It was the Friday night before a relaxing Memorial Day Weekend when my wife, Amanda, came to me and said that she was bleeding the scary way that she had been learned about in a pregnancy book.  Bright red blood was bad and it was a reason to immediately go the ER.  I didn’t know how to react but we got into the car and I drove us very slowly over the speed bumps in our apartment complex.–In my mind, I reasoned that we should still be okay.  We had waited for three months to tell anyone that we were pregnant because we know that it’s risky and didn’t always work out.  But we were past that phase and we should be safe.  We even took a 3-D ultrasound image where we could see our son Daniel moving around.  A friend at work started calling me Papa Rick, though, I don’t like being called that–We drove in silence to the emergency department at the hospital where worked as an IT Director.
When we checked in at the triage desk, I made sure to wear my employee badge so that would give us any good will or special attention.  We were shortly brought back to a bed in the ED where an emergency doctor ran through a set of questions with us about how many weeks were we along and anything that had happened.
I looked across the room and noticed a nurse that I had seen before in IT-related meetings with the emergency room leadership team.  My team of analysts and programmers had built an Emergency Department Bed tracking application that had made them pretty happy.  But now, she looked over at me and I could see a look of sadness for us come across her face.  Now, I understand that she knew the journey that my wife and I were about to take.
After a couple of hours in the ED it was about 4 a.m., we were brought into the Labor and Delivery Triage area which a room full of beds with pregnant women under observation.  Amanda was assigned a bed in the back against the wall with a privacy screen on each end making something like a berth on a fishing boat.  In less than an hour, our doctor came over to assess Amanda.
After a minute or so, he leaned over and said to Amanda, “You are having a miscarriage…”  And I couldn’t hear the rest.  I was stunned about how instant and matter of fact that was said.
The triage nurse looked to me and asked, “Did you hear what the doctor said?”
I nodded.
Again she asked, “Sir, did you hear what the doctor said?”
A few more hours later, we were brought into a Labor and Delivery room.  At this point, it was a sunny morning and our nurse introduced herself and tried to make us a welcome as possible.  Amanda couldn’t get comfortable because the bed was positioned where the head of the bed was lower than the foot of the bed.  This allowed gravity to help reduce pressure on the cervix.
The doctor came in again and told us that this was a case of incompetent cervix where the pressure of the baby cannot be handled by the end of the cervix closed by a mucus plug.  Under the pressure, the mucus plug ruptures and the cervix begins to open up.
At this point the discussion with the doctor felt cagey.  We wanted to know what was going to happen or at least what was most likely to happen and we weren’t getting straight answers.  He was very careful not to recommend anything or make any predictions.  To degree that he did, he told us that our options were to induce birth or wait and see without any clarity on what we were waiting for.   There was the added risk that an infection could develop endangering Amanda.
I felt like we were in a situation where no one would tell us clearly what was going on.  Everything was implicit rather than direct, and you just can’t interpret implications when you don’t understand the full context of what’s going on.  Or if those implications are not what you want to hear.  For us, this wasn’t supposed to happen.  We had waited three months before telling anyone, we were supposed to be home free.  Between inducing birth with what we took to understand as a low possibility of Daniel’s survival versus waiting and seeing, we chose to wait and see as an act of hope.
The doctor ordered what the nurses called “the fern test” where a sample of discharge from the birth canal was applied to a chemical patch.  Our nurse along with a trainee nurse applied the test.  When the chemical patch revealed its result, the nurses looked at each other knowingly.  The fern pattern appeared indicating that amniotic fluid was leaking suggesting that the amniotic sac was damaged, further suggesting that things were bad.
As a watched the nurses perform the test, I wanted to say that the experienced nurse should perform the test.  How do we know that the trainee is doing this right?  And how do we know that this says anything for sure?  I didn’t want to become one of those patients that lashes out at the staff, but I also wanted to make sure that this was being done right and I had know idea how to do that.
A while later, the doctor called our room to see if our thinking had changed about inducement.  Amanda asked this doctor if he could back to our room and discuss this with us because we were still unsure.  The doctor told Amanda that he’d been up for multiple shifts and needed to rest.  He couldn’t be certain when he would return to meet with us.
This left it to me and Amanda to figure out what to do with what little perspective we had.  Even as we tried to ask questions of our nurse, she was understandably careful to stay in her lane and reply with, “You should discuss that with the doctor.”
Amanda was willing to stay inverted in this bed for the rest of the pregnancy if that’s what we needed to do.  But it didn’t look likely that Daniel was going to survive and over time there was an increasing likelihood of an infection that could threaten Amanda, as well.  I just wish that we didn’t have to piece together these bits of information from coded messages.  I wanted our doctor to look us in the eye and tell us where we were at and what we could realistically fight for and what the risks were.  But he couldn’t seem to be bothered.
Our choice was to let go.  We seemed to be hoping for some kind of miracle unrecognizable to anyone who had experience with this.   I remember feeling like I had to make this okay for Amanda.  In the end, even though we can share the emotional burden and support each other, she had bear the physical burden and ultimately, she had the final say.  She called the doctor back and told him that we would go forward with the inducement.  After, she hung up the phone, she wailed.  It was crying that came deep from within her core.   Somehow, our doctor found the time to come right over and administer the medication that would induce birth and document that professional fee.
Amanda labored for a few hours and I was able to be present at the birth.  Daniel emerged like a 10-inch G.I.Joe doll encased in a clear jelly bean.  The amniotic sac was tight.  The nurse actually had to manually rupture it.  I could see his little heart beating in his chest.  The birth team treated Daniel’s birth like any other birth.  I was invited to cut the cord.  Daniel was moved to be under a warming light.  And the nurse took a picture of us like any other birth event.
Some may find it hard to understand these photos, as I had before I was in one.  But you have to view these as a parent, and even for an extremely premature birth, I could make out how Daniel looked like his great-grandfather Thomas and had Amanda’s nose.  These photos will be all we have forever, and we cherish them.
Daniel lived for just under an hour and then he was gone.
The hospital prepared a celebratory dinner for the new parents and we were allowed to sleep overnight with Daniel in the room with us.  The door of the room was marked with a sign showing a heart and prayer hands reading “Quiet Please, Grieving Family”.  It was decent of the hospital to allow us these courtesies so that we could prepare to leave the hospital without him.  Before we left, Amanda and I took the time to hold him in our arms a final time and kiss his cheek and say, “Goodbye, sweet boy.”