At the end of my talk to my local midwifery students, I gave them a handout, that speaks volumes. You may recognizes some words, because they were simply taken from the comments section in response to my question of what would you like midwifery students to know about baby loss. Feel free to comment if you have more advice to give! Here is the handout:
Words of Advice from Baby Loss Moms
“Video clips of ultrasounds meant so much to me and I would have like a recording of my daughter’s heartbeat if they could have given me one. At the time I didn’t know it those would be my only memories of her. I appreciated when my doctors were honest but sensitive.” -mother of Caroline, carried to term after a Trisomy 13diagnosis, who lived for 58 days.
“I think they didn’t tell me anything because they had no clue what was going on themselves and wanted to wait until they had more info- but, that choice made things much worse!!!! Talk to the patient, you have to talk them through what’s going on, you have to tell them. Also: if there’s a chance a baby might not make it, you have to prioritize letting the parents see the baby while working out the logistics. I didn’t get to see my kid until after he was gone. I even asked but was told it was too complicated. That’s still absolutely devastating to me, and probably always will be….One other thing: I was given the choice to go to private room on postpartum, or to a different floor. I really appreciated having a choice.” –mother of Sacha who died day after birth from unexpected brain tumor
“Perinatal loss can be such an “ambiguous loss”. It was so validating to see everyone reinforce that he really was a real baby (a concept that almost all brand-new mothers struggle to comprehend at the moment of birth).” –mother of Sacha who died day after birth from unexpected brain tumor
“Even if the death occurs later, call or write or visit the parents. We so appreciated that one of our midwives and her intern were able to make it to the ceremony we held for Paul. But a call would have been just as meaningful…. If applicable, invite the parents to share a photo of their baby for the baby photo board or book.” –mother of Paul who died unexpectedly a few weeks after birth
“And for subsequent pregnancy: if you need to discuss the death of the previous baby, give notice in advance so the parents can prepare (especially if you need them to tell their story, or to dig into traumatic events). Also I was offered a viability scan I didn’t “need” but that was really reassuring.” –mother of Paul who died unexpectedly a few weeks after birth
“With miscarriage (or infant death in general I suppose), even if there is ‘something wrong’ with the baby that you can prove with genetic testing, no one should ever say ‘It’s OK- the baby had a problem anyway.’ I’ve noticed a lot of pregnancy books use this kind of logic, and it’s bad. We don’t throw out people or stop caring about them because they’re sick, so what are we supposed to feel better that our baby that died wasn’t perfect, and that caused his death?” –mother of Serphim, who died of Potter’s Syndrome five hours after birth
“Encourage parents to hold, kiss, love, bathe their baby… If you’re uncomfortable handling a dead baby, please ask one of your colleagues to take over. This was our only negative experience with the staff- and it felt awful to have someone reject our precious babies. Remember that these parents need your care, support, love perhaps more than anyone else on the floor.” –mother of A&C, twins who died after PPROM at 20 weeks.
