I wrote this in Afrikaans originally but I have translated it for this website:
Babies should smell like baby powder and Elizabeth Anne’s shampoo – not like formalin and death. ‘n Baby has to have a pink little mouth that is open-mouthed and loudly looking for his next sip of milk, not purple, lifeless lips. Babies should have little hands and feet that practice kicks in his mother’s womb so that he can do so vigorously in real life – not lifeless little limbs that are still breathtakingly perfect. A baby should have a warm, snugly little body that one can hug ever so often to feel and smell their ‘babyness’. Not an ice-cold, lifeless little body in a lonely carrycot.
He is carried into the room in a navy-blue carry cot by the owner of the funeral services and she placed him on the boardroom table – the only place I could take proper photographs of him. She had asked me to take photos of him, as his mommy has passed on with him, so it’s the only photos the family will have. She looks at me and nods, and silently closes the door behind her when she leaves. My heart catches in my throat when I slowly peek into the carrycot: The most beautiful, perfectly formed little baby boy is lying on a pretty baby-blue blanket. It looks like he is in a deep sleep. Oh, how I wish he was only sleeping! How I wish that he would just open his little eyes and give me that newborn stare! But it’s not going to happen. He is dead. This perfectly formed little body is dead.
He is not going home with his nervous first-time parents that are going to check over and over again that he is properly tucked in his safety chair. They are not going to check up on him a million times in the night, after he fell asleep hours before. Grandparents, uncles, aunts, nieces and nephews aren’t going to wait at the front door for the long awaited little prince to come home, with excitement they can hardly contain. His mom is not going to oh so carefully lift him from his safety chair, wrap him in a warm cocoon and over-cautiously lay him down in his brand-new cot.
His newborn little body is not going to be washed for the first time by clumsy, inexperienced parents. Nobody is going to walk around on their toes in the house because the baby is sleeping. No one is going to wake up every two hours because he is hungry and keep his parents on their feet the whole night and sleep like a trooper during day time. Nobody is going to argue if he has his grandpa or his uncle’s ears and if his hands look just like his dad’s or not. No photos are going to be taken of his baptism, first birthday, first day of school, matric farewell, 21st birthday, his wedding…
Because he is dead. This beautifully and fearfully made little boy with his dark hair framing his perfect little face is dead and his potential as human being on this earth is dead. His parents’ dreams for him are dead. His mother is dead. Dead, dead, dead…
But then in my mind’s eye, I see a dark-haired little boy hopping and skipping in heaven. With indescribably joy shining from his face, and big brown eyes that sparkle because he has just met his Maker. He does not know pain, or sorrow – he only knows unspeakable joy and a peace that has never yet been told. That peace which transcends all understanding. That peace that everyone on earth is yearning for. He has that. He has peace. And that is what I am praying for after I packed away my camera and drove home in the pitch-dark, windy night. Be still my heart. And give me peace oh Lord. Silence my questions. Quieten my rebellion about this little boy’s death. I beg for peace…
Except for different room numbers, the two doors looked identical. If you could have peeked inside, you wouldn’t have been able to tell the stories apart. Except for their age difference and the gestational age of their pregnancies, they were just two mommies-to-be waiting to give birth. And they did give birth, almost simultaneously. Yet contrary to what the naked eye could see, the stories behind those two doors are so far apart it’s mind boggling.
You see, the one gave birth to life and the other to death. Behind Labour Room 1 in an upmarket suburban private hospital, a young woman was unsuccessfully trying to take deep breaths to ease the pain that threatened to overcome her young body. She was very obviously experiencing severe discomfort with each contraction and as I held her hand I could almost feel her pain. Annah* looked at me and asked “Is this going to get worse?” I had to be honest because this is the one thing I promise my clients from the second we meet: Honesty.
I looked at her and told her that yes; unfortunately it was going to get worse. Her big brown eyes followed me as I walked around the bed and straightened her IV line. I saw earlier that her brown eyes had little specs of flashing green in them and I thought to myself that she was such a beautiful young woman. She asked again in a strong, clear voice, “How much worse Nicci?” I took her hand and assured her that it was going to be painful but it doesn’t last forever and she will forget the pain. Her mom Lisa* just looked away. I couldn’t tell Annah that the pain of the memories never leaves you. It would have been cruel and something she couldn’t prevent anyway. So I just squeezed her hand.
