Handling of miscarriage pt.

  1. I recently went through a very traumatic miscarriage. Any miscarriage is traumatic, but I ended up with a hemorrhage and a D&C under general anesthetic. Because of the anesthesia and the late hour, the doctor decided to admit me and keep me overnight rather than send me home afterward.

    I was emotionally distraught as it was, but I was shocked and wounded to realize that I had been admitted to the maternity floor. Each newborn wheeled past my door and each tiny cry was like the proverbial salt in my wounds. My door was directly across from the nursery and though I tried to keep it closed, the nurses invariably left it open upon leaving my room.

    I know most women who miscarry are not kept in the hospital, but when you do have a woman admitted, is it really standard practice to surround her with happy families and their newborns? Is this also the standard for IUFD?

    I understand that there are specialties involved, but this really was the most painful part of the experience for me. It seems unnecessarily cruel to me, and I guess I hope by posting this I can change things for another woman like me.
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  2. 30 Comments

  3. by   kids
    I am very sorry for your experience, I don't think it is necessarily the standard.
    I lost 7 babies at 16 to 24 weeks, in 6 different hospitals . Twice I was placed on a Maternity unit following the delivery, I think the decision to place me there was, in part because I had spent 10-14 days on the unit trying to maintain the pregnancies and had developed a relationship with the staff. The remaining times I was placed on Gyn units.

    I am curious how other hospitals handle this.
  4. by   imenid37
    i work in a small hospital in a small town where most people know one another. when we have a miscarriage pt., she always goes to our maternity unit if she stays in the hospital. in some ways, there are good aspects. for example, she can take advantage of the perinatal bereavement services we provide more easily than on another unit. unless we are filled to the max w/ delivered moms, she will come to us. if she requests some other unit, she can go to peds. why? one of the reasons is the preference of our ob drs. we would try not to put her across from our nursery or next to a mom w/ a baby. we do have all private rooms. when you feel better, you should call or write your local hospital where you stayed and let them know your feelings. i think that many pts. w/ miscarriage do not want to be on the maternity floor, but the hospital/drs. have decided that they know what is best for the pts.in our hospital, this is esp. true as you may be in a room across from your neighbour or relative who just delivered their full-term baby. i have worked other places where pts. are given the choice. i am sorry for your loss and your poor experience.
  5. by   imenid37
    sorry, i meant to say if we are filled to capacity, she will be put on peds. often close to some crying baby or toddler. mostly pts. have no choice and are not asked where they'd prefer to go. our drs. want them on our floor because they know our staff and for convinience want all their pts. on our unit.
  6. by   caroladybelle
    In my current facility, thereare no gyn/OB services.

    In my previous facility, they were placed on the Family Care Unit (postpartem/clean gyn surgery). However, they were never placed near the Nursery. North to South on the hall - vag/uncomplicated postpartums, then post C-sections, then postpart with comp/premmie births/ then prepartum with complications, then gyn surgery, then ectopics, then miscarriages/stillbirthes. That way, the mothers with happy outcomes were near the nursery and the mothers with more complex issues were closer to the nurses station.

    (Yes, I am Onco nurse, but had to give methatrexate or IVIG on that unit many a time - needless to say on the complex end)

    My thoughts and prayers are with you.

    Carolina in the South
  7. by   fergus51
    We put miscarriage and stillborn patients on the OB side as well. The reason is, these are the only nurses who are trained to deal with the physical and emotional issues these families face, and secondly, because you aren't going to be sheltered from newborns when you go home. We feel it is best to provide sensitive care and be honest about what happened and what the patient lost. Putting them in a room where they are secluded won't be doing them any favors once we discharge them to the real world.

    I am sorry that it was painful for you, but really I don't know if anything can make it less so.
  8. by   sherryrn76
    we put our IUFD patients and miscarriage patients on antepartum which is on the same floor as L&D. our mother/baby unit is on another floor. So sorry for your loss.
  9. by   SmilingBluEyes
    As a two-time "loser"----this year alone, (and a labor nurse to boot!!), I feel for you. OH yes, I can relate.....however...

