Monday, July 10, 2017

Motherhood and Grief

I've been hiding from my grief. It is hard to make time for it, but it shows its face now and then...

I look at Juliette, and I wonder... What kind of mother would I have been to Anya? What kind of mother would I have been if I hadn't lost Anya?

Would I love as fiercely? Yes.

Would I worry as much? Yes... But I imagine my feelings of worry would be naive and abstract as they once were. Now when I worry, it is a gnawing pain, a knowing ache of loss... Fear flashes before me as a deer in the headlights, and it is terrifying, if only for a moment.

Would William and Juliette be here today? Probably not. It makes me sad to think I could only ever have had Anya or William and Juliette. It makes me grateful I wasn't the one to choose... because William and Juliette are everything to me... Today, William and Juliette mean more to me than Anya does. I feel sad and guilty about that.

I also find that I am angry with myself, disappointed to face the same shortcomings as all parents... I feel like I should know better. Life gets busy and I forget the lessons Anya taught me about life and love.

I get impatient at silly things. I get lost in thoughts about dinner or work, when I should be paying attention. I don't play enough. But Anya taught me that this moment is precious... it could all be taken away in a moment. One day these precious moments will be gone...

I keep trying to simplify and be present. Though I know I will forget sometimes, I will try again and again to truly appreciate each day. Because that's all we can do isn't it?




Friday, May 26, 2017

Music and Memories

Music has a way of helping me relive certain moments in life. There's something therapeutic about it. Over the years, I've created particular associations between Anya's short existence and a handful of songs. They have helped me to relive certain moments, reflect on them, and progressively come to terms with them.

I feel like they deserve to be part of this overall record. They are worth remembering. So here they are, along with what they represent.

1- Across The Universe (Fiona Apple cover) . This song played during the early stages of labour, while Kayleigh was trying to stay calm. It reminds me of the calmness and the faith in life that we once believed in so strongly.

2- Babys (Bon Iver). This song reminds me of the anxiety-ridden drive between the birth centre and the hospital. Anya had been born, and she had been taken way by ambulance. Something was wrong - but I was trying to stay hopeful, until hope was taken away in a crushing instant.


3- To Build a Home (The Cinematic Orchestra). Saying goodbye to her. Returning home from the hospital without a baby. Seeing the note we had pasted on the door to let Kayleigh's mom know that we had made our way to the birthing centre. Ripping it off in anger. Being greeted by the mess we made as we were excitedly leaving the house. Remembering the thought that "when I come back to clean this, i'll be a dad". Feeling the worst feeling of defeat I've ever felt.


4- About Today (The National). Lying in bed on the evening of December 19th. Feeling exhausted, incredulous, powerless. Dreading sharing the news. Wishing for a time machine to go back just 24 hours and fix things.


5- The Wolves, Act I and II (Bon Iver). New Year's Eve. The day after her funeral. The lyrics "With the wild wolves around you; In the morning I'll call you" remind me of a certain feeling of loneliness and anxiety I felt at that point - as much as I was surrounded by loved ones, I was alone in coming to terms with what was happening in my mind. That feeling of failing as a parent at the single minimum requirement for parents - keeping your kid alive.


6- World Spins Madly On (The Weepies). Trying to find some sort of return to normally. Being upset at how life just seems to keep going for everyone else.



7- One Sunday Morning (Wilco). This song reminds me of those first few weeks, getting up on what would usually be a workday, and instead of going to work, just... having to find something to do. Painting a wall. Fixing something. Contemplating what the hell we do from here.



8 - Father Daughter Dance (Craig Cardiff). Reflecting on what could have been.



9 - Nobody Dies Anymore (Jeff Tweedy). Trying to find faith in life again, and in the idea that things can turn out alright.



10 - Sky Blue Sky (Wilco). Starting to believe that the worst may be behind, and that sunnier days are ahead.




11 - Hanging from the Earth (The Pines). Coming to terms with acceptance, and with the guilt of feeling happy.


Here's a Google Play Music playlist.

Thanks for listening.

Saturday, April 15, 2017

Contrast

As a grizzled veteran of three births, I thought I might offer some observations which compare and contrast the various birth options we've experienced in the Gatineau/Ottawa region. Who knows - it might offer some food for thought for prospective parents. Keep in mind this is from a father's perspective. Also, fair warning: this is long, and probably only mildly interesting.

The three different facilities we went through (in chronological order) are:
  1. The Gatineau Birth Centre (Maison de naissances)
  2. The Montfort Hospital in Ottawa
  3. The Gatineau Hospital 
Before the Birth

Prenatal visits are nerve-wracking, especially as a first-time parent. There are many questions, and many doubts associated with this new experience. They range from 'when am I going to feel those first kicks' to 'what the hell is this bloody show' (don't Google that until you have to).

