baby

In Australia, six babies are stillborn every day. Chloe was one of them.

By Hagar Cohen and Alex McClintock

WARNING:  This post deals with stillbirth, and may be triggering for some readers.

Regina McDonald, a senior nurse at the Mater Maternity Hospital in Sydney, answered the phone at 5:30pm.

On the line was Hanh, a first-time mother who began to feel ill while out shopping. Now, hours later, she had noticed a scary-looking discharge and was in pain.

For McDonald, a quiet, precise woman with more than 30 years experience as a midwife, nothing about the call was out of the ordinary.

She asked the routine questions: “What shade is the discharge? Is this your first pregnancy? When is the baby due? Has the baby been moving?”

Brown, yes, in one and half weeks, yes. Satisfied, McDonald told Hanh to put a pad in and call back later if there were any further issues.

At home, Hanh felt worse and worse. Sitting up or lying down, she couldn’t get comfortable. Contractions began and the discharge thickened.

“You don’t want to be that person,” she said later. “You don’t want to be that bride, and you don’t want to be that pregnant lady who thinks she’s the only pregnant lady who’s ever had a baby, who rings the hospital every itch.

“So you try and be brave, and logically go through your mind about whether this is normal or not. As a first time mum you don’t know what is and isn’t normal.”

She called back at 7:30pm: “We’re going to come in.”

At the time, Hanh was concerned, but she didn’t imagine that her baby girl had already died. In Australia over 2,000 babies are born dead each year — six a day.

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Australia’s stillbirth rate falls behind those of Poland, Portugal and Croatia, and the figures have changed little in the last two decades. For Indigenous women the rates are much higher.

Now there are growing calls for a national campaign — like the one that successfully reduced the rate of SIDS in the 1980s — to educate doctors, midwives and expectant mothers about the steps they can take to reduce the risks.

By the time Hanh and her husband Matt got to the Mater it was 8:00pm. McDonald was waiting at the door to take them to a room with a cardiotopograph (CTG) heart rate monitor.

Matt’s chief concern was the fact that Hanh was in pain. He said so to McDonald, who reassured him: “That’s a good thing, she’s having contractions; you’re going to have your baby soon.”

In the room with the CTG monitor, a grey box about the size of a desktop computer, McDonald began her routine. She turned on the power and began looking for the heartbeat, running the ultrasound disc over Hanh’s stomach.

But there was something wrong with the machine; McDonald couldn’t hear the heartbeat. She connected another ultrasound, tapping it with her finger to make sure it was working, and tried again. Nothing.

Hanh was avoiding eye contact with McDonald, who, despite her growing concern, was trying to maintain a neutral expression.

After five minutes, the ultrasound picked up a faint, slow rumble.

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“There she is,” said Hanh.

“No, I think that’s your heartbeat,” said McDonald, who left the room, first to find a colleague to double check, then to call the obstetrician. Hanh was in shock.

“My baby hasn’t got a heartbeat, which means she’s dead,” she thought.

“I don’t have a stillborn baby. This doesn’t happen to me. This is an illusion.”

The birth

McDonald left the room and rang Deb de Wilde — known to the midwives at the Mater as “Saint Deb” — a social worker who specialises in looking after families who experience stillbirth.

De Wilde has been helping bereaved parents for more than 25 years. Though the service she offers is virtually unique in Australia, attitudes to stillbirth, once a taboo topic, are slowly changing.

Where stillborn infants were once disposed of without even being seen by their parents, many hospitals now offer “cuddle cots” or “cold cots” — refrigerated bassinets that allow parents to spend some time with their child.

“I’m sure there are many people who’d find any kind of interaction with a person who died extremely confronting,” said de Wilde.

“What I would say is that people have been doing this since time immemorial. That there’s nothing new about this approach, it’s just legitimising it within a hospital setting.

“I think we have many cultural black holes in our society — one of them is around death, and particularly the death of a child.”

But before Hanh could see her daughter, she had to choose between delivering her daughter, which the obstetrician advised could be beneficial for future pregnancies, and getting a caesarean. Grief-stricken, overwhelmed and medicated, for her the rest of the night was a blur.

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“She said she wanted it out,” said McDonald. “Then once she’d made that decision it was more of a personal thing: the baby became a baby again.”

Stillbirth stories

More than 2,000 babies are delivered still in Australia every year, but stillbirth is still a taboo topic. These parents want to share their stories to raise awareness.

The theatre was unnaturally silent as the baby emerged. Despite everything, both Matt and Fiona Nicholson, the midwife taking over from McDonald, expected the cries of a newborn.

