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Advice on Helping Others through Miscarriage

a blog by Traci Shahan, RN, WHNP-BC, Doctor of Nursing, Albrecht Women’s Care Denver IVF, March 24, 2012

I recently received an invitation to a book signing by a fledgling author who has written about recurrent pregnancy loss, “miscarriage” in parlance. The invitation is elegant, embossed on ecru in charcoal ink. It states that this new author has written a book about miscarriage and how dreadful and lonely that event is for most of us. I intend on being present for this event, even though I have never met this person. My reason to attend is this: For those of us who have lost a pregnancy, life will never be quite the same, and there is oftentimes no or little support for these people.

I lost several pregnancies — twins and singletons. Many of our patients have lost babies in utero. I always tell a woman has lost a baby that she deserves her own little sacred acre on which to heal and that we, as a profession, have a terribly long way to go in understanding this very unique kind of loss and the emotions that can accompany it.

Most medical people feel sad, frustrated and sometimes at a loss to explain why the fetus died. Certainly much of the time we know what caused the demise, but not all the time. If the pattern of losing pregnancies continues, we generally refer to that condition as recurrent pregnancy loss. Despite rigorous training and accoutrements like white coats, walls full of diplomas, and otherworldly embryology labs, we are, in the end, people just like our dear patients. We hurt too when a patient’s pregnancy does not go on. But not as much as our patients do, as I can attest, having been both patient and professional.

So what do we do when we tell a patient that her baby stopped growing or died? Most people I have worked with are pretty feckless in this regard due to weak training in our respective graduate schools about loss, but also because we badly want to help a patient have the family for which she wishes, and some of us feel like we failed. Many of us wear a tacit mantle of feeling like we have to be the know-all and end-all. So many of us will make a referral to a mental health professional and breathe a tiny sigh of relief that the patient will have someone else to help her get through an incredibly sad time. Then what do I see happen to these patients? Most never call the psych professional and instead suffer alone. Some might share their pain with a family member or friend, but most never do. Some patients attend a support group, but few stick with it. I usually only told a handful of people myself, especially as I had more and more losses and felt less and less strong.

I will say here that I have seen an improvement, with pregnancy loss being more talked about in society overall. Although I don’t watch television, I noticed online last week that a woman billed as a reality TV star was highlighted because she had a miscarriage. Then I heard about a former first lady who had recently admitted the same, followed by receiving the aforementioned invitation. This is a change from even 10 years ago; however, we still are learning as a profession.

So if you have had a pregnancy loss or know someone who has, I recommend the following ideas to support her.

  • Do not avoid her. Yes, you might be uncomfortable or not know quite what to say, and that’s okay. I oftentimes will say something like, “How can I help you get through this tough time?’ or “Tell me a little bit about what’s going on right now.”
  • Intentionally be with her. Do not look away from her eyes, do not fiddle with, say, a remote, your hair or your shoe string. Sometimes the most magnificent way of helping someone cope is just to be still with her. Just sit, breathe — your presence will be healing if you have a level of respect and trust with that person.
  • Do not simply drift away after a couple of weeks. Some of the hardest times are in the weeks following the loss, partly because of the nature of grief and also because nature is readjusting the woman’s hormone levels and circuitry.
  • Send or take her small gifts, like her favorite soap or chocolate. One of the languages of love of is that of giving.
  • Go on a walk with her. I know in our high-tech age, this might sound lame and old fashioned, but I really believe that sunlight and fresh air lift the spirits and improve mental outlook and mood.
  • If she wishes to have a memorial ceremony, please attend.
  • By all means if she asks you for support, do so. Even if this is not convenient for your schedule, you will have imbued the world with compassion and love.
  • Support her partner also. That person will be certainly be grieving in his or her way.
  • Slip her a handwritten note, detailing all the good she has done in the world. I think the written communication is better for this, so she can tuck it into her purse or put it on her nightstand to remind her that someone loves her and cared enough to write it down. Make sure that you communicate her specialness.
  • And it almost goes without saying that if a woman expresses the desire to harm herself or others, call 911 and get immediate help. Do not let her talk you out of this. If she is in this much this pain, the first goal is to keep her and others safe.
  • Be well.

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