It's hard to know what's normal and what's not, and it sure helps to have someone that can take the time to explain it to you.

To this day, I am still of the opinion that the best prenatal follow-ups we received in this regard were at the birth centre. For those who might not be familiar with this option, in birth centres, midwives run the show instead of doctors. They offer a more relaxed environment than the hospital, where nervous soon-to-be parents can take the time to express questions and concerns (if I recall correctly, the appointments are about an hour long) They also take the time to get to know their patient's views and expectations on a personal level. As soon as high-risk factors manifest themselves, they refer patients to the Gatineau hospital.

In the hospital setting, the approach is much more... methodical.

At Montfort, once you arrive, you check in (a very quick process), and there are series of standard follow-ups and questions administered by nurses (Blood pressure time! Weigh-in time! Any cramping? Bleeding? Etc. ). After this, you wait in a room, and your doctor shows up. We'd spend generally between 10-20 minutes speaking with the doctor about how things were going in general, getting the regular doctor-administered checkups (you don't need details) and discussing our history / autopsy results / possible ways to minimize risks.

At the Gatineau hospital, it sometimes felt like there was someone who's job it was to try and waste as much of your time as possible. At the beginning of the Juliette pregnancy, when we had a scheduled follow-up, we'd walk up to the counter which administered the external clinics to check in. You would get called within generally 15-20 minutes of your scheduled time. But then some genius decided that, no, that's too easy. First, you need to go to the general check in (in the same general room). But not right away when you get there. You need to grab a number first. And if you're there at a busy period, it's an easy half hour or more before your number is called. When you're finally seen at the general check in, all they do is.. give you your file. Then you bring that file to the same exact counter you used to just check-in at.

And then you wait the usual 15-20 minutes to be seen. And at the end of it all, you need to take another number at that general check-in to book your next appointment.

WHY? Why would this be necessary? What are you possibly accomplishing, my fellow bureaucrat, by adding this extra step? This is why people hate us.

Anyway. Comparing our two hospital settings, it was interesting to note that while at Montfort, the dad is welcome to be present during the nurse-administered portion of the check up, there is an explicit sign in Gatineau which notes that companions must wait in the general waiting area. I imagine there's a good reason for this (patients waiting for their gynecologist in their hospital robes may not be too comfortable to be sitting next to an excited dad), but it still feels like there's a design flaw. I still had to walk through that same area for the actual doctor's follow-up.

The actual follow-ups were much quicker than at Montfort, and usually lasted all of five minutes (we weren't even asked the usual series of questions we'd become accustomed to, regarding any cramps or bleeding). Maybe this was due to an assumption that we would know to report anything that was off, but this was never clear.

It's interesting to note that the best and worst prenatal follow-ups were both in Gatineau. It feels like the two systems could probably learn from each other.


The Birth

The birthing centre offers a relaxed environment for those who aim to give birth naturally. They don't offer epidurals. For that reason, a fair amount (I don't remember the precise number) end up transferring to the hospital during the birth. If I recall, there are circumstances where your midwife can still be present during a hospital birth, but I think this is fairly limited since the province wishes to refrain from duplicating care.

Objectively, I continue to realize that outcomes at birth centres are no worse than ones at hospitals. And yet, speaking as the outlier that did not have a positive outcome, I cannot say that I would recommend it. If things take an unexpected nosedive, commuting elsewhere is the last thing you will want to do.

Both Montfort and the Gatineau Hospital were surprisingly equally impressive to the birthing centre as far as being able to offer a comfortable birthing environment. All three facilities offer baths, and various types of equipment that help get through labour.

When you are admitted in the hospital setting, you are assigned a nurse. When there is continuous monitoring, they are there at all times; when there isn't, they check in at regular intervals (more and more frequently as labour progresses). We had excellent nurses in both hospitals.

A couple of points where i'd give the edge to Montfort over Gatineau:

1. The initial method suggested to induce labour was simply the use of a hook. That's all that ended up being necessary. In Gatineau, while our doctor was quite open to the hook as a first method, this was not the initial approach suggested, and was met with surprise.

2.At Montfort, laughing-gas is offered as a pain-relief method, whereas it is not in Gatineau. Pain has a way to make you feel 'to hell with what I thought I wanted', so it's probably not a bad thing to have a method that can be administered very quickly during the dire few moments where there's doubt.  

One thing to keep in mind about Montfort is that it is a teaching hospital. That can mean the birthing room getting surprisingly crowded when the big moment comes. I can't even tell you how many people were there in our case. Too many to count at a time where my focus was elsewhere.

In Gatineau, as far as staff, there was only one doctor and one nurse during the birth. This made the experience feel much more relaxed (though it stands in contrast with the standard for non-teaching hospitals in Ontario, where I was told two nurses are called during the birth - one for the mom, one for the baby). Overall, both Montfort and Gatineau were quite good - I don't know that I'd recommend one over the other for the birth.


