I was not expecting to be emotional during my usual Friday morning lecture. Most of the time the class is interesting, and I am more often reaching into my backpack for another pen to take notes rather than a Kleenex pack to dab my cheeks. Instead of a lesson on pathophysiological disorders of pregnancy or neonatal assessment, our professor spoke on the sensitive topic of perinatal loss.
In 1988, President Ronald Reagan declared October as National Pregnancy & Infant Loss Awareness Month. He was driven by the void of acknowledgement in our society when a baby passes away:
When a child loses his parent, they are called an orphan. When a spouse loses her or his partner, they are called a widow or widower. When parents lose their child, there isn’t a word to describe them.
Losing a baby is indescribably painful. As nurses, we are to be companions in our patient’s grief and wade through the depths of their sorrows with them. Our instructor stressed the fact that perinatal grief can be even more difficult to bear when our culture denies the significance of the loss.
“We should never say to our patients that they ‘lost a pregnancy’. They lost a baby. When we don’t acknowledge that, we minimize the reality of their suffering.”
Nodding in agreement as my professor spoke, I was inwardly perplexed. Just weeks prior, our readings referred to a pre-born child as a “product of conception”. Do we only acknowledge the humanity of what we know scientifically to be a human being when the parents want the baby?
My instructor continued on, presenting research that suggests that grief following the loss of a child feels just as heavy in all stages of pregnancy, contrary to the societal belief that later term losses are worse. We were encouraged to support parents in naming their baby. “Because after all,” she said, while clicking to the next slide, showing a popular quote from Dr. Seuss, “a person’s a person no matter how small.”
At that point I had my own personal earthquake. The mental gymnastics necessary for our profession to acknowledge the real, significant loss of a pre-born baby in one instance, and then assist in the killing of that child in another, is unbelievable.
But then my professor addressed the elephant in the room. She went through the statistics on women experiencing grief after abortion, and gave the usual spiel on how nurses ought to be nonjudgmental and supportive in patient choice.
I was scribbling down notes as she explained a procedure called “medical interruption”. It is often done when parents receive news that their child has a genetic anomaly, or even for conditions such as dwarfism. Parents sign a DNR, labour is induced early, the baby is delivered and does not survive.
Sometimes the nurses participating in this will bring the baby to a mementos room to collect footprints, handprints, or locks of hair as a memory keepsake for parents. My prof described her experience there:
I remember suddenly realizing that I was standing between three dead babies. I put a child in a transport container and walked through the hospital basement to the morgue, where there were dozens of other dead babies in boxes. A sense of wrongness overtook me. Children dying before birth is not how things are supposed to be.
A curious student raised her hand. She asked the question that everyone was thinking.
“When the babies are born, are they already dead? Or do you… you know… watch them die?”
The question was met with silence. I looked up from my notebook to see my professor sobbing.
“The most distressing thing is seeing those babies gasping for air. And you can’t do anything about it.”
I think chills fell down the spines of the one hundred and fifty students in that lecture hall. We all just sat there, motionless, as my instructor continued to choke back tears. I felt a visceral horror.
In one unit in the hospital, we are to sit with families as they experience the horrible pain of miscarriage. We are to acknowledge that they lost their child, and with their baby, they lost all sorts of hopes and dreams. They lost the first day of elementary school, attending their child’s graduation, even the prospect of future grandchildren. And yet in the next unit over, when parents feel pressure to cut short the life of a baby with a disability, we are supposed to do nothing. Labour is induced, and we watch the baby struggle for life. We do nothing. We watch babies die.
I agree with my professor that in every perinatal loss, a person dies. And that is a terrible, twisted tragedy in our broken world.
Though if that is the case, why are we grieving over some babies, while helping to kill others? Why do we resuscitate the wanted ones and watch while others gasp for air, surrounded by people who can save them, until their little lungs stop?