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Reflections on almost motherhood

“Is that really two pink lines?” I heard my own voice say, as my mind raced with a mix of excitement and anxiety. It was July 1, known within the medical community as a kind of “first day of school” – medical students become fresh PGY1 residents, junior residents become seniors overnight, and final year residents magically transform into attendings or fellows. It’s a time of change and excitement to say the least. On this particular July 1, I was post-call, having completed a 26h+ shift at one of the trauma hospitals in my city. My body and mind were exhausted. When I saw the two pink lines on the pregnancy test I had just taken, I could barely process what I was seeing.

Then came the tears. After years of carrying the diagnosis of polycystic ovary syndrome (PCOS), I was convinced that I was doomed to suffer infertility. But like a little miracle, after one month of trying to conceive, we got our big fat positive (BFP)! I was elated. I wrote a beautiful and personal note for my partner who was still at work and organized my little surprise reveal for him. We were going to have a baby! I was overjoyed and so was my partner when I shared the news. He immediately wanted to tell our families even though we only had one positive test and didn’t even know our due date yet! He drove me across the city to my parents’ house and we showed them a photo of our positive pregnancy test. It took my mom a whole minute to understand what I was showing her. Then she screamed excitedly and hugged me tight, crying tears of joy. The last time she was this emotional was the day we found out I had matched to my top choice residency program in our home city. My father, always a pragmatist, said “we thought you’d wait till you were done residency, but this is a blessing and the best news!”

We called my partner’s parents immediately after announcing the news to my parents. They were so overwhelmed that the only thing my wonderful mother-in-law kept repeating was, “all thanks to God.”

On the drive home, we started to hear the crackle of Canada Day fireworks exploding in the sky above us. My partner turned to me, with a big grin across his face, and said, “everyone is celebrating our baby!”

What a beautiful, innocent, and naïve pair we were, setting out on our journey to parenthood.

The next several weeks went by quickly, almost like a dream. We did our first ultrasound, got a great ObGyn, and started fighting over baby names. The first trimester flew by and I started getting rounder. I bought maternity clothes, got a body pillow, and made plans to go to the local baby expo with a girl friend. We started planning our gender reveal party – would we get a cake or pop a balloon? Maybe we should get those powder smoke cannons instead? These were the small, beautiful joys that occupied our lives.

On September 30th at 3am, I woke up with sharp shooting pains throughout my abdomen. I rushed to the bathroom. I could feel a low pressure in my pelvis but nothing else – no fluid, no blood, nothing. After waking my partner up, we decided it would be best to go to the hospital and get checked out. I texted my senior resident “Sorry for the early message. I’m on my way to the ER to make sure nothing is wrong with my baby. I’m sorry for the inconvenience. I’ll come in as soon as I’m cleared.”

The triage nurse saw us first.

32-year-old female, G1P0, 16 weeks and 2 days. Sudden onset abdominal pain. No discharge. Patient otherwise healthy.

She took my vital signs which were all normal. “As long as there’s no discharge, you’re ok,” she said. I clung desperately to those words, not yet willing to accept anything bad could be happening.

The wait in the ER was excruciatingly long. I knew, as a healthcare provider, that this was par for the course, and everyone was working hard to move things along. As a worried mom-to-be, I was impatient. I tried to reach out to my friends who were ObGyn residents, but no one I knew was on service at this hospital. More waiting. A nurse finally took us into a room and had me change into a gown. She took my vitals again and drew some blood for tests. At this point, the pains were starting to subside a little bit. I tried to close my eyes and breathe while my partner nervously paced the length of our small exam room.

An ER physician came in, wheeling a bedside ultrasound with him. I cannot recall any of the questions he asked me that day. But when he put the ultrasound probe on my pregnant belly, I saw with relief, that my son was still actively moving around. His heartbeat was strong and fast. “The fluid looks a little low, but the baby is moving well. Let’s get a formal ultrasound.” Then the physician was gone.

More waiting. Now out in the hallway because the room was needed for another patient. What felt like hours later, a porter came to collect me. He wheeled me through several hallways, a short elevator ride and finally stopped outside the diagnostic imaging department. I thought about how unusual this view of the hospital was, lying on my back in a stretcher, staring at the ceiling.