After the Birth

The first few minutes after a birth (that goes well) are exhilarating. It's hard to believe what's just happened; that there's a brand new, living being right there, crying a beautiful cry, that you're now responsible for.

The first couple of hours, you're on a bit of a high, running on adrenaline, slowly calming down, and settling into this new reality.

And at a certain point you think 'Okay. Great. What's next?'. You start to think 'When does the whole nursing thing start? When do we get to go home?'

At Montfort, we first got pretty good support with nursing. A nurse came in, and helped coach Kayleigh through how she should do it. It all seemed to be going pretty well. Until that nurse's shift ended, and the next nurse told her to do slightly differently. And same thing with the one after that. And the one after that. Advice that is not uniform from nurse-to-nurse is quite frustrating.

This was in the context of doctors telling us we needed to stay at the hospital longer than the initially-hoped-for 24 hours, because William had lost a bit too much weight for their liking, reasoning that staying would help us get additional support in figuring out nursing. Argh.

In Gatineau, the postnatal care was just excellent. Check-ins seemed better timed, and the advice was consistent. Though admittedly, they might have just figured we needed less advice than first-time parents.

Final thoughts

Perhaps not surprisingly, each facility is better than others at certain things. There seems to be a pretty good opportunity for increasing quality of care if they would just speak to each other about the things they do well. However, that would mean measuring client satisfaction, and identifying strengths and weaknesses in a systematic way, at the point of service delivery, by actually asking for feedback when people are discharged. If that isn't done, maybe we should take the time to ask why not.

Friday, March 3, 2017

Our Third Birth Story

On most Monday mornings, our routine is a bit rushed: wake up to William calling us between 5 and 6. Go downstairs around 6. Have breakfast. I get dressed and leave by 6:30. Kayleigh gets William dressed and at daycare by 7:15 (or around then). I assume she also gets dressed at some point.

In that sense, Monday didn't start off feeling too differently than any other day. We didn't have the luxury of a lazy weekend morning; after all, we had somewhere to be by 8:30! Except this morning, we wouldn't be going our separate ways - our job that day was to go through a third birth together.

We arrived at the Gatineau Hospital shortly after 8. A bit early. There hadn't been as much traffic as expected, what with the Quebec March Break. So we took the time to get a tea and coffee at the cafeteria, and had a conversation about... exactly what you'd expect for people in our situation: how the cafeteria was in need of a few improvements.

At 8:30, we made our way up to the birth centre, and Kayleigh was given a bed to lie in for the fetal monitoring (which they do prior to admission). Since they were a bit busy, we had to wait for them to have the chance to get to us - however, we were well prepared with a board game on hand! It was helpful to have a distraction to focus on.

Finally, monitoring began at around 9:30. Juliette was in great form. I felt confident staring at the heart beat monitor, and I remember hoping that my confidence would be able to last throughout the day.

We were admitted shortly after 11, and Victoria (our doula) started to make her way over. This time, it would be just the three of us. It felt like enough.

We were given the choice of birthing room. Thank goodness for having been offered that choice, because the first room our nurse showed us was the very same room where we had spent December 19, 2013 with Anya, after she had passed. We decided on the room right across from that one. It felt a bit like slaying some personal demons, having something wonderful happen right next to where we had the most difficult day of our lives.

Our doctor let us know the typical way they induce in Gatineau - setting up an IV of Oxytocin. She informed Kayleigh that they would get that set up for her. However, given our experience with William, where the only intervention needed was a hook to break Kayleigh's water, Kayleigh suggested starting with that approach instead. After all, it only took about four and a half hours from breaking the water until birth last time.

This didn't seem like a request they get very often, but our doctor agreed to start that way, and re-evaluate if needed.

And so, around 12:15, after another short bout of monitoring, we got started with the hook.

As with William, the contractions came gradually. My beautiful wife took them in stride, being as zen and relaxed as possible at first.

Victoria set Kayleigh up with a TENS unit, which had some success at dulling the pain. But as with every other birth, there came a point where there was no relieving that pain. That point seemed to come more quickly than ever before. Kayleigh had to endure. And I had to help her, re-assure her, and be proud of her.

And I was very, very proud of her. Still am.

There were moments when she questioned why she was going through this without an epidural. It was, once again, extremely difficult to see her in so much pain. But I was determined that this time I wouldn't let anxiety get the better of me. And while it came close a couple of times, I was able to re-focus myself on supporting Kayleigh. It helps to not pay too much attention to the monitoring, and to trust in our medical professionals.

Before long, Kayleigh was ready to push. By that point, she was a woman possessed, and determined to bring our second daughter out into the world. At 3:42 PM, a mere three and a half hours after induction, Juliette was born, and with her cries I felt the weight of the world lift off of my shoulders. It was replaced with absolute wonderment at how amazing life can sometimes be.

