Handling of miscarriage pt.

[keeper]

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.

[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.

[SmilingBluEyes]

no follow up here. none. to them, it was a surgical case and that's that. (can you tell how i am angry here?) that is why these folks belong w/OB nurses ----they know what to do and how to handle pregnancy loss. I did not suffer an IUFD but, i did lose a baby.....anyhow...Med-surg nurses are not so inclined, trained, and certainly have no time to bother. good thing, i AM an OB nurse and can find my OWN resources; what about the others who slip thru the cracks?

[keeper]

Thank you for all the replies. I've learned a lot and I do plan to write a letter to the hospital. I had a friend who went through IUFD and I know they took good care of her and she received a care package similar to the ones described here. I got a few, "I'm sorry's" but that was it. I know there wasn't anything on the door to tell warn people of my condition, because a nursery nurse almost accidentally brought me someone else's baby at one point.

While I understand the reasoning about not wanting to shelter a woman from babies she will invariably see on the outside, I think there is a difference between seeing a baby here and there at the store and being surrounded by them in a place you can't leave until your doctor says so. At home, I can at least choose when I'm ready to go out into the land of 50 newborns per square foot (I live in UT).

I do know what you mean about the nurses, though. I guess I was blessed to get the kind of nurses who at least offer their condolences. When I went in for the D&C, I was very scared and the abused little girl in me wanted the surgical nurses to introduce themselves before the procedure, so they wouldn't be strangers. They didn't even talk to me, just continued their conversations with each other while they strapped my arms down.

I do want to let you ladies know that I've been lurking here for months and, while I don't agree with everything I read, I have grown to appreciate you all so much. I'm a homebirther and sometimes I can get carried away in my anti-hospital feelings, and reading your posts has helped me to realize that there are good and caring people out there helping women have babies. Thanks for taking the time to reply to my post, and keep up the good work.

Keeper

[mark_LD_RN]

i am sure they were not trying to be insensitive.but being on that floor they are used to dealing with those cercumstances and caring for that kind of patient sorry about your loss

[JAYNE DANCE]

SORRY FOR YOUR LOSS

[indynurse]

I am sorry for your loss.

At my hospital, the pt is given the choice of post-partum or the GYN unit. The GYN nurses are also in-serviced on caring for IUFD patients.

When I was in nursing school we had some guest speakers from a local support group for families who have experienced IUFD, stillbirth, neonatal demise or babies in the NICU. One of the speakers was placed on a med-surg unit after she had an IUFD. She was not happy about that because she felt she had lost a child and that she was a mother in pain and not a "medical" patient. She wanted to be on a post-partum unit but was not given that option. I think the decision belongs with the mother and at my hospital, we have a checklist for IUFD patients and the mother's unit preference is listed on the checklist.

Also, if we have a mother whose newborn dies while she is still in the hospital, she is given the option of remaining on the post-partum unit or going to the GYN unit until she is ready to go home.

[fergus51]

I am sorry it wasn't as caring an experience as it could have been Keeper. We actually revisit this issue fairly often. The year before last we decided to give women the option of OB/gyn (it's one floor) or a surgical floor. Well, after some HORRIBLE comments patients got from the surgical nurses (like "well, you can always have another" and "why would you waste such a pretty name on a stillborn?" GRRRR!!!) we have kind of laid that issue to rest and put all women on our floor.

We put a sticker on their door so that they are identified and we don't bring them someone else's baby by mistake. I think OB is the only floor where the whole staff acknowledges that you lost a baby. Not a thing, that can be replaced, he or she was your child and you were his or her mother for no matter how short a time. I think that acknowledgement is one of the most important things for a woman and her family to start the grieving process. On the medical floor, they seemed to think that there was no reason to grieve.

[SmilingBluEyes]

EXACTLY fergus, and it hurts like HELL!

[debyan]

I am so sorry for your loss. I had 2 miscarriages 27 years ago and they did the same thing back then. I still think about them sometimes wondering if they would look like my other children and tear all up, such a sentimental fool. deb

[kids]

Originally posted by Debyanelsworth

I am so sorry for your loss. I had 2 miscarriages 27 years ago and they did the same thing back then. I still think about them sometimes wondering if they would look like my other children and tear all up, such a sentimental fool. deb

deb,

You are not a sentimental fool at all. Many people have no idea what it is like to lose a child at any point.

I grieve no differently for my loss at 16 weeks who never had the most rudimentry sign of life outside my body than I do for my 22 weeker who had a heart beat and tried to breathe when she was born. I remember every little detail about them: name, date/time of birth, length & weight...just like I do my surviving 3.

In rereading what I just wrote I realize I could sound like a real basket case. My grief is not all consuming, most of the time I am very matter-of-fact about it...but every now and then I get to wondering and I end up finding a few minutes to my self, to take my babies out one by one to "hold" them and love them, and put them away in the past until next time.

My experiences being place on a Gyn unit were all positive and probably unique...maybe I encountered Nurses who had experienced the loss of a child either by them self or someone close to them, or they had received training. I know for myself it was the best place for me to be. I am one of those people who needs to grieve quietly and privately before I can put a public face on it- I am that rare patient that needs you to close the door and check on me every so often, I will let you know when I need something...and that includes the social workers (I will eventually ask for them too).

Crap, the water works are going now just writing this, husband just asked if I am OK, I told him I was just talking about "the babies" he gave me a squeeze on my shoulder, a kiss on the head and went back to reading his book. He knows I'll cry, talk or just hold on if I need to.

[NicuGal, MSN, RN]

I am so sorry for your loss I have had two miscarriages, one with a hospital stay. Our hospital has a gyn floor that is separate from OB, so the people that have miscarried or have an IUFD or a baby that dies in the NICU (and are still in house) have the option of going to the GYN floor or the postpartum. Many choose to stay on postpartum because many of them were antepartum on the same floor. I stayed on the same floor because I knew the nurses there and felt comforted by them.

[SmilingBluEyes]

Deb, You are not strange. Even tho my losses were so early, the question that torments me is "who were these babies I lost"? It is a universal question that is asked whether experiencing an early miscarriage or late-term demise or infant loss. The pain is real and palpable and you have to work through it. I really do urge you to find a support group near you and try that book I suggested. This will help you immensely. Not to take away the pain, nothing ever does that....but to deal with it in a way that you CAN GO ON LIVING a happy and productive life with time. Bless you. You are not alone.