Mirari’s Birth Story

What do you do when God answers your prayers but not in the way you expected? Or when he answers some prayers and not others? What do you do when it feels like you were brought to the very edge of the cliff of your fears before being pulled back? Yes, you didn’t fall off that cliff, your prayers were answered, but why did you have to be pushed to that edge first where all hope felt abandoned and lost? Where it felt like God had utterly forsaken you? Over the last few weeks, I’ve been wrestling and processing many of these mixed emotions and questions from Mirari’s birth, and while day by day, I’m able to see and focus more on God’s goodness and faithfulness in the midst of his birth, I don’t think I’ll ever have the answers to the desperate ‘whys’ that are always in the back of my mind.  And that’s okay.

One of my favorite stories from Dallas Willard’s life was the following from near the end of his life:

On April 11 surgery was performed, and it revealed the tragic news that [Dallas Willard’s] cancer had spread.
Was there ever any dark moments of doubt? Any feelings of being abandoned by God? Jane [his wife] remembers only one, and it passed quickly.
“One day at the supper table, after the report had come in from the final surgery and we knew that the cancer had spread and, without a miracle, it would prove fatal, I looked at Dallas and said, ‘I just don’t have any theology for this.’ And he said,’I don’t either.'”

Becoming Dallas Willard

I’ve gone back to that story many times because I so relate and resonate with it. So much of life’s complexities, injustices, tragedies, and suffering, there is no theology for. And when I reflect on Mirari’s birth story, it is the same – I don’t have neat theological answers to comfort myself with, because what theology can there be to explain away the dark moment of feeling utterly abandoned and forsaken by God? Or what theology is there to soften the depths of grief? But what I do have as an assurance and comfort is that being abandoned and forsaken is not a foreign concept to God himself, having deep sorrow or pain is not a foreign concept to God, so while there is no theology for it (and even if there were, there would be no comfort in it), I know I can place the pain of feeling abandoned within Christ’s own pain of being forsaken on the cross.  I know that even in the midst of feeling abandoned and forsaken, I can trust that God was still there because even in Christ’s abandonment on the cross, God was still working.  

Some context is needed first to understand all that went on with our labor and delivery. In addition to praying for a smooth and quick delivery (neither of which happened), we really prayed for and hoped for the following:
1. to go into natural labor
2. to not have an epidural
3. to not have a cesarean birth
4. to meet Mirari alive

Natural labor – we really hoped that I would go into natural labor as induction can often bring on more intense contractions more quickly, which can negatively affect the baby during labor.  Natural labor is typically a more gradual and less intense process. Since labor is already very hard on trisomy 18 babies, we preferred not to throw the potential risks of induction into the mix.  However, a further consideration we had to make was that there is a risk of trisomy 18 babies passing away in the womb at any point and since Mirari was full term already, we had many stressful weeks of weighing the pros and cons of waiting for my body to go into natural labor (and Mirari potentially passing away in the womb) vs. inducing labor when we knew Mirari was still alive and doing well because we were trying to optimize for meeting him alive. We ultimately were induced though as we saw some potentially negative changes in the flow of blood/oxygen in Mirari’s umbilical cord.

No epidural – the pushing stage of birth is often the most difficult on babies and especially for trisomy 18 babies. We had read many stories of trisomy 18 babies who passed away shortly before delivery.  So our goal was to keep the pushing phase as short as possible, and since research has shown that epidurals can lengthen the pushing phase, especially in first time moms, our goal was to not take the epidural if possible. This goal was also another reason we had really hoped for natural labor, as inductions lead to higher rates of epidurals because 1. inductions can be more intense and painful and 2. inductions can be multi-day processes and sometimes, you just need some sleep to get through the rest of labor/delivery and one of the more efficient ways to do that through painful contractions is to get an epidural.

