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.
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.