Zane's Story

I wrote this as soon as i could after being discharged from the hospital. I meant to write a short piece containing just the facts, but it ended up being longer than i thought.  I am not trying to win any prizes for English with this writing. I simply wanted to always remember what happened the day our son was born and the day he died.

On Saturday evening (14 October 2006) I went to bed as normal hopeful that the membrane sweep I was given the previous day was going to work. During the early hours of the morning I woke several times to go to the toilet and was having contractions, but they were not painful and so I went back to sleep. At about 7.30 I woke up and felt a trickle down below. When I felt and looked at my hand there was blood. I tried to sit up, but had to get a towel to protect our sheets. I hobbled to the toilet where I had a gush of blood and felt a loss of clots. I assumed this was my waters breaking with perhaps a bloody show so I called the hospital and made arrangements to go in.

When I got there I was hooked up to the monitor and the trace showed that baby was active and seemingly happy and although I was contracting labour was not imminent. It was decided that I should be kept in all day and that night for observation, just to be on the safe side. I was disappointed that I wouldn’t be seeing baby yet!

The bleeding slowed down during that day and I went to sleep that night after being monitored throughout the day. I woke at 2.30am and reported a bleed to the midwife on duty who promptly hooked me up to the monitor again for a while. Baby seemed fine again and was moving well and the heartbeat was strong. When they left me to go to sleep I found that I couldn’t so I lay for a while reading and hoping to drop off. I started to notice that I felt wet again and realised that I was going to have another gush so I lay for a while wondering whether to call the nurse or just get up and spoil the sheets. I called for the nurse and explained to her that I wanted to use the loo, but knew that I was going to make a mess getting up. She told me it didn’t matter about the mess and helped me stand, but as I did I had a massive bleed and lost a lot of clots so they brought me a bedpan. After I had gone to the toilet on the bedpan the midwife tried to find baby’s heartbeat with a Sonicaid and could not. I started to worry, but thought that perhaps she wasn’t very good at it. Then a lot of people came into the room and wheeled me on the bed to the labour ward. They took me straight away to a room where a doctor attempted to find the heartbeat with the Sonicaid. When he couldn’t find it either I started to shake uncontrollably and I remember that I couldn’t stop my thighs quivering. They tried to find the heartbeat with the pad from the monitor, but that wouldn’t pick it up either. After that they brought in an ultrasound scanning machine and after a lot of manipulation the doctor managed to find the baby’s heartbeat and showed it to me on the screen. I burst into tears.

They could then use the image to find the heartbeat with the monitor and hooked me up to that again. I could tell immediately that something was not right because where previously the heartbeat had been between 130 and 170 bpm it was now hovering at about 60 to 70 bpm. At this point, though, I was just relieved that he was still alive.

The doctor broke my waters, but then told me that they would be sending me to have a caesarean section and that they would need to put me under general anaesthetic. I was glad that they were working quickly. A lot of people were talking to me and telling me that things were going to move fast, but that it was for the best. I was asked to sign a consent form that I didn’t have time to read and pricked with loads of needles. They told me that Scott was on his way. When I was taken into the operating room I could feel them preparing my belly, but I wasn’t asleep yet. I panicked that I wasn’t going to be under when they cut me, but it wasn’t even five seconds after I smelled the gas that I was asleep.

Literally the next thing I knew I was waking up with something attached to my face that I didn’t like so I pulled it off. Then I noticed that I was in complete agony on my belly and the nurses explained how to use the morphine button.

Most of that day is a complete blur. I remember Scott being there and both sets of our parents arriving. I also remember being told that Zane was very poorly, but the morphine meant that nothing really sunk in. I understood fully, but it didn’t seem to penetrate. He had gone into shock due to the lack of oxygen and this meant that his organs weren’t functioning properly and his blood pressure was very low. He had also suffered seizures and as a result his brain was swollen.

I was wheeled on my bed to see Zane, who was in special care and he was full of tubes, but I was pleased to see him. Scott stroked his side and it tickled him so he kicked his legs up. Apart from the tubes he didn’t seem that poorly if he was reacting to being tickled.

The next day Scott went to find out how he was. I couldn’t go because I was still hooked up to drips and morphine. When he came back he explained that the consultant had advised him that Zane was very poorly indeed and his blood pressure had fallen in the night. I was anxious to be taken off the morphine so that I could go in a wheelchair to see him.

