking out.  With the 70 degree bend in her spine, I did expect some pretty big malformations, but I was surprised that so few organs were out.  It looked like the hole in her body was smaller than what the doctors were suspecting, and less organs were sticking out/less were sticking out as far as I expected.  It was hard to tell if it was due to her spine now being free and also because it was bendy at this gestational age, but she straightened out pretty well.  It was the second time that I questioned our decision and wondered if things weren't as bad as what the doctors thought/told us.  I realized the organs sticking out would have still been fatal and did not relate to the heart failures that were already occurring on the ultrasounds, but it still made me wonder.  Abigail was a bit harder as she was a perfectly formed little baby.  She was very, very small and early in gestational age, so her eyes were sealed shut, but there was nothing wrong with her.  She was completely and correctly formed.  Statistically, she should have survived the surgery and been born.  I broke down and cried as I saw my daughters--or more accurately their bodies.  I went into the restroom to cry in some privacy, then I went back out to be with Tella as they delivered the placenta and then decided to do a D & C.  I stayed next to Tella during that procedure to support her.  I felt like I'd already initially seen the girls and knew that they had already crossed over.  

After the procedure, they wrapped the girls up and brought them over for Tella to see and to hold.  She greeted them and talked to them as though they were here.  Part of me felt it was a bit strange since they had already crossed over; however, as I reflected on it in the moment, I felt this was important for Tella and I also felt like they maybe were a bit specially spiritually present as an answer to prayer (that sensation came more as we talked to them longer).  As such, I also chatted with them when I held them.  I apologized to Abigail for having focused so much on Grace and our decision we had to make regarding whether to do the RFA procedure or not.  In a sense, I felt that I had taken Abigail for granted, though I still talked with her and celebrated her and loved her--much of my attention had been on whether or not to do a procedure that would kill Grace.  I also very much loved my little mobile and adventurous Abigail.  I told her that and shared how much I loved her.  I explained we had intentionally not picked a full name before she had passed away because we were hopeful we'd see her alive on this side.  I also apologized to Grace for the decision we had to make.  I was thankful we could be with her as she crossed, and I told her we had wanted to help her cross comfortably with less pain and to help protect Abigail--the procedure was never that we didn't want her.  We desperately wanted both.  I told both girls how much I loved them.  I also cried intermittently throughout this time.  During and after that, we took some pictures as I felt it would be very important for our memories later.  I then gave the girls back to Tella to hold and talk to, which she did for quite awhile.

After it felt like we'd said much of what was necessary, we put them back under the heat lamp.  We had also chatted with our doctor somewhere between the D&C procedure and putting them under the heat lamp, and she had asked if she could pray with us, which I very much appreciated.  The prayer was touching and painful as she directly addressed much of what we were going through; she was glad our birth had gone so fast, which was what she had been praying for the night before.  Going through 18 or more hours after the 12 hours with Laminaria can apparently sometimes happen, and that makes it all the harder.  I was glad she was a believer who felt comfortable praying with us, and I was glad to pray through what we were experiencing.  This, itself, was an answer to many of the prayers for those who were praying with us.

The rest of the morning moving on into the afternoon was actually almost 100% constant between nurses stepping in and checking vitals and talking with us or other visitors who were necessary as part of the stillbirth process.  Tella had initially held the girls again to talk to them when breakfast arrived, so we put them back under the heat lamp.  After that, our next visitor was from a local ministry called Agape that our nurse the night before had reached out to.  They help make arrangements for stillbirths with local funeral homes and provide urns and/or caskets for free or at a very reduced rate.  We had several questions for them about the legalities of getting the girls' bodies back to Hays verses having a Wichita funeral home handle them.  They agreed to make several calls for us as our preference was likely to get them home to Hays ourselves and to have them cremated.  

The next visitor was a stillbirth coordinator from the hospital who was able to answer some further questions about legalities regarding stillbirth paperwork and who brought us several grief counseling tools.  She also brought in some special knitted clothes, hats, blankets, and 'cradles' for the girls that a local group makes.  They were very cute, and we took some pictures and decided which girl would get which clothes and blankets.  Tella also talked to the girls about them and about clothes and what it would be like to wear them and pick them.  We then ordered lunch.

During this window (I think--it's a bit hard to remember the order of everything as emotionally overwhelming as the day was), I started to notice the smell from the girls.  It directly reminded me of anatomy and physiology lab when we did dissections.  It bothered me a bit that I had a slight repulsion at the smell of my daughters' bodies.  I approached them and talked with them a bit, then I cried.  I can't remember if I kissed my fingers and wiped my tears onto them or if I just wiped my tears onto my fingers, but I then reached out and touched both girls on the head and gently caressed their heads as I would had they been born and needed comforted and talked with them.  Even though this was just their bodies, I felt it was important to overcome the momentary repulsion I was experiencing and affirm my love for both girls.  I did that and prayed silently, and then I sat down to rest for a minute.

