The Final Hours of Amirah Rayne III

An End to Our Beginning

Photo by Joshua J. Cotten on Unsplash

Wednesday, July 27, 2022 - Hours 72 to 82

Mom began to really struggle through contractions and at 1:30 AM, Dad contacted on-call midwife Amy Wessner, reporting contractions 5 minutes apart, lasting 30-45 seconds. When asked if she was feeling me move, Mom realized that she hadn’t been feeling much, if any, movement. Mom had been focused on working through the pain of the contractions while being extremely sleep deprived. Wessner asked if Mom could still talk through contractions and she could, so Wessner told my parents that the contractions needed to be 2 minutes apart and lasting at least 60 seconds. It wasn’t time yet to come into the birth center.

Not long after the call, contractions became even more intense, but Mom still didn’t think it was time — she didn’t know that my amniotic sac had broken and her contractions were not yet matching the midwives instruction. My mom struggled with so much pain, never considering that Rogue Birth Center midwives would do or not do anything that would endanger either of our lives.

7:50 AM

Mom has just seen a brownish-yellow substance in her diaper. Dad calls the midwife (Wessner again), describes the substance and texts a photo to the birth center. Calmly and casually Wessner tells my parents to gather up their stuff and come on in. She didn’t express any concern and didn’t tell my parents what it was that they were seeing. My mom wondered if this was amniotic fluid, but her question went unanswered.

Dad drove slower than usual so as to not throw mom and me around in the car on the curvy roads. Mom had an urge to push me out twice on the long ride to Grants Pass, but never again.

8:50 AM

We arrive at Rogue Birth Center. Mom has to stop twice due to the pressure pain during contractions as she’s walking to the front door. The door is locked. Dad rings the buzzer. Student midwife Malaney Gibson answers the door and tells my parents to go to the examination room. Mom doesn’t think she can get up on the table and lay back because she’s in too much pain and trying to lay on her back makes it worse.

9:05 AM

Suddenly Mom needs to use the bathroom, which she does and wipes away the same brownish-yellow substance. She calls to Dad to take the toilet paper and show the midwives, becoming more upset and concerned asking, WHAT IS IT? Dad finds the midwives standing in the hallway, shows them and asks what it is. Again the question is ignored and left unanswered — the midwives want to do a vaginal exam.

9:16 AM

Student midwife Taylor Rackey is doing the exam. Once Mom could finally get into position, Rackey determines that her cervix is dilated to 10 cm and 100% effaced. Rackey pulls her gloved hand out of Mom and it’s covered in the brown substance.

Wessner tells midwife Megan Pratt to call 911 EMTs to be on standby for resuscitation due to “thick mec” (meconium aspiration). Pratt’s role today is entering notes on the computer.

A couple of minutes later a stream of meconium shoots out of Mom like toothpaste. The midwives exclaim, “SURPRISE BREECH”, and Mom is ordered to get on her hands and knees.

9:27 AM

Mom actively begins trying to push me out.

9:35:11 AM

My torso is outside of my mother but my head is stuck in her pelvis. Wessner sticks her hand inside my mom and puts her fingers in my mouth to dislodge my head.

9:36:14 AM

My head has been flexed to allow me to come through and I am fully outside of my mother.

Pale, limp and not breathing, I’m immediately placed on a resuscitation cradle like a rag doll. Wessner and Rackey start preforming neonatal CPR for the first 4 minutes before turning my care over to American Medical Response (AMR) EMTs.

I’m still attached to Mom and placenta with my umbilical cord while resuscitation efforts happen. Daddy is right there assisting the EMTs. He touches me and tells everyone that I’m cold. I am being pushed on, injected with epinephrine and having oxygen forced into my lungs with a bag and mask device. My parents watch helplessly, completely traumatized and in shock.

9:52 AM

Sixteen minutes pass before my umbilical cord is cut. There is no Wharton’s jelly. I am completely separate from my mother.

10 AM

EMTs are talking about transferring me to the hospital and Mom needs to deliver the placenta before she can leave the birth center. Wessner has my mom lean back as she tugs the umbilical cord and pulls out the placenta. Mom starts bleeding quite a bit. Wessner assesses that Mom has a 2nd degree perineum tear and should be checked. My mom and dad need to go with me and so my mom’s medical needs are left unattended.

10:20 AM

I’m transferred from Rogue Birth Center to Asante Three Rivers Medical Center (TRMC) — located less than a mile away. Transfer took place 44 minutes after my delivery and 57 minutes after EMTs arrived on-site at RBC.

AMR refused to transport Mom with me, so Dad drives them, following the ambulance to the hospital.

