When An Unexpected Birth Defect Occurs

Most of the time babies born in the United States are born healthy. Most of the time being a Nurse-Midwife is a fun, happy job, serving the needs of women, helping to keep them in good health or pointing the way to better health and wellness. But there is that awful 3% of the time when two or three babies out of 100 are born with a major birth defect. Then the best of words sound empty and a profound sadness fills the room.

It had started out as a spontaneous labor, a few weeks early, but with high expectations of a normal labor and delivery for a low risk mother having her second baby. The prenatal course had been uneventful, with a second ultrasound to take another look at the fetus’s heart, which had turned out fine. No other comments or recommendations had been made, and now it appeared we would soon welcome this sweet child. Once mom arrived at the hospital her labor moved along quickly, an epidural choice was made by mom to relieve the intense discomfort from her rapidly progressing labor. Shortly thereafter she was fully dilated to 10 cm. Now that she was comfortable, a time of rest was given while we waited. When mom could assist her contractions with pushing, we worked together, expecting her baby to descend through the birth canal, as her first had done. We worked and waited an appropriate time, but no descent. The physician was consulted and the decision was made to deliver the baby by cesarean section.

An air of expectation filled the operating room as mom, dad, and nurse-midwife waited patiently for the physician and expert OR team to deliver this loved and longed for baby. As her little head was delivered and sweet face appeared the remainder of the baby did not follow effortlessly. It seemed to take more effort to get this baby removed from the womb, as if she sensed she would not do well on the outside. Then we saw that her little tummy was much larger than usual, and had prevented her descent for an expected vaginal birth.

A team of neonatal intensive care personnel worked expertly on this little life, and assisted the heart rate and breathing. Prayers were made for the baby and family and we waited…an expert team of perinatologists worked on, tested, and consulted on how to try to save this baby’s life, but an unusual childhood cancer would claim it two days later. What do you say to parents who were only given two days with their child?

Most infants with birth defects are born to couples without known risk factors, often having other normal children and no history of genetic problems. Many times there is no explanation of what went wrong.

The grief process includes:

1. Shock and denial-“This can’t be happening to me/us”

2. Anger- “Why me? Why us? Why now?”

3. Bargaining with God.

4. Depression and loneliness.

5. Acceptance and hope in the future.

Each one walks that path differently and will find a way to go forward.

Believing that a loving God knew your child before it was born (Jeremiah 31:3) eases some of that pain, but doesn’t fill your empty arms. There will be days when people laughing and smiling around you will seem insensitive to your pain, but each day will bring with it the promise of a new day, new opportunities, another day to heal from the inside out, and one day closer to seeing your baby again and raising her in heaven.

Psalms 30:5 promises …”Weeping may endure for a night, but joy comes in the morning."

Isaiah 65:17-20a “For behold , I create new heavens and a new earth; And the former shall not be remembered or come to mind.

But be glad and rejoice forever in what I create; For behold I create Jerusalem as a rejoicing, And her people a joy.

I will rejoice in Jerusalem and joy in My people; The voice or weeping shall no longer be heard in her, Nor the voice of crying.

No more shall an infant from there live but a few days…”