by Heather Carnaghan
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By Heather Carnaghan
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Dear New Mama,

We were pregnant together, waddling around the same hallways at school and laughing about what bold little girls we would raise.  We imagined maternity leave playdates and shared daycare possibilities when the time came that we would have to return to our classrooms.   We just knew that they would skip off to kindergarten together some day and we’d have the unique journey of experiencing our daughters as both their mothers and their teachers.   They were supposed to be friends.  How could we know that my daughter would never meet yours?  

When I learned that you were going into labor, I texted my support.  I wrote, “Thinking of you today.  Can’t wait to meet your sweetheart!” I assured you that you were almost there and that your perfect girl would be wiggling in your arms before you knew it.   I didn’t tell you that I was worried for you or that I stayed up all night terrified that my fate would be yours too.    I told you that I love you, and I meant it because I wear my bare heart on my sleeve now in a way that I never did before.   

When you texted me that gorgeous baby picture, a flood of feelings knocked the wind out of me.  I was relieved that your baby was safe and that babies could, indeed, still be safe.  I was filled with love for this perfect little creature that you just brought into the world.  I grinned from ear to ear.  You, my sweet friend, just became a mommy for the first time, and I know that you are going to be so very good at it!  

My heart was brimming with excitement for you, but it broke a little for me too.  I couldn’t help but think that every second of this baby’s life was one that Charlotte would never have.  That first breath, the first cry, the first drink of milk.   In one picture, she is resting on your bare shoulder.  I could imagine the warmth of her against your skin and how wonderful that must feel.  Charlotte only had my warmth, and like every piece of her, it was gone so quickly.   I know that you will cherish every minute with your baby, because I know that, sometimes, you will still think of mine.  

I refuse to let my tragedy to keep me from celebrating your miracle.  I want to hold your daughter and smell that little head of hair.  I want to hear her sweet coos and wonder about who she will become.   I want to celebrate when she rolls over, or makes a funny face when she first tastes peas.  I was so happy when you said that you couldn’t wait for me to meet her, because, secretly, I was scared that you wouldn’t want me to.  We both know that I will cry, and not in the joyful, “new baby, happy tears” way, but rather the “tsunami of grief meets the mountain of joy”, confused kind of way.  I don’t want to be that mom who is always consumed by emotion, but the truth of the matter is that I am still very much consumed.  I’ve gotten better at masking it.   It has been two months since my baby was stillborn and every moment still hosts a conflicting dichotomy of feelings.  I feel joy and sorrow at the same time and I never know what trigger might tip the scale in one direction or the other.  

Thank you for texting me when you didn’t have to.  I know my story is the last one that you want to think about as you face childbirth.  Thank you for sharing her picture and knowing that it would hurt a little, but mean a lot.  Thank you for letting me be a part of your daughter’s life, just like I might have been before.  Our first meeting may be teary, but you will both always know nothing but love from me.  ​

by Heather Carnaghan
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I looked around, confused.  It was dark; I needed to turn on a light, but where was the switch?  I was standing in the dining room of my own house, a house that I have lived in for six years now.  I have high-fived that temperamental dimmer switch a thousand times before, but today I forgot where it was.  It occured to me that I might be losing my mind.  

 Grief doesn’t just take our emotions hostage, it also wreaks havoc on us physically.  On October 21, 2017, I experienced the most traumatic event of my life.  I say “in my life” because I sincerely hope that nothing can trump it.  I was 38 weeks pregnant (that’s 8.5 months for those of you who only tie your own shoes before leaving the house each morning).  My baby had been training in utero to become a parkour champion...until she just stopped.  My baby’s little heart stopped beating.  She was gone and I couldn’t imagine how my own heart could continue pumping so rapidly and not explode messily out of my chest.  It didn't end there.  You see, stillbirth isn’t one trauma.  It’s a series of them.  They come one after the other before you’re ready for them like balls hurtling from a pitching machine.  Only you have no bat.  No helmet to protect yourself.  Labor. BAM.  The silence. BAM. Telling my five and three year olds that their sister had died.  BAM.  Her due date arrived two weeks after I lost her.  I felt utterly numb.  I was broken and couldn’t form complete sentences that day.  

