# Advice needed for health care professionals' protocol!



## ~Mamaterra~ (Jul 5, 2006)

Dear Mamas,

I have decided to set up a protocol for health care professionals who care for, not "treat", women who have suffered a miscarriage or birth loss.

Most hospitals seem to have a protocol for women who have had a baby born still but nothing else.

Unfortunately, I have heard too many stories, and experienced myself, the insensitivities of these health care professionals in dealing with m/c and birth losses.

So I am polling you mamas as to what you would like to see all health care professionals, from the front desk clerk to the radiologist to the OB, whoever you deal with along the way, in how they care for you.

I choose the word *care* because I believe that we need to take more of a palliative/grief care approach to mamas who have lost rather than *treat*. Treating is external, caring is internal. Change needs to happen even in the language we use.

So mamas who have BTDT, what would you include or like to see?


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## Amydoula (Jun 20, 2004)

Oh this is so wonderful! I am so glad you are doing this. Honestly I was treated so well during my time at the hospital. Everyone was very respectful and compassionate. The ONLY thing I personally would have wanted different would be to NOT see my dead baby on the ultrasound. I think something like this should have been asked of me: "I am going to do the ultrasound now to check for a heartbeat on the baby, would you like to look or would you like me to turn the screen away?". The had me facing full on the screen and I did not want my last memory to be of my dead baby sitting in my uterus. I'm sure for others they would want to look, it would help them, but I would want to be given that choice to look away.


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## mytwogirls (Jan 3, 2008)

I agree with the not seeing the deceased baby on the screen. However, my situation was different. I was in for a routine visit with no symptoms and we just were checking for a heartbeat. I work in the health care field, and I could tell right away the baby was gone. It was just so distressing. I have found my OB to be very caring, understanding and the nurses and staff were awesome in the hospital. I wish everyone who had to endure this had the same experience I had.


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## heatherh (Jun 25, 2005)

A few things I can think of right now...

Flag our files to avoid the awful awkward questions about the baby later on. I've seen countless numbers of us that have been further traumatized by well meaning (or not!) office staff who just don't know.

Be *sure* to adjust/cancel later appointments. Do NOT call to remind us when we miss a follow up appointment that is now a moot point.

One thing I really appreciated was the dr who did the diagnosing ultrasound left DH and I alone for a little bit to kind of gather our thoughts. It is nice to at least be offered this opportunity.

What about ways to minimize the drama around payments/insurance issues? Any way we can simplify things there?


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## namaste_mom (Oct 21, 2005)

The hospital where I delivered didn't seem to know what to do...

We waited for two hours just to begin the process of having blood drawn during the induction.

Nobody mentioned a support group or anything in the area.

One insensitive nurse barged in at the beginning and said "Do you know what sex the baby is because we are going to get some stuff from the NICU together". It was very insensitive and all I could do was shake my head. Maybe the nurses could have more training or they should mark the door and flag our files.

The same group of nurses seemed to not even know why they were taking 15 vials of blood. They just seemed to not be professional.

I've been treated very rudely by the receptionist at my OB's office. She has made me say "stillborn" several times which at the time, led to me sobbing.

I left the hospital without any discharge papers. Nothing to tell me what to do in an emergency, what to look for, when to make another appointment, it is almost like it never happened.

Some nurses were kind but it just takes one insensitive person to make me angry.

That's all I can think of right now.


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## somanyjoys (Mar 14, 2006)

Our hospital must have some excellent protocols in place. Here are some things they did do that others should:

-- marked our door so anyone entering knew. It was a picture of a leaf with a droplet on it.
-- took pictures of the baby for us, but put them in a sealed envelope so that we could see them (or not) when we chose.
-- put together a box of mementos that included a tiny hat and booties and blanket knitted by volunteers, a James Avery pendant -- a heart with a tiny heart cut out, a couple of other handmade items.
-- allowed us time alone with the baby
-- once we learned of the baby's death (at the anatomy ultrasound) my doctor got me in immediately and didn't leave me waiting in the waiting area


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## Megan73 (May 16, 2007)

Thanks for this, mama. Two things my midwifery practice did come to mind:

DON'T make women whose babies were born still wait and wait for their six-week post-partum visit surrounded by pregnant women and babies.
DO flag the files of women who have had losses so you don't ask chipper questions about the birth of babies who died.


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## labortrials (Aug 7, 2007)

1. Take women having active bleeding IMMEDIATELY to a room. Don't make them sit bawling their eyes out around other pregnant women or in a horrible ER waiting room.

2. Don't subject them to unnecessary protocols when they make a request - I was "forced" to accept a heplock, and not only was it completely unnecessary, but the nurse sucked at getting it into place.

3. Don't tell a woman (especially when you're not her provider) that she put the pregnancies too close together and that she pushes herself too much. We already blame ourselves enough.

4. Don't misread ultrasounds. Misread ultrasound leads to misdiagnosis which further complicates things. I am angry over the insensitive and mismanaged "care" I received.

5. If your patient miscarries over the weekend . . . follow-up with her. It's the least you could do.

6. Make the billing process more clear and more simple to digest. I don't know where all of my bills come from and why I continue to have to pay so much out of pocket. I thought I had insurance???

7. Make sure you have RESOURCES to share with your patients/clients in the form of personal support, support groups/networks, reading materials, etc.

Yeah . . . all of this (and more, I'm sure) I experienced with my 10/07 miscarriage. That was my one and only experience with our local hospital. I won't be going back there unless I'm seriously dying.


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## NullSet (Dec 19, 2004)

Quote:


Originally Posted by *somanyjoys* 
Our hospital must have some excellent protocols in place. Here are some things they did do that others should:

-- marked our door so anyone entering knew. It was a picture of a leaf with a droplet on it.
-- took pictures of the baby for us, but put them in a sealed envelope so that we could see them (or not) when we chose.
-- put together a box of mementos that included a tiny hat and booties and blanket knitted by volunteers, a James Avery pendant -- a heart with a tiny heart cut out, a couple of other handmade items.
-- allowed us time alone with the baby
-- once we learned of the baby's death (at the anatomy ultrasound) my doctor got me in immediately and didn't leave me waiting in the waiting area

My hospital was also very good and had many of the same protocols.

-Like above, our door was marked so everyone knew before they entered.
-Pictures, footprints, lock of hair were taken and placed in a memory box.
-My OB's office was in the same building as the hospital, so I was wheeled down the "back way" to avoid all pregnant women. I'm pretty sure I was placed in a farther room in Labor and Deliver, I did not hear any babies crying. They also did not make me move from the nice laboring room to a not as nice recovery room.
-I was required to come in for a 1 week PP appt, instead of the regular 6 week appt. This I'm pretty sure is to talk and gauge how well I am coping emotionally. I was apologized to profusely for having to wait in a room of pregnant women and babies. The appt was also made for me by the nurses in delivery, so I didn't have to think about calling.

I found the doctors, nurses and midwives at my practice to be extremely caring and that is what meant the most to me. I felt _cared for_. I received so many hugs and they all still remember me.

The only complaint I have is that I was never offered any information on support groups. That was big for me. Thank goodness I had mdc, because I didn't really have an outlet for the pain irl.


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## mommyfied (Jun 25, 2007)

I was just thinking tonight about how they send you home for a miscarriage and tell you it's going to be painful, but like a "heavy period". If I hadn't read on here what to expect, I would have been terrified by what was happening to my body in the midst of the miscarriage. I feel for those unsuspecting women who haven't found a great resource like Mothering. OBs need to prepare women for what is going to happen. "Heavy period" doesn't even begin to explain it. "Labor pains" doesn't even do it.


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## skybluepink02 (Nov 9, 2005)

My OB was absolutely wonderful.

* When I signed into his office, I was brought directly back, so I didn't have to sit in the waiting room with all of the pregnant women.

*We went into his office, so we could talk face to face, fully clothed, and he could answer my questions.

*When we did the ultra-sound, he turned the moniter away from me to make sure there wasn't anything traumatic on it. He asked if I would like to see what was going on. I did.

* He left orders with his nurses that I was to be buzzed straight to his office if I called. I called a few hours later for some pain relief and was on hold for only a few seconds when he picked up the phone.

*Called all prescriptions straight into the pharmacy we use, so we wouldn't have to wait for them.