Around this time, the nurse asked if they could take the girls out to the hallway to do casts of their feet for us, which is apparently something that the hospital does for stillborn infants.  We said that was fine, and shortly after they had wheeled the girls' bodies out, the hospital chaplain came in.  He said he'd heard that we had indicated we didn't need to speak with a chaplain (I had declined as I already have good spiritual connections with several local pastors and didn't feel a need to talk to another person about everything), but he had still wanted to swing by to say hi just in case.  Upon his arrival, I noticed that I recognized him, but I couldn't figure out where I recognized him from.  He also recognized me.  It turns out that he had been an associate pastor in a small town near mine and had attended several pastors' lunches in the area that I had also attended as a local ministry leader a few years prior.  He had left his church and moved away, and I hadn't heard from him since.  Apparently, he had expected to run into people he knew from the Wichita area as that is where he had grown up, but in his time as a chaplain he had yet to run into anyone he knew until running into us (from a very different part of the state).  That he was the chaplain on staff at that time and ran into us was quite a low probability; I'm not entirely sure why, even at this point, but I felt like it was a bit of a God thing or answer to someone's prayers that we met him that morning.  He shared with us both a bit about these ceramic hearts that their office provides for parents of stillborns.  The heart is cut from one piece with an inner heart and an outer hollow heart (missing the inner piece).  Both have a cord and can be worn as necklaces.  They advise tying the small hearts onto the stillborn as a necklace during burial and keeping the large hearts ourselves to remember that we are always connected with our little ones; there is also a reading with the presentation of the hearts that gives several symbolisms to each heart.  Among those symbolisms, they share that the big heart holds the truth that each child will always be a part of our family and the small heart that is left with the baby's body also symbolizes the dreams we had for our baby and milestones we wouldn't get to experience that also need to be left with our babies' bodies.  This was a teary moment for me and for Tella and the chaplain, but a good moment.  In the background, the doctor who had originally diagnosed Grace with limb body wall complex also showed up from across the street.  She was very emotional and shared her sorrow with us as she cried along with us some.  We appreciated her condolences.  While the most impactful thing about her visit was her presence, it did strike an interesting chord in me when she mentioned that she was glad to have gotten confirmation from Children's Hospital of Philadelphia that her diagnosis of limb body wall complex was correct, because she hadn't been certain before then.  This was surprising to me because she had spoken with fairly great certainty (and had ended up being correct) as to her diagnosis early on.  To learn she wasn't certain when she sounded so certain left me reflecting a bit on the information that all the doctors had given us throughout this journey.  I could only think about it so much at this moment, though, because the person from Agape came back and wanted to talk with us about mortuary options.

It turned out that we were able to have the girls' bodies signed over to us to be transported by us from Wichita to Hays where Clines-Keithley mortuary was willing to accept them after hours late at night.  They were also (very generously) willing to cremate them at no charge.  Agape was willing to send some urns to Hays at a later date with the girls' info on them, which we accepted.  Then our lunch arrived (fairly late in the afternoon), so we ate.

After this, we met with our final nurse (they changed during shift changes) who went over several of the discharge requirements and who checked on Tella.  She was also having trouble figuring out if we needed to fill out further stillbirth paperwork but was ultimately told we did not.  At that point, we received the casts of the girls' feet and then waited on a photographer who our nurse the night prior had set up.  Apparently a different local nonprofit does photos with parents and stillborns that can be very important later.  The photographer arrived and helped us dress the girls in the outfits that had been made for them and take a variety of pictures.  Though we don't have any yet (it usually takes 6-8 weeks to receive them), she also was willing to take a few pictures with our cameras that we could have until we got the rest.

This led us to our final phase.  The nurse brought in a casket made from a cardboard-like paper that is used to transport infant bodies.  We got the girls situated in their clothes, hats, and cradles within the casket.  I re-opened it after tying it to make sure that anything that couldn't be cremated was removed, and also to tell them a final tearful goodbye as I wouldn't see their bodies again after this.  Though I knew/know their souls had already crossed, it was still a hard moment to look on their bodies for the last time.  Then I sealed up the casket, and we carried them and all of our dismissal stuff and packed clothes etc. to the vehicle.

The drive home after everything was a bit surreal.  We got Jimmy Johns right outside of the hospital to eat on the road, and we drove as continuously as possible despite being fairly emotionally and physically overwhelmed (neither of us had slept much the night before).  Nonetheless, we needed to make it back before it was way too late as the mortuary director was generously going to meet us as soon as we called him about 30 minutes outside of town.  While driving, I reflected that I felt emotionally swollen.  Each moment in the day had been important and emotionally intense, but my emotions had been engaged so frequently and so strongly that I felt like everything was just very tender.  I wasn't hurt or in pain--just very overstimulated to where anything that touched my emotions had an overly strong response.

We got into Hays around 10PM and turned the bodies over to the head funeral director.  He was very generous and helped us set up a time to meet him on Monday to go through the final required legal paperwork to have the bodies cremated.  After that, we got home to our very quiet house.  It felt very empty to me, but not necessarily in a bad way.  After all the emotionally intense and busy encounters throughout the day, it felt ok that it was empty and that I could finally rest.  In a sense there was an emptiness of loss, but there was also an emptiness of having poured out all of my sorrow and stress and finally being able to rest.  Both my wife and I were very ready to see our son the following day, but that night it was good to just go to sleep.