When a Baby Dies

01.06.10: Our side of the sadness


On Christmas Eve, a Colorado man received a miracle. His wife, Tracy, went into labor essentially healthy, then experienced complete cardiac arrest during labor. Doctors and nurses did everything they could to bring her back to life but after four minutes and no heart beat, they knew it was time to focus on saving another life – the baby’s. If they waited any longer, they’d both be gone. Doctors performed a C-section and started a resuscitation. The first few minutes didn’t look good. Baby Coltyn was limp with barely a heart beat. The resuscitation team worked their magic and soon, Coltyn was breathing and crying. And here’s the miracle – Tracy started breathing too. She came back to life.

I’ve never had one of “my mothers” die. It’s happened to nurses I know but…knock on wood…not to me. I’ve experienced the death of several newborns, however. Most were terribly premature or had severe genetic anomalies that meant they never stood a chance to live beyond birth.
There have been labors where we knew the baby was already stillborn or who had something obviously life-threatening (like a torn placenta or deformed heart) occur. These are tragedies, for sure, but it’s the ones that are completely out of the blue or after a completely normal delivery that are the scariest.
Here’s what it’s like, from the nurse’s/doctor’s side of things. Whether you see it coming or it comes as a shock, there’s a moment when you realize a life is swirling down the drain. You do everything you’ve been trained to do to save that baby and still, all the training, medication, technology and care in the world isn’t working.
You never want to stop a resuscitation. You never want to stop trying. You can’t believe what’s going down in front of your eyes. “Breathe, baby. Just breathe, dammit. C’mon, breathe.” You do CPR. You place IVs in their tiny veins, breathing tubes in their airway and force air into their lungs. You give lifesaving drugs that should start their heart. You do it all and still…that heart won’t beat. Those lungs won’t breathe. That baby won’t live.
You know the parents are staring in disbelief at your back as you and your team desperately try to save their baby. Someone, probably a nurse you’ve worked with for years, stands at their side, narrating what we’re doing in soothing tones. Another nurse records our every move. The room fills with more doctors and nurses but we know it and the parents know it…this is bad. Eventually, someone stops the “code.” Someone says the words no one wants to hear. “There’s nothing more to do. This baby has died.”
As the parents cry, wail and beg us to do more (and often we will, until they know there’s nothing left), the nurse and doctor taking care of them, the ones whose names are all over the chart, will cry too with shock, grief and despair. She’s bonded with these parents. She took care of them. She wanted this baby too. Or maybe she hadn’t had time for all that. Maybe she’d just come on duty and an hour before she’d been eating dinner with her own kids. It’s part of the job.
After she’s wrapped the baby and placed him oh-so-gently in his parents’ arms, she’ll step away and allows them their privacy. She’ll be surrounded by her peers who will offer support. They know what she’s up against. The anxiety of knowing the baby was lost on her watch. The fear that maybe she missed something.
It doesn’t really matter if it’s a doctor or nurse; she’ll be grilled by administrators and attorneys. Every moment of her care will be scrutinized. Every word she did, or didn’t, chart will be combed through. Her judgment, skills and decisions will be questioned. She’ll worry that even though she did her best and all she did was her job, she could land in court. There’s fear, doubt, dread and sometimes anger. “All I did was come to work. I did everything right. Why?” Often times, we never know “why.” It happens.
A doctor-friend of mine stood at the end of the hall, tears streaming down her face. She said, “I don’t know what went wrong. I know they’ll blame me though. I’m supposedly in charge here.” No, ultimately, none of us are in charge here. It happens. Most of the time, no one is at fault. We just came to work and…
As for the miracle in Colorado? Those doctors and nurses got one too.

Jeanne Faulkner, R.N., lives in Portland, Oregon with her husband and five children. Got a question for Jeanne? E-mail it to labornurse@fitpregnancy.com and it may be answered in a future blog post.

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