“Researchers completed an intriguing study that illustrates just how profound and widespread the effect of negative personal events can be and how your brain reacts to grief. Three finance professors from major business schools tracked the performance of 75,000 Danish companies in the 2 years before and after the CEO had experienced a family death. Financial performance declined 20% after the loss of a child, 15% after the death of a spouse, and almost 10% after the demise of any other family member.” -Dr. Thomas Crook
               
Even though I felt lethargic and foggy, my brain was in overdrive.   My amygdala, the part of my brain that is always on the lookout for pain, catalogues every instance of hurt so I won’t pick a fight with a tiger.  When it detects imminent danger, it releases a chemical called cortisol.  Cortisol elevates your heart rate so blood will race to all the muscles needed to protect yourself or run away from the source of alarm.  The problem is, the amygdala doesn’t distinguish between physical and emotional threats of pain.  When my doctor said that Charlotte’s heart had stopped, my amygdala logged this trauma and started firing like a trigger happy bodyguard.  It fired every time I passed her empty crib or opened a sympathy card or saw a pregnant belly brimming with life.   "TIGER, TIGER, TIGER!"  Cortisol levels may exceed ten to twenty percent more than is typical during prolonged periods of stress.  With cortisol constantly pumping blood to my fight or flight zones, there was little left for systems that weren't essential in defending myself against a giant cat attack.  Digestion, concentration, memory.  Arielle Schwartz, developer of Resilience-Informed Therapy & author of The Complex PTSD Workbook, says that “when stress cortisols are at their highest it is common to feel numb, cut-off, and disconnected.”   Sound familiar?  

I eventually found the dimmer switch and I know I will eventually find the strength to carry the loss of my daughter.  It’s starts with telling her story.  With each telling, I retrain my amygdala, reminding it that Charlotte is no tiger.  My brain is resilient. 
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"Cultivating resilience is unrelated to the clichéd notion of time healing all wounds; overcoming is not the end goal. Instead of moving on, it's about living with what has happened. A resilient person is emotionally and psychologically flexible enough to allow the effects of a traumatic episode into her life, to "receive the shattering," and use those effects for healing. This means accepting the feelings of despair, but also remaining open to the possibility of love and connection." -Emily Rapp Black
 
​ Each time I remember her hiccups and how they felt in the base of my belly or recall the joy I felt when the doctor said that she was a girl, I replace a little bit of the fight or flight cortisol with a gentler, happier chemical called serotonin.  I rewire my grief brain by reminding myself to look for the good, and there is so much good that is left.  I only wish that Charlotte was here to witness it with me.  

by Heather Carnaghan
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When my daughter was stillborn, friends and family reached out in countless thoughtful ways to show that they cared.  They brought meals to fill our bellies, sent cards to offer condolences, and gifted trinkets to help us remember Charlotte.   The overwhelming majority of those well-wishers suggested that she would "be in our hearts forever".   This metaphor is truly a beautiful one: I will hold my child in my heart by honoring her existence and she will live on as I revisit those few, but meaningful memories of her.  What they likely didn't realize, is that their kind sentiment actually has some pretty legitimate scientific backing.  

          Charlotte's stillbirth was a particularly rare one in which, after a battery of tests and review of all available medical files, there just wasn't an answer regarding the cause of her death.   I decided to read everything I could in the hopes of understanding those tests and identifying even a glimmer of an answer.   Most pre-labor stillbirths are caused by placental or cord issues, so this seemed like an important place to begin.   

The placenta is an organ that is shared by mother and baby during the pregnancy. (Science nerd moment: Can you believe our bodies construct a whole new organ for each of our children?  Talk about the ultimate birthday gift!)    We typically think of the placenta and umbilical cord as providing nutrients to the baby, but it does so much more.  It actually allows cells to pass between the mother and her child.   In a study at Leiden University Medical Center, pathologists found cells with Y chromosomes in autopsies done on women who died during or shortly after pregnancy.  Why is this interesting?  Cells with Y chromosomes are male cells and should not exist in a female body.  Each of the 26 women had been carrying sons.  Scientists believe that this is evidence of fetal microchimerism, or the passage of fetal cells to the mother's body.  (History nerd moment: "microchimerism" is named after the chimera, an odd creature in Greek mythology with three heads, one of a goat, one of a lion, and one of a dragon.)  The finding that was most surprising to me in this study was where the cells were found.  

          The pathologists found these rogue little baby boy cells in every organ that they tested.   The cells had developed into functioning tissue in each of the organs.  Fetal cells in the brain developed into brain tissue, fetal cells in the kidneys became kidney tissue, and fetal cells in the heart became heart tissue.  The cells of these baby boys were, literally,  a part of their mothers' beating hearts.  Even more amazing yet: these cells have been found to be quick to spread and extremely long lasting.  They have been detected as early as seven weeks into a pregnancy and may last a lifetime.   One study found definitive evidence of fetal cells in a mother who had given birth to her son 27 years prior!  
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            Dr. Nelson and her colleagues at the Fred Hutchinson Cancer Research Center believe that fetal microchimerism is "very common, if not universal" as they found these cells in 63% of subjects in a 2012 study.  The scientists theorize that the baby may be able to manipulate the mother to some degree in order to help them thrive (for example, sending messages to produce more milk, keep them warmer, or provide more resources for their growth).  

          So the next time you suggest to a grieving mother that her beloved little one will be in her heart forever, say it like you mean it.  Then tell her that he'll be in her lungs, kidneys, and brain too.  Science has your back.  ​