Friday, May 21, 2010


It is an aspect of Labor and Delivery that isn't talked about. Miscarriage and fetal demise. There are tons of women out there who have experienced miscarriage, it is more common than we realize. For some reason, it isn't talked about. The only people who ever ask how many times that you have been pregnant are health care workers. Everyone else always asks how many kids you have. For those that have experienced a fetal loss, there is always the thought of that child that is somehow not counted, not talked about, but that you can never forget.

I have been spending a lot of time at work organizing all of our bereavement supplies. We have knitted hats, lovely sewn outfits, blankets, memory boxes, and lots of handouts to give our patients. I know that I try really hard to do my very best work when I am taking care of a mother who has a demise. Labor is an unforgettable event as it is, but when you add grief to it everything that happens to you stands out in stark contrast. What I have realized, is that my training as a doula is what has best served me in nursing to help someone die while feeling comforted (a nursing school experience) and to help a family experience the loss of a baby.

It is more than being nice or being respectful. It is being present, and being a witness. It is holding hands, while normalizing the process. It is doing everything possible to make memories for that family to keep. I take lots of pictures, make tons of hand prints/ footprints, take a lock of hair from the baby, the family keeps the baby with them as long as they wish, and I always call pastoral care. It is comforting and praying with the family. Honestly, it is the hardest thing that I do.

I have taken care of all kinds of demises at this point. 12 week miscarriages to 38 week demises for no known cause. Babies with multiple anomalies that lived for hours after birth to babies that died in utero a week before delivery. What people need to realize is that it is all the same. That 12 weeker will be just as missed as the term baby. That mother will cry just as much, will hurt just as much, and still needs just as much support. The family will feel confused, will be scared, and will need as much help as you can give.

I've used the word "miscarriage" here, but I have  to admit that I hate it. It implies that somehow the mother did something wrong, that she didn't carry the baby properly. I don't even really like the word "loss". It is like they left the baby somewhere- like they lost it. In medicine we use the term spontaneous abortion, but the word abortion has so many other negative connotations in our society. What it is, the word that you can and should use is "death". It is a death and it should be treated accordingly. Using the word death absolves the mother from blame, whereas every other word implies somehow that she did something wrong.  I say immediately, "I am so sorry" shortly followed by "this is not your fault, you did nothing wrong". I leave it at that, I answer questions if asked, but I really try to avoid using the above words.

I wanted to post this so that maybe if you have experienced a demise, you would know that you are not alone. That if your friend, or sister, or client has a demise you would know how to act.

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