A physician who lost a patient to home birth

There is a strange feeling that every kid has experienced: the flip-flop sensation of your stomach dropping while you careen down the descent of an enormous roller coaster; the sinking swoop of a high-speed elevator dropping to the ground floor. My children find it hiding along a rolling country road, driving to the lake in our jeep. With the top down and the sun shining, they shriek and beg for more hills, more tummy drops.

Shortly after one of my 30-somethingth birthdays, I started experiencing this feeling fairly frequently and without provocation. Several times a day, occasionally several times an hour, I would feel the earth drop away, and roller coaster feeling would hit hard.

The really odd part was that it wasn’t in my stomach. The sinking, dropping feeling was in my chest. I normally would head straight to the cardiologist or the ER. I would beg for a cardiac monitor, to evaluate for dropped beats or some arrhythmia. I might look at my sleep, my caffeine intake and my stress level. I should’ve been worried that something was deeply wrong.

I didn’t go to the cardiologist. I didn’t call my doctor. In fact, I don’t really have one. I didn’t cut back my caffeine or try to sleep. I didn’t need an event monitor. I knew exactly what was happening with my body. My heart was broken. It is an oddly physical sensation. I felt a wave of something similar once after a silly college break up. More recently, a similar pang hit when my parents moved cross country. Those were moments that passed, events that had reasonable explanation and the sinking feeling passed quickly. This time I had no explanation and nothing could make things right.

I didn’t lose a child, or a parent; my husband didn’t leave me. I lost a patient, someone I knew only briefly and fought just one long night trying to save. I barely knew her; I couldn’t save her. What more is there to the story? There is simply no good reason for a mother to die on the day she gives birth.

The sinking feeling is less frequent, but it is not fully gone. The weeks that followed held an odd combination of distance and reassuring words from colleagues while normal OB/GYN life continued. I managed to shepherd more mothers and babies through safe, mundane deliveries. I became sharply aware of just how dangerous the day of a birth is for each my patients.

I recently received a letter from a very dear long time patient. The letter was lengthy and heartfelt, thanking me for my years of care, for helping her through tough life events and various medical issues and guiding her when she carefully planned and achieved her first pregnancy. She would like her records sent to a home birth midwife; she feels that her model better suits her needs and that she is low risk; home birth is preferred.

I want to scream. I want to vomit. I want to show her coolers of empty bags of blood and plasma. I want her to see the image burned on the back of my eyeballs — that of a newborn baby, skin to skin on her mother’s mottled chest, the only softness amongst the ET tube, the screaming alarms, central line with pressors streaming through.

I want her to understand that birth is real and vibrant and deadly, but that I can help her stay safe. I think for a moment about calling her and telling her my story and begging for her stay under my care. My heart drops away heavily, and I suddenly realize that the end of my tale doesn’t make my point very clearly.

I hand the letter to my office manager and release the records, say a prayer for my home birthing patient, for the orphaned newborn, and for my own sanity; a deep breath and a knock on an exam door, moving on to the next smiling, hopeful pregnant mother.

The author is an anonymous physician.

Image credit: Shutterstock.com

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