The Quiet Culture of Pregnancy Loss

               broken-heart

Recently, Mark Zuckerberg made headlines for opening up about his family’s experience with miscarriage. Hearing one of the most powerful couples in the world talk about their struggle with pregnancy and pregnancy loss was honest and eye opening. Regardless of who you are, or where you come from, or how much you wished for and loved your baby, pregnancy loss can blindside anyone.

We aren’t supposed to talk about miscarriage. It’s as if we’re all supposed to believe the pregnancy never really happened, as if it never really existed. Every word used to describe the way you feel after a miscarriage epitomizes everything you are in that moment…empty, hollow, exposed—but none of those words describe what you really are…overwhelmed, devastated, and incredibly sad. Stripped of every expectation and left without an answer to a single question spilling out of your head, you don’t know much.  But you know you are no longer pregnant.

As a labor and delivery nurse, I don’t often take care of women who are experiencing a miscarriage because they don’t normally come to a labor and delivery unit. Even as I type that, it sounds strange. Many women experience their miscarriage at home, and don’t require any hospital care.  When they do, they are usually discharged home as soon as possible, or sent to any other unit besides labor and delivery. It’s as if it isn’t even a real pregnancy, or a real birth.  And although I have never had a miscarriage, I have taken care of a handful of women who miscarried and somehow ended up in labor and delivery.

Fresh out of nursing school, I found myself caring for a woman who miscarried early in her pregnancy.  She had come to triage for cramping, and although at this particular facility we didn’t normally take care of women who weren’t at least 20 weeks pregnant, she had slipped through the emergency room and ended up in front me and my preceptor. When she didn’t come out of the bathroom, I opened the door to see her standing there, her panties bunched around her ankles.  Blood dripped down her legs and splattered on the floor, like raindrops on a window. Her eyes were squeezed so tightly shut, as if she didn’t want to open them and see everything so evident beneath her. I didn’t know what to do. I had never taken care of someone who was only 12 weeks pregnant. In my mind, I tried to think back to nursing school and tried to remember what a 12 week fetus would look like. Would I know? Or would I help her back to the bed and wipe up tissue from the floor that would have been her baby? While thoughts like these ran through my mind, I grabbed her hand as hard as I could and guided her back to the bed, her eyes still tightly shut.  I sat on the bed next to her, hugging her as tightly as I could, and let her cry into my shoulder until her partner arrived. And then I got her ready just like I would any other pregnant woman giving birth. She signed consents. I started an IV. I placed pillows behind her back and all around her. And before I knew it, she had delivered and was no longer pregnant.  I remember the way she held her stomach afterwards. I remember the blank expression on her face. I remember the way she laid in bed, seeming to suffocate in disappointment and disbelief.  And from one minute to the next, it was all over.

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Women experience loss differently from men. Women feel broken, not quite whole.  Men tend to feel as if they have to be the source of strength for their partner, their helplessness silencing many of their words.  Maybe women don’t want to talk about it with other women because they don’t know if their feelings are founded. Maybe they didn’t have an actual baby to hold, and maybe they don’t know that that doesn’t matter.  Maybe they somehow feel responsible for the inability to keep their baby secure inside of them.  Maybe all of this contributes to the quiet culture we have cultivated as a society.

Now, years later, I still often think of that woman and wonder if she remembers that I was there to witness her miscarriage. I wonder if she ever has an opportunity to talk about the pregnancy that ended so surprisingly, shattering the early formation of any dreams for that baby.  And the one thing I can say without hesitation, the one thing I can say with absolute certainty, is that miscarriages matter. They are a birth. It’s the birth of a baby, of your baby, a baby that no one will speak of, may not think of, and might not remember. But I remember that day. I was there and saw your face, shocked that you were suddenly alone, and I remember the way you held your abdomen, unexpectedly empty of another life.

For any family out there that has experienced the loss of a pregnancy, I understand that it is so much more than that. And although I can’t give you an answer of why things happen, or change the experience you had, I hope you find some sort of peace knowing that so many people out there have experienced the same loneliness and suffocated on the same disappointment of losing what could have been. And if we can learn anything from one of the most influencial couples speaking out about pregnancy loss, it’s that it’s okay to talk about it miscarriages matter.

Until my next delivery ❤

More Than Birth and Babies


24 thoughts on “The Quiet Culture of Pregnancy Loss

  • August 6, 2015 at 3:27 pm
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    Thanks for writing this. I really love how your blog balances the light side of pregnancy with the darker side, and it means so much to know that there are healthcare professionals who care, who are thinking of the women who don’t go home beaming with a gurgling baby. I had to deliver my first-born daughter at 18 weeks in a L&D ward last September, and it was the worst experience of my life (I also had a bad experience with nursing staff that day, but that’s another story). I’m now 12 weeks pregnant with a son (hooray for the NIPT gender reveal!), and every day I wonder if I’ll end up back there again, listening to the cries of healthy infants while I hold my dead fetus, or if I’ll be one of the lucky ones this time.

    I’ve never thought less of a healthcare worker who talks about our loss or asks how we’re doing — it’s actually jarring now when nurses and sonographers are chirpy and positive, because it’s so at odds with how I feel. This morning we had our NT scan and the ultrasonographer was whipping through measurements for what felt like forever before I finally said “Is he alive?”. She stopped and said, “Oh, of course! Look, you can see him moving!” It’s never “of course” to me anymore. I wish all sonographers would be trained to start off by pointing out a heartbeat or movement to reassure the parents. I can’t be the only one who breaks into a cold sweat every time the ultrasound goo comes out.