The ambulance driver waved my parents over to the parking lot and my mom had to walk several yards to reach the entrance. Blood was running down her legs. Her shoes were soaked. An ER attendant quickly got Mom a wheelchair in which she sat and bled, watching the final attempts to resuscitate my lifeless body, with my dad by her side.

10:42 AM

Asante TRMC emergency room personnel document this as my official time of death.

My death will be listed as occurring at the hospital in Oregon Vital Records. This is one of the ways that fetal-maternal deaths caused by uneducated, poorly trained and inadequately experienced midwives are hidden from the public. Transfer data is also made difficult to locate for cross-referencing.

I never attempted to take a breath, ever.

I never moved a muscle, ever.

Allegedly I had some heart tones, but I certainly wasn’t a super-human baby. My family thinks that if any heart tones were truly detected, it could have been my mom’s picked up through the umbilical cord with Doppler, or artifacts of resuscitation attempts.

Mom’s vital signs were never taken before she was admitted to RBC or throughout our experience there today. This is an Oregon Administrative Rule (OAR) violation.

I was supposed to be monitored at least every 30 minutes while my mom was in active labor, but we went through all of it alone and unmonitored — another OAR violation.

My mom endured 80 hours from the time my amniotic fluid had started leaking and over 75 hours of consistent contractions, yet they weren’t the frequency and duration to be considered active labor. It was, however, both Prolonged and Pre-labor Rupture of Membranes (PPROM) and prolonged labor, which often indicates that there may be an emergent condition preventing labor from progressing normally.

AMR arrived at the birth center 13 minutes before I was delivered, and remained on-site for a total of 57 minutes before transporting me to actual doctors with real training and equipment. EMS protocols indicate that they should have transported us to the hospital immediately upon arrival at the birth center. At that time (9:23 AM), my breech position had finally been acknowledged and everyone was aware that it was a high-risk situation. Everyone, that is, except my parents. No one ever informed or asked them what they wanted to do.

Midwifery Rules also require immediate transfer when newborn APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) scores are below 5 at 5 minutes and less than 7 at 10 minutes.

All of my scores were 1.

Extreme violations of OARs actually began with my breech ultrasound at 20 weeks, and a vast amount of invaluable information has been discovered in The Aftermath of these devastating Final Hours of my viable life.

If our story can save babies’ lives & a lifetime of heartache for parents, then my existence has even more purpose, meaning and value on Earth. It is my gift to humanity.

Mom & Dad Speak

Dusty called the RBC on-call number around 1:30 AM, because my contractions were 5 minutes apart and lasting 30-45 seconds. Amy answered and said they weren’t long enough. I was managing to sit in my make-shift donut thing and breathe through them, so she reassured us that I had an irritated uterus from having a vaginal exam yesterday, plus the heat of the day.

She suggested that I take a bath, rest as much as possible and check for good baby movement. Dusty looked at me and asked if I felt good baby movement and I said, “I don’t even know.”  I hadn’t felt much because anytime I tried pressing on my belly to feel Amirah, my contractions intensified. It was so hard to feel movements at this point!

I struggled as the night moved into morning: walking, walking, walking. bath attempted, can’t sit, I’m miserable.

7:50 AM

My contractions were close together.

I had Dusty call RBC — my fluid had lessened and there was a yellowish-brown color in my diaper.

Wessner answered the on-call line again — Dusty tells her that it looks like poop. He texts the photo to RBC.

We’re thinking, Oh this must be amniotic fluid then!” Midwife Amy said in a cheery voice, “Huh. Well guys, grab all your stuff and come on in!”. There was no urgency in her voice and that reassured us that everything was okay — no rush.

Dusty gathered a handful of things we needed, and proceeded to make himself a cup of coffee.

The drive took us about an hour when otherwise we would have arrived there in 30 minutes or less if we’d known that this was a high-risk emergency situation.

I was silent, grabbing the ‘oh shit’ handle of the car the whole time. When we were just a few minutes away, I felt the urge to push. We arrived and I struggled to walk. Dusty held me as I breathed through another contraction.

We walked to the front door and had to ring the doorbell because it was locked. In that moment of struggling and contractions, I thought to myself, How could the door be locked when they know we were coming?!

The door was opened and we’re told to go into the check-in room where we found student midwife Taylor Rackey laying on the couch using her phone.

I told her, in tears, that I was scared. She said that everything was okay and that I was safe, and told me to get up on the exam table. She left so I could get undressed. I will never forget the uncomfortable feeling of being left alone with Dusty in that dimly lit room, as we listened to another woman in labor in the other bedroom/birthing room.

