Insights, Not Answers.

Today we had our bi-weekly OB appointment where we also received our final autopsy results.

The day after I gave birth to Brooklyn, we had to sign consent to let them know what tests we wanted done on her. The nurses told us that over 50% of the time, there are no answers found with a full-autopsy anyways. This, along with not being able to handle the thought of a stranger cutting open our perfect baby's little body, made us decide to only do a partial autopsy.

They took blood from both Brooklyn and I, examined her body visually and through x-ray, and examined the cord and placenta visually and microscopically.

Here is what they found:

- Small Placenta: Although the size of my placenta looked appropriate when I delivered it, upon further observation they noted that the weight was at less than the 10th percentile for 39 weeks gestation. Small placentas have to work extra hard to supply the baby with oxygen and nutrients, which can cause complications while in labour.

- Meconium Exposure: We already knew this as Brooklyn was covered in meconium (baby's first poop) when she came out. Her skin was stained, and the autopsy showed that the cord and placenta were too. This is often a sign that baby is/was in distress. Knowing that our baby was in distress and we weren't able to do anything about it makes me feel sick. Thinking about her final moments inside of me makes me wish I could have done something.

- Acute Chorionitis of Placental Membranes: This is an inflammation of placental membranes (blockages), which makes it hard for oxygen to flow through. This is often associated with a long labour (which I had).

- Edema of Placental Membranes & Amnion Degeneration: Caused by a baby going into distress and results in reduced or insufficient oxygen.

- Brooklyn's heart, lungs, bone structure, stomach, extremities, etc. all looked perfect. All of her measurements were between the 70th and 90th percentile, except for her cute big feet which were well over the 100th percentile. She was a perfectly healthy and normal baby.

In a nutshell, the OB said that while this provides insight, it doesn't provide complete answers. One thing that she did say, was with the combination of a small placenta and high blood pressure, when I went into labour, it is possible that Brooklyn went into distress due to the placenta not being able to work as hard as it needed to, and her oxygen supply was cut off.

She also said that as far as we know, genetically there was nothing wrong with Brooklyn, which would lead us to believe that genetically, there was nothing wrong with the placenta. She did say that there is always a chance of it happening again (which we already knew). Just because it happened to us once doesn't mean we get a "Pass Go" card this time around. However, it also doesn't mean that it is more likely to happen again. We try to remain hopeful that with close monitoring that the outcome will be different this time around.

We had a perfect baby, with an imperfect placenta that just wasn't able to provide her with what she needed when I went into labour.

For someone who used to be very pro home birth, this has made me completely rethink how I understand monitoring during labour, and the need for hospitals to admit women sooner than the "4cm norm."

From here, the OB said the only thing we are going to do differently is have me take a baby aspirin daily. This will help to increase blood supply to certain organs - including the placenta. The weekly ultrasounds that she has scheduled for me will also be able to measure the function of the placenta and see how much oxygen supply Baby A is getting. And the non-stress tests will make sure her heart rate and movements are appropriate, and there is no indication of reduced movements (which often happens when the placenta begins to fail). Unless ultrasounds show decreased placental function, my induction will take place between February 10th and 17th.

Even with these insights, I do not feel satisfied. It doesn't help me feel more calm or confident about the outcome of this pregnancy. In fact, I find myself angry. How are third trimester ultrasounds STILL not part of the normal prenatal screening? If I had one, they would have been able to see that my placenta was working extra hard to get oxygen to our baby and Brooklyn's life may have been spared. While I continue to be thankful for our medical system, I am also aware of the many holes it has, and how even one ultrasound in the third trimester could drastically reduce the rate of stillbirth in this country.

Reading the autopsy report was really hard for me. After completing a medical placement in the hospital, I understand the need for terminology to be straight to the point and impersonal. But seeing our daughter referred to as "female fetus" and having her death described as "intrauterine fetal demise" are really difficult things to read.

Please pray for us as we digest this new found information. We are feeling emotionally drained after receiving these results. Please pray for our OB, midwives, the ultrasound techs that will be monitoring the placental growth, and the nurses who will be monitoring our non-stress tests. Please pray for Baby A - that she continues to grow strong and healthy. And though it sounds strange, please specifically pray for the placenta - that it continues to grow without error, and is able to supply our baby everything she needs until she is safe in our arms.