“I saw this beautiful little face,” said Nicholson later, close to tears herself.

“You hope: ‘Just open your eyes, just take a breath, I hope this is just a big mistake.'”

Nicholson took the baby to the resuscitation table and wiped her down. Perfect and pink, with delicate fingers, she looked like she could wake at any moment.

“She’s beautiful,” Nicholson said to the parents.

“Is she?” said Hanh.

De Wilde wrapped her and brought her over to the bed. Hanh held her while Matt sat watching. Both had tears in their eyes.

“The joy is the first thing that you feel,” said Matt.

“You’ve been waiting for so long to meet this person, to see who’s nose they’ve got. It’s just relief: there you are. I just couldn’t wait to meet you. I think we would have felt it even if she was alive.”

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For Regina McDonald, the night had come to an end. Her shift over, she said goodbye to Matt and Hanh in the operating theatre. In 35 years as a midwife, it was the first time she had been the one to discover a stillborn child.

At home, she sat down. “Why are you having a glass of wine?” asked her husband.

The room

Deb de Wilde walks through the third floor corridors confidently; the nurses and midwives know who she is. Matt and Hanh are the third set of parents she’s looked after in the last 10 days.

The refrigerator is behind a nondescript door marked ‘holding room”; Chloe is on a middle shelf, dressed in a white terry-towelling onesie. Apart from her deep purple lips, the illusion that she’s sleeping is total. She even has rosy cheeks.

But with new and expectant mothers everywhere, de Wilde cuts through a service door to avoid carrying Chloe around the hospital.

In Hanh’s room, tulips and roses line the windowsill while neck pillows and spare jeans sit in green reusable shopping bags at the foot of the bed. Matt looks slightly unkempt, while Hanh, sitting on the bed in a white nightgown, is composed, even chatty. You could be in any other room in the maternity hospital.

Over the last week, the couple have established a routine as they seek to come to terms with the loss of their baby. They spend time with her in the afternoons and the evenings, but have to be careful: if she stays out for too long her body could begin to deteriorate.

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Two tiny, premature-sized outfits — one pink, one black and white — lie on the bed.

“What would you like to wear today, my darling?” says Hanh. “Pink or stripes?”

Delicately, Hanh undresses Chloe and, after a mock argument with Matt, opts for the pink, elephant-themed ensemble. Matt takes her.

“She’s heavy,” he says.

“Don’t call our daughter heavy!” replies Hanh in faux outrage, taking her back.

The Mater allows couples like Matt and Hanh to spend up to seven days with their baby. With de Wilde’s quiet reassurance, they’ve opted to spend the whole week. She’s assisted them with everything from professional photos to dealing with friends to legal paperwork.

She also helped to organise the funeral, which will take place the next day. More than anything, the fact that they will have to farewell Chloe tomorrow upsets Matt and Hanh.

“If parents are given a choice they should spend time with their bub,” says Matt.

“It could seem a little weird. We know that. We’re not under any illusion here. But I wouldn’t take it back.”

The week has also given them time to reflect on how things might have been managed differently. Thinking back, Hanh realised that Chloe stopped moving much earlier than she first thought.

It’s not yet known why baby Chloe died, and the hospital is still investigating this. But it’s babies like Chloe — born full term with no congenital defects — that experts say might be saved if the warning signs for stillbirth were heeded more often.

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The experience of other countries, such as Finland and Norway, suggests that the stillbirth rate could be reduced by as much as 30 per cent. An internal audit of stillbirths in Queensland hospitals found the same may be true here.

Both Matt and Hanh feel there’s not enough information about stillbirth available to expectant families and that the medical profession doesn’t take the concerns of pregnant women seriously.

“I think I had this little alarm bell going on in the back of my head; I wasn’t well. You’re so afraid of being a hypochondriac and being treated like you’re that mother,” says Hanh.

“There’s almost a disinterest in you. They see this all the time, so they’ve got this indifference towards you.”

Sitting next to Hanh, Matt scratches Chloe’s tiny, wrinkled feet. Hanh puts her arm around him.

“You get educated on everything,” she says. “There’s books about pregnancy: you know that at 32 weeks there are fingernails. But this is a whole world that we’re in that we have no idea how to manage.

“This time tomorrow, it’ll all be over — Chloe will be gone and we’ll have her service, but what’s next for us?”

 

If you need help or you’d like to talk to someone about miscarriage, stillbirth or newborn loss, SANDS Australia have a 24 Hour Hotline. 1300 072 637. Or you can call Lifeline on 13 11 14.

This post originally appeared on ABC News.

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