When a Mom Miscarries

Nurses Relations

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Having overheard some really insensitive, stupid remarks about miscarriages lately, I would like to share something with all of my Facebook friends. Especially my friends who are medical professionals.

In between Jaylen and Matthew, I had a miscarriage at 7 weeks 6 days. It started with spotting. It slowly progressed to a steady trickle of blood. I had no cramping, no pain, no symptoms of a miscarriage at all. The MD I saw first said there was nothing I could do to prevent a miscarriage if it was one, and to go home and wait. WAIT. I was bleeding away a baby that I had already met on an ultrasound screen, and it was like a ******* Zen lesson from the MD.

Lesson one: do not pat a mom (who is scared and unsure) on the hand and tell her to be patient. To wait at home. To wonder, each time she goes to the bathroom, if she's going to be pregnant tomorrow or if this is the last time she can dream that dream.

The other MD at the practice I was at took pity on my panic. She called me and said I could come in for an ultrasound to assess the situation and see if anything could be determined about my slow but steady bleeding. I made the hour drive to the clinic and waited in the lobby, surrounded by big, smiling mommies-to-be, feeling even more scared and even jealous, because there were ladies with big healthy pregnancies, and here I was, no one could even tell I had a baby I was losing.

Lesson two: if you have a miscarrying mom, please don't pop her into the lobby with all of your healthy, term mommies. Have an office or exam room ready. Offer staff or ask the mom to bring family/friends.

I eventually was called back for the ultrasound. The tech was very kind and did her job quickly and smoothly. When she identified the beating heart, she showed me the screen, counted the rate, and assured me that a good heartbeat like that was 95% positive for a healthy pregnancy. She quieted down and began frowning once she started measuring the rest of the baby's structures. The gestational sac was a week behind the rest of the measurements, but she wouldn't say anything else.

Lesson three: Please. Do not offer empty statements like "Oh a heartbeat's a good sign!" or "I think this baby looks great!" when the woman is being referred because of bleeding, cramping, or other early pregnancy loss risks.

I went home for the weekend, hopeful that the bleeding was a little hitch in the road and that it would resolve, just like the tech mentioned. Everyone is in such a hurry to reassure moms that bleeding in early pregnancy is often not a fatal issue. The MD glossed over the gestational sac issue and just said she couldn't predict the future, she wished us the best, and that I was to call if the bleeding changes or I develop cramping.

That Monday, I got up with Jaylen, bent over to get dressed, and felt a woosh.

I lost my baby.

I called the nurse in tears. She was so kind. So patient. She asked if I was able to bring any of the tissue I passed to the clinic, so they could do testing and try to help me figure out what had happened. I did. It was one of the most heartbreaking actions of my life.

I had to go back, give the nurse the rest of my lost baby, and have another ultrasound done to make sure I didn't have anything left, retained, that could kill me. I had the same ultrasound tech. She was very somber. I was very angry. I was hurt. I hadn't fully grasped the finality of this last ultrasound. Ultrasounds are supposed to be happy times when you are pregnant. They are supposed to be a time to meet the baby, see the wonder of life in your baby bump, build your dreams. They aren't, in any mommy's ideas, a time to confirm, without a doubt, that you aren't a mommy-to-be anymore. I couldn't believe I had just been here, less than a week ago, with that same stupid tech telling me I was a part of the 95% with a reassuring heartbeat. Now she was showing me my empty womb. I was the 5%. The anger and injustice I felt from that one ******* "statistic" did so much damage to my grieving.

Lesson four: When mommies have a couple different negative signs going on (in my case, bleeding, partially opened cervix, and small gestational sac) STOP SAYING STUPID PLATITUDES. Women are not skittish stupid animals that must be lied to. They need the truth. If there's a good chance she's going to lose her baby, tell her that. She'll find that sliver of hope, but she'll also begin the slow, painful process of thinking through the loss of her baby before she ever had the chance to hold it. Feel it. Name it.

The worst part of the miscarriage, for me, was that I felt no pain. I had no cramping. It was like I had just had a flushing handle installed in my uterus, and I went from pregnant to not pregnant with one flush of my womb. No pain, no symptoms. Like it meant nothing to my body. Staff kept offering me pain medications, like percocet and norcos, fretting that I didn't have to suffer for nothing. Their focus on treating my (nonexistent) pain made me feel even worse. Like something was completely wrong with me. Incompetent of carrying my own baby.

