Client's baby in NICU...how do I move on?

[Charmie981]

I have a client whose birth was pretty traumatic. I'm having a hard time knowing what is really going on and how much of it is "homebirth germs" syndrome. I'm so sad for her and feel really powerless to help her at all. She hasn't held her baby since after the birth ::

In some ways I have moved on...I mean, she's the one in the hospital, still unable to hold her baby. I had Thanksgiving at home with my family and she ate hospital crap food and a plate of homemade stuff brought to her after her family's meal--at home. I'm putting my my Christmas tree and she's waiting until the moment she's cleared to hold her son. So yeah, life is definitely going on for me more than for her.

But I'm having a really hard time thinking about my next clients, one of whom is now overdue. I've had two potential clients call me and I just feel so blank toward them and their births. It's a really different feeling for me. I've had clients transport before, but everything has always been FINE and they got to enjoy their baby. This gives a whole new meaning to that trite comment we all hate..."well, as long as the baby's okay." I feel that way now, though. I feel like I just can't move on until I know that her baby is okay and she has him in her arms nursing him!! And I feel powerless to make that happen because she's so far away and because she's in what is apparantly a very unfriendly hospital environment.

It probably sounds like I'm whining, but I really need some help with how to cope with this. Ignoring the emotions isn't working!!

[RaRa7]

I feel for you--don't really know what to say-this a lot of why I am not certain I will pursue my dream of midwifery.....I am very sensitive as it sounds like you are. I tend to dwell/obsess.
I hope that some others will offer some words of wisdom/coping........

[1stimestar]

Yes that must be difficult. I would say to allow yourself some tincture of time before expecting yourself to feel "normal". It's heartbreaking to think about. Why WOULD you not feel affected? You sound like a normal, compassionate person so you of course will feel "off". Do what you can to help momma. Perhaps phone support at least. Do what you can to go on with your normal life even if you have to pretend to feel normal occasionally (such as with other births). In a couple of weeks if you do not feel your pain subsiding, you might want to take to a professional. Sometimes an objective person listening is very helpful.

[majikfaerie]

I do understand what you're going through. Its normal and healthy for you to need some time to process that.

It is a part of our profession; we choose to work closely with birth, which is also working very closely with death.

I attended a birth where the baby died (from massive brain damage) early this year. It was very hard for me to process that, all the questions and what ifs, so I can understand how you feel.

just give it some time, and make sure you're there for the mama as much as you can be.

[JunipersMom]

I have to agree - its part of our profession. Thankfully it doesnt happen often, which is why I continue to practice But when it does happen I've found that continuing contact, alot of postpartum talking and mothering the mother, and helping out when you can is extremley helpful. There's not a lot you can do when the family is in the hospital - plus then their friends and family tend to rally around them and its hard to know if you are a reminder of the birth or getting in the way etc.. but phone calls and emails are a great way to just let them know that they are in your thoughts and that you want updates etc when they are ready to share. You just dont want them to feel like you abandonded them. Mom still needs to be midwifed.
Huge hugs to you - we've all been there.. Just trust in birth. If at your next birth you start to get anxious - call a sister midwife and have her 'talk you down' it worked wonders for me. Even if your scared of a birth - your training and that babe WILL take over if you let birth just happen. After a few births and in talking with the mom I think you feel much better. It just takes time.

[Charmie981]

Originally Posted by JunipersMom

There's not a lot you can do when the family is in the hospital - plus then their friends and family tend to rally around them and its hard to know if you are a reminder of the birth or getting in the way etc.. but phone calls and emails are a great way to just let them know that they are in your thoughts and that you want updates etc when they are ready to share. You just dont want them to feel like you abandonded them. Mom still needs to be midwifed.

Exactly. I agonized over posting this at all, and have apparantly fed the anti-homebirth movement by posting (wow, I can't believe they can't find something better to talk about!):. My issue is not the birth...what happened would have happened in the hospital as well. My issue is what my role is as a midwife when everything isn't "okay" afterwards.

Oh, and just FYI: there are 6 other babies in the NICU who were born in the hospital, but of course no one is debating why those babies are "sick."

[Girlprof]

I'm not a birth professional, just a mom who has had a couple of losses and has friends who experienced full-term loss. No one can speak for another in this situation, but I'm betting that emails, a phone call, a visit from you will be helpful in a way that friends and family can not help. You can tell this mom that she did nothing wrong. She will probably need to hear that many many times and she may not believe friends and family in the way she might believe you. She may have questions that only you can answer. Having a baby in NICU is a little piece of hell on earth at times and often the best you can do is make sure the parents are not alone there.

That is really about helping her, not about helping you. Yet I think that by helping her you will find that you help yourself as well.

Sarah

[courtenay_e]

In my experience, calling and asking her what you can do to help often helps. A woman I attended ended with a baby in NICU for five days with a collapsed lung. I called and asked what I could do. She needed simple things to start. SHe needed a good pump and help using it (the hospital one was making her feel like a cow and she wasn't letting down). She needed some healthy and appealing food. She needed suggestions as to how to talk to the staff about wanting to do kangaroo care...and then, when she was allowed to, she needed non-nursing staff's advice on how to breastfeed (as they were pretty much pro-formula all around). I think calling her and asking what you can do...and if she says nothing right now, just checking in with her every day at regular intervals would be a good thing, to let her know that you're still "there" if she needs you.