* After all that, he told me exactly what was going to happen and what to watch out for. He told me I was going to cramp, then they were going to get worse and worse, and a lot like contractions. He told me they would last a minute or so at a time and a few minutes in between. He said I'd have a few hours of this, but if it lasts more than 6 to call him. I really liked knowing exactly what was going to happen, and knowing that if I was worried, I could call his office and talk directly to him.

A miscarriage is a horrible reason to need an OB, but he was so wonderful and I'll always be greatful.


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## skybluepink02 (Nov 9, 2005)

He was also very forthcoming about the pain. He was supportive of me doing it at home, naturally, but he felt he needed to warn me about the pain, particularly since it's my first pregnancy and he didn't want me to be scared by it. I really appreciated it, because otherwise I would have though something was very wrong.


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## punkrawkmama27 (Aug 31, 2007)

This is such a great idea, I ended up going to two different practices during the month of Decemeber from the beginning of finding out the baby was not alive anymore, to the m/c, to the d&c, and the first practice I was at was so unprofessional and so cold.
*When the NP couldnt find the hb at first she thought it was the doppler, she was huffing and puffing, when she had to go around my ds in the stroller and yelled at the nurse. She was in such a crabby mood.

*When she couldnt find the hb on the other doppler she took me down to ultrasound tech. The tech was so rude. She was popping and snapping her gum. All she said to me was "the baby has no hb, it measures about 9.5 weeks" then she popped her gum again. No, I am so sorry dear, nothing. Not even from the NP. She didnt offer to take me to her office to talk about it, didnt give me any info on it. She just said to call and schedule an appointment with a doctor. No hugs, nothing. I was so angry at first. Health care professionals are supposed to be caring and compassionate arent they?

*No one called me to check how I was doing, not even after more than a week, so I finally had to call because nothing was happening on its own, and I did end up crying telling the nurse over the phone who poorly I thought I was treated when I called to make an appointment with the doctor. Shouldnt the ob office have called at least the day after to see how things are? To check on the patient to make sure things are stable?

*When I went in for my appointment, I waited for an hour! The whole time surronded by pregnant women coming in going out, it was torture! Then I get to the room to see the doctor, and there are all kinds of pregnancy magazines in there. There should be a special room for a mom who suffered a loss to go to, right away.

*The doctor did a transvaginal u/s, and had the screen right in my face! I couldnt look, he explained that the baby had already decreased in size, was probably decomposing, and asked if I wanted pictures!!!! WTH? I already had pictures of my baby with a hb. Couldnt he see I was crying and not looking at the screen? Why would he ask that?

*He was one of these male doctors that was very pushy and he was right, didnt even want to listen to me. He said such nasty things. He said you are lucky to be 3 for 4. You have 3 living babies you should feel lucky. Well no, I felt very unlucky at the time, I had just lost my very wanted pregnancy. He also told me I needed to get on with my life. I should get a d&c so I could move on. Doctors who care for women should have to go through special training on what to say and what not to say!

*At the next appointment after I finally m/c, I waited another hour, pregnant moms everywhere, one lady even brought in her new baby and all the receptionists were ooohhhing and awwwing right in front of me, I just let the tears run down silently. But, after waiting all that time, I finally see the doctor, I told him what happened, he did not do an exam, no ultrasound, nothing. Sent me for an hcg test that was it. If I wait there for that time, he should spend more time than just 5 minutes. He made me feel like I took up too much of his time.

*The results of the bloodwork were supposed to be back the next morning, but by 3 pm after them not calling like they said they would, I got worried and called them, I was very angry. And they didnt have my chart had to find it, I had to call back. Isnt that their job?

Well as a result of the poor care, I ended up in the ER with an infection. I was begging them not to call that doctor, thank God, he didnt have priviledges at the hospital I went to! I met such nice doctors and nurses. THey were caring and understanding. THey hugged me, let me know what to expect. Gave me pain meds because the pain was unbearable!

Then I met my new ob doctor! SHe did the surgery, explained everything to me. She was caring and told me that it was alright to grieve it was a loss! She checked on me each day I was up there. They called me to check if I was resting at home comfortably. When I had a question and had to call, they helped me right away. I really felt like the entire staff cared about me and what I was going through!

When I had to go to her office on Monday for the 2 week post d&c check up, I went right into a room, I didnt have to see any pregnant women. When it was time for my exam, she had a nurse come take my dc out of the room and walked with them and gave them a lolli. She hugged me and told me that it was alright to cry. I gave her a thank you card, because she helped me out so much. That is how a doctor should treat a woman after such a terrible loss.


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## ~Mamaterra~ (Jul 5, 2006)

Bumping this one for more suggestions....


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## barose (Dec 6, 2006)

Quote:


Originally Posted by *Megan73* 
Thanks for this, mama. Two things my midwifery practice did come to mind:

*DON'T make women whose babies were born still wait and wait for their six-week post-partum visit surrounded by pregnant women and babies.*
*DO flag the files of women who have had losses so you don't ask chipper questions about the birth of babies who died*.

For this very reason, I walked out of my 6-week post-partum appointment NEVER to return until a year and a half later for a well-woman appointment.

*I wish the nurses would have warned me about lactation. I was given an instruction form, but it was placed at the bottom of my bag. No one talked to me about what I should expect, how to treat my breasts, etc. Some chuck pads or something to sleep on would have been nice when I suddenly woke up soaked the day after I came home. That alone is traumatizing in itself.


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## ~Mamaterra~ (Jul 5, 2006)

Bumping again, I know there are lots of mamas out there with this unfortunate experience and I need a statistically significant amount of replies to make this work.

Please tell me your opinions!!!!


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## Breathless Wonder (Jan 25, 2004)

For miscarriage:

I valued the option to take home my babies' remains. Some states have it, some states don't. When I had my first miscarriage, my baby was disposed of as hospital waste. All these years later, it still breaks my heart. This time, I specifically miscarried naturally, because the PA was unsure of my state's guidelines, and while I was not sure I was prepared to deal with the baby passing on my own, the thought of my baby being medical waste was more than I could bear. I prepared myself mentally as much as I could, but during the miscarriage, I was afraid of passing the baby into the toilet, or passing the baby while out in public. When I did pass the baby, I hadn't thought ahead as to where to put the remains.

Somewhere on this board is a list of what NOT to say to a mother who has just suffered a loss. Make sure everyone coming in contact with the mother- doctors, nurses, phlebotomists, US techs, has familiarity with dealing with a mother's grief. During BOTH miscarriages, I had some appalling things said to me. My doctor could not even remember who I was, the PA the first time just blurted out, "So your baby is dead.." Perhaps, some things were said in an attempt to comfort, but hearing, "Well, you have other healthy children, so you should be thankful- you know you can do this, and you can try again" was NOT helpful (US tech this past miscarriage).

Take a cue from the patient- if she keeps referring to her loss as a "baby", don't keep calling it "the product of conception".

Offer an ultrasound picture- the mother may or may not want it. If she is unsure, ask if she'd like copies placed in her file in case she changes her mind in the future.

Remember the fathers.

If possible, the person who has been monitoring the pregnancy should be there when the results are announced. I can't tell you what it meant to me when the PA came down to comfort me and my kids, and gave me her personal cell phone number. I didn't use it, but wow! I felt like a real person.


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## momoftworedheads (Mar 6, 2003)

Just saw this as I have been off the computer for a few days....

Ok, first of all, let the mama see the U/S of her baby and offer pics even when there is no HB. We had heard the HB at 12 weeks and then at the 16 week u/s when there was none the Peri jsut told me and wouldn't let me look at the u/s screen or have pics.

Secondly, flag our charts forever, I mean forever, unless we tell you otherwise! I went to see Peri for pre-conception planning, I was asked when I was due (twice) and how my baby was doing (like I just gave birth to her and she was alive). Read the chart, figure it out and do not ask those kinds of questions.

I'll post more later.

Take care,


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## barose (Dec 6, 2006)

Quote:


Originally Posted by *momoftworedheads* 

Secondly, flag our charts forever, I mean forever, unless we tell you otherwise! I went to see Peri for pre-conception planning, I was asked when I was due (twice) and how my baby was doing (like I just gave birth to her and she was alive). Read the chart, figure it out and do not ask those kinds of questions.