Lesson five: LISTEN. Listen to the mom. Listen to the friends and family of the mom. If she says she doesn't have pain, reassure her that this is not abnormal or a failure, tell her its okay to not have pain. If she's feeling ashamed or guilty, sit down and show her why it isn't her fault. Listen to her explain how she's a horrible person and then build her back up and validate her experiences. Miscarriages are still wrapped in shame and misinformation. Women aren't usually told the reasons behind their miscarriage, and they will find or make a reason. Because the mommies aren't able to hear the real, medical reason for their miscarriage, they will take the blame, make their actions the cause. There is no correction, and her family and friends won't know either, which leads to a vicious cycle of blame, guilt, and shame.

I had a family that took care of me. Even though they couldn't see the baby I had lost, they couldn't see the emotional pain I was in, they stayed with me, cried with me, and loved me. Many women aren't that lucky.

Short list: Don't assume. Don't lie. Don't say stupid zen things to make yourself feel better at the mom's expense. Don't be afraid to cry. Listen. Educate. And always be aware, and be available.

I hope this can help others. Please be aware.

I had tears running down my face while reading this thread. I am a 19 year old nursing student who dreams of becoming an OB or neonatal nurse. My mom had four miscarriages, her fourth being almost 4 years ago when I was 15. She miscarried at 8 weeks and had not shared the pregnancy before the miscarriage. I saw firsthand how traumatic this loss was for her, and my family. I will never forget her sobbing uncontrollably in her room and being unable to talk about it. Just a few weeks ago we were discussing health records and that when the physician entered "spontaneous abortion" into her chart from her first miscarriage, that term made her feel so guilty like she killed her own baby. She felt like she had no support and did something wrong. Her first pregnancy was a miscarriage and it crushed her hopes of being able to have a healthy baby. My mom now has three healthy young women. Women need to know that it's not their fault, and this is a (very horrible) part of life. I am dedicated to providing the best holistic care for all women, and helping women grieve. I liked the comment about holding the baby in your heart. I am so sorry for your loss and know that there is so much support available to you and your family. God bless.

Specializes in pediatrics; PICU; NICU.

I had bleeding & mild cramping when I was 9 weeks pregnant. When I had an ultrasound the next day, everything was normal. No one was ever able to tell me why it happened. I didn't like the OB I was going to then but had no other choices because of my crappy insurance. At 24 weeks, I went into premature labor & my care was transferred to a high risk OB doctor who was absolutely wonderful. He actually stayed in the ante partum unit for 24 hours until my contractions finally stopped. I was very lucky & went on to carry my daughter to term.

I have seen many babies die in NICU and I've had several friends have miscarriages. I honestly don't know how a woman can survive that type of emotional pain. I don't know if. I would have been able to.

Thank you for writing this article.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Women need to know that it's not their fault

This is a very important thing, and one I'm sure to talk to women about (generally in the context of a previous miscarriage, when someone else told them it happened because she did or didn't do X, Y or Z). I reassure them that it's NOTHING they did, nothing they could have done differently would have stopped it from happening, and it's not their fault.

And yes, the medical term for a miscarriage is a spontaneous abortion, often abbreviated to "SAB" (an elective abortion is EAB or TAB, and those are okay too, no reason to feel guilty if you've ever chosen to have one).

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Been there several times. I am so sorry for your loss. ANOTHER thing: DO NOT TREAT MY LOST PREGNANCY AS BIO HAZARD WASTE without at least letting me see and grieve. It may be a bio hazard piece of junk to YOU but to me, it represents lost dreams, a lost part of my future and my heart and soul. HAVE SOME EMPATHY or DO NOT ASSUME MY CARE!

Once I miscarried at home, which turned out to be a blessing. I was able to retrieve the lost baby and the placenta and put them in an heart box and bury them. This was by far, the best grieving period following a loss I had ever had. At least I could hold what was lost to me, cry over him or her and give that baby a proper burial. I don't give a damn if it was "only" 10 weeks, it was a BABY, yes a BABY to me.

Obviously this brings up painful memories for me...sorry. Again, so very sorry for your loss, OP. I feel your pain. May you grieve, completely and fully, and be able to rebuild your life after the loss, and I hope you feel some semblance of comfort in knowing many of us share your excruciating experience.

