Where is the Care in Miscarriage?

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Maybe it’s too soon to be writing this. Maybe I am still hormonal. Maybe I am alone in my thinking. But, I can’t help but ask what happened to the care in miscarriage?

If the statistic is true that one in five pregnancies ends in miscarriage, certainly the doctors-turned-messengers of quite possibly the worst news you will ever hear, could show a little more compassion and sensitivity to the patient laying with her legs in the air who all of a sudden can’t think, can’t breathe and certainly can’t collect herself enough to stand up and exit the practice through a room filled with happy-go-lucky pregnant women.

The news that my baby’s heartbeat was no longer beating… that the baby I thought was almost 11 weeks old had actually stopped growing a few weeks before was like a sudden knife to the heart. In a matter of seconds, the moment I was so looking forward to turned into my worst nightmare. After trying to comprehend what I just heard, I didn’t hear another word that came out of the doctor’s mouth. She was talking, but I was in a fog. I sobbed in the white sheet I’d been given to cover up with and stared at a screen of what looked like a perfectly healthy baby except for the missing tiny thumping motion in the middle where I had seen a mini heart just three shorts weeks prior.

At 39 years old, I admit I was completely ignorant about miscarriages. I always assumed you would know if you were miscarrying because of the obvious signs–like bleeding and cramping. I had no idea that it could take your body weeks and even months to recognize the pregnancy was no longer viable. Weeks to wait to see if your body would naturally expel the prune-sized sac you were expecting to see on the ultrasound screen. Weeks of walking around still feeling pregnant, just not actually pregnant anymore. It’s quite possibly the most gut-wrenching, emotionally and physically *$cked up thing you could ever imagine. It’s actually hard to believe it’s even possible until it happened to me.

I will spare you the details of what happened next–except for when I had to return to the same office where my heart split into two. At my last visit, the doctor said she wanted to see me back in a matter of days to see if things were progressing naturally or if surgical intervention would be necessary. If I can find something to be thankful for, it’s that it happened on its own in the privacy of my own home.

But, I knew it wasn’t over. I knew I had to return to the place where my worst nightmare came true just a week prior. I cried the entire way to the office just thinking about it. I cried riding to the third floor in the elevator. I cried while I signed in and my hand could barely stop shaking enough to write my name. I cried in the chair surrounded by soon-to-be moms staring at me and wondering what was wrong with me. I listened to one woman about 36-weeks pregnant joke about wanting the baby to come out immediately because she couldn’t waddle around anymore. In a normal situation, I probably would not have wanted to punch her in the face. Nor would I want to rip the phone out of the hands of a few future dads playing video games just to pass the time because their wives made them come to the appointment. Meanwhile, my amazing husband who did things no man should ever have to do was doing all he could to fight back tears and hold my hand, so I didn’t run out the door screaming.

After 30 minutes of waiting and crying (and yes, still surrounded by perfectly pregnant women), I was called back to answer questions that certainly should have already been noted in my medical file after talking to the on-call nurses more than I ever cared to over the past few days, starting with “how are you doing?” How the hell do you think I am doing, lady. As she took my blood pressure and jotted down notes, all in the company of pregnant women with smiles plastered to their faces and bumps as big as soccer balls, she went on asking, “Can you describe your bleeding–from light to moderate to heavy? Did you notice passing any tissue?” I’m sorry, but for God’s sake are you really asking me to repeat the worst moment of my life–again? In front of very pregnant women? I think she got the hint and took me back to a room to wait for the doctor. As my husband and I waited, we noticed a loud sound coming from the room next door. It was a doctor and his patient listening to their future baby’s heartbeat. I don’t want to sound like I was unhappy for them because that’s not the case. I was just sad for me because I knew that was not something I would hear today–or maybe ever again for that matter. The sound echoed in my room and seemed to get louder and louder with every passing second.

After my exam had revealed that my body did what it needed to do, I was directed to walk down the hall past hundreds of photos of successful births and into the doctor’s office where my file was spread wide open, and a photo of the last negative ultrasound was staring back at me. Really?!? Are you kidding me? This is torture. Around every corner, there is something there to haunt me and remind of what will never be. I just wanted out!

The doctor asked me if I had any other questions for her before I left. I told her I didn’t have a question but more of a comment. I explained that the day I physically lost the baby, I also received a phone call from a number I did not recognize. When I answered, in between sobs, it was the high-risk clinic calling to schedule my 12-week appointment (because I elected to have more advanced scans given my age). “Pretty crappy timing to say the least,” I said. “I’m not sure if there is any way to avoid that for future patients in my situation, but…” She cut me off saying, “Yes, that was bad timing.” (You think!!?!?!?) “Once the consultation is put in, we don’t have any control over when they will call to schedule the appointment.” P.S. the consultation was ordered five weeks prior and after calling twice to see when I might hear from someone, they couldn’t tell me. Here’s an idea–how about a nurse spends five minutes at the end of each day to shoot over an email to the clinic to inform them that a few patients’ lives changed forever earlier that day and to please take them off your call list immediately. Is that honestly asking too much? How is this not part of their process already?

