Making the Decision to Pass in Arms



It’s not easy.


I guess that’s what I really want you all to know. It’s just not as simple as it sounds. But let me back up a bit…


When I tell C’s birth story, I can typically tell it in under two minutes. To be honest, as much as I adore hearing and reading birth stories, it always kind of amazes me just how wordy women usually get with them, even when everything goes smoothly. C’s story is wild and long and full of twists, but I still wrote it in under 800 words. Maybe it’s the fact that it WAS so intense that I’m able to dial it down and tell it in a pretty straight-forward way. I don’t really know.


Admittedly, though, I typically leave things out when I tell her tale. I don’t consider them to be major details and, truly, I don’t actually think most people are that interested in me that they need to know all the nitty gritty specifics.


One thing I mention to very few people?


That moment when they asked us if we’d rather let her pass in arms. (“Passing in arms” is the medical community’s polite way of referring to not employing– or discontinuing– most support and intervention, excluding comfort care. The baby is then allowed to naturally let go in as peaceful a manner as possible. This is how cases are usually handled when there is deemed no chance of survival or quality of life.)


When I do tell people about that decision, they usually have the same response– they glance at C., look at me, and widen their eyes with horror. “How could they even ask? I mean, who wouldn’t do just what you did? I can’t believe they even said that.”


And what I want you all to know is this– as hard as it may be to stomach, it’s not that easy.




When I tell the story now, you see a happy, healthy eight-year-old girl. You see a happy, healthy mother of three. You see a family that is intact and doing well.


That may not have been what you saw on Christmas Eve back in 2005.


The doctors saw a healthy, 29-year-old woman who had a ten-month-old to care for. They saw a woman who had had no health issues whatsoever in the pregnancy and would likely bounce back (physically) from a vaginal delivery of a one pound baby rather easily. They saw a young mother who could likely get pregnant again without much difficulty and whose body was, as yet, not traumatized by surgery.


They saw a woman who had lost three units of blood already and the prospect of cutting her open was incredibly dangerous.


They also saw a not-quite 24-week gestation baby whose chances of survival weren’t great. Were she to survive, the odds of evading long-term significant repercussions were slim to none. The road to discharge would be difficult, painful, and long, should she make it. She would endure spinal taps, heel sticks, blood draws, IVs through her scalp, and more on a daily basis.


“Would you rather let her peacefully pass in arms?” they ask.


They don’t ask to be cruel. They aren’t trying to be heartless. They are not saying this baby counts for nothing.


You have to see what they see to grasp it.


They see the risks of putting a healthy young mother through a surgery that carried major risks of complications– it was not a straight-forward, average c-section. Cutting someone open, both vertically and horizontally, following so much blood loss is dangerous. Administering anesthesia in those conditions without time to prepare is tricky. Trying to maximize a tiny baby’s chances of survival means placing more risk on the mother– and they couldn’t even guarantee she’d survive the birth.


So, yes, when you see me now, obviously here and obviously healed… when you see a smiling, bounding third grader… I understand that it’s easy to say, “How could they even ASK that?”


But I want you to know that they did the right thing in asking. And I will never hold that against them.


It’s not as easy a choice to make as you might think.

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6 comments to Making the Decision to Pass in Arms

  • earleyml

    I never knew they gave premie births this option. I can’t imagine how hard it must be to make a decision like this. I’m glad everything turned out well for you and your family but I’m sure that’s not always the case.

    • I’m sure it’s a very case-by-case basis thing, Michelle, so I don’t want to speak for all preemie parents certainly, but I do know that with very, very early preemies or those with significant, ongoing complications, the choice is sometimes given. It’s extremely hard, because no one wants to give up their baby, but no one wants their child to suffer either.

  • jc

    JL I don’t know how you do it, but your posts almost always hit home with me. 11 weeks ago, I gave birth to twins- a boy and a girl at exactly 22 weeks. I felt contractions, saw blood, went to our tiny local hospital. Once stabilized, I was offered a transfer to a much larger teaching hospital with one of the best NICUs in our state, in hopes that I could make it just one more week, but hopefully two. In the 45 minutes it took to get there, I went from 3cm to 9cm. When we arrived we saw the neonatologist who said, “They will pass peacefully. Its simply to early.” He then explained why. It was a grim situation with a horrible outlook. Jesus is giving our children a much better life than I ever could have. Our daughter lived almost four hours, our son about 45 minutes. We held them, hugged them, sang, and told them about Jesus. The hospital gave them little caps after they were born. After their death, the nurses washed them and gave them little outfits someone had crocheted. These very well might be our only children (that we held. I have miscarried twice.) I have fertility problems. In the past 11 weeks, I have had to learn how to live life again. Luckily, God has blessed us with a wonderful support group in our area for people who have lost children.

    • Oh, JC… I am so incredibly sorry. Those words are not enough, honestly, to convey my sadness. I don’t know if it is any comfort to you, but please know that I am truly praying for your family and your precious babies who are now with their blessed Father in heaven. I am grateful you had a caring hospital and have a good support group– please take care of yourself in any ways you can. xoxo– JL

    • Celine

      ((((Hugs))))… I am so sorry to hear about your loss.

      Angie Smith has a Wonderful book “I will carry you” that you might want to check out down the road.

  • Heather

    At 29 weeks we were well past that option. But if it had been a few earlier I would definitely be tormented by the decision. If your baby is going to die you definitely don’t want it to be alone in the isolette. :( but then I think I’d always wonder if it was the right choice…what if. Ugh gut wrenching.

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