I was expected to lay back with my legs spread on stirrups like I was just some pregnant woman who wasn’t in labor having a prenatal appointment.

I vividly remember looking at the table and watching that door shut as tears ran down my face. The amount of pain from pressure that I was in made it almost impossible to get undressed, up on the table, and laid back. Feet in stirrups was a fuck NO for my body. The pressure gave me the urge to poop, so I asked to use the bathroom.

A midwife told me to use the bathroom in the empty birthing room, unattended by any of them.

I was alone in there for a minute or so when Dusty came in as I wiped more of this yellowish-brown substance onto toilet paper. Annoyed, I asked Dusty to go show the midwives — I’m freaking confused if it’s amniotic fluid or… what is happening???!!!

Dusty finds Rackey, Wessner and Pratt in the hallway and showed them the TP. Again there was no indication of concern or urgency and no explanation of what was coming out of me.

Rackey, Wessner and Pratt come in to the birthing room. Rackey checked Amirah’s heartbeat with Doppler and she was in distress at 170. My vitals signs weren’t taken.

A conversation began about electrolytes, so Dusty suggested I drink some pickle juice, which was a No for me. One of the midwives handed me a yellow electrolyte mixture they’d made, implying that Amirah could be in distress because I hadn’t had anything to eat or drink in awhile.

Dusty went to the car to get our crystals, oils, and baby things that we planned to set up in the room as we welcome sweet Amirah.

I finished the drink and Rackey asked where I would be the most comfortable to birth. I didn’t really know so I just went over to the bed.

Rackey wanted to do yet another vaginal check but I seriously struggled to lay on my back. She said that I was “full” at a 10 and ready to push! Then she pulled her gloved hand out and it was COVERED in the brown substance.

Rackey looks at Wessner with panic in her eyes and I see Amy’s mouth as she whispered SHIT.

EMT’s were called by Pratt to be on standby for meconium (baby poop).

As I laid on my back being told to start pushing, more meconium comes out. Amirah’s little butt is coming out when I heard one of the midwives say “surprise breech”. Owner-midwife Willa is called. Megan is watching and documenting on the computer.

Wessner and Rackey looked at each other and then in a demanding and annoyed tone told me in unison, “This is your midwives telling you to turn over”.

I got on my hands and knees and Dusty began wiping away the meconium from me and Amirah.

EMT’s filled the room behind me.

I birthed Amirah’s body with her head flexed upwards in my pelvis. Dusty watched Wessner forcefully pull on her body and her hands kept sliding off. Dusty held an EMT oxygen mask to my face and midwives told me to breathe deeper to get more oxygen to Amirah.

I focused, staring out the window with light shining through but saw nothing but a glare. It was as if I was in and out of reality, in another world.

An EMT struggled to place an IV in my left arm. Wessner reached up inside me, grabbed Amirah’s head, and put her fingers inside her mouth to flex her head with her jaw.

Amirah’s body was delivered in 8 minutes—at 9:35 AM, and her head was delivered at 9:36 AM. She was immediately put in the resuscitation cradle and chest compressions started.

I waited to hear Amirah cry as minutes went by before EMT’s took over resuscitation. Electrical leads were applied but kept falling off. Several epinephrine shots were given, and her umbilical cord was finally cut after 16 minutes. EMTs had been attempting to go through her umbilical cord with a needle but it kept bending.

Amirah’s left hand was close to mine and I couldn’t even touch her because I knew when I first saw her that she wasn’t there.

I heard Wessner say to me, “Talk to her Rachael. Say Amirah… Amirah”, while Rackey rubbed my back. I made an attempt to touch her hand and say her name, but couldn’t.

The light and bubbly energy I once felt from this beautiful human wasn’t there. She had no signs of life after 48 minutes of CPR at RBC.

Finally the EMT’s decided to transfer Amirah but refused to allow me to go with her. They said that there wasn’t room.

Midwife Wessner pulled out my placenta so we could leave, put it into a silver bowl, and that was the last I saw of it. She gave me a Pitocin shot in my left leg for bleeding. She wiped blood from my legs, the floor and then finally put a diaper on me. She told me that she didn’t get a chance to look at my bottom. I put my dress on, slipped on my shoes and went to pack my bags. I was in a fog of shock and didn’t know what else to do as the midwives sat there and watched me.