I'll post more later.

Take care,

ITA! Three years later, I still get asked those questions.


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## lolalapcat (Sep 7, 2006)

My first 2 m/c's were very early, and happened at home. When I called the hospital to speak to a nurse about the first one (I was bleeding, and was pretty sure what was happening) I wish she hadn't been so darned optimistic, and would have directed us to written material or websites telling me what to expect.

The RE I went to after those m/c's handed me a booklet on m/c & birth loss, addressing physical and emotional issues. She also gave me information on support groups. That was really nice, and the most helpful thing I got.

When I had the 3rd m/c, the hospital where I had the d&c sent in the chaplain to see if we would like him to pray with us, and EVERYONE was kind and gentle with us, the nurses, anesthesiologist, doctors...they were so considerate.

I still get invitations to the hospital's annual balloon release, for those dealing with pregnancy and birth loss.


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## ~Mamaterra~ (Jul 5, 2006)

Bumpity bump bump!!!


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## youthpastormama (Mar 24, 2007)

The NP that I saw was amazing. She was very gentle and compassionate. She explained everything that was going on. She told me that what was happening was natural and that my body was doing it's job, but that it she knew it didn't make it any easier. She said to love my three dc at home, but that I needed to take time to grieve this little one. She also called my OB and told him what had happened, and let us know that he knew who we were - our story, and not just one of many patients. (I hadn't been in for over a year, but to know that he remembered us was comforting.) The NP is an example of what to do. The office staff, however - what NOT to do.
I had to leave to get blood drawn, then come back for a shot. When I came back I told the receptionist to call the NP and tell her I was back for the shot. She had to ask me my name three different times, and I had to tell her what I was there for three different times. On my way out I had to change my scheduled pre-natal appointment to a follow-up with my OB. The appointment schedulers were talking back and forth across the office about what I needed - loud enough for women in the waiting room to hear. I totally agree with other posters that my file should be flagged, marked in the computer, ANYTHING to keep me from having to explain again and again what has happened


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## ~Mamaterra~ (Jul 5, 2006)




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## McNic (Feb 1, 2008)

All I would ask is:

A) Do Not leave me in the emergency room waiting room. I presented 9 weeks pregnant with vaginal bleeding - put me somewhere, anywhere by myself. I would have taken a broom closet!
B) Doctors...READ the chart first. The OB on call, who was called in to help rule out an ectopic pregnancy, said "OK, now this thing is not going to be able to count fingers and toes so don't get excited!" *rolls eyes*


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## ~Mamaterra~ (Jul 5, 2006)

for all of the new mamas here.

Your suggestions/stories would be greatly appreciated.


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## Kayda's Mom (Feb 5, 2007)

When I had my first daughter the public health nurse came to the house and called. When I had my second my midwife was at the house frequently.
I just had a m/c and a d&c. I spoke to my midwife when everything first happened and she said she would come over later this week. She got busy with births and wasn't able to but I didn't know this until I called her wondering what happened to her.
I would like to see a system in place where a health care professional is required to do a home check on women who have miscarried (I cannot speak for stillbirths as I did not experience one and do not know if there is any system in place). Luckily for me I have a great husband and family support system. I do not know what I would do if I didn't. Today was a difficult day for me and I don't know if my hormones were wacked and/or the situation was taking it's emotional toll but I was very angry and very depressed. If I were alone...who knows...I could be sitting here with a gun pointed at my head. I am not suicidal but I could see people going down that dark path if they did not have proper supports in place. It hurts me to think of somebody suffering and nobody is checking on them. Miscarriage is an extremely emotionally devastating traumatic event...add in the physical trauma and it is an ugly mix.
I also thought today that maybe the people who write the "what to expect" books could write a new one called "What to Expect When Your Baby Dies and Your Heart is Ripped Out".
Is it obvious I am having a bad day?


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## Lyne-M (Feb 12, 2008)

After my stillbirth, I was placed in a ward with of pregnant women!!! Imagine how it felt to spend 6 days in a ward full of women pushing tummies. I was told I could see a counsellor whenever I required one but it was very difficult crying and discussing my unhappiness when they were all these women happy to be on the vedge of delivering in the room. At least twice aday each woman had her baby`s heartbeat measured for about 30 minutes. So after my baby died I spent the first week listening to other babies`s heartbeats!!! I`m in South Africa.


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## SaphiraKay (Jun 26, 2004)

I would love to see hospitals hire a infant loss liason of sorts. We were sent to hospital admitting for the D&C, then sent up to surgery for instructions and an appt, then back to the dr's office. Then when I came back for the D&C two days later, my chart was misplaced and dr's orders were not found. We also dealt with insensitivity several times such as the lab tech announcing my beta levels to a full waiting room. Having a single person to show us where we needed to be would have been great and would have acted as a reminder for the staff.
My dr's staff was great, she was out of town when we learned our baby died but called me at home that night and cried with me at my D&C. But I did find that there weren't standard procedures in place. For instance, I requested a repeat u/s and repeat beta prior to the D&C. My dr ordered them but the hospital balked at doing it, considering it a waste of time. I also discovered that outpatient surgery at my hospital is awful, they run you thru like cattle. I was privildged to see one patient's nude fanny when the staff asked him to walk to the surgery room. I was embarrassed.
I also think followup care should address more than just if one is physically recovered and when to begin to TTC again.


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## jaclyn7 (Jun 9, 2005)

I'm sorry this is still the biggest issue of my miscarriage and its late, so I haven't read the responses. Here are my initial thoughts, I'll probaby add some more once I've thought this out a bit more.

My initial care was at our local hospital and generally they handled well. I had a private room and my Mom & Husband were able to be there and keep me comfortable.

However, during my ultrasound (the next day) my husband wasn't allowed to come with me and I never saw the foetus. The tech did hold my hand when the doctor came into confirm the loss, but it sucked having to walk out and just shake my head to my DH & Mom that I had lost the baby.

However, my treatment I received at the major hospital for my miscarriage a few days later was atrocious. You can read some of it here . My Dad looks like an RCMP officer and he was the one who went to the admitting staff and explained what was going on. He used terms like incomplete miscarriage and excessive blood loss with well over a pad an hour of blood loss, all true but more so because I was so calm they did not take me seriously.

I also hated that my prescription for the follow up ultrasound said abortion (which others could clearly see in the waiting room) and I think I'm pro-choice.

I know that it is the technical term for a miscarriage, but WTF? Think of all the nice little phrases we have for men's issues or all the other PC crap we're forced to put up with. Yet, when it comes to women's issues we still face this sort of lack of compassion. Abortion. Failure to progress. Hysterectomy - lets get the hysterical out of her.

My husband had to physically cancel my appointments for blood tests, etc. and I wished there was a coordinated system.


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## Fyrestorm (Feb 14, 2006)

Is there a way we can dispense with the term 'products of conception'? It was a baby damn it....my baby!!!


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## Kayda's Mom (Feb 5, 2007)

I am glad I am not the only one who hates the terms "product of conception" and "incomplete abortion". I hated seeing it written on the form when I had my D&C. There is no reason they can't use more compassionate terms.

The hospital made the appt. for the gync for us. We were waiting for the gync in the examination room when she walks in and says "what can I do for you?". I look at her thinking "wtf, are you kidding me?". There's awkward silence and my husband says "you don't know?" and I say "I had a miscarriage". It wasn't written on the chart and the hospital didn't fax anything over. It was a very uncomfortable.


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## Mama25 (Jul 20, 2004)

When you start a conversation with a mom who is having a miscarriage with "I don't mean to sound insensitive but....."
----Nope it means *you are* being insensitive!

A nurse said this to me as I came into the room to get an ultrasound to confirm my baby had died. She said this since she was doing me a favor and fitting me in on her lunch break and she would be fast and I wouldn't be able to stay in the room. So sorry for the inconvenience!


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## ~Mamaterra~ (Jul 5, 2006)

Bump for the new mamas...


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## erin_brycesmom (Nov 5, 2005)

We just went through this and we were really hurt by a lot of the way things were handled so I'll give my feedback while it is still fresh in my mind.

