On January 21, 2015 I held a small plastic stick in my hand. I held my breath and waited to see if a plus sign would appear and turn my life, and my husband’s, towards a new path.
Little did I know then, that as soon as I saw that plus sign, I should have put down the pregnancy test and immediately picked up my phone to call midwives’ offices.
Throughout my first pregnancy I had all the naïve expectations for a completely “natural” pregnancy and birth. I believed that somehow my body, strong as it is, would know what to do. I absolutely did not believe that my baby or I would need medical intervention for what I thought of as “the most natural thing in the world.” I was never against medical intervention if needed, but right from the beginning, I wanted my pregnancy to be supported by people who shared my views and had the training and sense to support us through a healthy pregnancy, and call in the doctors if needed.
And so, in late January I set about finding a midwife. Not as easy a task as I had imagined, especially not in the month following the most festive time of the year. I called midwifery clinics in New West, Coquitlam, and then Burnaby. Each time I was put on a waitlist or was told they were full for late September/early October arrivals. I didn’t know what to do.
Midwifery care is covered by BC’s Medical Services Plan. Many pregnant women choose not to follow the “traditional” care path of an obstetrician or delivering GP and—unless there is a medical reason to be with a doctor from the beginning—will seek out a midwife for the same reasons as I. With only 322 midwives registered in BC and nearly 45,000 live births in the Province annually—not to mention supporting mothers whose babies die in utero—midwifery care is in huge demand. Midwives are also limited in the number of clients they may take on at any one time.
Ganga Jolicoeur, CEO of the Midwives Association of BC (MABC), says: “BC leads the country when it comes to midwife assisted births,” and notes they are well on their way to reaching their goal of having 35% of all births midwife-assisted.
“MABC believes that an increase in maternity care services across the province will improve health outcomes for expectant families.”
The association is also an advocate for both the International Bridging Program—to allow midwives from other countries to be registered to practise in BC—and the doubling of seats in the midwifery program at UBC.
In my case, I visited my family doctor to begin my prenatal care and we talked about the differences between doctor and midwife support. I shared my preference for the midwifery model, but said I hadn’t been able to find one with space. She highly recommended Pomegranate Community Midwives in East Vancouver, who also service clients from New Westminster. I called their office, and was able to book an appointment. From our first meeting Rob and I felt confident we had made the right decision and that we, and baby to be, were in very capable hands.
During our time with Pomegranate, my family’s wishes were respected and we felt heard. We also felt we were given enough information to make informed decisions about optional testing or screening and we discussed where and how we wanted to deliver our baby. Also, they were available to us by phone 24/7!
We had monthly appointments until my eighth month of pregnancy. Each appointment lasted 45 minutes to an hour and began with our midwife asking Rob and me if we had questions or concerns. It impressed me that they asked questions about possible stresses in my life—financial security, the baby’s and my safety, the availability of a support network, my work, and how was I feeling about pregnancy, about labour, and about becoming a mother. Our midwives understood that this pregnancy affected all areas of our life, in good and in challenging ways, and wanted to make sure we were managing these changes as best we could. They took my blood pressure and felt and measured my growing belly. The very best part was listening to baby’s heartbeat. I always felt they shared in our excitement for our little one.
My pregnancy progressed beautifully. Smudge (our baby’s nickname) was hitting all her prenatal milestones and I was in excellent health. Rob and I went to prenatal and breastfeeding classes and toured the hospital’s labour and delivery ward. Things were going so well we began to talk to our midwives about about birthing at home or even a water birth. During labour, I wanted to remain home for as long as I felt comfortable, and possibly for the entire birth. The option to go to the hospital was always there, but as long as everything was okay we could stay put under the care of our midwives.
Towards the end of my pregnancy, we saw our midwives weekly. Our due date came and went, but everything seemed just fine. Until week 40, day four. During this appointment, my midwife was concerned that I was developing preeclampsia—a serious condition marked by high blood pressure and swelling of the hands and feet.
I learned that midwives consult with obstetricians and gynecologists as needed. Our midwife referred me to a specialist where tests confirmed I was developing preeclampsia. Now that Smudge’s and my health were at risk a hospital birth was mandatory. My dream birth plan was not to be, but ultimately this was my ideal birth—no medical interventions unless needed. Now they were needed, and I will be forever grateful they were available to us.