Annah was a young woman from a happy home with a great family and awesome siblings. At the end of the previous year, she just finished university and she was celebrating the New Year and the beginning of new things with her friends. Unfortunately, as it often happens, she drank too much alcohol. What happened is still a blur to her, but she fell pregnant right when she was supposed to start her new life. To her it was devastating news. But the news was not as devastating as the terrible news they got from Annah’s gynaecologist when she was around 20 weeks along. The pills Annah was taking for a chronic condition causes severe birth defects, deformities, paralysis and even brain damage. A medical termination had to be done as the doctor explained to Lisa that the viability of the pregnancy is virtually zero. According to the doctor it was a lot beter to terminate at 22 weeks than to lose a baby at 38 weeks. So a medical termination was booked.
I spoke to Lisa over the phone for the first time. “Lisa, it’s Nicci, I function as a bereavement doula and I was told that you want to make use of my services?” It is with relief in her voice that she confirmed that they needed my services. She also told me straight away that she suffered three miscarriages – all three between 20 and 24 weeks of gestation. Her first miscarriage was at 24 weeks, but they didn’t show her the baby or allowed her to hold the baby and she later learned that the baby was incinerated as medical waste – something that devastated her and still haunts her up to this day. I could hear the pain in her voice. I made it very clear that this will most definitely not happen if it is her daughter’s wish to see her child and to bury her child.
After I explained to her how the process worked, she asked me to please come immediately, they were about to break Annah’s water. I ran to get my camera and then I rushed to hospital. As fate would have it I couldn’t find parking anywhere and I ended up parking a block away from the hospital! At long last I reported at the nurse’s station and I was taken to the Labour Rooms. It was when I came around the corner that I saw the two identical doors…
Lisa is a beautiful woman in her early fifties and she looks much too young to be a grandmother. The first thing I noticed when I saw her was the utter sadness in her eyes. It was very obvious that not only was she in pain for her daughter’s sake but this medical termination scratched open old wounds. But after we talked a while I realized that although she was sad I could also see the shimmer of a tenacious woman with hope for the future. When I was first introduced to Annah she seemed a bit hostile but within five minutes we were chatting like we knew each other for ages. After a while she told me that she was pregnant with a little boy she was going to name *Zach. I was so relieved that we clicked. It is extremely difficult to assist someone who doesn’t want you there! In fact, it’s virtually impossible. It is also very important to always put your client’s needs before everyone else’s – in this case even her own mother’s.
Annah starting talking about Zach’s funeral – she said she wanted a particular casket and elaborated on exactly what she wants. The moment I saw that Lisa was about to say something (that I knew was going to be perceived as negative) I motioned to her to keep quiet. We both listened as Annah told us about Zach’s name, his casket and a few other details about saying goodbye to him. She seemed content that we were just nodding and agreeing with her but I could see that it was very difficult for Lisa not to say something…
Annah was complaining about her contractions again and I demonstrated to her how to breathe to make things a little bit easier for her. But I could see that the contractions were becoming very uncomfortable. I left the room to give Lisa and Annah a moment alone and as I was waiting in the corridor I couldn’t help to hear the familiar sound of a baby’s heartbeat in the womb over the ultrasound machine’s system from the other room. The nurse was telling the mom in Afrikaans ‘Dit is nou amper tyd’ (It is almost time now) and I could hear them laugh and make jokes about the impending birth of the woman’s baby. There was a lot of laughter indeed. The contrast to Annah’s situation was so stark it made me catch my breath for a second and I had to concentrate very hard to not let the sadness overcome me.
After a while Lisa came out and we went around the corner to have a quick private conversation regarding the situation but after five minutes she received a frantic phone call: Annah was in full-blown labour! I was astonished that this poor child went from 3cm dilation to full dilation within a matter of not even 20 minutes. We both ran to the room. We were there just in time. The doctor arrived as we got there and the next moment Annah’s agonizing screams could be heard echoing down the labour ward’s corridors. Between her pauses to take a gulp of air, I could hear a mini commotion next door as well. Unbelievably both women were giving birth at the same time. Oh the irony! The next moment Annah was screaming so loud my ears were ringing and with a soft popping sound little Zach was born. But contrary to the celebrations and exuberant exclamations next door of a healthy baby boy that had just been born, the tears were streaming down Annah’s face and Lisa was barely coping herself. If pain was a picture, I saw it in that delivery room.