I was planning a homebirth and found out at 18wks 2dys that my baby was no longer alive. The ultrasound showed the baby was starting to deteriorate and had probably passed almost 4 weeks prior. I talked to my MW and since I was still offically assigned to my local military base, she referred me to them (she was great btw and told me what to expect, answered my questions, etc). The military base has no protocols for how to handle a loss after hours (I was also running a fever) and I ended up being sent to the urgent care, waited 4 hours only to be sent home (they did nothing in the UC). L&D would not see me because I was not 20 weeks and that is their policy. I specifically expressed to L&D beforehand that I did not want to go to the Urgent Care if I was just going to be sent home because that was not the way I wanted to spend the evening as we were totally devastated by the loss. They assured me that I would not be sent home but I was and it was a complete waste of everyone's time. The whole process would have been sped along greatly had L&D seen me because they could have done an u/s to confirm the passing and I could have been scheduled for the d&e that I ended up having later.

So instead they had me come back the next morning only to wait in a waiting room with a bunch of pregnant women and women with newborns for an hour and half until my dh finally asked if we could have some privacy since I was balling at that point. When someone has experienced a loss, the policy should never be for them to wait around for hours around pregnant women.

We then waited in a room for a couple more hours. A couple of other people came in and said some very insensitive things and kept rudely reminding us that we did not have a scheduled appt (how dare us not have know that this was going to happen and scheduled this appt sooner!!???!







). We just kept getting reminded of the "policy" over and over again and being told that the back up on call OB handles these situations and "his first priority is the L&D floor". It just feels awful being told that you don't matter because your baby is gone.

The thing that kept really hurting me was that several staff members at the hospital kept saying that they needed to "try to find the heartbeat" because they had not yet confirmed anything since I got the u/s somewhere else. When you know that your baby passed away weeks ago, you don't want to hear that they are going to "try to find the heartbeat". YOu can't find the heartbeat of a baby who has not been living for 4 weeks. I saw my baby with almost no fluid, no cardiac activity, molded head, shriveled body, completely lifeless on the screen. After the 4th person said this to me, I finally lost it and said that I didn't think that was appropriate thing to say and this woman actually defended herself and said it was "policy" to confirm it. I have no problem with that and I know they have to confirm it but it was just the way they were saying it as if there was still some hope of life left when I knew there wasn't and I certainly didn't want to form false hope at that point. This same woman said they sent her in to us because she is "good at making people wait". All she did was reiterate policy and try to get me to say "ok" when she was doing absolutely nothing to help and was being completely insensitive.

Finally, they sent yet another nurse in and this one also happened to be a bereavement counselor and she was truly wonderful. She knew all the right things to say and was so comforting. Even though nothing could make this situation feel ok, she did say "confirm the diagnosis" which didn't hurt as much. She made me feel like my baby mattered and my feelings mattered. After she got involved, everything went much smoother. After 5 hours of waiting, we finally saw a doctor and he was also wonderful, caring, and understanding. The only other thing I would comment negatively on was after I came out of recover from the d&e they put me in a room right in L&D right next to a room with a woman who had just had her baby. Even as they wheeled me in there, the sweet sounds of newborn cries were overwhelming. The baby continued to cry and the walls seemed paper thin. Eventually my dh asked if they could move us to a different room and they did. I could not hear anything in the new room.


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## honeybunch2k8 (Jan 14, 2008)

Quote:


Originally Posted by *jaclyn7* 

*However, during my ultrasound (the next day) my husband wasn't allowed to come with me and I never saw the foetus.*

I know that it is the technical term for a miscarriage, but WTF? Think of all the nice little phrases we have for men's issues or all the other PC crap we're forced to put up with. Yet, when it comes to women's issues we still face this sort of lack of compassion. *Abortion*. Failure to progress. Hysterectomy - lets get the hysterical out of her.

My husband had to physically cancel my appointments for blood tests, etc. and I wished there was a coordinated system.

That's exactly how I feel. I do feel guilty about the fact that SO did not get to see the baby. I don't understand that rule. I didn't make that baby on my own.

Oh and I got yet another bill, that says I had a spontaneous abortion. Gosh, that just sounds so horrible. Couldn't the say pregnancy loss, I mean, there have to be better terms.

Oh yes and another thing. Hospitals need to make sure that they take down the woman's insurance information. They didn't take mine, and guess what? Every so often I get a bill-a reminder of what happened-when it should be billed to my insurance provider. Every now and then I get another one, and I have to go thru all the same steps, and it hurts every time. I feel like they were financially and emotionally torturing me. That's another thing-why can't they consolidate it to one bill anyway?

Next, I wish they have given my body time to expel the placenta instead of rushing me to surgery.

ETA: I also think that practitioners should offer ultrasound printouts amongst other things. I wish I had one.


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## ipeabody (Jun 4, 2007)

I've had two miscarriages that required intervention and so two different experiences with the medical community. The first miscarriage was diagnosed by ultrasound after I expressed concern to my midwife about a lack of pregnancy symptoms. I somehow already knew the baby had died, so I was expecting the worse. The Dr (it was an OB) who did the ultrasound just matter of factly said that the baby had no heart beat. He expressed no concern, nothing and sent me to make an apt for a D and C. No one explained anything to me or told me there were any other options. They just said I had to have this apt. I had to explain to every staff person in the process why I needed the apt and wait in the hall with all the other people while I sobbed. No one offered me a private room or expressed any concern. My husband wasn't allowed to wait with me for the D and C in the pre op room ( which really upset me).

The second miscarriage I called the Dr (no midwife) and told him I had the feeling again that I was going to miscarry. He told me I was over reacting, but made an apt for an ultrasound. ( I hate being told I'm over reacting, hate it so much) Once again, they found no heart beat. This time an OB at the hospital who did the ultrasound explained about the medication you could take. He did not tell me how painful it would be, or explain about what would happen. I was incredibly sick for the entire night, vomiting and bleeding profusely. Scared my husband. My husband was really angry about that. I received no brochures, no follow up, no referrals, nothing. Just check in with your family Dr. My family Dr didn't really want to talk about it. I don't think we ever did, not until I asked for a referral to a specialist for miscarriage.

After that I decided to seek professional fertilty treatment for recurrent miscarriage. Those professionals were great. But once I got pregnant again, sucessfully this time, I had to deal with every other health professional asking me about my other children and hear about this being my fourth pregnancy. I kept having to explain that, yes it was my fourth pregnancy but my first child. Which totally sucks, especially when you are pregnant and terrified that something could happen to this pregnancy.

I wish that dr's and nurses would just treat you respectfully, honestly and thoughtfully. I didn't need to be coddled, but I did need some privacy to grieve, some thoughtfulness, like "i'm sorry this has happened to you". I don't really need to hear anything else. It got to the point where I felt sick every time I had to see a Dr. My great experience with the fertility clinic help to remedy that.


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## birthangeldoula (Feb 1, 2008)

Quote:


Originally Posted by *heatherh* 
A few things I can think of right now...

Flag our files to avoid the awful awkward questions about the baby later on. I've seen countless numbers of us that have been further traumatized by well meaning (or not!) office staff who just don't know.

Be *sure* to adjust/cancel later appointments. Do NOT call to remind us when we miss a follow up appointment that is now a moot point.


I agree with these two.. I can't tell you how many times I went to the OB/GYN (I've since switched) after I lost my son that they asked how the baby was doing, or where the baby was, or asked why I was trying to get prego again so soon with a newborn at home. I also got called about an ultrasound appointment that I had missed and was chastised about not calling to cancel. (which was the furthest thing from my mind at that point)
I also have gone through 2 d&c's due to "spontaneous abortion" in the last 6 months. I feel lucky enough to have a compassionate and caring OB to help us through this process, but I also know this is not the case for all. I switched OB/GYN's after the loss of my son.. I just couldn't deal with the questions any more, or the chipper nurses asking why I didn't bring the baby in with me.
After reading through this thread, all points are valid and I'm hoping that these health professionals hear all of these opinions! These issues all need to be addressed. Going through what all of us mama's have been through has been tough enough, so I think compassion and professionalism from our care providers and hospitals should be a HUGE priority.


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## cristeen (Jan 20, 2007)

My situation was a little different, but when I was in for my 20 week U/S (alone), the techs were poking and pushing at my belly to the point I had bruises, trying to get a clear picture. There were 2 of them, and they spent almost an hour trying to get a picture, talking and laughing with eachother. I never suspected there was a problem because of their attitudes. They told me nothing at all. They made me go get lunch and come back, hoping he'd move.

