When a Mom Miscarries

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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.

Specializes in LTC, med/surg, hospice.

Everyone doesn't have the same experience. I have had a miscarriage and it was a wanted pregnancy. I had some intense emotions during the process but I wasn't devastated like many have described here and then I went on to have a healthy baby the following year.

I definitely think people and healthcare providers should be sensitive with their words. I don't have pre conceived notions of how I think a person should react to their loss therefore the treatment and support should be unique and personal to them. Talk to them, see how they feel and don't assume.

Im sorry for your loss. My oldest daughter was 8month when I miscarried our baby at 8wks. I had just found out the day before we miscarried but we already had a name if the baby was a girl, Haley Maria so we are convinced the baby was a girl. The ER doc was a guy and just simply said there is nothing you or I can do, miscarriages are common and please dont try to get pregnant for at least 6 months. It was a very empty meeting. The nurse luckily was sweet and came back into the room to say to ignore the doc that she got pregnant immediately after a loss. We got pregnant with our 2nd within a month. We are now blessed with 5 healthy babies since our loss. But i too feel horrible about losing that one sweet baby and that I didnt realize until it was too late and I flushed my sweet baby in a toilet at my job. Ugh!

My family was not supportive and my mom said it was for the best that my oldest deserved to be the baby a bit longer. I was shocked at anyone being so insensitive. I am glad you had family to support you! It took many years for my hubby to mourn and thus we appreciate these little lives we are blessed with.

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.

Or OB office in this case...

I am an RN/BSN and I avoid making comments to patients that are outside my scope of practice; I have seen techs make comments that they should not have and it tends to cause problems. I am also a mother who started miscarrying while I was at work but my experience at the Naval hospital was much kinder and more understanding than yours. I pray you never have another miscarriage and I hope that your story encourages someone to learn a little reticence and compassion.

Specializes in pediatrics.

I had two techs who both appeared nice but did not seem to get the depth of my fears for my breast cancer diagnosis. Yes I was scared to death but I just dont want to hear the opinion of a tech who should not be interpreting the results. The answer is your doctor will let you know. I know I was an emotional train wreck which is a big part of the problem but do not step outside your scope of practice even if you have know. Grieving is a an ugly, sad, and labile state to be in and go through particularly in the diagnosis situation. The patient is emotionally raw. I had to get a pet scan and drink that 20 oz cup which is bad enough once in the tube. I brought extra clothes because I figure I would pee my pants anyways. I got 20 minutes into the test on my back and I was so full I thought i could pee through my ears. One cannot pee laying on your back, bad planning. The tech was put out to stop the test when i started to shake from full bladder pain and he was mad that I would mess up his test. I was eventually let off the table to relieve myself and had no problem finishing the scan. I am not tube fearful but the male tech said I had mental problems. Maybe a small or anxiety bladder but I said he was out of place and and until he gets his diagnosis of cancer that he needed to keep his opinion to himself. I reported him. Yes I was over stressed but I am paying for this party. Next tech for MRI 5 days later was trying to nice when she said during my MRI for breast cancer admonished me for not having a mamo the year before (only time I did not get one). I found a lump 6 months after missing my mamo. I was 52 then and with my clean family history, I believe the mamo would have missed it and they do not normal do ultrasound until 60 unlessa lump is felt. (My good breast was checked during ultra sound and it took the radiologist an extra 30 minutes to find a 1cm hot spot that he said was next to impossible to find, it was positive on biopsy, the tech was concerned and had the MD come in to check it and she was right, great tech.) Back to MRI tech - I grabbed her hand and put it on my lump and said feel the fear and never admonish a patient for something that was out of my control. I have no family history of any cancer for 3 generations both family trees. Never have ever been sick, no previous diagnosis for anything in my 53 years, my chart was empty. I advised her never have a busy life and miss any appointments since Joan Lunden NY health news caster was diagnosed 1 week after me (after having a clear mammogram) only to be diagnosed with triple negative aggressive breast cancer on her ultrasound. She never missed her mammograms go figure but I bet no one admonished her. I am thankful that she put her private diagosis on TV because it help with make better decisions in my treatment course. Bless her. I am sure my fear was a big part but it is best to defer and not say anything. Know your place and assume that folks are working through the grieving process - oh maybe the techs do not get that training due to going through a certificate program and not having a degree with at least some training the kubler ross steps of grieving. Patients and folks in general will cycle through the anger and sadness many times as they need to reach acceptance. A shoulder hug or just holding my hand and reminding them the doctor makes the interpretation, while not satisfying, is the best answer. The blood draw guy instinctively held my hand while taking my labs and I thanked him. What a great person, such a simple act, no words and I thanked him and talked with his wife (she was another tech, for having a wonderful caring husband. She said he has always been like this. I asked if he could be xeroxed.) Thank you Ken for a random act of kindness at the right time.