    Reply
  • August 6, 2015 at 3:51 pm
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    As a nurse practitioner working in obstetrics and women’s health and a woman that experienced 3 miscarriages of my own this rings so true. Even though you didn’t go through this yourself, you are perceptive and really seem to understand what your patients are going through. I always enjoy reading your blogs and share them with my nursing students. Thank you for sharing your insights.

    To lyra211: After my first miscarriage I also felt scared and anxious in every subsequent pregnancy whenever anything was done. You are afraid to tell anyone of your worries for fear of it occurring again. I agree that sonographers would do well to be sensitive to this in all people they scan and show them the fetal heartbeat if possible as you suggested. This speaks to the climate of not talking about this issue. Thank you for sharing your experience and feelings so others will learn from it.

    Reply
  • August 6, 2015 at 8:08 pm
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    A little life that that is over so fast, but lives forever in the heart.

    Reply
  • August 7, 2015 at 4:51 pm
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    Shelly,
    Your article brought me back to the day I lost my son. The emptiness one feels is so deep; like a bottomless pit. The grief so primal and comes from a place you never knew existed. And you feel that loss forever. Over time the pain is not as intense and you begin to see the blessings that this little soul has placed in your heart. You are able to identify with your patients who are experiencing the same type of loss. It makes you a better nurse and a more compassionate person. I will be forever grateful for my tiny blessing and look forward to the day I will see him again and hold him in my arms.

    Reply
  • August 8, 2015 at 1:54 pm
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    Shelly,
    Your post was perfect. Your patients are so fortunate to have you! And to Cindi B. for her reply…you described loss so perfectly. Thank you both so much!

    Reply
  • August 8, 2015 at 6:36 pm
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    Dear Writer,

    I am a student nurse based far away from the USA. I am just 2 months into my training and this week I helped care for 2 patients who had miscarried. I didn’t know how to act around them – wanting to be professional and not prying into their personal space, but more than anything, wanting to be sensitive and compassionate – as a nurse, woman and mom.

    So thank you for sharing this post.

    I hope to one day be the nurse sitting at the beside, letting the mom hold my hand or cry on my shoulder, if need be.

    Reply
    • August 8, 2015 at 6:52 pm
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      ❤ your desire to want to do the right thing will guide your practice and I’m sure you will provide excellent care. ❤❤

      Reply
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  • August 10, 2015 at 8:23 pm
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    I just read your article and felt compelled to write to you. I’ve had 3 miscarriages and I will never forget the nurse who helped me during my first, she found me in the toilet like your patient crying after seeing the blood, even thou I knew from the ultrasound there was no heartbeat and she walked me back to the bed hugging me as she did so. I will be eternally grateful for the compassion she showed me and how she helped me get ready for the d&c . I am sure your patient remembers you too. Thanks for a lovely article.

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  • August 28, 2015 at 4:49 pm
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    I was wondering if any of you L and D Nurses have experience of assisting a woman/young woman who has carried a baby to term and is relinquishing that child for adoption
    I think that takes a very special and compassionate nurse to be there for such a woman. I am such a person…a birthmother and I would have to say that I gave birth a while back when society was pretty much judging an out of wedlock pregnancy But fast forward, I would like to imagine how having compassionate nurses around me might have helped. Believe me to NOT talk about these things is almost worse than talking about them. Everyone around me just avoided talking about it.
    I was placed in a regular surgical floor and I was crying and my roomate, an older woman was so concerned about my appendicitis pain
    We, as a group, I believe suffer a loss that society is not prepared to acknowledge. We are just supposed to “go on with our lives” IMPOSSIBLE
    For all intents and purposes we too have had a “death”…a loss so incredible…and it wasn’t until years later a counselor gave words to what I experienced when she said ” You had a death ( to you) and there is no societal acknowledgement such as a funeral…no place to grieve or have sorrow.”
    Lin

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  • November 15, 2015 at 4:16 am
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    This post has touched me in so many ways. As a Canadian L&D nurse who also does postpartum and surgical care (small hospital=you do everything!) I have come into contact many times with moms dealing with loss of their babies. I would never wish miscarriage or infertility on my worst enemy! For a woman I feel that these two things are so life altering and yet rarely discussed which makes it so hard to work through. Thank you for giving light to this topic.

    In my personal life, this has effected me completely but in a different way. Last year when I was pregnant with my son, almost every one I knew was dealing with an inability to conceive, miscarriage, or having life circumstances which did not enable them to feel stable enough to have the baby they desired. I felt so isolated and unable to be excited for my pregnancy. I believe I had troubles initially bonding to my son because of this. I had written a blog post about how others losses had effected my life since I thought it may help others, but in return received negative feedback: though I had not described others specific situations it hit too close to home. I felt awful and immediately took it off, but it really speaks volumes to how closed mouthed we are concerning this topic. If you would like to read it I can inbox you.

    Anyway, thank you for your post and site in general. I will subscribe obviously since I have so much in common. How could your site not be helpful to me?!

    All the best,

    The Mama Nurse
    http://www.themamanurse.com

    Reply
  • January 30, 2016 at 3:49 am
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    Your blog offers unique perspective that I’ve laughed over before, sitting in a recovery bed after the birth of my 3rd child. Today I’m finding it again after following someone’s share on Facebook, but grieving my second miscarriage in the span of six months (in fact you wrote this post only two weeks before my first one, I see). What I can tell you is no act of compassion by our health care providers in this situation is too small. Like the ultrasound technician (who recognized me from the times she scanned my 2nd and 3rd children), after telling me there was no heartbeat, touching me on the shoulder and leading me to the bathroom, ostensibly to empty my bladder but really I think to let me cry, then printing me a picture, the only tangible evidence that I was ever pregnant for those 9 weeks. Or my GP calling me personally twice just to check up on me even though he’d already referred me to an OB and was no longer directly involved in my care. It means a lot to feel like we’re seen.

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