The nurse delivered the placenta after the doctor cut the umbilical cord (and subsequently left straight away) and was gently busy cleaning Annah up. Lisa was standing with little Zach wrapped in a soft white towel blanket that was embroided with a pretty white silk bow that I gave to her shortly after the birth. I moved close to her trying to cover the baby up whilst the nurse was busy with Annah when I almost jolted in shock. The baby moved! This tiny little creature was still moving for some reason. I tried to stay calm but I was in so much shock I nearly fainted. Without thinking twice I closed the curtain with one quick pull and motioned to the nurse to come to us. Lisa was in an absolute state – she was crying and shaking, muttering under her breath “He’s moving Nicci, he is still moving. He is alive! Oh God help us!” The nurse rushed over and patiently explained to me and Lisa in a hushed voice that unfortunately this happens sometimes.
Apparently some babies moved for over an hour since they were born, struggling to take their first gulp of air that was sadly never going to happen – even at only 22 weeks of gestation! I was so traumatized and upset; I cannot even fathom how poor Lisa must have felt. Even the nurse was as white as a sheet! My heart went out to both of them. I couldn’t help but wonder if this was not the reason for the gynaecologist’s hasty exit? Did she realize that this baby was fighting to stay alive and couldn’t deal with the fact? Or was she just in the routine of popping in during a medical termination, do the delivery and pop out again? Whatever her reasons, it just didn’t seem right to me…
We decided to keep Zach with us behind the curtain until he stopped moving – we knew it would terribly upset Annah. If we were so distressed I can’t even imagine what Annah would do! But after a while Annah was demanding to hold her baby and we couldn’t postpone the moment any longer. Lisa took the baby boy to his young mommy and I quickly grabbed my camera to snap a few photos. I managed to hide it from them, but I was shaking so much I could hardly take a photo. That baby moving underneath my fingers is something I will never ever forget for as long as I live.
Lisa gently handed the little boy over to his mom and I could see a thousand thoughts running through Annah’s head as she took him from his grandma. “He’s beautiful. He’s so tiny. Look at his perfect little nose. He is so, so beautiful,” Annah softly murmured. I could feel the pesky lump in my throat returning to torture me again and I swallowed very hard to keep my composure. Not long after that, Lisa took the baby from her daughter – obviously fearing that he was going to move again. Unfortunately it seemed that her worst nightmare was going to come true…
Annah insisted to hold him again and almost snatched Zach from her mother’s arms. The next moment she became deathly pale. “Mom, I’m sure I felt the baby move?” Annah looked at Lisa with questions in her eyes and had a horrified expression on her face. I looked at Lisa and saw that she was speechless, and before she could say anything that could upset Annah and possibly haunt her for the rest of her life; I gently took the baby from her and explained that it was only his little muscles still contracting after death and not because he is ‘alive’. She seemed satisfied with my explanation and stroked her baby’s head with her forefinger, without saying anything. I sighed an inaudible sigh of relief. Thank God for small mercies!
I then told Annah that it was time for me to photography her little boy. I took a few photos of especially his tiny little hands and feet at the bottom of the hospital bed on a white towel. It was when I gently took his miniature, perfectly formed foot in mine that I felt a tremor from his leg again. It was so upsetting I felt like vomiting and I could feel the blood drain from my face. Lisa saw something was wrong and distracted Annah by giving her a sip of water. I knew I just had to keep my composure and without blinking an eye, I kept on pressing the shutter without even focusing on what I was doing. When I was finished taking photos (I deliberately took quite a while to do this, hoping the baby will finally stop moving, which he did,) I wrapped the baby and gave him to his grandma. Lisa took little Zach from me and gently rocked him. It was heartbreaking to watch…
The nurse motioned me outside and when I closed the door behind me she asked me when I was going to go to the police station to have the affidavit completed. We have to complete an affidavit, basically stating that we are taking a placenta out of hospital – you just fail to mention that the baby is part of the parcel! I told her that the commissioner of oaths was actually coming to the hospital herself – there was no need for anyone to go to a police station. She looked unsure of herself and then she asked me where the ‘casket’ was. I told her it was in my car but if she wanted to see it I will go and fetch it. She indicated that this was indeed what she wanted so I quickly ran to my car to get it. Our caskets are beautiful little woven baskets that look like a Moses basket and not like a casket at all, so luckily I didn’t upset anyone with it.