When we got to special care we were advised that they had contacted the Leeds travel team who were coming to transfer Zane to the special care baby unit at the LGI in Leeds. He needed a machine to help his kidneys because he wasn’t weeing. He had, however done a big poo and they were cleaning this up when we arrived. We stayed with him for a while and Scott stroked him and spoke to him. I couldn’t get to him because I was in the wheelchair, but I watched him as the nurses worked on him. When the Leeds team arrived we left to wait for them to tell us that they were taking him so that we could follow in an ambulance. As I was leaving I looked at Zanes face and his eyes were open. They looked for me as I was wheeled out and I hope he saw me.

After a few hours we were transferred to Leeds and taken to see Zane in special care there. He was asleep, but everything seemed under control and we were hopeful. We knew that he would most likely be brain damaged, but we had a renewed belief that he might pull through.

We had been back in our room for a short while and the midwife hurried into the room and rushed us off to special care because Zane had gone into cardiac arrest. We arrived to find he had been stabilised, but the consultant took us to one side and explained that although he had been brought round this time the chances were that he would have another cardiac arrest and that this was his way of saying that he had had enough. The doctor suggested that perhaps it was fruitless to keep reviving him and so we agreed that if he went into cardiac arrest again that they should not attempt to bring him back around. After all he should not be made to suffer and we respected the consultant’s professional opinion.

We decided that Zane should be baptised and after contacting our parents to let them know that they should come straight away we were told that we should baptise straight away as his heart monitor was showing fluctuations.

After the baptism when both of our parents and my sister and Scotts sister had come to say goodbye the consultant asked to see us again. He explained that Zane was only being kept alive by the machines and in his opinion the most ethical thing to do would be to withdraw care. His blood pressure was still dangerously low, his kidneys weren’t functioning and his heart had gone into arrest once and was fluctuating. Worst of all his brain had swollen due to seizures and there was no telling how much damage there would be if he survived, but the bottom line was that he wouldn’t survive and that by continuing care we were only prolonging his suffering.

Scott and I decided that the kindest thing to do would be to withdraw care and cuddle Zane until he passed away. This is what we did. Zane passed away in our arms not 36 hours after he was born.

What Makes A Mother

I thought of you and closed my eyes

And prayed to God today.

I asked what makes a Mother

And I know I heard him say.

A Mother has a baby

This we know is true.

But God can you be a Mother

When your baby's not with you?

Yes, you can He replied

With confidence in His voice

I give many women babies

When they leave is not their choice.

Some I send for a lifetime

And others for a day.

And some I send to feel your womb

But there's no need to stay.

I just don't understand this, God

I want my baby here

He took a breath and cleared His throat

And then I saw a tear.

I wish I could show you

What your child is doing today.

If you could see your child smile

With other children and say

"We go to earth and learn our lessons

Of love and life and fear.

My Mommy loved me oh so much

I got to come straight here.

I feel so lucky to have a Mom

Who had so much love for me

I learned my lesson very quickly

My Mommy set me free.

I miss my Mommy oh so much

But I visit her each day.

When she goes to sleep

On her pillow's where I lay.

I stroke her hair and kiss her cheek

And whisper in her ear

"Mommy don't be sad today

I'm your baby and I'm here."

So you see my dear sweet one

Your children are OK

Your babies are here in My home

And this is where they'll stay.

They'll wait for you with me

Until your lesson is through

And on the day that you come home

They'll be at the gates for you.

So now you see what makes a Mother

It's the feeling in your heart.

It's the love you had so much of

Right from the very start.

(Jennifer Wasik)

The Cord

We are connected,

My child and I, by

An invisible cord

Not seen by the eye.

It's not like the cord

That connects us 'til birth

This cord can't been seen

By any on Earth.

This cord does it's work

Right from the start.

It binds us together

Attached to my heart.

Though no one can see

The invisible cord

From my child to me.

The strength of this cord

Is hard to describe.

It can't be destroyed

It can't be denied.

It's stronger than any cord

Man could create

It withstands the test

Can hold any weight.

And though you are gone,

Though you're not here with me,

The cord is still there

But no one can see.

It pulls at my heart

I am bruised...I am sore,

But this cord is my lifeline

As never before.