Then I had an actual radiologist doing another scan, I'm lying on my back with my shirt up, she flips the lights on (right in my eyes), and really abruptly tells me there was a problem and what she found. She tells me that a counselor would be down in a few minutes to talk to me and walks out, leaving me alone. No empathy, no "is there someone we can call?", nothing. The counselor was really sweet, but by the time she got there (about 10 minutes), I was a mess. I had to answer all her questions, and then go drive myself home.

Of course, when we got to the hospital and went to check in at the maternity ward, the first nurse that greets us says "Aren't you excited? You get to meet your baby today!" The woman never even glanced at our chart.

I was in the hospital for almost 48 hours, and they fed me twice, and never once offered my DH anything (not even the meals they weren't feeding me)... like he was going to leave me alone to go find food.

There was also the doctor who ignored the fact that I had been explicit repeatedly about the fact that I didn't want an epidural and tried to browbeat me into getting one when the contractions were at 2 minutes (and I was non-verbal). My DH and BF had to threaten violence to get her to leave me alone. She didn't like how much noise I was making to get through the contractions.

Overall, a little respect would have gone a long way. Not just respect for me as a person, but respect for the difficult situation, respect for my wishes, respect for the people trying to support me through all this, etc.


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## purplepaisleymama (Jan 31, 2007)

With my first mc, we were not aware that there were any problems, I had had 5 pregnancies with no issues. I have hg and the mw asked me to come in for a consult before she would refill my rx , she couldn't get a heartbeat and sent me to radiology to have an in depth us. Dh had to stay in the car with our
older children, so I was alone in the room. When the tech couldn't confirm a heartbeat she sent for the radiologist, he asked if I this was my first mc? I had not been told that this was a mc, I of course knew but there was no mention earlier.I was told to return to the mw office the next day for blood work to check my antibody levels and to receive the rhogam shot. I called in the morning to see what time I could go for the bloodwork, they assured me that anytime was fine. I packed my kids up and met DH at the office, almost an hour away from our house, when I went to the lab, I was told that I would have to come back the next day, they were running behind and couldn't get the results until later and they would be closed before I would be able to get the shot. I was instructed to go to the front office and speak with the nurse manager, she made me wait in the waiting room with the pregnant mommas and then called me over. I was 10 feet from the waiting area and she asked why I needed to see her, I had to explain in front of a bunch of pregnant women, who I didn't want to upset that my baby had died and I needed blood work and the rhogam shot. She told me to come back the next day, I explained that I couldn't do that because I would have to drive over an hour with 5 kids by myself and I didn't think that was safe. I explained that I had called earlier and that my mw had left orders for me. She told me that I could either come in the next day or go down the street to the hospital. I ended up at the hospital for the next 3 hours, with DH and the kids so that I could get the bloodwork and the shot, I had the best experience on the L&D floor, the nurses were so wonderful to me there. I had a d&c at the hospital after a week, I had been vomiting 30 or more times a day and my throat was beginning to bleed from the trauma. I had an spinal because they were concerned with intubating me, and I was not told that I had a choice about pain management, I would have welcomed a valium. After the surgery I was brought to recovery and released after about 3 hours, my treatment at the hospital was ok, the nurses were kind and the gyn who performed the surgery was nice.
I had a spinal headache that was the worst pain of my life, that lasted for more than 5 months. The treatment from the anesthesiologists was horrible, I was treated with no respect and was assaulted by the head of anesthesiology , he screamed at me and botched the procedure. The way that I was treated at the hospital during the epidural patch for the spinal headache was deplorable, they didn't even read the chart to see why I was there, and when I did finally tell the doctor why I was there he shrugged and said that I was lucky it wasn't for something serious.

I had to go to another hospital to get treatment for the spinal headache and they were wonderful about the mc, the nurses were caring and the doctors were very apologetic about the mc and about how I was treated at the other hospital. I stayed overnight at the second hospital and DH and ds stayed with me, ds was 21 months old and still nursing, he slept with me in the bed and as long as DH was there to take care of him, it was fine.
When I got pregnant again I called my mw and told her of my concern, she had me come in for hcg levels, the levels were a bit low and she called me back the next day to tell me that I was going to mc. I went in the next Monday, 3 days later to have a re-draw and the numbers were fine, they had increased properly. When she called after this she said that we had gotten the dates wrong, I was only a few weeks along, no matter how much I tried to explain she wouldn't get that if I went by her numbers I would have gotten pregnant 3 days after the positive pregnancy test. She was insistent that I was almost 5 weeks along,and I had gotten a positive 7 weeks before... I searched around and finally found the best mw that I ever could have imagined. All was well for another month and then I started bleeding.
With my second mc, I stayed home and called a homebirth mw that I had begun seeing for prenatal care, she was aware and very supportive of my choice to UC this baby. When I started to mc, I called and she was great. She asked what I thought about the pregnancy and what I thought would happen, and she believed what I told her. She offerd her support at my house if I wanted her, and called me throughout the day to check on me. I was so touched that even though I had only met her twice she was willing to help me so much. I talked with her every day that week and she still calls me to see how I am, it has been 9 months since the mc. I was so touched by her love, she was so gentle with what I wanted and she respected all of my decisions. I have since seen her in public( we both homechool and we have met at a few get-together), she always gives me a hug and it really makes me feel that she cares for me and my family. I know that no matter what time of day and what the circumstance she would be available whenever I need her. The most difficult and emotionally painful time with my second mc was when I called my previous mw to schedule an appointment to get blood drawn and my rho-gam shot, the office staff were nasty. They made me repeat the story 4 times, when they did get the story straight they said that they would have to call me back, when they did finally call me back 6 hours later they told me that if I wanted anything I would have to go to my local ER, they were too busy to help me. My DH called back to see if they really did say that I was on my own, and they were rude to him and hung up on him. I haven't gone back. When we did go to the hospital, our local ER, we sat there with our youngest son for 6 hours, waiting for my bloodwork and the shot, the attending doc was confused as to how I had known that I had a mc, when I explained the entire process and used medical terms he finally believed me. We didn't find out until after 3 hours of waiting that the lab had done the wrong test, we waited another 3 hours until they finished the correct test and found the rhogam and then administered. I was very lucky that my DH is very convincing because he finally got us food about 1/2 an hour before we left, we had been feeding our son pretzels and crackers the entire time in the ER. The nurses there were great about the mc, they tried to be comforting, and the doc did come around after he realized that I was not looking for any drugs. I know women who have had mcs in this hospital and it is routine to just leave a women pouring blood in a room alone, or even in a cubicle in the triage until she asks to leave. I will never go to another hospital again for a mc, unless I have to , it is a very personal experience and I feel that it is too much for me to have to share it with anyone else.
I had another mc this past week and I did not call anyone, I knew what was happening and I felt most comfortable alone. I am not sure where we will go next as I am hoping to figure out what is happening with my body. I am afraid that the next ob/gyn that I go to will not be very supportive of my desires to have another child, as I already have 5 now..... how many more do I want?
I would love for all employees to have to undergo a grief awareness seminar, they should have to adhere to a policy of kindness and gentleness. These are for many of us some of the hardest times we will ever experience. I understand that this is their everyday job, but this is my LIFE, I should be respected and protected, they should be concerned with my well-being. I should not have to look back on this time in my life as the time when I felt invisible, the time when I felt less of a deserving person. I would like to be cared for, not just taken care of.
laura


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## joanq (Oct 27, 2005)

I agree with the poster that said they should tell us what to expect. With my first miscarriage (9weeks) I was told that it was "up to me" and I could "go to work or not" depending on how I felt. I asked the midwife what to expect, and she vaguely said "like a heavy period, maybe some extra cramping".
This was NOT at all what I experienced. My experience was more like labor, with regular contractions and at the end such a huge release of blood and tissue. Even being a health care provider and having had a baby before it was alarming and scary. I can't imagine how that would have been if I was a first time mom.
They need to be honest with us!