No cesarean birth – A cesarean birth is a major surgery so not only would recovery be much harder, it also increases the risk and complexities of your future pregnancies and births.  However, a cesarean would give us the best chance of meeting Mirari alive, but given the other heart and lung issues he had because of trisomy 18, it would still be very unlikely for him to be in a good enough state for us to take him home and depending on how much time Mirari had with us, me recovering from a big surgery may not be ideal for spending quality time with him. So after a lot of prayer and discussion, Vinayak and I decided to leave the outcome of labor on Mirari in God’s hands; we decided on neither elective nor emergency cesarean birth unless there was a clear harm to me. It was a difficult decision, and while I’ll always have unanswered ‘what if’s, I am grateful that Mirari did meet us alive. While we knew that doctors would do all they could to make sure we didn’t end up with a cesarean, we still knew there was a chance that could happen, and so while we had to stay open to the fact that this could always happen in any birth, we very much prayed it wouldn’t happen as the worst outcome would be if I required a cesarean and we were not able to meet Mirari alive because if that were the case, we could have done an elective cesarean, saved ourselves from the pain of labor, and guaranteed ourselves with meeting Mirari alive.

Meet Mirari alive – this doesn’t need much of an explanation. At the end of the day, if 1, 2, and 3 were not able to be met, but we could meet him alive, that was the most valuable one for us because 1 & 2 were always to optimize for meeting Mirari alive and 3 was to optimize for my body’s well-being.

There were many adjustments we had to make even in preparing for our labor and delivery because coronavirus concerns quickly escalated and by late-March and early-April, many of our pre-arranged plans had gone out the window as hospitals implemented new protocols.  I reflect on how the coronavirus pandemic introduced new “losses” in our pregnancy journey, but also revealed hidden blessings along the way in another post.

Our labor and delivery was long and was quite the emotional journey. Our induction began around 3 PM on May 4th with a Cook balloon, which is essentially a hard plastic water balloon put within your cervix for 12 hours to mechanically dilate it. We checked into the hospital on our second anniversary, May 5, around noon to continue the induction process and Mirari was born May 7 at 2:49 PM. The final 12 hours before Mirari was born were the height of our emotional roller coaster, but the first two days set the stage for our emotional and mental state.

First two days:
The first few days (and really the weeks leading up to our induction) we felt like we were literally clinging to hope and God. There were so many unknowns and fears going into the induction – we worried how it’d affect Mirari, we worried whether we were making the right decision or if we should wait for natural labor, we worried about the possibility of my body not progressing or responding well to medical interventions. We prayed so hard each step of the way. We prayed so hard for natural labor and yet my body did not progress and Mirari’s umbilical cord stats changed unfavorably. We prayed that our first try at induction, which actually occurred a week before on April 30, would be quick and uncomplicated through the medicine route, and yet we ended up going home when we realized the only option for our induction was the mechanical route of a Cook balloon due to me having too many painless contractions already. We prayed that my body would naturally progress after we went home – it didn’t progress at all over the next three days. We prayed that the first Cook balloon of our second induction would work and dilate me to 2-3 cm – it only dilated me to 1cm. Because I had so much fluid and Mirari was so small, he was floating so high up that breaking the amniotic sac had the risks of me hemorrhaging from the placenta coming out first or him passing away from his umbilical cord coming out first. So we prayed pitocin would work at dilating me more and that Mirari would move lower into the cervix before we broke the amniotic sac – neither happened.

Some prayers were answered though – the second Cook balloon dilated me to 5 cm but only after an initial scare at the 7 hour mark where I was still only 2 cm dilated, and breaking the amniotic sac didn’t put me or Mirari in danger. But the continual back and forth of being given hope (our doctor had been confident the first Cook balloon would work, our nurse was confident based on her experiences that the second Cook balloon would work substantially before the 12 hour mark) only to be disappointed and put through more stress, worry, and difficult decisions started to take a toll those first few days. It felt like I had to keep picking myself up from the ‘no’s and disappointments we were getting to our prayers to cling still to God and to cling still to our belief that God was still with us and providing for us.

The last 12 hours:
With my water broken and with me being on pitocin, all that was left was to hope that I’d continue dilating and Mirari would be born soon, otherwise a cesarean was the only remaining option. 12 hours after breaking the amniotic sac (on May 7, around 2:30 AM), our nurse decided to check on my progress and, with much surprise, told us that I was already at 9.5 cm and Mirari had finally moved down my cervix! The surprise and the excitement of the situation left me shaking uncontrollably with adrenaline. Vinayak and I were so excited to be finally meeting Mirari soon and we were so thankful that something finally was going well in our labor, and what’s more, the team on call that night was a team we really liked and felt a rapport with – my obgyn happened to be on shift and the neonatologist on call had been so compassionate and empathetic to our situation that we had no doubt Mirari would be under great care with him. It felt like all the right pieces were in place for us to meet Mirari.