I was that woman, sitting in the OB office following my 19 week anatomy scan when the midwife came in with a student and very coldly and matter-of-factly started to explain the slight anomaly found on ultrasound. When I started to cry the midwife offered little support and I could tell she was busy and I think she really believed the finding was nothing major and that I was over-reacting. It was the student who came back into the room alone and sat with me, let me cry, and explained what was going on as best as she could. So my advice to your students is that there will be days in clinic when you are busy and running behind and stressed, and these are the days when you might have to break bad news to a patient (or several patients), and your pager might be going off, and your receptionist might be reminding you that you have 3 patients in the waiting room, and you will probably have a huge stack of papers on your desk that need to be reviewed… but in that moment, for that patient- your time and presence is what she needs most.” –mother of Clara, carried to term after a Trisomy 18 diagnosis and born still at 36 weeks
“It might be tempting to let the parents know that their loss isn’t a big deal compared to what other people go through, but that can be very disturbing to the grieving parents. Don’t tell them it was nature’s way of getting rid of damaged goods. It was their baby. They loved that baby and would have done anything to save it. To you, it was a blighted ovum, or a common Trisomy problem, or ‘barely even a positive’ – but to that family it was precious and beloved. The loss is still very real no matter how unformed the physical person may have been.” –mother to baby lost to miscarriage
“Our nurse hung a doorsign of a baby in an incubator on our door so that those entering my postpartum room would know that we had a NICU baby. That was great as it eliminated any too-cheerful questions. However at my six week postpartum checkup, the doctor didn’t know my baby had died.” –mother of Anderson, born at 24 weeks who lived for 26 days
“Cyr, take photographs- YES. And remember, you can never tell a loss mom that her baby is too beautifulm too perfect, too special and too unique. She will never hear this as her child grows. Give her a lifetime of school picture Oohing and Aahing in the short time you have with her. Use the baby’s name.” –mother of Anderson, born at 24 weeks who lived for 26 days
“I was pregnant with our 2nd baby and had our first u/s at 9 weeks. They couldn’t find a heartbeat. I t was hard and still is. I recall the u/s tech saying ‘oh I just know you’ll be back in 3 months pregnant again!!!” She was just so hopeful. But that’s not what I wanted to hear. I needed to honor THIS baby and THIS loss. So overall, I just wanted the midwife team to honor the present and respect what we are going through at the moment.” –mother of baby lost through miscarriage
“To make sure parents have all mementoes of their baby that they would like; to make sure parents know they have no been ‘cast adrift’ from the unit- you become so close to staff whil your baby is being cared for going home is like an estra wrench on tope of the loss of your baby; to make sure parents know how to access counseling. I would also add a couple points about traumatic birth- whether it’s something like PPH or an illness such as preeclampsia and HELLP syndrome- that mums know where to get information about what happened to them and why, and how to access support/forums/debrief about the birth.” –mother of Hugo, born at 24 weeks and lived for 35 days
What more do you have to add?
Expecting the Unexpected 
Reblogged this on Wrapped Up In Parentheses and commented:
I have a lot of friends and readers in the medical community so I want to share this…
One of the key points that I’ve found from my own experience and from looking through the literature about how pregnancy loss and infant death are handled, is that providers (and well-meaning others) have an instinct to rapidly say “Don’t worry, you can have another”. The message they’re trying to convey is “There’s nothing wrong with you, this wasn’t your fault”. They are trying to be reassuring and provide hope.
But the message a bereaved parent hears is “This is nothing to be upset about, your pregnancy/infant/child wasn’t that important anyhow, the precious creature most important to you in the entire universe doesn’t even matter at all”. This message is wounding and bewildering. When it comes to parental bereavement, the age of a child is completely irrelevant.
In due time, it is necessary to address any impact on future reproductive health. But a reflexive “you can have another” is woefully unempathetic and inadequate.
you put it so well- the well meaning words intended to inspire hope is not what we often need at the time, we need pure empathy.
With my first miscarriage at 10 weeks, my OB told me to take comfort in the fact that the sac was empty and there never WAS a baby, therefore it was the loss of a pregnancy, not the loss of a baby. I believe he meant for this to be comforting, but it made me so very angry. For myself and my husband, empty sac or not, there was a baby, in our hearts and mind. One we wanted so very very much, one we had hopes and dreams for, one we talked about and sang to and cared for even if only for 10 weeks. Eventually, this may have been a comfort, but at the moment we found out the baby was gone, it didn’t help at all.
In the beginning of Mabel’s pregnancy, we first thought she was simply an empty sac. I had only known I was pregnant for a week or two and I was just so sad to hear. in the week that followed as we waited for another ultrasound to confirm, I mourned the loss of the baby I had been growing in my mind. It was an even shorter time than you had, so I can only begin to imagine the hurt. good point for practitioners to know
Thank you for carrying these words to people who need to hear them.
it’s so important and I plan to do more.
Reblogged this on Headspace Perspective and commented:
The wonderful Meghan is Mabel’s Mummy. Today is Mabel’s first birthday – Happy Birthday, Mabel – and it is sadly also the day she died.
Meghan blogs at Expecting the Unexpected. She is a midwife, and as part of a talk to local midwifery students prepared a handout about baby loss. Meghan had asked her readers about what we would like midwives to know about baby loss, and the handout contains our suggestions. The suggestions are very insightful, so I would like them to share them with you, too. Thank you, Meghan.