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## honeybunch2k8 (Jan 14, 2008)

Quote:


Originally Posted by *joanq* 
I agree with the poster that said they should tell us what to expect. With my first miscarriage (9weeks) I was told that it was "up to me" and I could "go to work or not" depending on how I felt. I asked the midwife what to expect, and she vaguely said "like a heavy period, maybe some extra cramping".
This was NOT at all what I experienced. *My experience was more like labor, with regular contractions and at the end such a huge release of blood and tissue*. Even being a health care provider and having had a baby before it was alarming and scary. I can't imagine how that would have been if I was a first time mom.
They need to be honest with us!

I was a 1st time mom, I was in labor (2 1/5 cm dilated probably more that morning), and it was scary. I had no idea i would be bleeding so much let alone gushing blood. Ahhhhhh!


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## ~Mamaterra~ (Jul 5, 2006)

Bumping to the top!!!


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## dnr3301 (Jul 4, 2003)

in the ER, they tried to make me go to the ultrasound room alone, and I refused, and they kept trying to fight me on it. Eventually they relented, but I should not have had to fight that hard for it.

"my" ob should have visited me, even though I had never seen her before (I homebirth, but have a ob/gyn clinic I go to for paps and bloodwork).

the only person who acknowledged that I had lost a baby was a nurse I knew outside of the hospital. I was in overnight due to blood lose, so I saw a bunch of people.

someone who was kind would have been nice, but maybe that's too much to ask. Everyone was so rough with me. When I felt like I was going to pass out, the ER nurse said, "that's ok, you're already on the bed, you won't fall" and I passed out.

When I complained about "gushing blood", she said something about it being ok because the bed had plenty of padding and it would soak it up. No one ever actually assessed my blood loss until my MW showed up and she tried, but wasn't really supposed to be doing anything, she doesn't have priv. at the hospital.

the whole ER could use some sensitivity training. They were mean and made an extremely sad and scary time completely traumatic.


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## Zan&Zav (Nov 25, 2006)

When I miscarried, I was asked if it was a planned pregnancy. Which it was, but if it wasn't I would still be devestated.


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## ~Mamaterra~ (Jul 5, 2006)




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## ladybug732 (Apr 29, 2008)

After reading so many horror stories, I feel blessed by the care I received at two different hospitals during my recent stillbirth.

I went to the first hospital after my midwife couldn't find a heartbeat with the doppler. (I was 34 weeks.) We went to the only hospital with an OB ER to get an ultrasound. My midwife called ahead, so they were ready for me. After getting changed, they immediately brought in the ultrasound machine. (They could tell I wanted to know right away.) I could not see the screen, but I knew something was not right from the nurses's expression and when she left briefly to call the chief OB on duty. The OB told us very sensitively that they couldn't find a heartbeat and said she was sorry. At that point, they left my husband and I alone to grieve.

Later they came in to talk about my options. They didn't pressure me into anything and said I had however much time I needed to decide and if we decided to leave, we could always change our mind and come back whenever. They again left us alone to think/grieve. Later they drew some blood and did another ultrasound. This time they asked if we wanted to see our baby and whether we wanted a picture, which we did.

After this, we were just waiting on the results of the blood tests to make sure I was safe to go home, which is what I wanted. A mom in labor came into the ER, which was hard, but shortly after, they moved us to an actual L&D room, saying that there would be more moms coming into the ER and they knew we wouldn't want to be in there. A caring nurse came into the room and explained what was to come, both the labor/delivery process, what would happen immediately after the birth and even about death certificates, etc. She was sensitive but also gave us all the information, knowing that we needed to hear it. Before we left, she brought us a folder with information about support groups and research studies in case we were interested.

A day later, we decided to induce, and I was able to talk to my dad's coworker's wife, who is an OB (I had been receiving prenatal care from a midwife who practices in a freestanding birth center.) She had already called another hospital where she practices and learned that they had space for an induction the next morning.

When we arrived, they put us in the nicest/biggest L&D room, which I was allowed to stay in my entire stay (a day and a half). The nurses were all very sensitive and all told us sorry for our loss. They put a white rose on the door to alert the staff about the loss. Everyone was incredibly accomodating. They sent a social worker in to give us information about funeral homes and also gave us information about support groups as well.

After the birth, they cleaned and dressed our daughter before bringing her to me, which is what I wanted. We were allowed to spend as much time as we wanted with her and allowed to bring in as many family members as we wanted to see her. The hospital asked if we wanted a photographer to take free professional pictures of her, which we did. (We also called in a photographer from the non-profit organization called Now I Lay Me Down to Sleep, which we recommend very highly.) The nurse who had been taking care of us all day brought us a memory box with handprints and footprints, clothes, a lock of hair, a poem and a card signed by the nurses. The doctor let us take a small piece of the placenta home to bury when we planted a tree, even though the request seemed new to her. (We couldn't take the whole thing because they needed to do testing on it because it was the cause of death - it had stopped receiving bloodflow.)

I go in for my two week followup next week, so I will see how the doctor's office staff handles things.

Here's a short list that summarizes what I feel is important when caring for a woman after stillbirth (all of which my hospitals did):

- Give the parents time to make decisions. There is no need to rush.
- Explain everything that will happen thoroughly and sensitively. Don't hide anything, but make sure you say it caringly.
- Let everyone who will care for the family know what happened and instruct them to offer condolences or at least have an appropriate attitude.
- As much as possible, ask what the family wants and honor their requests.
- Do whatever you can to make the paperwork easier/faster.
- Offer information regarding funeral arrangements and support groups.
- Give parents items to help them remember their baby.
- Give parents space and privacy to grieve.

Thanks for letting me tell my story. This is so new for me, and even though it is hard, I know it helps to write it all out.


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## Fyrestorm (Feb 14, 2006)

Ladybug -









I'm so sorry for your loss! I can't even imagine!

I'm glad you received the care you and your family needed and deserved. Nothing can ever relieve the pain of the loss you suffered but having compassionate care can make such a big difference in the grieving process.

Sending healing vibes to you and yours be kind to yourself and take all the time you need to process this!


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## tangledblue (Apr 5, 2008)

Ladybug, thank you for posting. It must have been so hard for you to write about it. I am so sorry for your loss of your beautiful daughter.

This is a good thread. I hope some medical professionals see it. I had a miscarriage last summer that led to me switching medical practices. The first OB just said "You can wait it out or have a D&C" without really explaining anything about either option. I was in shock and I said D&C, but then changed my mind, called her back to ask some questions, she was curt. I immediately switched to a wonderful practice where the CNM actually spent time with me talking about how I was feeling and explained what my options were (including the drug option, which the OB hadn't mentioned). I chose to wait it out naturally and it was much better than having unnecessary surgery. They checked my hcg levels repeatedly to make sure that things were progressing--it took a while for it to be all finished, but I'm glad I did it that way.

So my suggestions for medical staff are:
Don't minimize a loss, even a first trimester loss.
Always offer a picture. I will always regret not having the u/s pic of that baby.
Explain all options
Take time to listen to the patient. Know helpful things to say.


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## ~Mamaterra~ (Jul 5, 2006)




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## supakitty (Mar 6, 2002)

This subject is why I wrote this:

http://www.mothering.com/discussions...d.php?t=690655


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## Quate (Oct 24, 2007)

I'm still in the midst of it all (miscarriage hasn't happened yet, still waiting for confirmation that things aren't right).

I found out when a dating ultrasound showed no baby.

Here's what I did find helpful: the doctor discussed the possibilities with me (maybe dates are wrong, maybe it's a blighted ovum, etc.), listened to me and gave weight to my opinion, asked me if I had questions and took the time to answer all the questions I had, gave me Kleenexes and told me to take as much time as I needed, was generally very kind.

Also: the person who took my blood asked if I was ok, answered her own question (it was pretty clear I was trying not to cry), found me more Kleenexes, got me a glass of water and a cool wet napkin to wash my eyes. Also let me take as much time as I needed before leaving her room.

Here's what was not helpful at all: In between the two, I had to go from the ob's office to the lab, and apparently the lab requires you to resign the paperwork and give your insurance information every time. So I had to interact (bad, to begin with--I did not want to talk to anyone) with someone who seemed completely oblivious. She asked me if I had a cold or allergies. I confess, I lied. She had seen the paperwork--it should have been obvious that there might be another reason my eyes were red and I was blowing my nose. I told her I had allergies.

I think the worst part was that I had to wait in a waiting room full of people then for half an hour before they got to me. All I really wanted was to be alone and cry until I was done crying.