Our doctor came in at 3 AM to do a final cervix check to see where I was at. She checked and said that I was actually only dilated to 6 cm but Mirari had indeed moved down lower. My heart sank – 6 cm? Our nurse had mistakenly thought that there was no cervix left around Mirari’s head anymore, but it was actually higher up behind his head because he had now moved lower.  If we had been correctly told that we had progressed 1 cm in 12 hours, we would have thought ‘well at least we’re progressing!’. But to have to adjust your mindset and emotions from the relief, joy, and adrenaline of ‘we’re just about done!’ to ‘oh, we’re just at the start of active labor and we haven’t even gotten to the hard part yet (8-10 cm)’ – it was a big disappointment and it was an unnecessary one because it was due to a mistake, but it added nonetheless to the other disappointments I’d been feeling already over the last few days.  

Our doctor did her best to encourage us in that we were at least seeing progression and said that from here on out, I could expect to progress much faster. I didn’t get much sleep that night because the nurse kept coming in to increase the pitocin and my contractions kept increasing in intensity. I finally gave up trying to sleep around 7 in the morning and got up instead to manage the labor pains with Vinayak and was also introduced to our new nurse for the day. The contractions were unbearably painful at this point – I bit Vinayak in my pain at one point and was swearing and moaning through all my contractions, surprising both Vinayak and our midwife.  I was definitely in active labor, and four hours later, at around 11 AM, the midwife finally checked me. 

All I was praying for at that point in my pain was to have dilated to at least 7 cm. My hopes were quickly dashed when the midwife said I was still at 6 cm and the baby was in the same position – we had made zero progress since the last time I was checked 8 hours ago at 3 AM when we were told I was at 6 cm, not 9.5 cm. I was utterly devastated that despite getting through 4 hours of the most painful contractions there was 0 progress to be shown and I lost all hope and resolve at that point.  If I had been told I was at 7 cm, I would have had the willpower and confidence that I could keep powering through the pain to get to delivery. But with no end in sight, nothing to show for all the pain I had gone through already, and what’s more, to be told by the midwife and doctor that my already nearly unbearable contractions may not actually be strong enough to progress me, I mentally and emotionally gave up in that moment – I didn’t think I could do it anymore.

The next best option we had was to get the epidural and have them adjust the pitocin.  I was exhausted from not sleeping that night and disappointed that our only and best option was to get the epidural so I could get some rest and they could increase the pitocin. I wasn’t ready to make that decision in the moment though, so I asked for fentanyl so I could get some temporary pain relief and try to get an hour of rest so I could make the decision when I was in a better mental, emotional, and physical state. The fentanyl instantly put me in a drowsy and foggy state, but it barely diluted my pain and so I was still unable to rest.  The next hour was a haze and a mix of emotions – I was disappointed and upset that the fentanyl was doing almost nothing for me but making my mind foggy, I was disappointed and scared that my body had not progressed at all despite all the pain, I was disappointed that our only best option at this point was to get the epidural after managing so well and long without it, and I was utterly devastated that this felt like the final staggering ‘no’ I was getting from God to my prayers: we were on a one-way track to an epidural and to a cesarean.

I was emotionally crushed. In my foggy state, I remember saying to myself ‘God is not here. God is not with us.’ and fully feeling the abandonment and forsakenness by God. Why all the disappointments? Why all the ‘no’s to our prayers? Why was our induction so long and seemingly complicated? We knew there was a chance this could happen with induction, but we had hoped that our induction story would be like the majority of our friends’ stories – medicine to soften the cervix, pitocin to start the contractions, and baby delivered within a day.  Was it not enough that we were about to lose our baby? Did we have to be put through a long, stress-filled labor process as well? Did we have to have all our worst-case scenarios materialize before us as the only options left? I cried through the next contractions, not out of how incredibly painful they were, but out of disappointment with myself and with God, out of hopelessness, and out of feeling utterly abandoned. Never in my life had I felt such abandonment by God, never did I feel my faith break so much as in that moment – even when we got our baby’s diagnosis, even when my mom received not one, but two cancer diagnoses within a few years of each other, even through all the death and tragedies I’d seen growing up as a pastor’s kid, I didn’t feel so utterly void of God’s presence and goodness as in that moment.

