Seven and a half years ago, I got a phone call that would changed the course of my grieving. This phone call came about 3 weeks after Kenna had died. The pathology from my placenta study had come back and while they could not definitively provide an answer as to how she died, they had some clues as to why. Even after only three weeks living in the world of baby loss mamas, I knew how rare it was to have even just clues.
I remember being almost giddy when I got off the phone.
The reason I was so excited is that when you have clues to the big why? question, you have things you can watch for in the future. In Kenna's case, it was discovered that she had an anomaly in the formation of her umbilical cord. Depending on which cross section they looked at, it could appear to have 2 vessels, or it could appear to have 3. Ultimately they determined that the 2 umbilical arteries were asymmetrical, possibly affecting the blood flow between the two of us. She also had a blot clot in one of the arteries, but they could not definitively determine if that clot occurred before or after she had passed.
They said it was probably a fluke, but for all of my pregnancies since Kenna (including Siena) I have still had careful monitoring of cord blood flow. They watch closely for any sign that the flow is impeded, indicating that baby may need to be born early. After three healthy pregnancies (Kylee, Logan, & Lucie) I was almost even convinced that it really was just a random one-time thing.
Almost as soon as we found out that Siena was a girl and that she was likely to die soon after birth, however, I started questioning if there could be any relationship between what happened to Kenna and what happened to Siena. They assured me there wasn't any connection. My ultrasounds had all shown 3 vessels in the umbilical cord. It had been pointed out to me by the techs and it was noted in my charts as well. It was kind of one thing we DID know from ultrasounds.
They still checked the flow with every ultrasound, but there was never any cause for concern.
During the awful, awful MRI only 2 vessels were noted, but there was some confusion due to the lack of fluid and the official report deferred to the ultrasound finding of 3 vessels. Even then I noted that it was an interesting finding.
But moving forward it all seemed irrelevant.
Then at birth we saw the small placenta. I said to myself, placenta....cord....cord...placenta. Is there a a connection?
They said no.
I have had four girls and two are in the ground. Should we be looking at something genetic or something else wrong with me?
They said no.
I moved on.
Until today I got the report from my placenta pathology that says she only had a 2 vessel cord on the placenta end they studied. We know, however, she had three in her belly button because they attempted to place umbilical IV's. That being said, they weren't able to place the arterial line and weren't sure why. The neonatologists couldn't figure out why, but now I have to wonder if she had the same sort of asymmetrical anomaly that Kenna had. (You can see from the picture at the top of this post, most of Siena's cord was left on her end presumably to facilitate the placement of the umbilical lines which means they didn't have as much to study as they did with Kenna.)
And if she did, what does that mean for us moving forward?
Other than making my brain feel like it is going to explode.
I've been putting off writing the Answers Part 2 post (you can read Answers Part 1, here) because we are waiting on hormonal work ups for me that would have explained other things, but it wouldn't have explained this. Less than a week ago I sat with my OB and discussed the lab work and how it could be a bit of a missing puzzle piece that pulled a bunch of stuff together. The best part of all of it is that if the suspected problem turns out to BE a problem, it's fixable. In fact, after 2 very short cycles in the first 7 weeks postpartum (23 and 21 days!), the cycle I am supposed to have this lab work done I am sitting on cycle day 13 with not one sign of impending ovulation at all (and I've been ovulating on or around cycle day 10 since before Lucie was conceived).
Instead of finding answers, it appears for the time being all I am finding are more questions.
Have I said, GAH! yet this post?
I'm trying to breathe. I'm trying to let this be information for the doctors and pathologists to make sense of. I'm trying to keep taking steps forward even when I'm getting frustrated with the speed at which they are occurring. Medically and maritally speaking I feel like I have to make long term decisions with some major implications based on incomplete information, when I can't even decide what to make for dinner most nights!
More being gentle with myself and honest with others (which is sometimes the hardest part).
More frustration, knowing the cord that was supposed to bind me to my daughter was incomplete.
Not once, but twice.
Just when I think I'm getting close to full surrender and acceptance.