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.

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.

So, should OB's offices have 30 separate cubicles instead of a waiting room, because someone, at some point, might be offended or hurt by having to sit in a room with (other) women who appear to be pregnant? How far does "sensivity" need to go??

Specializes in Clinical Research, Outpt Women's Health.

It is really hard for medical professionals to deal with this situation. Lit is such an emotional time. You may something to one person that is very comforting and reassuring to them and the exact same thing in the exact same situation may make someone else feel enraged, uncared about, and lied too.

I don't know the answer, but I am very sorry for your loss and that you felt you were not supported in a way that was reassuring and honest.

Specializes in hospice.
And yes, the medical term for a miscarriage is a spontaneous abortion

While that may be true, that doesn't mean it's okay to call it that in front of a grieving woman. I would think everyone would know that the word abortion is just too charged to be comfortable. Being right doesn't make it okay to be totally insensitive.

elective abortion is EAB or TAB, and those are okay too, no reason to feel guilty if you've ever chosen to have one).

This attitude is nowhere near universal, and you can't go around just stating it as fact. It's merely your opinion.

While that may be true, that doesn't mean it's okay to call it that in front of a grieving woman. I would think everyone would know that the word abortion is just too charged to be comfortable. Being right doesn't make it okay to be totally insensitive.

The word wasn't "charged" until the anti-choice community made it "charged." It used to be just another medical term (and still is, for a lot of us).

This attitude is nowhere near universal, and you can't go around just stating it as fact. It's merely your opinion.

And it is "merely" other people's opinion that it's not okay ...

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
While that may be true, that doesn't mean it's okay to call it that in front of a grieving woman. I would think everyone would know that the word abortion is just too charged to be comfortable. Being right doesn't make it okay to be totally insensitive.

I never stated or implied that I call it that in front of a patient. I call it a "miscarriage" - I was simply validating the 19yo poster who indicated that she heard it referred to as that, and I wanted her to know that that is indeed the correct medical term.

This attitude is nowhere near universal, and you can't go around just stating it as fact. It's merely your opinion.

It's the law that women can have abortions. And it's attitudes like yours that make many women ashamed to have an abortion they want or need, or to discuss it afterwards.

When I gather pregnancy histories with patients, I discuss abortion very matter-of-factly. I don't want my patients to think they have anything to be ashamed of by having had one, and I want them to understand that I don't judge them if they've had one in the past, or they want one now.

So, should OB's offices have 30 separate cubicles instead of a waiting room, because someone, at some point, might be offended or hurt by having to sit in a room with (other) women who appear to be pregnant? How far does "sensivity" need to go??

Well, of course not. My point was only that at that time in the OP's life, it stung to see happy big-bellied pregnant women and whether or not she knew of other's difficulties, it probably wouldn't have eased her grief and pain at that time.

Same reason L&D units try to place a woman who just gave birth to a stillborn baby in a room away from the hustle and bustle (crying babies, jubilant family and friends) of the unit.

So, should OB's offices have 30 separate cubicles instead of a waiting room, because someone, at some point, might be offended or hurt by having to sit in a room with (other) women who appear to be pregnant? How far does "sensivity" need to go??

I agree. There are 5 stages of grief, the OP is apparently feeling anger and displacing it. My own mother birthed a still born child which died 2 weeks before the due date and she was aware that the baby had died and carried it to term for 2 weeks. So again, I say, when you are in a waiting room full of pregnant moms, you do not know any of their complications, struggles or emotions either, in a perfect world, everyone would be accomodated. Had I been in that metaphorical waiting room seeing someone else walk in and be whisked away straight to their exam room, I wouldve been at the clerks desk demanding to know why I wasnt being seen and I am sure the whole room would be wondering that as well. I am not trying to be insensitive to the OP's grief, I am just pointing out that they are angry and grieving and not everyone may agree with your views. I am sure many of us nurses have experienced this with our pt's family members....

So, should OB's offices have 30 separate cubicles instead of a waiting room, because someone, at some point, might be offended or hurt by having to sit in a room with (other) women who appear to be pregnant? How far does "sensivity" need to go??

It can go at least as far as letting a woman who has just been devastated by her loss through a back door.

Had I been in that metaphorical waiting room seeing someone else walk in and be whisked away straight to their exam room, I wouldve been at the clerks desk demanding to know why I wasnt being seen and I am sure the whole room would be wondering that as well.

And if the clerk was able to reveal to you the reason why (which they couldn't) and told you that patient had a baby that was dying/dead inside of her then I bet you'd feel like a great big jerk! Is it unreasonable to think women going through a miscarriage should be able to sit comfortably and wait in an exam room alone? If you've never been through it yourself then you cannot even imagine. After I had a d and c that didn't get everything out I was GUSHING blood 2 weeks later and had to rush to my Ob's office. You cannot imagine the horror I felt as I ran into the waiting room to sign myself in while there were 10+ people there, tears STREAMING down my face, blood about to gush out of my and onto the floor. So you bet I was glad that after I signed myself in and ran outside sobbing hysterically that they brought me straight back to an exam room where I could wait so I didn't have to experience that in front of everyone! And as I was waiting their exam table and floor became a sight out of a horror movie due to my excessive bleeding, I thought I was going to die and I'm glad my husband and I didn't have to have those thoughts and experience that in front of a waiting room full of Random strangers who may or may not have been angry that I was whisked away to a room before them.

And if the clerk was able to reveal to you the reason why (which they couldn't) and told you that patient had a baby that was dying/dead inside of her then I bet you'd feel like a great big jerk! Is it unreasonable to think women going through a miscarriage should be able to sit comfortably and wait in an exam room alone? If you've never been through it yourself then you cannot even imagine. After I had a d and c that didn't get everything out I was GUSHING blood 2 weeks later and had to rush to my Ob's office. You cannot imagine the horror I felt as I ran into the waiting room to sign myself in while there were 10+ people there, tears STREAMING down my face, blood about to gush out of my and onto the floor. So you bet I was glad that after I signed myself in and ran outside sobbing hysterically that they brought me straight back to an exam room where I could wait so I didn't have to experience that in front of everyone! And as I was waiting their exam table and floor became a sight out of a horror movie due to my excessive bleeding, I thought I was going to die and I'm glad my husband and I didn't have to have those thoughts and experience that in front of a waiting room full of Random strangers who may or may not have been angry that I was whisked away to a room before them.

I was thinking kind of the same thing....as in, it's none of your business why anyone else is there or gets taken back before you. As healthcare professionals (and adults) we should know that it's not always first-come first-serve...especially with OB. Babies come whenever they please.

Specializes in hospice.

You would think people would assume something emergent or negative is going on when someone gets "whisked back" like that.....but that would require them to stop thinking about themselves for a minute and I think we've all experienced the relative rarity of that these days.

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