Perhaps it was the culmination of everything from the pregnancy to that moment – from the ‘no’ we got to our prayers for a healthy baby to bring home, the ‘no’ we got to natural labor, the ‘no’ to a typical medical induction, the ‘no’ to the first Cook balloon working, all the ‘no’s that led to that final ‘no’ made it so I no longer felt I could cling to the hope that God was still in this with us.  Perhaps it was too much expectation and feelings of entitlement on my part – the feeling of if we’re going through so much already, can’t we at least have something that goes well?  It was a combination of everything I suppose. And though I don’t think that vivid feeling of abandonment in that moment can be explained, resolved, or comforted away, what has allowed me to see God in that is to remember Christ’s own abandonment and forsakenness on the cross. As contradictory as it seems, though Jesus was indeed cut off from God when he took upon himself all our sins, yet God was still there – “the paradox that, while this God-forsakenness was utterly real, the unity of the Blessed Trinity was even then unbroken” (Dr. Charles Cranfield).  Christ’s separation from God was needed for our redemption and renewal, and perhaps my own moment of feeling abandonment was needed in some way to break my faith and transform it to something different.

With confirmation from our doulas (over the phone) and our nurse, Vinayak encouraged me to get the epidural, and so the nurse called in the doctor. It was about noon. The fentanyl was wearing off and I was still exhausted.  The doctor came in and laid out our two remaining options – to get the epidural and see if adjusting the pitocin would allow me to progress, and if not, a cesarean. While she was still speaking, I had a strong contraction and an uncontrollable urge to push, and as I gripped the side of the bed, I was exclaiming, “why am I pushing? why am I feeling the need to push?” The doctor didn’t take much heed to my concerns and simply patted my leg and said, “yeah, sometimes that happens with contractions”, and continued on with telling us our options. This happened one or two more times – I’d have a contraction where I couldn’t do anything but push through it and I’d repeatedly question “Why am I pushing? I’m pushing. Why am I pushing?” But I wasn’t fully convinced myself either to ask the doctor to check me because it’d barely been an hour since they last told me I was at 6cm – was there any possibility I’d be fully dilated at 10 cm already? I finally told the doctor after a contraction that I wanted the epidural, and she finally paid attention to me and asked to have the anesthesiologist sent in. Fortunately, our nurse spoke up and told the doctor that she thinks I should get checked again before the epidural, so the doctor finally did and exclaimed, “oh! Christine, you’re about to have a baby! You’re at 10cm.” I’d somehow dilated from 6 to 10 cm within the last hour.

I’ll forever be grateful for how that nurse listened to me and advocated for me because if she hadn’t, we would have ended up with an unnecessary epidural and would have introduced more complications into our delivery process.  However, despite the sudden turn of events where we no longer needed the epidural, despite being finally at the last stage before meeting Mirari, despite Vinayak’s constant encouragement that we had did it, we were at the last stage, I felt no excitement and no gratitude in that moment. The disappointment had been so deep, I couldn’t pick myself up from it – I simply felt neutral and felt like this was just the next thing I had to get through. I was exhausted from the lack of sleep, lack of food all day, and the emotional turmoil of the last few hours, and the only thing on my mind at that point was my hope that I would have the strength to push Mirari out.

The emotions of everyone in the room were at a high though. The labor and delivery team were all familiar with our story and our baby’s situation, and our midwife had watched all the emotional turmoil of the day and had watched me manage through the painful contractions, be disappointed by the lack of progress earlier, and then suddenly was at the final pushing stage. When she was brought back to coach us through the pushing, she told us,”I hope you guys are okay if I start crying when the baby comes out.” After almost 3 hours of pushing, Mirari was finally born at 2:49 PM, and Vinayak would later tell me that the midwife really did have tears in her eyes.

Mirari’s heartbeat was very low at only 60bpm (half of what a newborn’s pulse normally is) and so they brought him to me.  As soon as they laid him on me, there was so much peace in that moment. All the anguish and turmoil of labor and delivery disappeared, and Vinayak and I got to touch our boy and tell him how happy we were to meet him and how how much we loved him.  After a few minutes, Mirari’s heartbeat went up to 110 and then 115bpm. He had not taken a breath up to that point though. Vinayak and I had agreed and made known to our NICU team beforehand that we did not want any aggressive interventions on Mirari as we wanted to optimize for his comfort, and so when the only option to potentially help Mirari breathe was to insert a breathing tube into his lungs and give CPR, we just held him and loved him.  He passed away about 10 minutes after he was born.

