My first birth as a birth assistant started quickly. I entered the center and immediately heard the screams of a woman in labor. For one brief moment, the piercing sound of her voice shocked me enough to pause and think, “Maybe I can’t do this.” But as quickly as the thought emerged, it passed, and I rushed to put my things away before entering the birth.

As a second assistant, my role is to support the midwife and nurse (the first assistant) during the birth. Second assistants help prep and clean up the birthing suite, chart the progress of the woman’s labor, record medications used (in the event of repairs after a vaginal delivery), and generally tend to the staff more than to the mother and her birthing team. I enjoy both the doula side of my internship and the birth assistant side; they are invaluable perspectives for me to have as I begin this new career.

I quickly started picking up what I needed to do. Having only been working at the center for a few weeks, and this being my first time responding on-call, there was much to know, yet not much time to process. The nurse and midwife moved around the client with ease and I began picking up the charting system and tried to navigate the dimly lit birthing suite. On the bed was the client, her husband, and their birth doula all working tirelessly to help the woman cope with intense back pains. There had been a few moments of deceleration in the baby’s heartbeat, but subsequent intermittent monitoring detected a strong beat. I followed the nurse around the center, recording the fetal heart tones. I heard them too, fast and strong and easy to find on the doppler.

Yet the back pain progressed, and no amount of support or nitrous oxide could keep the mama from suffering rather than coping with her labor pains. They decided to transfer to the hospital, changing care to the OB nearby who is known for his deep respect towards our clients’ wishes for minimally invasive labors. The midwife accompanied the family while the nurse and I cleaned the birth suite, closing the doors and headed home to rest just before midnight. We were sad for the evening to end without a birth.

A few days later, I was at the center working when a fellow birth worker asked me how my experience was going and if I had seen any births. When I told her about my last on-call experience being a transfer, she stated,”

“Oh, do you mean the stillbirth?”

WHAT?!??!?

I stared down at the papers in my hand, swallowing hard, trying to make sense of this news. I have no idea how I kept it together. Writing this now, I am still choked up thinking about that family. How, how in the world could there be a baby who’s HEARTBEAT I HAD HEARD, who was now dead??? I couldn’t fathom it, and I still can’t. I cried for days, for a woman I didn’t know and the baby she would never watch grow up. For her husband who had to carry the empty car seat out of the hospital. For every mother whose baby was born sleeping.

Miscarriages are pregnancy losses prior to the 20 week mark, and stillbirth losses are after the 20 week mark, a delineation that does not matter in my opinion to the grieving parents. According to the March of Dimes, stillbirth affects about 1 in 100 births in the US per year, amounting to 1% of pregnancies and 24,000 babies each year. That’s around 65 babies each day.

The causes are not always known, to say the least. There are plenty of possibilities: placenta problems, infection, preeclampsia, obesity, diabetes, drug and alcohol use, previous losses, loss of oxygen during labor and birth, trauma and injuries, preterm labor, pregnant with multiples, too young, too old, your socioeconomic status, your race! (African American mothers in this country are still at a disadvantage- they die of pregnancy complications at 3-4x the rate of white women). To the yet-to-be-educated nurse, it sounds like a laundry list of ALL possible reasons that anything could go wrong in any pregnancy, not a true list of reasons for stillbirth. The March of Dimes does admit on their website, “We don’t know what causes many stillbirths, but common causes include…”

Scarier still are the stillbirths that go full-term, that even enter labor and delivery. I stumbled across a forum of mothers sharing in their grief, and so many of these stillbirths were late- 40 weeks + 5 days, 39 weeks + 2 days, 36 weeks, 39 weeks + 4 days. The list went on and on. These were healthy mamas and healthy babies, until, they weren’t. When did things go wrong for this mother I met? Was there a moment to change course? We will never know. And it’s this unknown, this lack of closure, the failure to find answers that leaves parents in such deep oceans of grief and fear for the future. What if it happens again? What if we can never get past it?

How do we save the babies?

I’m not in a position to answer this question yet, but I have hope one day we will be closer to knowing.

Today I stared at the sweet face of my friend Morgan’s one month old daughter while I rocked her. I touched her cheek and stroked her hair; I kissed her forehead and smelled the sweet smell of baby, eternally grateful that she was here with us and that we had the immense pleasure of watching her get bigger and stronger each day. Sixty-five families were robbed of that pleasure the day she was born. We are so fortunate.

Rest in peace sweet baby. <3