My interaction with the nurse just made me realize again that the healthcare professionals in this country were ‘flying blind’ so to speak when it came to these situations. How on earth can one expect a nurse to know the laws and to handle the situation if a specialist doesn’t even have a clue? It also made me think of how terrible it must be for these nurses to put a perfectly formed little body in a red plastic bag labelled as ‘medical waste’. What does that do to one’s psyche? How you do you cope as a human being with ‘throwing away’ another human being? It must be so absolutely devastating and difficult for nursing personnel to deal with the situation! I had an epiphany right there and then: We weren’t only fighting the good fight for parents and for unborn babies. We were also fighting for this nurse who has to live with her own conscience and memories after disposing of a body like it’s an amputated limb or used needles that one need to get rid of! Interestingly enough both the doctor and the hospital flatly refused to issue a death certificate…
When I got back Annah was sleeping and the nurse had taken the baby to the cooling facilities in the meantime. Lisa’s eyes were red from crying but she was calm and asked me a few questions which I patiently answered. Luckily Sonja Smith (a funeral director and also the commissioner of oaths) showed up and we finalized the paperwork and chatted a bit about Zach’s funeral. Annah has woken up in the meantime and knew exactly what she wanted for the funeral – I was impressed with how composed she was. I had to fill out a report for the hospital stating that I take full responsibility for the ‘remains’, I will dispose of it lawfully and the necessary paperwork (affidavit) had been done. Whilst I was doing this, Sonja went with the nurse to fetch little Zach. The nurse asked the grandmother to stay with me. Sonja was shocked to see where they kept little Zach: A small little ‘box fridge’ standing next to a cleaning mop and bucket used to clean the hospital floors! No dignity at all. It was obvious why the nurse didn’t want Lisa to accompany her to fetch the baby!
After finalizing the paperwork, we put little Zach in a carry cot and after saying goodbye to Lisa and Annah, we left. Neither one of them wanted to see the baby again, they both confirmed that they had said their goodbyes and that they didn’t want to see him again. In these situations we are absolutely led by what our clients want and we respect and carry out their wishes as far as humanly possible. Little Zach was snugly tucked into a comfy carrycot, covered with his embroided towel-blanket. He looked so peaceful at last.
When we got to Sonja’s car, she carefully placed the carrycot on her car’s seat and fastened the seatbelt. Just before she closed the door I asked her to give me a moment to say goodbye. I gently touched Zach’s little forehead and whispered goodbye. This is always the toughest part of my job: Saying goodbye to a tiny little human being. I was thinking that those two rooms were going to haunt me for a long time – and I so wished that both rooms had the same outcome: A beautiful, lively little newborn baby boy. But we don’t always get what we wish for and that is precisely why I do what I do. Because the outcome can be so sad, someone needs to comfort the people going through this excruciating pain. Someone needs to answer questions, hold hands and utter soothing words to aching souls. Someone has to hide the fact that a medically terminated fetus was fighting to live from an already traumatized young mother. Someone just needs to be there…
I am honoured to say that that day, I was that someone.
*Not their real names
(Please note that the above is a true event that happened to me, Nicci Coertze, personally. Except for Annah and her mom, it is not someone else’s story to tell.)
This was my first official experience as Bereavement Doula and one that I will always keep very close to my heart. I wrote about this in 2015 but have been requested to post it as a Blog Post again, so here goes:
I walked into the room. He was in kidney bowl. Completely naked, not covered at all. I rushed to his side, blanket in hand and took him from his mommy. She didn’t protest. She just looked at me with big blue eyes, brimming with tears. I gently took his perfect little body and covered it in a soft baby blanket. When I gave him back to his mommy I could see that she was thankful beyond words. The little angel’s daddy whispered a hoarse ‘thank you’ and put his arm around his wife and child – as if to protect them from an invisible enemy.
