Depression after a miscarriage.

[MsGreenBeauty]

After a family has suffered a miscarriage, how can nurses help them if they are expressing signs of depression?

[mnicole]

I was always taught to offer yourself to the patient, sit and talk with them for example. My answer would never be "oh just go see your doctor for that". I know we can't diagnose and it may not be "postpartum depression", a patient may just need someone to talk to for a little while. Problem solved!

[kesr]

Depression or normal mourning the loss of their baby? I think people are quick to call grief depression. Best thing to do is let them talk, there are no words to make the pain go away, but plenty of words NOT to say. Like that old standby "you're young, you can have another" or "baby's with the angels". NOT HELPFUL!

[JenniferSews]

This sounds like homework to me.

To the OP: what do YOU think? What have you already thought about? What do you need further guidance on?

I agree. If you're a nurse working with patients who have experience a miscarraige you likely have specific questions. At least, as a woman who has suffered 4 lost babies, you SHOULD have more specific questions. Or you should find a mentor in your field who is willing to help you direct patients through this horrible time in their lives.

I also agree with kesr that the old standby platitudes don't work. In most cases they make people feel much worse.

[rn/writer, RN]

Depression after a miscarriage can be emotional, hormonal, or both. It could be an exacerbation or resurgence of a mood disorder or a result of PTSD. It could be medical (thyroid problems, chemical imbalance, SAD) or situational. It could be grief, anger, hopelessness, fear or deep and utter sadness. Or any combination of the above.

A nurse can communicate to the patient that her feelings matter, regardless of their source. She can also tell her that she might need more than one kind of help to get through the hard times. She can offer information on support groups, encourage the patient to get a good medical check-up and perhaps see a grief counselor.

Above all, she can listen and help the patient put into words what is in her heart and on her mind.

[BMNurse85]

Suggest they go see there OB,MD or PCP..

Hmmmmm :down:

[Sun0408, ASN, RN]

Dang it... Looks like I got another thumbs down for NOT doing someones homework for them.. I am sure the OP has a huge book like we all did in nursing school that has a few interventions for depression, and or grief.. Do we not all remember the lectures on death and dying?

[gail323]

I am another one that had a miscarriage - between the births of my two sons. Even though it happened 32 years ago, I often think of that baby and wonder what it's life would have added to our family.

I remember walking into church the Sunday after I lost the baby and having an older woman walk up to me, wrap her arms around me and say, "I've been there too - and there will be days when you think you are going crazy." Those were the best words that I could hear at the time - to realize that I was not alone and someone understood what I was going through.

At the time, I wish that someone had told me to name my baby, to do something to celebrate his or her short life, to create or purchase something that would have been a remembrance... but that long ago, people would say they were sorry but then because that baby was never real to anyone but me and my husband, they would forget.

I agree with others that suggest some sort of support group whether it is online or in person. She needs to know that she is not alone in her grief. There is a website that I recommend to others that contains the writings of many women who have dealt with miscarriage, stillbirth, SIDS, etc. It may be hard to go there at first but it is a place where she can read the many stories of people who have dealt with similar things.

And of course, if the grief reaction seems unusual and she is having trouble coping with it, she needs to see a doctor or a counselor to help her get through it.

Gail

[BluegrassRN]

This sounds like a homework question to me, too.

So here are some ideas to think about:

How do you discern normal grief from depression? What are the stages of grieving? How would you anticipate a woman who miscarried to experience/express those stages? What are some individual factors that may affect one's grief or depression post-miscarriage (age, previous miscarriages, single vs married, wanted vs unwanted pregnancy, etc)? How would a nurse support a grieving patient? How would a nurse evaluate whether a patient was grieving normally and healthily, or was clinically depressed and in need of intervention?

Do a google search for miscarriage support groups. Do an amazon book search for miscarriage and depression. What support is available--is there a lot out there, or is it difficult to find information and support?

How is post-partum depression different from post-miscarriage depression-physiologically, mentally, treatment-wise? How are they the same?

Good luck on your assignment.

[LACA, BSN, LPN, RN]

I've lost two sons (I've since had a baby girl who is now 22 months old). All three of my children are within 2 years of one another. My oldest son would be 4 this December and my youngest son would be 3 in a few days. I had a stillbirth at 23 weeks with my oldest and my youngest died at 11 weeks of age. Neither is a miscarriage, but I had to give some thoughts on the things I went through.

I was induced with the stillbirth, I was in labor for the worst, most horrible 36 hours of my life. When I was first admitted to the hospital, a nurse came in all smiles and was asking me what the gender was, what the name was, what's the nursery done in....she hadn't realized that my baby had already died. PLEASE make sure you do your "homework" before entering a patient's room. Had she taken an extra 30 seconds, she would have saved me a difficult, heartbreaking explanation.

Also, as someone else mentioned, NEVER EVER EVER tell anyone something along the lines of:

Baby is better off now

You're young, have another one

Maybe Baby would have had something bad in its life and this is the way of keeping from having to face that

Time will heal your pain

I've been told ALL of those multiple times since the loss of my sons. Everyone tells me what a blessing and miracle my daughter is, and while I agree with that, I do NOT agree that she "replaced" my sons or is my "reward" for going through the heartbreak of their deaths.

Please think about whatever is coming out of your mouth before you say it to someone who has lost a child. Because I can tell you from double experience, they are sitting in a world of dark, deep despair and heartbreaking agony. Don't pretend that you know how they feel and don't offer meaningless chatter.

The best thing to do is just let them know you are there and that you care. That meant the most to me during my situation.

My depression didn't set in until the weeks following my sons' deaths. The grieving process took a while and then things began to unravel. Please do urge the person on what s/s to watch for and when to seek help. I was blessed to have a wonderful husband and family to lean on and look to for help, but not everyone has that.

I'm sorry if I was rambling...