By now it is commonly known that one in four pregnancies will end in a loss. No one should be more aware of this statistic than the countless healthcare providers who will care for these women and their families during their loss. One would assume, given the common nature of pregnancy and infant loss, that healthcare providers would be accustomed to providing sensitive and supportive care to their patients.
Unfortunately, I have not always found this to be the case. I, myself, have experienced two miscarriages and a stillbirth. Sometimes I found myself in the care of people who knew how to support me and other times I found the care I received only added to my trauma.
I have had the privilege of listening to other families as they have shared their stories of loss. I know I’m not alone in wishing healthcare providers better understood how to support us through our heartache. Based on our experiences, I have put together a list of things that healthcare providers can do to help families through the experience of pregnancy and infant loss.
1. If applicable, refer to the baby by name.
Not all families have a name for their child who died, but many families do. Please ask about a name and if the family shares one with you, please use it. Using a child’s name is one of the most comforting things you can do for a grieving parent. It is a simple, yet powerful, way to honor the life that once was.
2. Read the chart and communicate with others on your staff.
The healthcare provider/patient relationship extends beyond the exam room. During any given appointment or hospital stay, a woman can encounter several individuals who make up her healthcare team. I do not believe it is anyone’s intent to cause harm with their words, but it often happens.
Whether it be the ultrasound tech who keeps referring to your baby after loss as your first or the orderly who wheels you to the lab after your baby was stillborn chatting about how much they love new babies–the triggering conversations are everywhere. They can’t all be prevented, but common sense and taking the time to communicate can make a difference.
Please make sure your staff and colleagues are aware of a current loss or any previous losses. This knowledge can help everyone to be more sensitive in the nature of their comments.
3. Provide options.
Losing a baby should not take away a patient’s options. It is an experience where the parents are going to feel a lack of control. Providing options can allow the families to have a parenting experience even though their baby is gone.
Mothers experiencing a loss have choices to make regarding their body and their baby. It is the role of the healthcare provider to present these options in a supportive and non-judgmental environment. Do not assume that one patient’s decisions reflect the wishes of every family who will come into your care.
4. Be thoughtful about your language.
Word choice matters. Many women and families are triggered by the medical terminology used for pregnancy and infant loss. To hear your precious baby referred to as a fetal demise or a spontaneous abortion–it hurts. Save the medical jargon for your reports and conversations with your colleagues. It does nothing to help your patient in their time of need.
In addition, avoid statistics and sweeping generalizations. There is a time and place for statistics and many effected by pregnancy and infant loss will take the time to learn them. However, in that moment the woman in front of you is not just one in four–she is one PERSON. Don’t make her feel like a number.
5. Be educated and provide resources.
Do not leave it up to your patient to seek out resources after their loss experience. Those first weeks following a loss are crucial in finding support and resources. Many individuals are left to seek out this assistance on their own. Given the heaviness of their grief, this can feel like a daunting task.
Give them a starting point–provide a book list or online resources that patients can access when they are ready. Do not just hand out a pamphlet and be done. Do some research and connect with resources in your area to have them help develop vetted resources for families of loss.
6. Check in.
Continue checking in on your patient after their appointment ends. Make a phone call, send an email or a card letting them know you are thinking of them. A gesture like this has the ability to let them know that they are not just another case of pregnancy or infant loss. This can let them know that they are a person and that you care.
7. Treat the mother as if she’s just had a baby.
Hopefully this one is obvious. You should treat your patient as if she’s just had a baby because she has. Do this regardless of how many weeks she was at the time of her loss. Her body will go through many of the same postpartum events as a woman who has had a living baby. Do not skip postpartum care just because the baby did not live.
8. Don’t forget the rest of the family.
Pregnancy and infant loss is not only experienced by the mother. Often there are other family members or loved ones involved and they have also just endured a heartbreaking loss. When sharing your sympathies, include the fathers, siblings, grandparents, and anyone else who is present during this difficult time. These other individuals may be busy supporting the mother and they can be easily forgotten. Taking the time to acknowledge the experience of all effected is an important way to extend your support.
9. Be willing to listen.
As a healthcare provider, you have incredible knowledge and medical expertise. However, the families you work with will remember none of that during this difficult time. They will only remember the ones who listened. I have heard from hundreds of people about the healthcare providers connected with their loss experience. Never once, have I heard accounts praising the doctor, nurse, or midwife for their expansive knowledge of miscarriage and stillbirth.
Instead, I have heard about doctors who shared their own stories of loss, about nurses who held hands, and about midwives who cried while they passed tissues. Your compassion and your willingness to be human will go a long way in carrying us through the most difficult moments of our life.