More waiting. The ultrasound tech took us into her exam room. She asked the same questions about my history and my symptoms. She put the cold ultrasound probe on my belly and immediately we could see our baby squirming around, dancing for us, like he always did during our check-ups at the doctor. Despite his performance, the tech’s face didn’t look reassured. She looked around carefully for several minutes, then stepped outside of the room to speak with an unseen radiologist, who would ultimately write the report. She came back, placed the probe back on my belly and looked around some more. She asked again “are you still having pain?” and I responded that no, the cramps had settled down. “That’s good” she said, not even convincing herself.

More waiting. We returned to our little patch of hallway in the emergency department, but never heard from the ER physician again. Unaware that he had already called in an urgent ObGyn consult, we continued to wait impatiently. A friend from med school rushed by with her internal medicine team. We locked eyes briefly and she looked confused and concerned but they were moving too quickly for a conversation. “Are you ok? I’m sorry I couldn’t stop to chat.” she texted me minutes later. “Yea, just getting a few tests, but I’m ok,” I replied.

More waiting. My partner attempted to read a book at my bedside, while I anxiously scrolled my phone and MyChart, trying to see if the ultrasound report was up on the system yet.

Another friend, an ObGyn resident who I went through Surgical Foundations with came around the corner and stopped in her tracks. “What’s going on? Are you ok?” she asked. I told her the whole story, “We just got back from the ultrasound, but we don’t know anything yet.” She conferred with her senior, then realized that I was the new consult she was going to see in ER.

They transferred us to a private room. Her senior resident, who’s name I don’t remember, but who’s kindness and professionalism made us feel at ease, took a history and performed a speculum exam.

She used beautiful and eloquent words, none of which I remember, but she confirmed my worst fear. My body was in preterm premature labour and we were losing our son.

I couldn’t see anything through the tears. My brain couldn’t understand what I was hearing. We were admitted to the ObGyn team, I had an IV placed, more bloodwork. We were moved to a private room in the ER until a room was available on the ward.

We called our parents and our siblings and cried over and over again.

Another porter, another ride through familiar hallways but staring at the ceiling and feeling vulnerable and scared. The bleeding had started by this point.

We were taken, to my surprise, to the mother and baby unit. I started sobbing uncontrollably. All of the other mothers here would be able to take their babies home. I would be going home alone, and empty.

I continued to labour for several more hours. They gave me medication to help move things along, a pain pump to manage the contractions (not cramps as I thought before), and a team of exceptional nurses made me feel more human.

Just after midnight on Oct 1, I could feel a shift in my pelvis. My son was on his way now with urgency. I was still wearing underwear and a pad for the blood. I paged frantically for the nurse, afraid that my son’s tiny little body would pass through my birth canal before I could pry the underwear off.

My magical nurse arrived quickly and flew into action. Scissors did the job that my tired and frantic hands could not. Within seconds, my son’s lifeless body was in the hands of this wonderful nurse. She quickly cleaned him, wrapped him lovingly in a blanket, announced “it’s a boy,” and placed him in my arms. I could barely see his face through the flood of tears. I just kept repeating “I can’t. I can’t.” as I held him in my arms. All the hopes and dreams of the past 4 months, shattered in the span of mere hours. We just held him as long as we could, throughout the night.

The rest was a blur.

The only feelings I felt for a long time were emptiness and sadness and anger. Guilt was another common companion. Despite the many reassurances from my wonderful doctors, I couldn’t stop feeling responsible for what happened. My one job as a mother was to protect my child, but my body had failed to do this most vital and basic function. I felt shattered. A leave of absence helped. Therapy helped even more. Speaking with other moms who have experienced this loss was the most helpful form of therapy. They couldn’t offer any answers, but they could empathize in ways no one else could. Ultimately, the love and support of my partner, my family, and my close friends carried me through the storm.

Now, over a year later, it all still feels like a dream. Was I really pregnant? Did I really carry his tiny little body in my womb? Was he a little miracle that we will never experience again?

Although I’ve learned to laugh again and find meaning in many parts of my life, the loss of my son has left an irreparable hole in my heart. Nothing will feel like enough, no amount of trees planted or donations made, or letters written to him will ever fill the void he left behind. But I will continue to find ways to honour and remember this beautiful little soul that we had the privilege of calling our son. His brief, but mighty presence has changed our lives forever.

- Gaya Naganathan

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