I have come to really loathe postpartum nursing. It’s boring. It doesn’t provide the excitement labor and delivery can bring. It’s full of sore, cracked, bleeding nipples, jaundice babies, and wacky visitors. I have become sick of listening to myself say the same things over and over with the endless teaching nurses do in postpartum.
And then came Melissa. I cared for Melissa the day she was in labor. She was highly anxious and had no pain tolerance. Everything she felt was accompanied by dramatic outbursts. The smear of bloody show that landed in the toilet resulted in a panic attack over hemorrhaging. Despite wanting to say, “Get a grip!” I managed to actually bond with Melissa. I liked her. And her husband knew just how to handle her. Anytime her anxiety began to escalate, he would start cracking little jokes to break her concentration on whatever the “problem” was at the moment. My shift was over before she delivered.
Today I was assigned to work on postpartum, and Melissa was on my assignment. One thing I do like is that continuity and I’ve noticed that the patients I have cared for during labor seem to respond well to me on postpartum. I’m a familiar face they have come to trust.
Everything was going well for Melissa and her new son. The baby was breastfeeding like a champion, Melissa was doing spectacularly with little pain, and she and her husband both got 2 four hour stretches of sleep the night before. And she was calm as could be. I was able to see she had a sarcastic sense of humor like me (for those who don’t get sarcasm, our conversations would have sounded like arguments). They were scheduled to go home today, and she and her husband were hoping to get out as soon as they could.
After all the discharge paperwork and all the other hospital hoopla that has to occur for a mother and baby to step off hospital grounds, Melissa’s husband went to get the car seat so they could leave. I could sense something was not quite right, something that I couldn’t put a finger on.
And then it hit me.
Melissa was scared to go home with her new baby. This wasn’t your typical new mother anxiety. The thing was, Melissa had given birth to a baby girl 3 years prior. This little girl was healthy and normal, but died after an apneic (stopped breathing) spell while nursing when she was 3 weeks old. There was no known cause for this baby’s sudden death.
Melissa had felt safe in the hospital while she breastfed her new son. She felt that there were skillful eyes all around her, just in case. But there wouldn’t be a nurse or pediatrician at her side when she went home.
As I stood for a brief second thinking about this, Melissa’s eyes began to water. I looked at her, urging her without words to say how she felt. She didn’t. Instead she asked, “Could you stay in the room with me while we wait for the car seat?”
“Yes,” I answered. After a few more minutes, I said, “You’re scared to take him home, huh?”
Down came the tears. We sat across from each other while she cried. At some point I said I’d be scared too. How could a mother not be scared given the loss of her first baby? I told her that there was likely nothing that was going to make that feeling go away, but she could always remember the multiple ultrasounds and non-stress tests she had during this pregnancy that were all normal. I told her that her pediatrician wanted her to come in frequently for well baby check ups, not because they suspected her son would also die, but to help her feel reassured. Melissa nodded, saying she knew that her son was ok. She knew rationally that it was a random tragedy that her daughter died.
Her husband arrived with the car seat. She let him place the baby in it. She busied herself with last minute bags. She took a deep breath as she crossed the threshold of the door. When she saw that it was a beautiful day outside, she said, “It rained when we took Ashley home.” Then she smiled.
We hugged and said good bye. I was glad I was on postpartum today.