Specializes in Surgical/MS/Oncology/Telemetry/OBGYN.

Ummmm this initial post was a bit dramatic, everyone is different in how he or she handles disappointment, and all are entitled to his or her opinion. I myself lost two previous pregnancies and had 3 healthy beautiful children in the end. Thank God for the bitter and thank him for the sweet. We can not and should not expect to think the same and because different emotions are shown or not shown should not give one the right to judge whether one is being insensitive.

Specializes in hospice.
Ummmm this initial post was a bit dramatic

Obviously the pain is still very fresh for the OP, and it sounds like recent events "ripped off the scab."

Specializes in TELE, CVU, ICU.

Actually you are the one hijacking the thread by trying to shame women you don't even know. I am reading this to improve my practice not to be preached at by the self righteous. There might be other women reading this who have had elective abortions for reasons you cannot fathom, there is no sense in you trying to get your little dig in. That is the kind of insensitivity the thread is about.

"Attitudes like mine" are hardly uncommon, with 47% of Americans describing abortion as morally wrong.

Why U.S. Views on Abortion Haven't Changed Much | The Rundown | PBS NewsHour

As you've seen from my postings in the euthanasia thread, I am indeed opposed to the purposeful killing of human beings at all stages of life.

However, my point was that, whether you like it or not, the word abortion is too politically and emotionally charged to be used with miscarrying women, precisely because you don't know their politics or feelings about it. Even pro-choice women will usually recognize a difference and could be wounded. All I was saying was that it's probably a word better avoided in such situations.

Hopefully this will end the thread hijack.

As a woman who has miscarried and was unsatisfied with my treatment by some medical professionals at the time, with time I've realized no one would or could have satisfied me at that time. The pain of feeling a tomb where my womb is was too raw and deep. It really wasn't them, it was me.

Specializes in Acute Care Pediatrics.
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.

I delivered my babies via c-section in a women's hospital. I could not have my child with me in recovery for this very reason.... I was sharing the PACU with women who were grieving a loss. A little sensitivity never hurt anyone.

Specializes in Acute Care Pediatrics.

I lost a baby between my first and second child, fairly early on. I will tell you that honestly, during that time - not much could have been said or done to make me feel "ok". Everyone means well, but nothing sits right. The people who offer you comfort seem patronizing, the doctors seem insensitive... there just is no "right" way to handle such a nasty situation.

OP, I'm sorry for your loss. :(

Specializes in PCU.

Thank you CountrMomma, for such an excellent article and for sharing what is a tragic experience for a family. I do not have words to tell you how very sad I am for your loss or how strong I think you are for sharing your perspective so that others may learn and benefit from it. We can, at times, come across as insensitive due to sometimes not really knowing what to say or do in a given situation or even because sometimes we see it so often that we may allow ourselves to become desensitized, thereby causing grief without meaning to do so. It is good to periodically stop and look around and realize that, while this may be our umpteenth loss for the month, umpteenth birth, death, whatever, it is often the first for our patient or his/her family. I have been a nurse for a wee bit, but I still remember losing my cool and letting the nurse in the PR hospital know that, although I was sure she had babies every day, this was my first and I did not appreciate her blase attitude (over 19 years ago now, but still remember it and try to not treat my patients in the same way).

I am very glad that you spoke with your doctor afterwards. It seems that, with your input, some positive changes did take place so that others would not go through what you did.

Specializes in SCI and Traumatic Brain Injury.

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.

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