Sharing our daughter’s autopsy results after stillbirth

We received Blair's autopsy results in early September. It's been almost three months since receiving the report. I still don't feel like sharing publicly but I feel that I have to duty to do so. I recognize that the decision is a personal one and I don't "owe" this story to anyone; however, with so much silence and shame on this topic, I also feel that I have a duty to do my part in breaking the social stigmas surrounding stillbirth. I share Blair's autopsy results boldly, with so much love for my daughter and for other families who have suffered this unfathomable loss. 

The autopsy "answer": Some anomalies in Blair's brain and kidneys suggests that an infectious process may have led to her fetal death. No pathogen could be identified as the cause of this infectious process. Unfortunately, there is no clear-cut reason why Blair died. On a quick and fast read, the autopsy results seems to link infection as the cause of fetal death. With no pathogen identified, however, an infection cannot be confirmed. To confuse things further, multiple ob/gyn professionals have noted that a placenta is usually implicated in an intra-uterine infection. My placenta for Blair was fully intact and without abnormalities. So, we've got nothing. To quote a friend who checked in with me after hearing the news: "How are you managing now that you have both some answers, and more ambiguity?"

Well, it's hard. It continues to be hard. It is hard because with no real answer, it is easy for feelings of guilt to creep in. I theorize various scenarios that might have led to her death. When there is a great deal of silence among people you interact with on a regular basis, I wonder if family and friends and neighbors and others are commenting about it and what judgments are happening (if any). I feel ultra sensitive and defensive on any questioning about what I might do differently in a new pregnancy, as - to me - it feels as if that implies that I did something "wrong" in Blair's pregnancy.  It is hard to get out of the darkness of Blair's ambiguous cause of death but by the grace of God and speaking my concerns to medical professionals, it helps to ease the pain and guilt. The important thing that I have learned is to not allow dark thoughts to fester, to say as often as I need to: While my child died inside of me, I did not cause my child to die. Blair was and will always be deeply cared for, deeply loved, and deeply missed. 

My memories in the days leading up to Blair's death were sheer joy. I don't say this lightly or in a way to make it seem like motherhood was always joyful or would always be joyful if Blair had been born healthy and alive. On the contrary, I struggled deeply throughout the first and second trimesters of Blair's pregnancy. I was nervous for how I would be able to handle three children under two. I mourned the relationship with my first two children that would soon be changing as a newborn arrived. After a tumultuous emotional journey throughout most of Blair's pregnancy, however, I had finally arrived at a place of excitement. Blair had been meeting all of her growth checks with flying colors. At 32 weeks, she was measuring at 4 lbs and 2 oz. Her biophysical markers were 8 out of 8 just one week prior to her death. During this time, I was filling Blair's registry with all the yellow things to bring her home in and decorate her nursery with. I picked up a single stroller from another mom and had her bassinet and crib ready to go. I was day-dreaming about having three daughters and looking forward to fixing their hair and putting them in cute dresses and bows. What I hate to remember that in those joyful days, our third daughter was dying. She must have slowing down and with life moving fast with twin toddlers, I never realized it until it was too late. 

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Edited to add: The more I think about my inability to recognize that Blair was dying, I realize that it was more complicated than just having a busy life with busy toddlers. There were three factors: .

1) Braxton Hicks contractions: My uterus was literally expanding and contracting at all time - it’s normal (especially in the third trimester) to experience this and never caused cervical changes. With my belly moving so much, it gave me a false security that my uterine movements included baby movements. It wasn’t until I was sitting in the hospital room waiting to be induced - still having contractions with a dead baby inside - realized how much of a mind game it was. The uterine movements felt to me like Blair was still alive in there. In hindsight, I’ve realized contractions do NOT equate healthy fetal movements.

2) The coronavirus pandemic: A part from attending the required prenatal visits and growth checks, I did not want to make any 'special’ trips to a hospital or medical office unless absolutely necessary. Although I didn’t have a clue that something was fatally wrong with Blair, I also didn’t consider that there might be situations that would warrant a trip to labor and delivery. There was. With eight months into this pandemic now, studies are showing an alarmingly high rate of stillbirths around the world since the pandemic began.

3) Feeling invincible post-twin pregnancy: When I was still pregnant with Blair and people would ask me how I was feeling, my answer was always how freeing it felt to not be in a high risk twin pregnancy anymore. I feel like I let my guard down, thinking that nothing could possibly go wrong in a singleton pregnancy. “If I birthed two healthy, full-term identical twin girls at one time, birthing just one baby would be a breeze”, I thought.

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In the first moments after Blair died when she was still in the womb, I prayed desperately that the answer for her death could be "easy". That a true knot in her umbilical cord would be found or some other physical trauma that could be immediately identified upon her birth. To be clear, a child dying is never easy, but I do believe it would have been an easier journey to peace and closure for me had there been a definite answer as to why she died or a reason that was so random there couldn't have possibly been a way to save her. I have had to come to terms with the fact that we may never know the reason and that we are unfortunately among the two-thirds of all stillbirths that remain unexplained.

My journey to peace in Blair's death is a winding road. I'll leave with Audrey Assad's beautiful rendition of the hymn "It Is Well With My Soul", that I have listened to on repeat while processing my guilt in Blair's death.

When peace like a river, attendeth my way,
When sorrows like sea billows roll
Whatever my lot, thou hast taught me to say
It is well, it is well, with my soul

As I personally repeat this as often as I need to, I will also repeat this one more time on this post: Blair was and will always be deeply cared for, deeply loved, and deeply missed.