When a Mom Miscarries

[CountryMomma]

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.

[Christy1019, ASN, RN]

I so agree with SionainnRN. I wish there was a list of things to say that WOULD be helpful for healthcare workers to say in a situation like yours, CountryMomma. I don't believe anyone meant to be hurtful. But people are not all alike in what they consider "comforting". Some people would feel encouraged, hearing that bleeding at X number of weeks may not mean a hopeless outcome. It was not the place of the ultrasound tech to give that information. But I can imagine her being so eager to make you feel better, but not knowing exactly what to say at the moment...that she did not think of that being disturbing to you. She probably did NOT want to "just say nothing"... and be perceived as being uncaring. Have you never been in such a position, yourself? It's the kind of awkward situation health care workers often face. After being around so much tragedy, we may (or may not) become a little more adept at reaching out to those who suffer emotionally.

Personally, I believe in presenting the facts that are known. I don't think I could be as stoic as the doctor who unceremoniously announced "your baby is dead". But that is the reality. That IS what a mother must deal with. Expressing sincere sorrow to a patient is fine. And even better, is seeing that she has a reassuring friend or relative with her to provide comfort. And whether a grieving mother will react with shock, denial, anger, depression, guilt, embarrassment or some cobination thereof, I can't predict. But,

in the end, she must deal with these in her own way and her own time.

I hope that you, CountryMomma, will be able to forgive those healthcare workers who hurt you. They have training. That does not make them perfect. And I hope the healing process for you is on going.

Wow, you said what I was thinking so eloquently. My sister lost her baby at 21 weeks due to incompetent cervix and although I am a nurse and knew that precious baby could not survive (the baby's feet were already through the cervix but the baby was still alive at that point), I am still her sister and still felt the need to give her some comfort and hope, despite the hopeless outcome until it was over.

Many of us feel anxiety in these situations and are unsure what to say. I know there are completely insensitive jerks out there, hell, I know a few of them personally... But I think there are more of us good ones than bad.

OP, I'm so very sorry for your loss.

[Been there,done that, ASN, RN]

Please accept my condolences .

Thank you for sharing your experience.I have listened and learned.

[LadyFree28, BSN, LPN, RN]

Please accept my condolences .

Thank you for sharing your experience.I have listened and learned.

So did I.

[traumaRUs, MSN, APRN]

Back to the topic at hand.

[84RN]

I'm so sorry for the loss of your little one. I have miscarried 4 times, and had varied experiences with what I experienced physically, and also the medical care.

As medical professionals we all need to be more aware of how our words and actions impact our patients.

[sistrmoon, BSN, RN]

I had 5 total miscarriages, 4 consecutive between my 2 boys. I had 2 later losses(12 weeks and 17 weeks after excellent ultrasounds and NT scans, one confirmed a chromosomally normal boy.) I definitely had some bad experiences. With my 12 week loss, the ultrasound tech went from chatty to silent and I had to wait 45 minutes in the waiting room for my own OB to be called and relay to me over the phone that the heartbeat was gone. With my 17 week loss in the middle of the night, the ultrasound tech showed us a closeup of the face, the hands, the feet, even though we all knew this was a loss. It was just strange because it seemed like she was doing a regular ultrasound. Thankfully my OB's office was very sensitive about the waiting room issue. I'm sorry for your loss and definitely think some education needs to be done.

[sistrmoon, BSN, RN]

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 actually had a coworker I was close to to "tell my story." With my latest loss at 17 weeks, I just couldn't tell the story without breaking down, and I had been through so many other losses at that point. She told my story to my coworkers so I didn't have to. And when I returned, I had a similar reception as you. I had a few "it was for the best" comments(which since I was losing healthy babies by all diagnostics, I had a hard time swallowing), but mostly, just silent support.

I was also one of those against all odds patients. I lost 2 babies after strong heartbeats, on target growth, etc. I had no bleeding with the 12 week loss...only no heartbeat detected at my normal checkup. The 17 week I had a small amount of bleeding, but cervix was closed and one nurse even thought she detected a doppler heartbeat(but she was wrong.) The chance of the recurrent losses I had as late as I had with all the clinical signs I had were astronomical, and yet there I was. I understand people want to be reassuring, but there is always the outlier.

[MO13]

Thank you for sharing this. I just lost my 4th baby and it's true you feel like it's your fault and that you are cursed. I pray for hope for you, me and all other hopefuls out there. I felt just like you, but my OB/GYN and his staff were so wonderful and supportive. I'm still praying, God is present and I am a true believer that everything happens for a reason. As hard as it is to accept that, I believe.