God answered our prayers to meet Mirari alive, and I’m forever grateful that Mirari had a heartbeat when born. But I’ll always wonder why did he never take a breath? I remember lying on the hospital bed, praying that Mirari would start breathing as I was watching the neonatologist rub Mirari on the baby warmer – there was so much hope and suspense in the room among the nurses, doctor, midwife, and us – and yet he did not breathe. God answered one prayer, but not the other. Despite most trisomy 18 babies passing away in the womb, our prayers were answered in that Mirari remained vigorously alive until 41 weeks gestation. He was a strong baby, surprising even our doctor with his movements and strong heartbeat at each ultrasound.  But why wasn’t he stronger at birth? Why didn’t we get more time with him alive? God answered one prayer, but not the other. I’m grateful our prayers for not having a cesarean birth or an epidural were answered, but why was our labor such an emotional turmoil? Why did we get so close to our fears happening? Some prayers answered, others not.

There will always be these tensions in our story. The tension between gratitude for the grace and mercy of God in the ways he did answer in sustaining and protecting us, and the unresolved questions of why other prayers went unanswered. I believe life is always going to have these tensions. The tensions between the ‘whys’ and the ‘thank yous’. God’s presence in some areas and God’s seeming silence in others. The tension between Christ already overcoming death, sin, and brokenness, but the truth that injustice, sin, pain, and grief are still expected realities in our day to day. So where is God? Seated on high already in victory over death and sin, but also here with us where defeat seems to be the current reality.

It’s a difficult tension to reconcile. Grief is hard to reconcile. The unnatural death of a child, the pain of having to bury a child is hard to reconcile with the love, mercy, and goodness of God. So what do I do? To be honest, the first few weeks after all that had happened, it was difficult to say “God is good” and really believe it. I knew it in my head because God’s goodness does not change based on my circumstances and feelings, and yet the feeling of God’s goodness was difficult in the midst of my pain. I didn’t know if I could trust a God who would allow so great a pain and so many disappointments. But as time has gone by, I’ve realized much of that is due to my own feelings of entitlement. Why should I think I deserved something different? Were we not promised sufferings? And weren’t we suppose to rejoice in them? What about everyone else that has experienced multiple losses, inexplicable tragedies, and even more hurts than we have? There is nothing so sure in this life as that we all will be hit with pain and loss at some point, and just because we’ve experienced pain and loss does not mean we will be spared from more.

But I’ve also realized that even in the pain, even in the feeling of abandonment, even when it feels difficult to say God is good, I can see He is good. The nurse that helped deliver us was an absolute godsend. Mirari survived through a long induction and held on just enough so that we knew he heard and felt us. Though we were on a path quickly leading to a cesarean, we didn’t end up there. I somehow progressed to fully dilated in less than an hour after a terribly long and stalled labor process. Why? How? There’s a lot I cannot explain in both the answered prayers and the unanswered ones. At the end of the day our prayers were answered – Mirari and I were as safe and protected as we could have hoped for, and Mirari was alive at birth – our prayers just weren’t answered in the way we had expected or hoped. And though in my own pain and grief I don’t always get the answers I need to resolutely believe in that moment that He is good, His own pain and grief does. I may always have questions and tensions around the inexplicable sufferings in this world and though God never gave a ‘why’ to suffering, He did do something about it, and I see it on the cross. So when I fix my eyes there, I can say yes, He is good. Because He’s stepped into our pain and suffering and taken it all upon himself, suffered and died, so as to redeem and to fix all the ugly and the broken of this world. And God knows what He is doing.

Is that not what Job was ultimately comforted with? God never gave him a ‘why’ to his sufferings, and if he did, would it have brought Job comfort? God simply pointed to himself, to the fact that He knows what He’s doing, that He is God and we are not. And somehow it comforts and answers Job’s questions and frustrations. I’m finding more and more that that is answering and comforting me too. No answers to the ‘whys’, but simply being pointed to Christ on the cross – abandoned, forsaken, and crucified for us so that the brokenness of the world can be both banished and redeemed – and I can start to trust again and say that yes, God is good because he sees the heartbreak of a mom who lost her child and He did something about it. He set about a whole plan that required him to suffer for us, to be forsaken by God for us so that we can be promised that one day all this suffering will end and all that we did suffer will be redeemed and restored.