Fetal Demise Delivery – What I Wished I Knew

fatal demise delivery - young woman sitting on a hospital bed

The Day it All Goes Down

When the ultrasound tech gave me a sorrowful face, apologized and looked down, my heart raced and tears started streaming. It’s like in the blink of an eye something was stripped from me. But not just something, the future, the excitement, the miracle, it was all gone in that second.

Losing a baby during pregnancy at any stage is traumatic and complex. Not only are you grieving but you then have to focus on the next steps. This being my first-time experiencing loss like this, I had no idea what to expect. But I realized in that moment when the doctor came up to talk to me, she expected me to focus on what she was saying and make decisions, major decisions. I waited a couple of days to be admitted to the hospital, it was too much to handle all at once. Please know that you can make that decision too, on when to actually have the procedure done – whatever you need to do.

The protocol may vary between hospitals

Because I was just shy of being 16 weeks and already in the 2nd trimester, that meant I had to deliver. There may have been other methods, but at my hospital this was their standard procedure. Since I was so not prepared for this in any way, I thought others could use some insight on what to expect. I know it sure would have helped me at the time to be a little more prepared. As I mentioned before, every health facility is different and offers different methods and procedures. This article is focusing on a “fetal demise” delivery. And yes, I hated that term, from the first second I heard it. It seems so harsh and impersonal but since that seemed to be the professional or medical term, I heard it a lot, so be prepared that you may hear it too.

Advocating for yourself

First, you will have disbelief. Immediately after the ultrasound tech told me the news and my doctor came to talk to me, I requested another ultrasound right then and there before I left and before we made any plans on what happened next. My doctor confirmed it. Yet again upon checking into the hospital a couple of days later, I made them confirm it again. There had to be complete certainty before I let them do anything. I guess I was hopeful for a miracle. So, if you find yourself in disbelief don’t hesitate to ask for as many ultrasounds as you like. After all, it is your body and your baby.

At the Hospital

When you get to the hospital, it’s hard. I checked in at 4 a.m. as they asked me to. I was on the same floor with all the other moms about to have babies in their arms but I knew that I wouldn’t be leaving with one. It sucks! You have to try to prepare emotionally for this the best way you can.

Walking down the hall seeing all the professionally done photographs of babies lining the walls sucks. Seeing little rolling bassinets, and pregnant women in labor walking the halls sucks. Be prepared to feel like a complete outcast because you are a different case than almost every other woman there.

Hurry up and wait

A lady led me to my room and told me someone would be down shortly. For several minutes after that, it was quite uneventful. My sister and I sat under fluorescent lights looking out the window into the pitch blackness outside at that hour. No one is in a hurry, it’s not like when you’re in labor. Eventually, a couple of nurses came down and had me change and got my IV started and all the typical doctor things that happen at an office visit, asking questions and taking vitals.

They were very apologetic about my situation but yet you could tell they have dealt with it quite a bit and aren’t affected by it, and they still do their job just as they typically would. Be prepared to hear condolences a lot! Although I would be ticked if no one acknowledged what was happening, you still get tired of hearing it and being reminded over and over again about how sad it is. Next, I had to wait for the doctor.

The emotions can be complex

So, there I was ready, nervous and waiting for the grimness of the day to start but the doctor doesn’t arrive until closer to office hours. Of course, my doctor was on vacation so I got the doctor on call. Once he is there, he offers his condolences (here we go again). At this point, I don’t know how to deal with it. I mean I’m sad and it sucks so bad but the way the doctor was grabbing my hand and talking slowly and carefully made me feel like I was supposed to have some reaction that I was not. At that moment I was too nervous with the weight of the day getting started.

Having 2 prior c-sections, one emergency, and one planned, I had absolutely no idea what to expect from labor and delivery. They had told me that because of the size of the baby I would only have to be dilated to maybe 5 cm.

They told me that if things didn’t go as planned that I would have to be taken to surgery, put to sleep and they would perform a D&E (dilation and evacuation) to get everything out. The thing with me though was how petrified I was to be put under. I had never had to have surgery other than c-sections but I never in my life had been put to sleep and that is a huge fear of mine. So not only did the baby need to be delivered but the placenta too, leaving nothing behind to ensure that I wouldn’t need surgery.

Getting Started

They would be administering Cytotec 800 mg vaginally to get labor going by softening and dilating my cervix every 4 hours. Then taking the dose down by half for all the sub sequential times. They told me that by administering it vaginally instead of orally that I wouldn’t have loose bowels or any side effects and it would be more effective.

By 8 a.m. I had 2 pills inserted. After this you have to lay still and not get up for 2 hours, making sure the pills stay in place right by your cervix. Be sure to use the bathroom or anything you need to do before this happens.

Labor begins

After a couple of hours, I was laying in bed on my side and felt some twinges of cramps. They were very vague but I knew that the pills must have started making some kind of change to my cervix. By the time the 4 hours went by and it was time for the 2nd round I was definitely having some mild but consistent contractions. Along with the contractions came diarrhea. Not cool!! Before the 2nd dose of the Cytotec got inserted they checked me and I was around 2 cm dilated.

