Dear Doctors of the World:
We want you to know that we respect you and your knowledge. But all the good stuff that you bring to your practice on a daily basis is not so helpful to us after a stillbirth. Please take these suggestions to heart, for us and your other patients who have suffered a stillbirth.
1) Please refer us to therapy and support groups.
We are lost. Our baby has died and we have no idea how we are, who we are, and how we will ever survive this. We could never have imagined that our pregnancy would end in a stillbirth. Please let us grieve with you. Please show us empathy. Please refer us for therapy and support groups, to let us know that we are not the only ones who are going through this horrible pain. We do not feel strong enough to do this by ourselves. We should not have to do this by ourselves.
2) Please flag our pregnancy loss in the chart so you and your staff do not ask us how our baby is doing.
We are fragile and so vulnerable. Many of us have PTSD and every time we walk into your office we have flashbacks and re-experience our grief. We are not “over it”. Please know that we are not trying to be difficult or dramatic. We are often just trying to get through the day. We can be triggered very easily back to our traumatic loss. Please know that we grieve every day for our baby who has died. Please let us talk about him or her by name. We are hopeful that we will have a rainbow child AND we cannot and will not forget about our child who died. He or she is always with us in mind and spirit.
2) Help Us to Plan For a Subsequent Pregnancy.
We are scared to death about the next pregnancy. Please meet with us and develop a detailed plan that will help us find the courage to try again. Help us to understand what happened. “These things just happen” will not suffice. Read the autopsy report with us and explain it, please. Please don’t give us false reassurances. We are too scared to hear them. We are still learning to trust our bodies—and you. We count time by every 15 minutes, every half-hour, every hour, and every day. The idea of a pregnancy that lasts almost 40 weeks freaks us out. Please tell us the truth. Give us the facts. If there is a way to do this safely, give us the plan. We don’t want to muddle through this. A subsequent pregnancy may not feel high-risk to you but it does feel high risk to us. Tell us that you will be willing to consult with perinatology (i.e., the high risk OBs). If we should not have another pregnancy, please say so. We don’t need any sugarcoating.
3) Don’t tell us that everything will be okay.
We are not okay. Anticipate that we will be hysterical during our next pregnancy. Normalize it. We will need superhuman strength to get through a subsequent pregnancy. It may be difficult for us to get excited about it while we are pregnant. Every day is unknown for all of us but a previous loss amplifies our fear of the unknown. Help us to be okay—for that hour or that day. Know that we will not really be okay until a baby is warm and squawking in our arms. For us this will be a “prove it” pregnancy. Do tell us that you will do anything and everything to work with us to ensure a successful pregnancy. Work with us collaboratively. Here is the most important thing for you to know: LISTEN TO US. We have lived in our bodies. You have not.
4) We need data for reassurance, not words.
Offer to give us more tests and scans when we ask for them. We will pay for them. When you tell us that insurance will not cover them, we will tell you again that we will pay for them. We need data, faith, and hope and we need you to have data, faith, and hope for us and with us. Remember: It’s about us, not you. If you cannot or will not meet us in the middle, we will have to find other care.
5) Show us your human side.
Talk to us as fellow travelers, not cases. Be our champion. So many people have played down the pain and trauma of our stillbirth, we cannot bear for you to be another. Please tell your partners and your nurses about the plan for this pregnancy, so we do not receive conflicting opinions or plans when you are not there. Give us a hug or hold our hand. Literally. We need everything you’ve got to get through this.
So, in conclusion, dear Doctors of the World, please work with us. We will do our best. Please do your best, too. It is through our connection and collaboration that something good can come out of our pain and loss.
Please rename this as “Five Essential Ways Doctors Can Help After Pregnancy Loss”. I am currently 12 weeks pregnant after five miscarriages (each <20 weeks). I have no living children, and I promise you that every.single.thing you've listed here is as necessary to me as it is to a mama pregnant after a stillbirth. Please help eliminate the idea that stillbirth is worse than miscarriage, or vice versa. Each is the loss of a loved child, and pregnancy after any kind of perinatal loss is terrifying, regardless of when in gestation the loss occurred. We need to be working together to end the idea that a miscarriage is somehow less awful than a stillbirth because "at least" we weren't farther along. A baby is a baby, a loss is a loss, and mamas pregnant after miscarriage need the same kind of support as mamas pregnant after stillbirth.
Melissa, we certainly do not mean to exclude anyone or their type of loss when publishing articles. You’re exactly right that loss is loss, and we absolutely want to validate that in everything we do at PALS. Our contributors have a variety of experiences, and often they write based on THEIR experiences. It is not meant to invalidate any type of loss. They’re just writing what they know. We cover miscarriage, stillbirth, neonatal death, SIDS, and child loss, as well as loss-after-loss. We love it when the more specific articles resonate with a larger audience. Please understand that they are never meant to isolate, exclude, or offend.
Magazine Submissions & Web Coordinator
Hi, Melissa. I want to mirror Valerie Meek’s comments. I also want to thank you for your heartfelt comments on my article. PALS seeks to support anyone and everyone who has suffered a pregnancy loss. This is my first article for PALS. There are more to come and I would be glad to write about your point, that this is not a competition of loss.
I send you my heart for your pregnancy losses. You are right–loss is loss. I see many women and their partners who have multiple miscarriages and many who have experienced stillbirth. Often the same person or couple have struggled with both. People feel devastated. Period.
I understand that you are currently pregnant and scared of your wits. I remember being in that place myself. I will be writing in the months ahead about how to get through an hour or a day in a subsequent pregnancy, when perinatal loss is part of your story. I wish you a safe journey and a good story.
I am surprised and amazed, that after reading the article as well as the comments the word DOULA was not mentioned once!
I am quite sure that Doulas could play a very effective part in dealing with all aspects of that problem.
It would be very interesting to read the Author’s reply to my comment.
PS. I’m not a Doula, but a very dear friend of mine who has intrduced me to the wonderful world of Doulas, is
Thank you, Peter, for your excellent suggestion about having a doula be part of the birthing team after a stillbirth. While I often discuss doulas with my clients, I did not think to add it to my article. It is a great idea, both for the woman going through a subsequent birth and her partner. Both partners are usually traumatized by the idea of even walking into a birthing suite at the hospital. Doulas offer a sense of calm and hope that is non-medical, and human. There is a complication, though. Doulas are not recognized universally by OB/GYNs and hospitals as part of the birthing team. There’s a lot of education to be done, don’t you think?
I had this exact doctor. I’m so sad that someone else also experienced these things. I sent her this article and she responded that she understands my grief and I need to get over it. I truly hoped she would take it to heart, but she obviously doesn’t get it.
Also, the hospital I was going to doesn’t allow doulas. I did have support from others, but certainly not from my OB,
Thank you so much for writing this.
Hi, Anonymous Excellent Person. I am so sorry that your doctor has missed the entire point of the article. I will give your doctor some credit for thinking that she understands your grief until the “get over it” part. We do not get over trauma in a neat package. We learn how to live with it and keep going, sometimes walking and sometimes crawling. I certainly encourage you to consider working with a different doctor. Patients often “vote with their feet”, meaning they work with a doctor who is more in tune with the situation they have been healing from.