Ava’s Story, Part II

How I told my husband we were expecting.

My day of celebrating 24 weeks had been overturned, and my world was spinning. We arrived at the hospital and checked in at Labor and Delivery. The nurse got us situated and the resident came in to speak with us. He asked questions about the circumstances that had led us to come in that evening. He ordered a new ultrasound, and I hoped with every inch of my being that somehow, the equipment in our small town hospital had somehow gotten everything wrong. The tech hadn’t been allowed to tell me anything, but I had seen on the screen the measurements had put Ava at 20 weeks, not 24. I had spent the last hour and a half crushed with the realization that this meant Ava had not in fact reached the viability milestone today. The ultrasound tech came in and we once again saw the awful reality we were facing. Ava was measuring extremely small, less than 500 grams, there was little to no fluid, and she was not practicing breathing because there was no fluid for her to do so. The resident and nurse had left the room, but all of a sudden the tech put the wand down and left the room. The resident and a crowd of nurses flooded into the room as the tech explained that the heart rate had just dropped when doing the scan. The tech put the wand back on my belly while nurses started prepping me for surgery and put an oxygen mask on my face. I remember feeling even more frightened, if that was possible. The resident went to me and knelt by my ear and told me that it was common for babies this early to have heart decelerations. The tech told the team the heart rate was back up, and everyone slowed down again.

The resident examined me and made sure that my water had not broken. He explained that likely the fetal maternal medicine doctor would suggest steroids and magnesium, but it’s very unlikely I would make it to term. I vividly remember him saying, “If you choose to do steroids and magnesium, we have to keep the fetal monitor on you, and you will hear the heartbeat continue to slow down. When that happens, we want to jump in and do a c-section, but because the baby is too small, you will hear her heart slow down more and more until it stops.” Just then the maternal fetal medicine doctor called, and we were put on speaker phone to go over what was happening. We were basically told that Ava was too small to have me start steroids and magnesium, and I would have to be monitored 24/7 if we chose the steroids and magnesium. We hung up and the perinatal doctor came in and explained that Ava was too small for a c-section and apologized there was nothing to do. We were told there was nothing to do by four doctors during my stay. The maternal fetal medicine doctor told us the next day, “We will do a weekly scan, and we anticipate that at one of these scans, there won’t be a heartbeat anymore, and we can discuss delivery at that time.” We were then sent home to wait for the inevitable.

The next week and a half was torture, and I think I had convinced myself that the limbo would be the worst part. Feeling Ava move, and knowing that she was squished inside of me was traumatizing. It was the worst scenario of Schrödinger’s cat possible. I had no idea if Ava had already died inside of me until she moved again. When I felt her move, I would mentally document the time, and then tell her how much I loved her and that she was so strong. I told her it was okay for her to let go so that I wouldn’t hurt her anymore. The last time I felt Ava, I had just gotten in bed for the night. I told her one last time I loved her soooo much, she was so very strong, and she could let go now. I cried myself to sleep and the next day, I knew.

My next scan was the following day, so I didn’t call the doctor to get in any earlier. I knew what was coming with the scan, and I was scared to have it confirmed. When we went in, the nurse took my blood pressure while asking when the last time was that I felt Ava move. I choked back my tears and said, “I heard her heartbeat Monday at the doctor, and felt her move Tuesday night.” My blood pressure measured high. I laid on the table and the tech put the wand on my belly. The screen was completely still, and the tech took the wand off, squeezed my arm and said, “I’m so sorry. There’s no heartbeat.” The nurse handed me a box of tissues and apologized for our loss. We were left alone for a bit while they informed the doctors.

I’m not sure how long we spent in the doctors office crying, or how exactly we got across the street to the hospital, but I remember the elevator ride. A little elderly lady got on and smiled great big and asked cheerfully if we had an appointment at the hospital that day. I wiped a tear and placed a hand on my belly as I mustered a weak, “Something like that.” She quickly apologized and exited the elevator that thankfully had just arrived to her floor.

Ava’s Story: Part III

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