Dear OB after pregnancy loss,
Before we make this “relationship” official, I have a confession.
I know my paperwork has already informed you that my number of pregnancies does not equal the number of babies who made it to viability. This gravida/parity equation is simple to read, but carries nuances that can be hard to fully comprehend. There is just so much these two numbers don’t say about the kind of support I need from you during this very vulnerable time:
1. Fear is a pretty big deal to me right now, especially when I’m pregnant again or thinking about trying again.
You see, I’ve had my very worst fears confirmed. I may have even had my fears dismissed too easily before they were confirmed. So nothing, nothing, about being pregnant after loss is immune to my fears. It touches everything.
2. I will sometimes be the difficult patient.
The sheer volume of things to be afraid of, coupled by how deep my fear runs, may cause complications in our doctor/patient relationship. The last thing I want is to be a difficult patient – no, scratch that – the last thing I want is to go through another loss. So that’s exactly the reason I might seem like a difficult patient at times, even when I don’t want to be.
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3. I’m choosing to be an especially informed patient.
I know that you are the expert I can rely on to keep me and my baby as safe as possible. But because I’ve had a loss under the supervision of another very capable, very smart professional, I may struggle to trust you. It’s not that you’re not worthy of trust. It’s just that my trust in all things has been compromised. So I choose to be as informed as I can be about possible complications, testing I’d like run, and courses of treatment. Please don’t take offense. This is just one way I strive to take control because my lack of control during our loss was so very traumatic for me.
4. I’m relying on my village.
I may ask for a second opinion. Or a third. I may ask to work with a maternal-fetal medicine specialist, or a reproductive endocrinologist in conjunction with you. I may spend a lot of time Googling and Facebooking, finding out from other loss mamas what they did in my situation. I’m not sure how you feel about all this extra input into my pregnancy, but it would mean the world to me if you would embrace the idea that this pregnancy will take a village.
5. You and I are going to see a lot of each other.
And I mean, a lot. I don’t want to waste anyone’s time, and I certainly don’t like to rack up medical bills for no good reason. But 9 months is a very, very long time to be in a vulnerable state where at any moment, things could go south. And when either my fears, or my body, or my heart is telling me something might be wrong, you better believe I’m going to call or come in. I hope you’re willing to support me coming in whenever I need to and staying however long it takes to have all my concerns addressed.
6. I’m going to need a lot of reassurance.
And I don’t mean a quick, “I’m sure everything is fine,” pat on the back, and usher out your door. I mean, I’m going to want proof. Bloodwork. Ultrasounds. Heartbeat checks. Non-stress tests. The works. One way you could make this journey easier for me is to welcome me into your office anytime to check on the baby’s heartbeat. This is the kind of reassurance I am counting on you to give.
7. I need you to accept my grief.
I am planning for new life at the same time as grieving the loss of a child. (No matter the gestation of my loss, I assure you, that was my baby.) I realize this is complicated ground as you try to assess my mental well-being during our checkups. Anxiety and depression look so much like grief, and that’s before you even add in all the crazy hormones from pregnancy. I’m not saying I won’t ever benefit from an anti-depressant. But I am asking that you take a look at the whole picture, allow me space to process the experiences I’ve just had, and offer other alternatives like counselors who specialize in bereavement or trauma before you offer to medicate my grief. That way if medication does become necessary, I’ll know we’ve covered all our bases first.
8. I’m choosing to trust you . . . at least as much as I can.
I’ve done my due diligence, checked reviews, gotten recommendations from my friends, and I’ve settled on you. My hope is that however this pregnancy or trying again journey looks like – whether it takes years and multiple losses, or we end up with a live baby this next time around – I hope you will be the one to help walk me through my greatest joys or my most devastating losses.
You’re officially invited into some of the most intimate, important moments of my life moving forward.
That is – if you still want me.
Your (hopeful, but terrified) patient,