Contractions were going strong

And so was the diarrhea. After they administered the 2nd round I was lying in bed, being still and trying to sleep. Within that first hour of the 2nd dose, contractions were definitely getting more intense to where I needed to position myself differently in bed for a little relief. Then came the other cramps, indicating that I had to use the bathroom again! I hit my call button and begged to get up and go to the bathroom and not use the bedpan since it wasn’t time to get upright yet. Thankfully, they obliged. I went back to bed but again had to rush back to the bathroom. I asked the nurse if the Cytotec was doing this and they confirmed that it could even though it was administered vaginally. Leave it to me to get any side effects, I have always been such a lightweight when it comes to any medication.

Keeping it moving and managing pain

Finally, the 2 hours were up and I could get up and walk around again to help things along. The contractions were so intense at this point. I had never experienced this level of intensity before, since I had an epidural with my first baby and then a scheduled c-section with my 2nd baby.

Although I had been told from the get-go that I could get an epidural, the nurse I had that day didn’t seem to be big on the idea and kept offering me pain medication through IV. Again, I hate medicine! I’m sensitive to the side effects and did not want to feel out of my head. The pain had gotten so intense though I knew if this were to continue all day there was no way I could handle it. The contractions just never stopped.

It was so continuous, I called the nurse in. She asked if I was bleeding which I was not and she seemed pretty confident that soon I would need another dose of the Cytotec. She even said that she thought I would be progressing farther by now. Super discouraging, and I was freaking out. It made me less confident that I could do this myself, especially since I always had to deliver by cesarean before. Sometimes you will get a nurse that you just won’t vibe with, so make sure to speak up, or have someone there with you to advocate.

What Happened Next

With the threat of a 3rd round of Cytotec and the discussion of what pain control order she should start putting in, she decided to check me again. I wasn’t hopeful. This time though, in a surprised tone she said I was about 5 cm and my bag was bulging and it probably wouldn’t be much longer. She said that she would go put in the order for a milder pain medication. I asked if the walking was helping and if I should continue and she said yes and left the room. I stood up out of the bed and took one step and felt something come out!

The delivery

I screamed and just fell back on the bed careful not to move. My sister ran out of the room yelling for help, and I asked my husband if my water broke. He looked at the floor and said he didn’t see anything. I told him I knew something happened and he raised my hospital gown and freaked out. I asked if she (the baby) was out and he said yes. In that moment a huge wave of relief fell over me.

The pain and contractions stopped immediately! I had been told several times that this could happen. Often times at this point in the pregnancy the baby is so small that sometimes it takes no effort to deliver, and may come out if standing. The entire process from the first dose of Cytotec to delivery was 6 hours for me and I only needed 2 doses.

Hard questions

Within 30 seconds after the baby coming out, I believe I had the entire hospital staff in my room. Then came the questions; do you want to see her? Do you want to hold her? I, myself, knew that I would fall apart if I held her lifeless little body in my hands. Up until that moment, I wasn’t even sure if I would be able to handle seeing her. I knew I would regret it if I didn’t though, and the hospital staff was very encouraging.

That is one thing that always surprised me; how my doctor and the hospital staff acted about the baby. I was told beforehand that they would try to do handprints and footprints and that I would be able to see her or hold her as much as I wanted.

My mom had a late miscarriage back in the ’70s and had told me how hands-off it all was. She just went into surgery and never saw a baby. When I told her how different it was these days, she didn’t know why they would do that. She thought this method was much harsher emotionally, so my decisions were a little skewed by that.

I told the nurse that I wanted to see her but not hold her. She held her up but I just couldn’t focus. By this time the doctor had made it in and was wanting me to start delivering the placenta, which means I had to hope and pray one more thing went right so I didn’t need surgery. After 20 minutes it was out and the doctor followed with an ultrasound to be sure and everything looked good.

I was in the clear and so relieved. However, I did start running a fever and my previously borderline high blood pressure went on the low sided. It was treated quite dramatically for the rest of the day, resulting in a whole panel of blood work drawn and lots of monitoring. I was grateful that they were keeping an eye on it but later found out that it was just my body’s response to labor and prostaglandins.

The Aftermath

After all the main medical stuff is over, the emotions may hit pretty hard. Mine did. I was like, “now what?” The reality sets in. The nurses kept asking if I wanted the baby brought in. Well yeah, I want her brought in and I want her to be alive, that’s all I kept thinking. I was curious though. I wanted to study her little face and body and tell her I loved her. So, with talking it over with my husband, who had previously said he did not think he could handle seeing her, now wanted to see her in a less dramatic way then just hours before. We agreed that we wanted her brought in.

Saying goodbye (or What it was like to see her)

They rolled her down the hall into our room in a regular bassinet draped with a receiving blanket over the top. We took it off and there she was in a tiny blanket they made into a pocket for her wrapped with a little ribbon and wearing a tiny little hat. So tiny, so lifeless, but yet everything seemed perfectly formed except her skin. She was very red. My husband could not handle it. I barely could. I told her I loved her and had them come get her. It all feels like it isn’t real.

It is horrible, it sucks, and then you are left in the aftermath of deciding “now what?” The vision that you had for the future is no more. I wanted to share this very real and raw experience for those facing the same situation. I really hope you know you are not alone, and find some comfort in the fact that others are going through this too, as well as insight on what to expect medically and emotionally. There really is no way to prepare and everyone’s experience will be different, but be sure to do what is best for you.

Our next recommendation: You might find the resources in our Stillbirth post helpful

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