I am thankful that God

Connects us this way

A mother and child

Death can't take it away!

~~~~~~~~~~~~~~~~~~

This is Zane's birth announcement. They were handmade by a friends mum:

This is Zanes Baptism Certificate given to us at the LGI Hospital in Leeds:

This is a card they gave us at the hospital. I can't read it without crying my heart out:

Zanes Obituary:

We had our appointment with the obstetrician and paediatrician at York Hospital today (11 January 2007). I have typed a summary of what was said...

The condition I had, which caused Zane’s death was called Vasa Praevia. This is where the blood vessels from the placenta are low lying and run through the membranes. So when my waters broke, so did the blood vessels and this is what haemorrhaged. They explained that it’s an incredibly rare thing to happen and very difficult to diagnose. I did nothing wrong in my pregnancy, it’s just how the placenta happened to grow. Also, even when this does happen it doesn’t always result in the death of the baby. I did have placenta praevia earlier on, but it had moved up. The blood vessels had not.

They confirmed that Zane was perfect in every way and he was only damaged when the bleed happened. A new born baby of Zane’s size (8lbs 12oz) only has an amount of blood equal to a can of pop in their system, so the damage was done quickly and irreparably. It was a comfort to learn that he would have felt no pain as blood loss results in feeling tired and feinting.

Because of the nature of the condition it means that I have just as much of a chance of this happening again, but the chances are so incredibly slim anyway I would be super unlucky for the same thing to happen. In my next pregnancy I could get a vaginal ultrasound to try and detect the condition, but it is so very hard to see, even on a scan. I guess the only sure way to avoid loosing another baby the same way would be to have a caesarean section at 39 weeks, which is what I was planning on doing anyway next time.

Even though the term Feto Maternal Haemorrhage was used on Zanes death certificate it does not define his cause of death. It was a lack of knowledge by the person who filled in the cause of death because it would have been more accurate to say Fetal Haemorrhage. A small amount of blood did pass from Zane into my bloodstream, but it was only 4mg, so very small.

I am at an increased risk of having placenta praevia next time because of it being my second pregnancy, having had a c-section and also because I’ve had it before. I’ll just have to deal with that if and when it crops up.

It was explained why I wasn’t offered an induction. The reason for this is because it is not as straight forward as it seems. The doctors have to use a hormonal pessary inserted in the vagina to force the cervix to ripen. If the cervix really isn’t ready it can cause powerful contractions which don’t do anything and this can distress the baby. They have to weigh up the costs and benefits and it was decided that they would be better to leave me. (This was after I was first admitted with suspected pre-eclampsia at 40 weeks). The doctor said that I would have probably been induced the day I had Zane anyway, even if I hadn’t had the bleed and things had gone how they did. He also explained that since the problem was blood vessels in my membranes that the outcome would probably have been the same, as i would have haemorrhaged the same when the membranes were broken. The only way it could have been avoided was a scheduled c-section, but who was to know?!

I didn’t have an abruption, even though this term was used at the time. This is a more common cause of bleeding like I had, but was not the case this time.

I did receive a horizontal uterine incision to match my scar, which gives me a better chance at VBAC should I change my mind and want one.

This incident did trigger two learning experiences for both the obstetrician and paediatrician. The obstetrician explained that the paper running through the CTG tracer was going at a faster speed to what they would normally use. He said that he had no idea whether this had any effect on the interpretation of our condition, but it happened. The paediatrician explained that they should have had a different type of blood ready to use for both mother and baby in the event that anyone needed it, but the wrong sort was there and it couldn’t be used for Zane. He added that the delay was not significant enough to have caused his condition to worsen, but it did highlight the problem and has lead to a change.

The obstetrician confirmed that we are fine to TTC again as soon as we are ready and the c-section should have no adverse effect on any subsequent pregnancy. My care will differ in that I will be able to have more scans than usual, but this is simply for my piece of mind rather than for any medical reason. I can either have more care or choose to go through the pregnancy as normal, it’s up to me. I can also have as many children as I want by c-section. There is no limit on 3 as I previously thought. The scar just gets weaker each time, but not significantly.

I will not be offered a Thrombophilia blood panel because my condition was not out of a tendency to bleed, but rather a very unfortunate fluke in the positioning and make up of the placenta.

Scott and I are both more than happy with the explanation and can now understand why things were done in the way that they were and why it was difficult to diagnose. We were just so very very very unlucky.