And in a way he was. He was protecting them against a cruel Act in the South African Law books that stated that this perfectly formed, beautiful little boy was medical waste or ‘human tissue’ as they so delicately try to hide the ugly truth in their ridiculous forms. This because he was born before 26 weeks of gestation… Natalie looked at Seth helplessly when I started to talk about all the legalities. Seth immediately got up and I could see fire in his eyes. “If they give you any hassles I will sue them from here ‘till kingdom come Nicci!” he hissed with a face contorted with sadness. I assured him that everything was going to be ok, and inside I was praying very hard that this would be the case.
Natalie’s doctor signed a death certificate for little Daniel. This should exempt his parents from filling in endless forms and looking for a commissioner of oaths to certify the documents. However, the hospital as an entity insisted on the affidavit wherein it is stated that little Daniel is ‘human tissue’ and that his placenta is taken out of the hospital for religious reasons. Seth was livid about this and I tried to talk sense into him. At long last he calmed down and I spoke to the nurse in charge, begging her to allow Seth to take the forms to be certified without her being present, as this will be a huge obstacle to overcome – commissioners of oath aren’t kicked out behind every bush! At first the nurse was a bit stubborn, but when she saw that there was no way I was going to back off, she agreed. Seth went to do the paperwork and I stayed with Natalie, as per his instructions.
Natalie was vomiting in a bucket when I walked back in the room, little Daniel was lying in his blanket right next to her. I gently pulled her long blonde hair back and whispered soothing words to calm her down. We cleaned her up, and I put Daniel back in her arms again. She gently touched him all over his little body. His feet, his legs, his arm, his tiny little feet… I was eerily calm, but I also realized that I was in survival mode and that I had to be strong for this amazing couple.
I told Natalie that I was going to leave the room to allow her to have some alone time with Daniel. She didn’t take her eyes off of Daniel, and just nodded silently. After asking the nurses to please not go into the room, I went downstairs to the coffee shop and waited for Seth to return. He was back in no time, but I could see that he was still terribly upset. I took him aside and told him that he must please relax and that everything was going to be ok. He just said “Nicci, I want to grant my boy the dignity of being treated as a human being. That’s all I’m asking. He is not human tissue or medical waste! He is my son!” Seth was sobbing out the last sentence. I gently took him by his arm and reassured him that his son will get the dignity he so desperately wanted for him. We then went back to Natalie.
I slowly opened the door to Natalie’s room. She was just sitting there in bed, Daniel in her lap, staring blankly in front of her. I nudged Seth towards her, he gently picked up Daniel and I closed the curtains to give them some privacy. The paperwork was given to the matron and she was doing only heavens know what with it. I found out soon enough. The next moment the nurse in charge was in the room with a red plastic bag in her hands, looking around and asking me in a loud voice where the ‘fetus’ was. I told her that the BABY was still with his parents and that they wanted more time with him. Before she could say anything I pulled open the curtains and gently took the baby from Natalie. I told her that I would be right back. I asked Seth to tend to her, as she started vomiting again. They both just stared at me. Baby in hand, I helped the nurse out of the room – I could see she knew I was boiling inside.
Once we were alone just outside the ‘waste’ room, the nurse took Daniel from me. I tried to stay civil. It was hard, but I had to. I asked her what exactly she was planning to do with the red plastic bag in her hand. “I am going to tag the fetus, put it in the bag and send it to the Maternity ward” she said, looking quite surprised by the question. I hissed at her in an ominous voice, “Over my dead body will you put that child in that horrid bag. You will not put him in ANY bag! He will stay in that blanket, as God is my witness.” She looked at me in genuine surprise. “But it’s hospital policy, we always do it this way?” It was crystal clear that these people didn’t know what the heck they were doing and that they did not know the law at all. I was livid, but I stayed calm. I knew that if it was Seth that spoke to this nurse he would totally lose it. What was I to do?
What I did next came automatically, without me planning or thinking ahead. It was pure instinct. I pulled the nurse into the ‘waste’ room and closed the door. I talked in very slow sentences in a barely audible voice. “The documents that were supplied to you effectively make me the owner of that baby in your hands, do you agree?” She looked at me and nodded slowly. I said “We agree then. Wonderful. Now, listen to me very carefully because I am only going to say this once: This is MY baby, I am legally responsible for it and thus I will choose what can and cannot be done with it. Please go and fill out the thousands of forms that you still have to do and give me my baby back.” I was speaking and taking the baby from her at the same time. Her mouth literally hung open. She handed me the baby in a haze. She started speaking, but abruptly stopped, turned around and walked back to the nurse’s station, shaking her head.
