SPECIAL DELIVERY

Being present at the birth of a child with a disability is a sad time for midwife Caroline Brophy, Midwife

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Through nearly a decade of assisting mothers through the joyous time of delivering their infants, there are times when that joy is tinged with sadness. One of these times is being present at the delivery of an infant who is born with an unsuspecting congenital malformation such as Down Syndrome. Usually the situation occurs following a normal pregnancy and an uneventful labour, all indicating that there would be nothing unexpected about the outcome. As labour comes to an end there is anticipated excitement as the parents look forward to the birth of their new baby.

I will now share with the reader a midwife’s privileged experience of being with parents during the initial time following the birth of their infant who has Down Syndrome, a genetic disorder of uncertain causes, resulting in alterations in physical and mental development.

It was the usual busy labour ward in a busy maternity hospital in the early hours of the morning. The unit was humming to the cries of newborn babies. About 3 in the morning, Kate and her husband John arrived into the labour ward. They were expecting their second child, having a baby girl, Anna, at home. The contractions were coming fast and furious, and Kate was coping well.

I introduced myself to Kate and John, escorting them into one of the rooms in the labour ward, where it was established that Kate was well advanced in labour. The birth of their baby was anticipated to be within the hour. Throughout labour the baby’s heartbeat was satisfactory indicating that the infant was dealing fine with labour. Kate used gas and air to help her, along with the support of her husband and midwife, through labour.

Finally the moment arrived for Kate to give birth. In the peaceful warm labour room Kate gave birth to a baby boy. Following the birth of the infant’s head, I was conscious of how the baby looked. Alarm bells within me suggested that this baby looked like it had Down Syndrome. I was not sure. Finishing the delivery, the infant was delivered onto Kate’s tummy—a beautiful, healthy, screaming baby boy. At least the hard work and anticipated excitement of pregnancy and labour was over, replaced by the delightful sounds of new life.

After a short period of time, I dried the infant, weighted him, and wrapped him in soft, warm blankets. My suspicion increased that their newborn son had Down Syndrome. I observed Kate and John’s reaction. They were thrilled. There was no sense that they were worried about their son. On questioning, they said their son looked exactly like their daughter, Anna, at birth. I reserved judgement, conscious of how devastating my suspicions would be, until I obtained a second opinion.

Within half an hour of the birth, the paediatrician came to the labour ward to review the baby. Beside the mother’s bed, the doctor examined the baby. He confirmed my own thoughts. Gently, we informed Kate and John of our suspicions that their newborn son showed characteristics of Down Syndrome.

Being present at a birth such as Kate and John’s baby is a sad time for a midwife. Initially when a midwife feels that a baby shows signs of Down Syndrome, she questions herself in order to confirm her suspicions. Once she is sure, she wonders if the parents see as she does. She is then anxious about breaking the news to the new parents.

My initial feelings are to protect the parents. I don’t know exactly how they feel, but I imagine a sense of sadness—that all their dreams for the future have been put on hold. Maybe I feel this because I believe that we live in, at times, a hard world that can be very cruel to people who are not seen as ‘normal’. I am always anxious about breaking news to parents, part of me wants to protect them from the news that I am about to break, part of me is unsure how they will react. However I realise it is important for them to hear this news from someone they trust, and are familiar with, a person who has shared the joyous birth of this special baby.

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