The reason for this long rant is partially to vent about the lack of care I received while going through a recent miscarriage. The other part is to encourage doctors to consider putting “care” back into how they treat patients who suffer a miscarriage.

To all of the OB/GYNs out there, maybe you will consider off-peak hours or off-site exam rooms for those going through the unimaginable instead of asking us to come back to the office like a regular and still-pregnant patient. Or, maybe you will consider opening for a few hours on the weekend, so we aren’t forced to put on a brave face when it seems impossible to even get out of bed. We just experienced the death of our unborn child, and we don’t want to sit in a room with a bunch of expecting families. We don’t want to hear another baby’s heartbeat when ours was absent. We don’t want to be asked to pay a balance for services rendered for a baby we will never meet (at least today of all days!), all while in the company of other patients who are lighting up the room with their pregnancy glows.

Please consider our feelings, our loss and our heartbreak. If you could just try and imagine the hell that we have just gone through, you would never ask us to come back under the same circumstances. There should be a difference in the way you care and treat pregnant and not-pregnant-anymore patients. We need time to grieve, and we need someone to act like they give a damn, and it starts with our doctor.

It’s time to put some “care” in miscarriage.

P.S. I thought I had turned a corner after a few weeks, and then I received an invoice for this nightmare which was not covered as part of the upfront fee I paid for services covered during my pregnancy and labor. I would need to write another blog about that conversation which eventually ended in my loss … again.

13 COMMENTS

  1. Dear author,

    I’m so sorry you had to go through this. I had a similar experience. I also had to go back four days later (my body refused to understand my baby wasn’t alive anymore and needed a d&c) and was made to wait out front with the big bellies. When I finally got taken back, I yelled at the poor nurse for asking me the standard visit questions and requesting I jump on the scale.

    Then I was taken in a room covered in baby pictures. It was too much.

    At my post-surgical appointment, I had a very understanding ARNP. (My doctor was so ciinical, it stung.) I made the suggestion that they have a room that was more non-description for visits like mine. As common as losses truly are, there needs to be a safe room and a protocol in place. Then I switched obgyns and never looked back.

  2. Such a good blog.it feels like I’ve written it myself..I had to have a D&c 2.5 weeks ago and I’ve no follow up,still have pregnancy symptoms,pain etc. It feels like it only happened yesterday as it still feels so raw and I keep thinking I’m going to wake up out of this shirty nightmare…while I was been admitted for my D&c one of the nurses asked me was I feeling anxious or relaxed…let me tell you my partner saw a completely different side to me that day…never thought something like this would hurt so much…I feel so empty inside…

  3. Dear author,

    Thank you for writing about this. Last summer I had a similar experience. On July 4, we had a positive pregnancy test. By July 29, it was all over. I remember waiting for my follow-up appointment and hating all the pregnant ladies there. In the exam room, every song on the radio seemed so sad and depressing. When my doctor came in, the conversation was fine, but what surprised me the most was that she didn’t give me a hug. All I really wanted was a hug from her.

    You’ve really hit on something. When 20 percent of pregnancies don’t make it, it’s important to treat it as the common occurrence it is, rather than a rare, one in a million instance.

    Thank you for sharing.

  4. Dear Author,

    First, you must be reassured that your loss was not caused by anything that you did or did not do during or before your pregnancy. There is nothing you could have done differently. The most common cause of first trimester pregnancy loss is related to fetal aneuploidy – something went wrong during development. And as you accurately stated, this a common event with at least 1 in 5 pregnancies effected.
    Delivering the news to a couple that their baby no longer has a heartbeat is the worst part of my job as an OB-gyn and I have to do it a lot. Some of these patients are women I know well and were my friends before I was also their doctor and some are new patients. It is horrible every time. But I can’t cry every time with every patient or I would be crying all day. There is so much very personal and bad news to give. Some who are trying to conceive who come in and their test is negative again. There are also women who are in my office to hear results that they have cancer or need surgery or that their baby has a heart defect or will need to be delivered early and need surgery soon after birth. Still others just like you who will leave a different person than when they arrived because now they are a part of a statistic of those who have lost.
    Their stories do not diminish yours or your pain, but we cannot have special waiting rooms for everyone. Similarly, I won’t be able to hide every pregnant woman at the grocery or censor every commercial for diapers.
    You request special rooms and hours, but don’t even want to pay for the services you received. We do care and part of that care is making sure that you are okay medically. This includes examinations and questions making sure you do not have signs of infection or hemorrhage that would require additional treatment.
    Having said all of this, I am still so sorry for your loss and saddened that your provider was not able to express the compassion you needed. Finally, it is important to know that your misscarriage does not put you at a higher risk that this will happen in a subsequent pregnancy.