Dusty came back inside from getting the car ready to help me walk out. Pratt ran by us as she said, “Son of a bitch”, and rushed into the other birthing room. We could hear that the woman in there had very deep labor tones in her voice. We passed Willa in the hall and then I saw her husband, RBC manager, Todd Ervin looking emotional while standing in the kitchen area

We followed the emergency vehicle; the car ride is mostly silent. All I could say to Dusty was, “I am so sorry”.

We arrived at the hospital 7/10ths of a mile from RBC. The ambulance driver pointed his finger at where we were to park.  I felt weak, hot, and empty walking into the hospital. I remember grabbing the side of the hot wall as we attempt to quickly get to where Amirah was.

A wheelchair was provided to me as we came through the emergency doors and I was wheeled to where Amirah was. Many doctors and nurses were hovering around her and they attempted to resuscitate her for another 20 minutes. As a last attempt they drilled into her leg to place an IO (intraosseous infusion of meds and fluids directly into bone marrow).

I’m pale and bleeding. A woman stood in front of us explaining what was going on and I didn’t hear a word until Dusty asked a doctor about Amirah’s chance of survival. The response: “It’s not looking good.”

The bright lights and doctors talking with the echo of beeps coming off the machines is something that I heard until I couldn’t hear anything. Everything felt so still yet so fast at the same time. I saw the guy who provided the wheelchair in tears. I hadn’t even cried yet myself.

Doctor’s walked away. Time of death is 10:42 AM.

Dusty paced for a second and then collapsed in tears outside our curtained room. I sat staring at Amirah laying on the table. A nurse came in to take her hand and foot prints.

I felt so strange that I asked the nurse for something to eat and drink, thinking that’s why I was feeling so light headed and weak. I eventually needed to use the bathroom and passed a HUGE blood clot. Once the nurse helped me get situated in the wheelchair again. I kept overflowing pads to the point of filling my shoes and making a puddle. My heart was racing like I had run a marathon.

I was wheeled in and out of the ER a few times to go to the bathroom. I remember coming into the room and seeing Dusty on the floor. He was on his knees holding Amirah to his chest and nuzzling her into the crease of his neck in pain and tears.

Dusty gave Amirah what I couldn’t and I am so thankful that he was able love, hold and spend that time with her. When minutes later he went out to the car to get his phone to take pictures, a woman came bouncing happily, smiling even - through the curtain of our ER room. To this day I can’t remember a word she said, but what I do remember is how chipper and strange her behavior was considering the circumstances. I told her to talk to Dusty as I got wheeled off to use the bathroom. When I came back, the woman was gone. Dusty told her to leave because she starting talking about death and birth certificate fees. Her name is Lyndsey Cotton, RN, JoCo Medical Examiner Investigator. She told Dusty that she had already talked to the midwives about the death of our baby and there was no need for an autopsy. We hadn’t talked to the midwives yet.

Ohhh the fucking audacity of this woman while Amirah laid right there. Where is the respect?!

A nurse took my blood pressure — I still felt like I’m was going to pass out. BP 85/45 and my heart rate indicated tachycardia to 120’s. I didn’t have a fever. I was admitted to Asante TRMC at 11:24 AM, and given an IV.

A doctor came to examine my injuries. There was no way that I could tolerate anymore pain and straight up panicked and told her that she was going to have to knock me out. I had to wait awhile before going into the operating room.

We called our moms, and that’s when the reality started to somewhat set in.

Then I finally held my beautiful baby girl, Amirah Rayne, for the first time.

I underwent surgery for a 3rd degree perineum tear and blood clots in my uterus. Otherwise I was going to be okay. For those that don’t know what the degree means… a 4th degree tear is to and through the wall of the rectum. We stayed overnight in the hospital. I’d also lost a lot of blood. Family and friends gathered. Dusty got a text from Amy (Hendrickson) Wessner.

Dusty hadn’t told me about the above text when Amy asked me if I still had my uterus as soon as she and Willa arrived at the hospital!

Later I would find out from my records that Amy had talked to the doctor who did my surgery and already knew the extent of my injuries, yet still decided to scare the living shit out of both of us. No more babies without my uterus.

Amy Wessner moved to the end of my hospital bed and Willa stood by the right side. They said that I was strong when I don’t have to be and that Dusty and I should consider taking antidepressants. Eventually talk began about how we weren’t impressed with the EMTs—leads falling off, needles bending, no transport for me, etc. Both midwives were insistent that EMTs were negligent and that’s why Amirah died.

Amy bragged about how the midwives at RBC have successfully delivered SEVERAL BREECH BABIES — the most in Southern Oregon. Willa shook her head in agreement. This is the first time we’d heard the midwives talk about breech babies born at RBC.

Coming Up: The Aftermath of Amirah Rayne