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## avivaelona (Jun 24, 2005)

I triple the idea to flag charts. My second son was conceived before my first would have been born and I got *SO* many stupid insensitive questions from the front desk staff, one even told me that my "dates couldn't be right" By that time I was fed up and I said "NO, that baby DIED" really loudly in a room full of pregnant women. I then had a complete fit in the doctors office and said that I didn't give a damn about privacy concerns I wanted it written on my chart in big black letters that I had lost the first baby, and that I wanted my name given to every person who might answer the phone so they wouldn't question what I said I needed.

Other than the awful front desk staff at my OB's office I mostly recieved very sensitive treatment once it was clear that I was undergoing a loss (we did not get such sensitive treatment during the initial problems that led to the loss but that is another story).

I did complain to my Perinatologist that his office had nothing but pregnancy magazines and for many of the people who came to his office (for losses, for infertility issues..) would probably rather have golf digest or Time or anything else.


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## Aeress (Jan 25, 2005)

I would have appreciated:

1)being told to grieve for as long as I needed, given tissues
2) a loss is a loss, whether a blighted ovum or anything else
3)not being told "you can try again in x weeks" "you are young, you'll have more"

My family doc was great minus
1)don't mislead a patient when they call and ask "are the numbers o.k?" "yes, we will see you tomorrow". but come to find out, they were not doubling.
2)when asked why I was told they were "ok" when they were not "I didn't want to tell you over the phone."

I can see not telling m over the phone but he could have gotten me in that day to tell me in person.


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## pottermama (Jun 14, 2006)

After having 3 miscarriages I can not say I was happy with any of the care I recieved.

One of the things that bothered me the most was when the OB told me that I was still within statistics because I had 2 live children and at that point "only" two miscarriages.







: I would ask for the doctors to treat me a little more seriously.

I also agree with the pp who said take us to a seperate room instead of making us sit with all the other pregnant women. That was heart breaking.

During my first m/c I had to deal with one of my midwives who was really new and didn't really know what to tell me about anything. I wasn't prepared for the pain and intensity. I almost passed out from loss of blood and she acted more incovienced that I paged her than anything. I guess more sympathy would be nice.

As for ttc after the m/c my midwives treated me like I made up my progestrone issues.(even though I researched like crazy) so maybe update doctors on progestrone and other medicines that help decrease multiple miscarriages.

I think overall doctors and midwives need to be educated more on miscarriages and everything that goes along with them. And I agree with all the other pp suggestions. I had so many bad experiences I don't even know what else to put down. I just feel so frustrated by the whole thing.


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## mandam (May 11, 2008)

I miscarried my first at 8 weeks and really feel I could have been treated better.

Definitely not making you sit in a waiting room full of pregnant women. I really don't want to listen to all the pregnant ladies discuss their babies.

The ER staff could use some SERIOUS sensitivity training. I am bleeding and cramping more than I ever have in my life. I am terrified. I am heartbroken I am losing my baby. Let me cry and don't tell me I need to calm down. And please explain what the heck is going on, and just try to be a little nicer.


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## gretasmommy (Aug 11, 2002)

Thanks for compiling this information, MT. I hope it helps another mama (and papa, perhaps).

Others have covered a few of the more important points - but I still have a couple of bits of advice. Other than not having us wait with the pregnant women for any/all follow ups/testing and flagging our charts to reflect our losses so that others will not be unintentionally insensitive - please, please be careful of how you say things to us. Know that we may actually hear you. When i was making an appt with the RE, I overheard the training receptionist refer to me as a "serial miscarrier"!!!!!!! Unbelievable! What a horrible, horrible thing to call someone! And I was already feeling so terribly vulnerable.


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## supakitty (Mar 6, 2002)

Quote:


Originally Posted by *gretasmommy* 
"serial miscarrier"

An even worse term used is "habitual aborter" that's what it has to be coded as in order to bill for care.


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## honeybunch2k8 (Jan 14, 2008)

Quote:


Originally Posted by *supakitty* 
An even worse term used is *"habitual aborter*" that's what it has to be coded as in order to bill for care.

OMG!


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## ~Mamaterra~ (Jul 5, 2006)




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## Mama Rana (Aug 18, 2004)

When I come in for a follow-up after having the MC confirmed by blood tests, don't ask me in that oh-so-casual-small-talk way, "How are you doing?". Cuz if you'd take 2 seconds to look at my chart you'd see that I'm not doing all that well, and being in a waiting room full of largely pg women has not helped.

[not sure if this is what you're looking for cuz haven't read the whole thread yet, but this was the first thing that popped into my mind]


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## mommymcnair6 (May 21, 2008)

This is an awesome thread. I lost my baby one month ago and have been thinking a lot about how they handled me at the OB. I have had my last three kids at home, so I hadn't been to an OB in ages. Anyway, I called them up and they did see me right away when I was bleeding, which was great. US showed no heartbeat, and I went home and let it happen naturally. They didn't want me to come back or anything. I called and went back one week later to make sure all the birth material had passed. All was fine. Had to go back two weeks later for uterine infection. Yuck! Anyway, as I am finishing up the antibiotics today, I was thinking about what they could do different.

1. Have a special waiting area for moms suffering from losses. I was in the waiting room wedged in between a pregnant mom and one with a new baby It was awful and I waited over an hour. I finally asked receptionist to put me in the doc's office because I was crying so much.

2. The need to tell moms that a miscarriage is NOT like a heavy period if you are further along. It is exactly like giving birth in my opinion and hurts a lot and they need to tell you that. You need to expect that it will be like labor, not like a period. I was shocked by how much like labor it was. Obviously, it is the same process. The baby is being expelled from the uterus and the process is the same. They also need to tell you the recovery is very much the same as after giving birth in terms that you should be resting and taking care of yourself and give it six weeks or so before you even begin to feel like normal!!!

3. I wish they had more resources for women who miscarry instead of just patting us on the head and saying better luck next time. It's so condescending and vulgar to brush off someone who has just lost a baby, no matter what stage of pregnancy!

4. Our homebirth midwives should also have more information and resources for women who miscarry. My midwife was very kind, but she kind of brushed me off after the first phone call. I know she has births and other people to attend to, but just because I didn't give birth to a live baby doesn't mean I don't deserve to have my questions answered as well.

Just a few thoughts and suggestions. It seems like most places don't have protocol for dealing with pregnancy loss patients. I wish they did. Your care provider can make this awful experience easier or worse depending on how they behave.


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## celtic_angel (Jul 27, 2005)

I just got off the phone with a good friend of mine currently going through a loss...she called knowing I had very recent expeirience with this myself and the thing she mentioned repeatedly (so i know it was hurting her greatly) was that in less than 10 minutes she went from *woman about to hear her baby's heartbeat* to *patient with unviable genetic matierial*
She kept saying "it's not *genetic matierial*...it's my baby"


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## thyme (Jul 17, 2003)

I would like to see all OB/GYNs have sensitively written options on their medical history intake forms.

One I went to was like this:

How many pregnancies ___
How many miscarriages/abortions ___

And in several other places they again listed miscarriage/abortion as if they were the same thing. They certainly are NOT the same, and I would think that medically they would actually need to know the difference anyway! It felt so insensitive to have to fill in a number in that box. Certainly entering 4 in there would have different medical ramifications if it was 4 miscarriages versus 4 abortions, wouldn't it?


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## Cuddlebaby (Jan 14, 2003)

Quote:


Originally Posted by *thyme* 
I would like to see all OB/GYNs have sensitively written options on their medical history intake forms.

One I went to was like this:

How many pregnancies ___
How many miscarriages/abortions ___

And in several other places they again listed miscarriage/abortion as if they were the same thing. They certainly are NOT the same, and I would think that medically they would actually need to know the difference anyway! It felt so insensitive to have to fill in a number in that box. Certainly entering 4 in there would have different medical ramifications if it was 4 miscarriages versus 4 abortions, wouldn't it?

ITA with you. there is a difference. It would be hard for me to put a number in that slot too.


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## Fyrestorm (Feb 14, 2006)

Quote:


Originally Posted by *thyme* 
I would like to see all OB/GYNs have sensitively written options on their medical history intake forms.