Specializes in pediatrics; PICU; NICU.

You're absolutely right, SmilingBluEyes. From the day I learned I was pregnant, "it" was a baby, not an embryo or whatever other term they like to throw around.

It's interesting to me to see that a lot of the feelings discussed in this thread are identical to those I saw in moms who had babies in the NICU. Guilt was a huge thing for those moms & I always told them they didn't do anything to "make" their baby come early.

SionainnRN, there is no reason an ultrasound tech should be spouting off comments about how awesome your pregnancy is going. Especially since the pregnancy was being evaluated for a threatened abortion. That's not top notch care. That's careless.

I feel like you didn't actually read this. It wasn't just me. I wrote from my perspective, but I have amassed the knowledge, feelings, and regrets of all the women I talked with when I spoke with others about our miscarriages. Sitting next to term moms while you are actively losing your baby, being told to be patient as you bleed away hope with no explanation, that's not top notch care. That's careless.

I hope you never experience that special kind of hell. But honestly, with your reaction, it exemplifies perfectly the trouble in our healthcare. "Don't complain, you got perfect medical care!" Medical care is not a one-size-fits-all. Women facing the death of their embryo/fetus/baby, they need to be approached differently than the woman coming in for a healthy checkup, that isn't rocket science.

Why would you honestly say that it is the mother's fault for being emotional and not at all a problem with the care? Isn't emotional support supposed to be PART of the medical care?

I remember last time you commented on an "article" I wrote, arguing that it was my mother's fault she was being beaten by her husband and that abused women are to blame for staying. I feel sorry that your empathy seems to be limited.

Tschus.

ETA: I didn't write this seeking pats on the head or there-there's. I've had time to take the ache away. I really wanted to help reduce the pain and anger of women to come.

How do you know everyone in that office is carrying a healthy baby? You do not know the complications/fears/emotions of others either.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

The subject of guilt is very valid and not lost on me. My first child, a boy, came early at 34 weeks' gestation. My water broke at 33 weeks and he was in there a week before I went into labor. I blamed myself six ways to Sunday for this, feeling like I must have done something wrong to bring on a preterm labor and delivery. Add to this that my son had a rare birth defect that required cranial surgery at 4 months of age, and I was a wreck. I thank those and will always, who were supportive and told me I was not to blame. I had not taken even Tylenol during the pregnancy, giving up coffee and would not let myself even breathe second hand smoke. I was baffled, and still am, why I went into preterm labor, but now don't carry so much guilt.

I remember my mother asking "what I did" to bring on preterm labor. That made me feel horrible, and all these years later, I have never forgotten how awful it felt.

The take-away? YOUR words weigh more than you know. Your non-verbal cues do not escape our notice. EVERYTHING you as a nurse say or do, cuts right to the soul of those of us enduring losses or preterm deliveries. Please, tread carefully, or ask another nurse to assume care who can. I have been around alot of insensitive people in my care through the years and how I felt has never left my mind.

Specializes in Home Health, Case Management, OR.

Having had 2 early miscarriages between my 2 healthy term kiddos, I have to say, a miscarriage destroys something in a woman that is never quite healed. I had a very painful loss the first time. No pain meds, nothing. But it was therapeutic in a way to suffer the pain. Being stuffed in the waiting room with everyone else right after being told my baby had died was horrific for both my husband and me. Referring to my baby, who once had a beating heart as "products of conception"...just no. The actual medical care was appropriate, though there needs to be more consideration emotionally to the grieving parents. Education on these things are much needed.

Specializes in SICU, trauma, neuro.

"Products of conception" makes me so mad. It takes exactly one more syllable to say "embryo and placenta," and the same number of syllables to say "fetus and placenta" or "baby and placenta," and is a hell of a lot more sensitive.

Honestly, has the mom forgotten that there was a living being in there? Does anyone honestly think that calling it an "embryo" or a "baby" will make her crack, but calling it "products" will be okay because then she won't think of it as the loss of a child?

I believe I've had one early loss...period two weeks late, faint positive test followed by heavy bleeding and then a negative test, and temperatures initially indicative of pregnancy which I only know because I do NFP. I didn't seek medical care, because there was nothing to do about it. I'm sure millions of women had the same thing happen without knowing it in the many years before early result pregnancy tests. You can be sure I grieved, though! In my mind and heart, it was a baby. In my spare moments I thought of names, thought maybe I'll wait until the birth to find out if it's a boy or a girl, since I found out the last two with the ultrasound.