    • I thank God you’ve never been my doctor. You missed the entire point of this authors post to a degree that frightens me. I pray you find humanity and a new profession.

      • You are wrong about me and wrong that I misinterpreted the post. You misinterpreted my post. I live the post. Every. Single. Day. This post is my life daily. I lived it today when I prayed that with a different angle of the ultrasound that I would see a heart beat. I will live it tomorrow. That is what happens with a ratio like 1:5, it’s a nearly daily occurrence. Does that it mundane? No, there is compassion, empathy, pain and loss. But with one loss there is hope. The author addressed OBs specifically and many may not care, but I do and that is why I felt the need to respond and explain. Miscarriages fucking suck but all OBs don’t.

  5. I am so sorry to hear your story. My heart aches for you.

    I started miscarrying two days ago. I’ve wanted to write about a dozen blog posts myself. I’m still sitting at home, in the dark, not wanting to face anyone or anything.

    “What not to say to a woman miscarrying her baby.” “The bleeding is killing me.” “No one understands.” “The medical system and miscarriages…”

    My favorite (see LEAST FAVORITE) might be: “Well, back in the day, you wouldn’t have even known you were pregnant.” {said by TWO people within hours of miscarrying} Hmmm…well at six or seven weeks, you can hear your baby’s heartbeat. Are you saying I should just pretend I wasn’t pregnant because years ago, people didn’t know they were even pregnant? Would this have made me any less pregnant, any less excited to meet my future baby? Any less excited to give my baby girl a sibling? Any less excited to have started picking out names for my baby? Any less excited to have both pregnancy tests stored in my sock drawer with a plan to have my baby girl carry them (in a baggie) and hand them to grandma as an announcement? I’m not quite sure how helpful it is to tell a woman who was pregnant two hours ago before the bleeding started that years ago, I would have thought this was just bleeding instead of my baby leaving me.

    Oh, and the ED nurse practitioner said, “Well, IF this was even a pregnancy (it was confirmed with an Hcg lab draw), it is no longer.” What the hell does that mean? IF this was a pregnancy???

    So sad.

    Thank you for sharing your story. I truly empathize with you.

  6. I have experienced 13 miscarriages. 10 were before 10 weeks. 2 were before 16 weeks and 1 was at 17 weeks.

    Needless to say each experience was dreadful. Even when it got to the point I knew what to expect, I just didn’t want to be around other pregnant women. I didn’t want to witness what I almost had. Unfortunately, my husband also did not understand the pain of (our)/ my loss so my journey each time was solitude. I made many suggestions to my doctors and midwives but to no avail. I did think the care was more compassionate via my midwives, and in all honesty there is just some things that will hurt as “life goes on” all around you. Be thankful you had a great partner to cry with. And don’t let it discourage you from trying again.

  7. I’m sorry you had to experience this. My first miscarriage was early, shortly after I got a positive test. When I called thr nurse was not sympathetic at all when I said I was spotting. Thr waiting 3 days to be seen was horrible. I felt like a number and didn’t feel any compassion from anyone. Walking in a week later and no heartbeat I felt so lost and alone. Fast forward 3 months, pregnant again. 8 weeks along and spotting again. I saw a new provider this time, I felt listened to this time, I felt like a person, a mom. Even though I went through 2 losses in 3 months my doctor made it better somehow. She actually made all the difference. It still was painful but overall a better experience. When I got pregnant again, she was willing to see me early on and give me an us, extra appts to help my anxiety. Having that right dr/midwife makes such a difference!

  8. After my First child, I have had four miscarriage over the years, I never thought I will fine the cure, until I got a contact of a Doctor, I make him understand my problem, then he sent me the medication which I took, after one month, I became pregnant again, I had no miscarriage, and I gave birth to a lovely son, which my husband is proud of, My son is two years old now, and he is my joy after many years of childlessness.
    Any one with such Issues, can mail him on [email protected], God has used him to solve my problem.

  9. I lost my daughter at 20 weeks. I was able to leave the office through the back door but experienced something similar when coming back for my check up after deliciery in L&D. I’m a nurse so I understand in a way why things are the way they are, but it would be nice if they could reserve a morning or extra day a month to see the patients who’ve experienced loss. Sitting in a waiting room full of expecting moms and dads is torture. Something I never want to experience ever again. I’ve since had my rainbow baby, and for that I am so grateful. But my life has been forever changed.

  10. There should at least be some sort of special protocol for miscarriages. It is the loss of a baby. OBs only focus on the physical aspects, but the worst part of it all is the emotional/mental trauma. OBs should provide their patients with a reference to a counselor (without the patient having to ask). When I was given the diagnosis ‘missed miscarriage’ I was in shock. I didnt know what to do. If my doctor would have simply referred me to a counselor I feel it would have prevented years of severe depression.

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