The next day, we went to Burnaby General for a previously-scheduled 41 week check up to see how Smudge was coping. Tests showed that Smudge was doing fine, but as the preeclampsia progressed, we decided to begin procedures to induce labour.
A team of doctors and nurses were now managing my health care, but Smudge was still with our midwives. I thought this was incredible. I was taken by the respect my entire team had for each other, and for us. Everyone knew my wishes for an intervention-free birth and supported me as much as possible. Smudge was continuously monitored and was never in any distress. That gave us time to talk with our team and, after many many hours of labour, Rob and I decided to go forward with a cesarean section. Our midwife was with us in the operating room.
At 4:37pm Saturday, October 10, 2015 our Mara was born.
After a quick stay in post-op, I was moved back to our room where I was assigned a nurse for 24 hours to monitor my high blood pressure. As ever, Mara was doing wonderfully and had no problems breastfeeding. Rob was quickly learning how to change teeny tiny diapers and to comfort our baby girl. A doctor saw me every day of our stay at hospital. Our team of midwives attended to Mara, and supported us, answering all of our questions and concerns about caring for our precious girl. Once I was deemed healthy again, we returned home. My next visit with my doctor was scheduled for six weeks later at her office. In the meantime, the midwives came to our home.
Our time together at home was perfect. Mara was in great health. She was feeding well, sleeping well, and gaining weight steadily. Our routine was completely focused on responding to our little girl’s needs. For us, this time was joyous despite the exhaustion known to every new parent. Our midwives visited to check up on Mara and make sure my incision was healing well. We asked friends to hold off on visiting until we were more settled, but did spend time with both sets of grandparents. Our world was perfect.
Then one morning everything changed.
We awoke to discover that sometime during the night, our perfectly healthy baby had stopped breathing.
Mara died on October 21 at 8:37am. We had only ten days with our baby girl.
Mara’s cause of death was Sudden Infant Death Syndrome (SIDS). This means it happened for no reason that anyone will ever understand. SIDS is the “sudden and unexpected death of an apparently healthy infant under the age of one which remains unexplained, even after a complete autopsy.” It is the term used when all known causes of death have been ruled out.
SIDS is not suffocation. It is a medical condition that is not yet understood by science. Though risk reduction strategies have helped lower the rate of SIDS in recent years, SIDS is not predictable or preventable.
I called our midwives as the paramedics worked on Mara. Our midwife met us at the hospital and stayed with us as we tried to make sense of what was happening. She was with us when we needed her, and also gave space for the three of us to be together to say our final goodbyes. Hours later, when we were ready, she drove us home.
We didn’t know what to expect in the blurry days that followed, but our midwives were a constant support to Rob and me. Even though Mara had died, they still came to our house to check on my health, and help us through this devastating time in any way they could.
Our empty house was soon filled with flowers from friends and loved ones. We wondered if there was a longer-lasting way to honour our Mara. We learned of a holiday hamper project for vulnerable families in our midwives’ care, and asked that donations be made to this project, in lieu of flowers. This year we have again decided to honour Mara’s memory by supporting the Pomegranate Community Midwives Holiday Hamper Fund.
Now our midwives at Pomegranate, along with our doctor who delivered Mara, are caring for us through a second pregnancy. We look forward to the arrival of Mara’s younger sister in early 2017. While we’re cautiously optimistic that everything will be just fine, we know too well that sometimes life has other plans. For now we hold our breath, and hope.
People tell me all the time that they think of us often, but don’t know what to say. My advice: say Mara’s name to us. Even though it may feel uncomfortable, let us know that our girl is remembered. Mara’s arrival brought us more happiness than we ever thought possible. Her sudden death brought more pain and sorrow than anyone should ever have to endure. Rob and I are realizing that time doesn’t heal all wounds, but somehow, bit by bit, time helps soften the pain, and lets us breathe a little easier. We will never get over losing Mara, but we’re slowly learning to keep her memory alive in ways that bring us comfort. Our grief for the baby we no longer have now rests alongside the joy her memories bring, and the growing excitement for the arrival of her younger sister. It’s a bizarre journey…trying to figure out how to be parents to a child who is no longer here. But somehow, I think both our daughters would be proud of us.