How lucky we are to be her parents.

Her heart beat never decelerated more than expected. We did not need any interventions to get her out. She had as perfect a birth as we could have hoped. It was actually... a good experience all around. Who knew that was possible?



Friday, February 3, 2017

Faith

Once again, we are nearing the finish line. We have hit the 34 week mark. If history repeats itself, we are under four weeks away from officially adding a new member to our family. Our second daughter. Juliette.

As was the case with William, the best word that describes the upcoming birth is 'daunting'.

On the one hand, I now know what a positive outcome looks like. But that's not quite enough to shake off that feeling that something could go wrong.

It's the same fear I had prior to William's birth, of course. So we sought to find ways to counter or alleviate them. Find a good doula. Insist on having constant fetal monitoring that we can hear at all times. Having a doula was one of the best decisions we could have made. Having constant fetal monitoring? Not so much.

Babies, as it turns out, like to move. That means a wireless monitor naturally loses the heartbeat quite often. And when you're relying on that heartbeat for comfort, it becomes a bit distressing when it goes silent. Again and again.

So I'm coming into this having learned a thing or two about how to handle a birth after a loss, and how to reduce sources of anxiety. Yet I can't shake the fear of another sudden anxiety attack the moment I perceive something to be going wrong. And that's not something I can rationalize my way out of. I simple must believe that things are going well. I have to have faith - in Juliette, Kayleigh, our nurses and doctors, and in life.

It is the least my family deserves, for all that they will be going through, while I watch from the sidelines.

Thank you all for your continued support. I look forward to writing about our third birth story.

Monday, December 19, 2016

To Worry

Three years ago today - already - Anya came into this world. How far we've come since. Her first sibling, William, followed some 15 months later. Her second sibling will be here in less than three months. Today, it seemed fitting to write to all three of them.

My dear children:

Your father worries. I always have! From the moment that I learned that each of you would be coming into this world.

Worry is a funny thing. Sometimes, it can be positive - leading us to a course of action that is safer than another, in the case of circumstances that we can control. But if we're being honest, we must recognize that in life, there isn't all that much under our control. And so, worrying is a (largely) wasteful exercise. Worry can't prevent all scrapes and bruises, and it certainly can't keep the worst parts of life at bay forever.

To have children is to worry. Every day. And the older I get, the more cognizant I become about all that there is to worry about in the world. All that could go wrong. Health goes into it of course- yours and mine - but it goes beyond that. Will you have the opportunities available to make a good life for yourselves? Will you have to grow up in a society that is increasingly fueled by populist hatred and fears?

It would be all too easy for a perfectly rational person to aim to prevent worry by reducing the sources of what they have to worry about in life. Not taking a shot at something wonderful, because of the chance that something bad might happen. It is safe. But it is counter-productive, and that it my long-winded point today: having something and someone to lose (like each of you) is the greatest of privileges. If I let worry dictate my actions, I would not have this privilege.

I try to remind myself of that regularly. There is a very real chance that things will go... perfectly well.  I need to keep worry in check with stronger hope and optimism. My hope today is that a better tomorrow begins with you. All three of you, through the positive things that you will bring to the world (even Anya, through her legacy).  Worry is a small price that I am glad to pay.

I will continue to do my best to keep it in check. Try to remind me of that, when you can. I am lucky to have the opportunity to love you all so deeply.

It's a dangerous business, Frodo, going out your door. But that doesn't mean you shouldn't step onto the road.

Dad

Thursday, December 1, 2016

Priorities

Since December 2013, one of the aspirations that I cling onto is to make Anya's legacy a net positive: bringing more good than bad to the world. And it has.

It's heartwarming to reflect on the relationships she has strengthened, on the friendships she has reinforced, and on the people she has helped through their own journeys with this blog.

Unfortunately, it has not been universal. One of the risks in being as open as we have been is that it can open wounds that others may not be ready or able to face. The following is part of a message I received from a family member in early December 2015:

"Understand that I cannot feel what you emotionally feel towards those images. To me, these images are akin to folks that shame women who have had abortions with dead baby photos. (...) I find them harmful for my own mental health (...)  dead baby photos are unkind to me and my trauma"

This exchange came after I had expressed my... frustrations (to put it mildly) to this family member about being disrespectful to Anya's legacy by insisting that photos of her be covered up, or taken out of sight when she was there. I have often questioned whether I was wrong to fight for my daughter in this case -  should the living not come before the dead?

Or does being a parent trump other relationships, even through death? Should I prioritize Anya's legacy, if memories of her might be harmful to some who have experienced different hardships?

 I wish there was an easy answer to this question.

 Ultimately I can only do what feels right, and fighting for her has always felt right. Even if I regret this particular outcome.

 Sometimes there are simply no perfect solutions. That's life.