Hugs, charmie.

[RaRa7]

yup-when my babe was in the PICU getting that visit from my m/w was so special-not really sure why it meant so much, just did.
And for the next 12 days it was talking to her and hearing her reassure and cheer me on that I wanted the most. I think because I look up to her and know how very wise she is. Definitely keep calling-- and calling

[majikfaerie]

Originally Posted by Charmie981

Oh, and just FYI: there are 6 other babies in the NICU who were born in the hospital, but of course no one is debating why those babies are "sick."

:

try not to let the opinions of the uneducated get to you

I just wanted to stress some more that the best thing is to keep contact with the mother. keep checking in with her.

[BugMacGee]

Why can't she hold her baby? Unless babe is on an oscillator, ECMO or has multiple chest tubes, absolutely no reason why she shouldn't be able to hold her baby.

[CarolynnMarilynn]

I am sorry you are in that situation. I think that you are feeling ambivalent about your next births coming up as a way to protect yourself. It is really hard to not see the happy ending in the work we do. It is those amazing moments that make the sacrifice to our families (and ourselves) worth it. I think that we have to take comfort in the things we did that made the situation a little bit better (kind gestures, just being with the family, offering information) or at least didn't contribute to it being worse (like other uncaring people may have done whilst caring for her).

After a few outcomes that were really stressful I found that the next few births were strange and I felt a bit detached from everything, as if I were going through the motions. Little by little my old personality came back and I eventually felt totally present and calm.

I had one birth this year where the baby had died in utero, before labour, and I was the one who broke the news, first to the mom and then her family. It was very difficult and the birth was somewhat traumatizing (the baby had been passed for several days and at birth it was... difficult on many levels). It was only my second still birth. I did feel though that I did a really good job of supporting that Mama and her family and helped her have an experience that did her no additional harm. I am sure that you can take pride in the same thing - that as difficult as the situation was, that she had a strong, kind support in you. And that is the key. Helping women when their babies practically fall out is very easy, helping them when their baby dies or is very sick is very hard, but those times can have the biggest impact.

I felt, in one of my births, that there was some feeling that perhaps if she used a physician the outcome would have been different. I opened myself up to any and all questions she and the family had, and felt like once everyone has asked everything, there was no more doubt, and we could all move past that issue. Unfortunately, some people will always be prejudiced against homebirth, even, as with your situation, when the place of birth did not affect the outcome.

I hope you are able to stay in touch with the Mom anyway possible. Distance at these time just makes it all more difficult. You still have a role in supporting her in these hard times when she is separated from her baby. You can provide a lot of support on this topic alone. Also, how is her body doing, and her milk?

I think you are in such a normal place for what has happened. It has been a trauma for the mom for sure, but maybe you too? Do you have supports in your life, professional or personal, to talk about how this has all affected you? Of course, we hide that part when we are supporting women through the aftermath of a difficult birth, but the birth professional has to be able to find an outlet for her own feelings, too.

Got to run - bb crying.

[~pi]

Originally Posted by arismommy

yup-when my babe was in the PICU getting that visit from my m/w was so special-not really sure why it meant so much, just did.

: My baby was in the NICU for a little while after a difficult birth. It really meant a lot to me that one of my midwives came to visit him with me. If she is open to it, I would definitely try to visit or at least call as often as is reasonable for you.

Presumably this mom expected to hold and nurse her baby after birth. If she hasn't been able to do that yet, in a sense, she isn't really done birthing him, you know?

to you and her.

[MsBlack]

Oh Charmie--

hugs to you and lots of prayer support. I second the others: do stay in touch with this family, if only to let them know you are thinking of them and supporting them in spirit--it will help! But if they know you are more available than just that, could help them in tangible ways, they might just take you up on it. I have had the privilege of helping parents through such times--merely by asking them what was going on, what treatments and prognosis--which lead to discussions of things like 'how to get to hold the baby and how important that is for baby's and mom's health both'....'what treatment choices are there, how to ask HCPs about this'....in other words, not 'doing' anything but listening and offering some feedback and encouragement that helped the family get more involved in the baby's care. Being more involved can make such a huge difference to parents (and to baby of course) in terms of how well they cope. That feeling of hopelessness and being 'useless' inside the Grand Scheme of Hi Technology and Professionals, I think, is so debilitating for parents when they need to feel strong and able to channel their love to their baby in SOME way. When they become empowered inside the med. milieu, and enter actively into baby's care even in seemingly small ways, it really can help change the whole experience for them and their baby. Just having someone to talk to, who understands, can be a tremendous help to the family, can help them continue to find strength to go on.

Also second the others about you right now--this takes time. It hurts, it's hard for you...give yourself some tlc and while it is not productive to brood, well--allow that it will take some time to heal your own heart. Part of what makes a good midwife, I think, is the ability for really feel from our hearts. Unfortunately, that means feeling the pain along with the love. Ina May Gaskin (I believe it was) says that 'being a midwife will pierce your heart...and that's ok because it helps you let more love out'.

let us know how it goes....and just ignore those with agendas based in fear and ignorance who would capitalize on your sharing here in a negative way!

[babycatcher01]

Having anything go less then perfect is hard. Just keep supporting her and her family and thats all you can do. These things do happen and they are not the norm. All this will just make you stronger. Peace be with you.