    I also agree w/fergus. You will feel pain (a physical and emotional burning and aching) when you see pregnant ladies, hear babies crying, and dealing with infants when you are out of the hospital. It is natural and normal. No one was trying to be insensitive by placing you on the OB floor! Listen, that I can do my job and stay professional and strong ( I dealt w/a fetal demise 3 weeks after my ectopic loss this past Sept!) is fortunate, but also took a *lot* of work on my part. Please, don't hesistate to ask for help w/all this. You are grieving and in pain and that must be worked through. But you need not do it alone. There is help out there. And your having been on the OB floor is an advantage this way, because we specialize in providing support services and referrals for just what you are suffering. I also have the name of a wonderful book that helped me immeasurably:

    Unspeakable Losses, Healing from Miscarriage, Abortion, and other Pregnancy Loss, by Kim Klueger-Bell (ISBN: 0-688-17390-X).

    It is a truly helpful read in your time of pain. Try it! And don't forget to take advantage of pregnancy loss groups/services in your area. If you don't know where to go, call the OB floor where you were and ask. They will point you in the right direction.

    Again, I am so sorry for your pain. There is no easy way past it but you will work through it. Give yourself time to GRIEVE! And be gentle w/yourself and take good care. If you EVER need ANYthing you just PM me; I will answer any concern you have, as an RN and a sufferer of miscarriage and ectopic loss.
  10. by   Nurse K-Bear
    Sorry for your loss. In the hospital where I work patients who have had a pregnancy loss are admitted to the gyn floor unless they choose to go to ob. We have a very good support program that continues after discharge as well. A card is placed under the patients room number outside their room andone on their chart. On the card is a leaf with a tear drop on it. The card symbolizes pregnancy loss. the patient can opt not to have the card placed. (none of my patients ever objected)
    For IUFD or stillborn families. We dress the baby. If the patient does not have an outfit on is given. A gold ring is put on the babies finger.
    We give the patient a hand painted box. Inside the box has the babies lock of hair, a baby ring (which most patients wear around their neck), the outfit the baby was dressed in for the pictures a memory book and the phone number for services after discharge. You do not have to take the pictures or the keepsake box with you. Most patients do though. They are stored on the unit until you are ready for them. (Some patient just called the other day from 2 years ago and she came and got her pictures.)
  11. by   SmilingBluEyes
    K-Bear, We have those same placards and chart cards. A very good way for us all remember the sensitivity of the situation w/that patient.
  12. by   misti_z
    I am so very sorry for your loss. Our hospital tries to put s/p miscarriages/stillborn in other areas of the hopital. They do however give the pts the option of staying on an OB floor. Since I have worked on my floor (almost 2yr) we have had one pt s/p stillborn at 32 weeks. So heart breaking I cried for the mom. I was very impressed when our A-1 (nurse administrators) brought a vase of beautiful flowers to the room purchased by the hospital.
  13. by   SmilingBluEyes
    another point: when i suffered my ectopic last month, they placed me on a med/surg floor after my D and C and open lap. NOT ONE SINGLE PERSON WHO TOOK CARE OF ME ACKNOWLEDGED THE FACT I LOST A BABY, yes it was a baby to me. To them I was a "surgical patient", just another to add to their overburdened work load. I would have welcomed being on the postpartum/OB floor if only to know that the nurses there might have actually acknowledged my loss and treated it as such. I can't say how it stings that no one cares. I am still smarting.
  14. by   Patsfan
    We keep our miscarriage and fetal demise pts. on our OB floor unless they request otherwise. We have a whole protocol worked up called HEAL(Help Educate After Loss). The same nurse usually stays with the patient throughout her stay. There is a checklist we go through, booklets for the parents and the sibs and the grandparents all dealing with the loss. (Fetal demise pts. get a memory box with the baby's hair, tags, a blanket etc. and can hold the baby if they want.) If the patient is going right home she still gets the packet and a f/up with social service. Most patients appreciate it. However it's not for everyone--some seem to want to deal with it privately and in their own way. I got a packet for my neice and nephew when she miscarried--they never even acknowledged I sent it or responded to my letter so I guess they preferred to deal with it themselves.

    I am very sorry for your loss. It is devastating to miscarry.
    Last edit by Patsfan on Oct 16, '02

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