I gently closed Daniel’s little head, and I walked back to Natalie’s room. Seth almost ran to me. “My boy! You brought my boy back. Oh thank you Nicci, thank you!” Seth was obviously in quite a state – he clearly thought the nurse was going to dispose of their baby. I carefully handed Daniel to him and walked to Natalie’s bedside. She was deathly pale and stared in front of her. I touched her arm and she grabbed my hand. We didn’t talk. I just stood there. Seth was cuddling Daniel in his arms, mumbling incoherent words to the small little body in his arms. He then turned back to Natalie and handed their son to her. She stared at him. Dry-eyed she was still white as a sheet. I motioned to Seth to take the baby from her, which he did. He turned around and stared out of the window with Daniel in his arms. Within seconds Natalie was vomiting in the bucket again. Her body was reacting to the utter shock she was in and I realized that it wasn’t going to get any better. I had to make a call. I cleared my throat and said with as much gentleness as I could, “Guys, I’m going to go downstairs to the coffee shop. Please say goodbye to your little angel? Seth, please call me when you are ready so that I can prepare baby to travel with me.” Nobody reacted to my words. Seth was still staring out of the window as I closed the door behind me…
After a while my phone rang and Seth told me that they were ready for me to fetch Daniel. I have watched countless programs on TV where the earie undertaker fetches a body from wherever. It had grossed me out, as it does a lot of people. And now I was that undertaker! It never dawned on me. I was looking at myself as being Seth and Natalie’s support system, not a cruel person that will grab the baby out of his parents’ arms and disappear into the night with him! I shook off the horrible thought and hastened to Natalie’s room.
I walked into the room and immediately prepared the pretty box I bought to put Daniel in to transport him to our facilities. It was already lined with a soft little blanket and I added the extra blanked and soft toy that Natalie gave to me. I then asked Seth to please fetch Daniel from Natalie. I could hear a little sob behind the curtains and the next moment Seth stood next to me with Daniel in his arms. He wouldn’t give me the little body. I then asked him to please put the baby inside his little nest. He said to me, “I want to carry out my boy please?” I had never been in this situation before and therefore I had to go with my gut again: “You’re welcome to do so Seth. We just need to close the box until we get to my car ok? We don’t want to shock anyone.” Seth was upset again. “Are you going to take him to your facilities closed up in a box? No, that’s just not right Nicci!” I gently explained to him that as soon as we get to my car, Daniel would be placed in a beautiful woven little coffin and will travel right next to me. (Thank heavens I happened to have one in my car!) That seemed to calm him down. I couldn’t look at Natalie when I walked out. She shouted after me, “Good bye my boy, good bye. I love you! I will come to see you again, I promise!” It was absolutely heartbreaking. Seth carried his baby with what I can only call pride, walking next to me with his head held high – almost daring anyone to say something. The nursing personnel did not say one word. All five of them stood still and watched silently as we walked by. I was relieved beyond words.
Outside, the hospital was basked in the last glorious sunlight of the day, tainted a pretty pink. The contrast between the beauty of the sunset and Seth’s almost palpable pain were stark. When we got to the car it looked like he was going to have a total breakdown. I was terribly worried about him. I took the box from him, got into my car, lifted the lid and carefully eased the tiny little body into the casket. Daniel was still covered with a lovely blanket. I took another blanket that Natalie gave me and put it on him. I then got out and told Seth that he can say a final goodbye inside the car, but then I had to go. He asked me if he could put the lid on the casket. I agreed. Seth got into my car and put a bunny soft toy in the casket with Daniel. He then gently closed the lid, tears on his face. I gave him a hug and whispered “I am so sorry you have to go through this. Please hang in there.” He just nodded and then he walked off – by now it was almost dark.
I fastened the little woven basket in the front seat and left for the office. My work was done. I made a difference. I made someone’s excruciating pain a tiny bit better. I was there. I was Nicci. I was a witness to Daniel’s existence and his parents’ love for him.I was a witness to beautiful pain…
(This is a true story of my, Nicci Coertz personal experience as Bereavement Doula, written in 2015)