Early (5-8 weeks) into the pregnancies with my 12 yr old and my 1 yr old, though, I had bright red bleeding. With my first I went straight to the ED...I was 22 and inconsolable, and couldn't just sit home and wonder what was happening. In my mind, bleeding = loss. With my youngest the bleeding was heavy like a period. I waited until the next day to go get hcg levels drawn, but I was sure I was losing him. I said my goodbyes and everything. Thankfully they both ended up being fine; youngest had a subchorionic bleed, and oldest they were never able to explain the bleeding.

What made things harder than they already were with the first one though, was the advice that "Right now there is a healthy heartbeat, but I'm still going to call it a threatened abortion. Go home and rest. If you pass any products of conception, bring them to your clinic for testing." Threatened abortion didn't bother me because I knew by that time that "abortion" was a medical term, with elective ones being one use of the word. But pass...like flatus?? Products of conception...like we conceived inanimate material? By that time I had gathered my composure and told the dr., "I'll go home. You go to sensitivity training." I was so angry.

SionainnRN, there is no reason an ultrasound tech should be spouting off comments about how awesome your pregnancy is going. Especially since the pregnancy was being evaluated for a threatened abortion. That's not top notch care. That's careless.

I feel like you didn't actually read this. It wasn't just me. I wrote from my perspective, but I have amassed the knowledge, feelings, and regrets of all the women I talked with when I spoke with others about our miscarriages. Sitting next to term moms while you are actively losing your baby, being told to be patient as you bleed away hope with no explanation, that's not top notch care. That's careless.

I hope you never experience that special kind of hell. But honestly, with your reaction, it exemplifies perfectly the trouble in our healthcare. "Don't complain, you got perfect medical care!" Medical care is not a one-size-fits-all. Women facing the death of their embryo/fetus/baby, they need to be approached differently than the woman coming in for a healthy checkup, that isn't rocket science.

Why would you honestly say that it is the mother's fault for being emotional and not at all a problem with the care? Isn't emotional support supposed to be PART of the medical care?

I remember last time you commented on an "article" I wrote, arguing that it was my mother's fault she was being beaten by her husband and that abused women are to blame for staying. I feel sorry that your empathy seems to be limited.

Tschus.

ETA: I didn't write this seeking pats on the head or there-there's. I've had time to take the ache away. I really wanted to help reduce the pain and anger of women to come.

I read it and I agreed with her. It's a catch 22. For some, added stress and worring can cause more damage. Which is why ALL are padded on the head and lied to. No one knows who those are. Feelings may get hurt, but it will not cause an medical issue to help someone relax.

How do you know everyone in that office is carrying a healthy baby? You do not know the complications/fears/emotions of others either.

It doesn't matter. In her eyes, she saw big healthy bellies and smiling mamas. Of course she'd have no way to know everyone else's stories. The fact that they might be experiencing difficulties too probably doesn't make her own issues any easier to deal with.

I remember after I had my miscarriage (a very wanted, planned pregnancy), I must have told someone (not sure who) that I didn't want to talk about it, that having my coworkers say anything about it would cause me to break down. That must have gone around, because I remember on my first shifts back at work, lots of squeezes on my shoulder and just kind smiles, but no comments. That was amazingly helpful to me. I hate crying in front of other people. 8 years later, I still remember those kindnesses, and appreciate it.

I am the same way. People coming up and hugging me or giving me well-intended words of support causes me to just break down. When I was in ICU after the birth of my child, on a ventilator and scared I was going to die, everyone (family, friends, nurses, doctors) kept asking if I wanted pictures of my children brought in and hung up on the wall so I could see them. Just someone mentioning my kids made me cry, every time. I would always shake my head "no" and afterwards, I explained to everyone that it was just too painful to look at their photos. I missed them terribly and was afraid my older child wouldn't remember me and my newborn would never even get to know me.

To the OP, thank you for sharing your story. My heart ached for you while reading. I have never experienced miscarriage, and I don't pretend to even fathom what you and the other poster's have gone through. My heart goes out to each and every one of you.

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