One I went to was like this:

How many pregnancies ___
How many miscarriages/abortions ___

And in several other places they again listed miscarriage/abortion as if they were the same thing. They certainly are NOT the same, and I would think that medically they would actually need to know the difference anyway! It felt so insensitive to have to fill in a number in that box. Certainly entering 4 in there would have different medical ramifications if it was 4 miscarriages versus 4 abortions, wouldn't it?

I wonder if this is because most woman who M/C end up having a D&C or D&E and what they really want to know is how many surgeries they have had since the procedure is basically the same...they just ask it in a horrible way.


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## dnr3301 (Jul 4, 2003)

it's because technically, miscarriage is a "spontaneous abortion" and the other kind is "surgical/elective abortion". That's just how the medical literature is written. I agree that they should ask it differently, it is insensitive.


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## lunarmagic (Mar 10, 2006)

I had a stillbirth, not a miscarriage, but I'll throw in my experience too.

One form I had to fill out for my RE (infertility specialist), they have "obstetric history". The options are "Miscarriage," "Normal delivery," "Cesarian," "Tubal/Abortion." I'm glad they separated miscarriage and abortion. However... what the heck do I have?? They don't list stillbirth! I assumed by "normal" delivery they meant VAGINAL delivery, so I checked that and wrote a note saying "STILLBIRTH" - because, hello, different things!!

Pretty much everyone I spoke to during my stillbirth was very sensitive. I did have to wait in the general waiting room for my ultrasound, however at that point I didn't know anything was wrong (they couldn't find the heartbeat via doppler but I was naive and never considered the possibility that he was dead!). So that was fine. When I came back for my 1-week appointment they didn't even let me go into the waiting room, they saw me come in and ushed me into a room. I really really appreciated that.

My husband wasn't with me, but they let me call him (bawling) and ask him to come in right away. They let us sit in a private conference room together while we decided what to do... and to get me from the U/S room to the conference room they took me through back hallways so I wouldn't have to see any pregnant women. I was given options for everything... if I wanted to induce or wait, if I wanted to go home or be admitted right away, etc. The nurses were wonderful, very caring and polite and sensitive. My midwife was great. The anesthesiologist seemed to not have a clue and was getting grumpy with me because I couldn't answer her (I was contracting every 2 minutes!) and I wanted to slap her, but I think that was her personal issue... there was a sign on the door announcing to all medical people what was happening. I was also placed in the L&D room furthest away so that I wasn't in the thick of laboring women (though I could still hear a baby cry now and then in the middle of the night - and they apologised to me for that). My husband never left my side from the time he arrived to the time we left (and then he didn't leave my side for another two weeks, heh). If they had told me to go somewhere without him I would have flat out refused.

They had me come in at one week PP and six weeks PP to check up on me and talk to me and see how I was coping. They gave us materials for support... support groups, helpful "what to expect" pamphlets, etc.

I totally agree with the flagging of files!! Getting any calls afterwards asking about the baby is like a stab to the heart. I can't imagine someone *arguing* with you about dates etc. Totally uncalled for.


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## ~Mamaterra~ (Jul 5, 2006)




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## mamabbbg? (Feb 3, 2005)

Contact Now I Lay Me Down to Sleep, a volunteer organization that takes heirloom quality keepsake photos for families experiencing a loss. All L&D units, midwifes and ER's should have their phone number.


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## boysmom2 (Jan 24, 2007)

Don't leave the woman who was just brought in by an ambulance alone in an ER exam room with no way to call for help if she feels like she's about to lose conciousness again. Ten minutes earlier my dh thought I was DEAD, and now nobody's even checking on me?!

Maybe take note of the fact that she was brought in with nothing but a bloody tank top (yep, not even underwear!) and offer her a gown or SOMETHING.

Even though you're an ER doc, and not an OB, try NOT to have a horrified expression on your face as you perform the pelvic exam. Also, try not to argue with the nurse who's helping you. The last thing I need is to feel like I'm ruining somebody's night because you're throwing such a fit over the fact that she gave you the wrong stuff.

Also, the rule that DH can't come with me for the ultrasound in the ER is ridiculous! We fought and insisted that he come with me, but she was really mean about it. She kept telling us that she wouldn't be able to tell us anything. Fine, don't tell us anything, just don't make me do this alone.

My mw has been awesome, but I do have one complaint: I went in to see her because I was STILL bleeding heavily more than a week after this m/c and hemmorhage and feeling like crap. She had a student with her. I don't mind students at all, in fact I hope to be one someday, but this one needed to get a clue. She was SO chipper! I feel like death, I have just lost ANOTHER baby, please don't act like you're participating in a beauty pagent. Dial it down, please!


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## honeybunch2k8 (Jan 14, 2008)

Quote:


Originally Posted by *boysmom2* 
Don't leave the woman who was just brought in by an ambulance alone in an ER exam room with no way to call for help if she feels like she's about to lose conciousness again. Ten minutes earlier my dh thought I was DEAD, and now nobody's even checking on me?!

Maybe take note of the fact that she was brought in with nothing but a bloody tank top (yep, not even underwear!) and offer her a gown or SOMETHING.

Even though you're an ER doc, and not an OB, try NOT to have a horrified expression on your face as you perform the pelvic exam. Also, try not to argue with the nurse who's helping you. The last thing I need is to feel like I'm ruining somebody's night because you're throwing such a fit over the fact that she gave you the wrong stuff.

*Also, the rule that DH can't come with me for the ultrasound in the ER is ridiculous!* We fought and insisted that he come with me, but she was really mean about it. She kept telling us that she wouldn't be able to tell us anything. Fine, don't tell us anything, just don't make me do this alone.

My mw has been awesome, but I do have one complaint: I went in to see her because I was STILL bleeding heavily more than a week after this m/c and hemmorhage and feeling like crap. She had a student with her. I don't mind students at all, in fact I hope to be one someday, but this one needed to get a clue. She was SO chipper! I feel like death, I have just lost ANOTHER baby, please don't act like you're participating in a beauty pagent. Dial it down, please!

Agreed. I dont think they should have to ask, I think they should be encouraged to be there. IMO it can make a HUGE difference in how a man grieves.


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## ~Mamaterra~ (Jul 5, 2006)




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## dismalgrrrl (Apr 14, 2008)

Quote:


Originally Posted by *Megan73* 
Thanks for this, mama. Two things my midwifery practice did come to mind:

DON'T make women whose babies were born still wait and wait for their six-week post-partum visit surrounded by pregnant women and babies.
DO flag the files of women who have had losses so you don't ask chipper questions about the birth of babies who died.

I can't say I am glad, maybe relieved?, to know that I am not the only person who got treated poorly by a midwife. I had felt like me mistreated by one made me even less of woman.

Don't make women whose babies were stillborn wait for more than an hour surrounded by women whose bellies you and your staff rub.
Don't close their files with a flourish and the admonition, "you need to be on birth control"
Do give them adequate information on what to expect afterward. For many of us this is our only child. We don't know what the postpartum period is like, and we were not full term we don't know if what is in the baby books will apply to us. (not to mention having to read about how to manage with a baby is really not helpful). And none of those tell what to do about the breastmilk.
Do have information available about ways other families have memorialized their babies. i wish I had thought of getting a lock of hair, or been able to dress or bathe my son. Instead we were left in a room to ourselves until it was time to go. We were worried we were doing something wrong by taking pictures, and that someone would stop us.
Do warn us at follow up appointments at other practitioners that in order to get to your office we have to walk through labor and delivery. Don't let us find out for ourselves and be paralyzed with fear and panic.
Do follow up. See how we are doing. Nobody ever did this.
Do have information on how we can stop the mailings that we get because of registering.
Do give women when they are discharged from the hospital the same pads that you give women who go home with babies. I never even knew these were given out.'
Do know if a bereavement doula works in the area, and have their contact information, and offer it to the family.


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## Bellabaz (Feb 27, 2008)

So far my doc's office has been very sensitive. When I called to cancel an appointment and tell them I had had a miscarriage they asked if I was ok and told me to call if I needed anything.

They called back and explained that my ob wanted me to have more bloodwork to check my levels and make sure they were going down. They offered to fax the order in to the hospital so I didn't have to go to the office and see other pregnant women and babies. I really appreciated this. I am also glad they aren't pushing more exams/u/s or a d and c.


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