Medical experiences in my pregnancy after stillbirth
With just a few days remaining before my scheduled 39 week induction for our fourth daughter, I have given some thought to the medical care I’ve received during this pregnancy after stillbirth. Some of it has been extremely compassionate, sensitive, and has brought dignity to our stillborn daughter. Other times, the opposite has occurred.
Here are some of the good memories:
When I went in for my pregnancy confirmation appointment just three months after Blair’s death, the nurse handed me the standard “Bringing Home Baby” manual and then left the room to grab something else. She came back and I was completely shattered, not wanting to believe I was starting all over again when I could have had a baby in my arms already. The nurse hugged me tightly for a long time (yes, even during COVID times!), gave me tissues, and looked at photos of Blair with me. She told me how beautiful Blair was and thanked me for sharing photos with her.
Multiple times over the course of my early prenatal appointments, my main OB doctor compassionately talked about Blair with me and shared her own experiences with baby losses/deaths. Maternal mental health was a priority for her, and she was overly gracious in letting me hear the baby’s heartbeat for as long as I needed.
Being asked by a midwife during my last prenatal appointment how I was doing mentally/emotionally since she noticed that I had an anniversary that weekend. The day of the appointment was the day that Blair had died last year, and the day after was her actual birth day. Despite not being a regular care provider for me, she had not only read my file but was very open to letting me share anything that I needed to share about how I was feeling on the anniversary of Blair’s death. A gentle touch of her hand on my shoulder at the end of the appointment was also so sweet and so appreciated.
Receiving regular follow-ups from a hospital grief counselor on various milestones, notably Blair’s due date, the Christmas holiday season, 6 months, and 12 months following her death.
December 2021: The moment I realized the definition of “live birth”. Over the years I always found it to be such a funny phrase, that “live” had to be added. Naively, I would wonder “aren’t all births live births?
As I filled out this form, I realized that I only had one previous live birth despite being in my third pregnancy.
Here are some of the not-so-good memories:
Other OB doctors referring to Blair as “the (fetal) demise” rather than my baby, my daughter, or asking for her name.
Mentioning my history of stillbirth to front-desk support or medical staff taking down the information with with the same neutral response as if I was sharing something impersonal like a phone number or mailing addresses. Acknowledging something brief like “I’m so sorry for your loss”, would have been so nice to hear.
Being told “Happy Mother’s Day!” at the end of my non-stress test, despite mentioning my history of stillbirth and that we were gestationally at the same mark that Blair died at the time. The appointment had been drawn-out and and I had been full of anxiety. Similarly, a few days later, I was asked if I had a “good” Mother’s Day. I would have appreciated a more gentle acknowledgement of Mother’s Day, like “I know this might be a more complicated Mother’s Day for you this year. I hope you find some time to rest and do something enjoyable. I’ll be thinking of you.” and, for the following week, asking more genuinely how the day went for me (and be prepared for any kind of answer).
Worst memory:
Anticipating an emotional reunion for an early third trimester prenatal appointment with the OB doctor who delivered Blair, only to end in a painful discussion when it was obvious that he hadn’t read my chart before walking in. I was initially asked if I had three children at home, and I had to remind him that I had two at home and a third that died. And that he had delivered my stillborn.
At this appointment, being told matter-of-factly that the recommended course of action would be to wait until the baby is at 39 weeks to induce despite being told prior that I could induce by 37 weeks. There was no room for discussion on how significant a change this would be to take in and how anxious I might feel to wait longer than I expected to bring this baby home.
Best memory:
At my 33 week prenatal appointment, being asking the names of all of my children - including Blair - and using their names throughout my visit. I had never felt more seen and valued as a person - the mother in a family with four children - not just a patient.
At this appointment, having a mental health check before discussing the merits of waiting to schedule an induction at 39 weeks versus 37 weeks. After a much more reasonable discussion, I was finally in support of waiting. until this baby got to be closer to full-term. Together we evaluated current guidelines from ACOG for managing pregnancy after stillbirth that advises for delivery at 37 weeks if a mother’s mental health necessitates. If I wasn’t doing well emotionally, I had the option of inducing earlier. With three-times-a-week monitoring, however, and the invitation to be seen any additional times that I might need during this pregnancy, I felt assured that the baby would being safely cared for. I was on board with waiting. This doctor also armed me with contact information for mental health support should I need it, and encouraged me to set something up so that I could use it to fall back on either in these last weeks of pregnancy or early postpartum. Do you see the difference in approaches between the two doctors, and how one was able to make a difference in how I perceived the birth plan?
The range of medical care I’ve received while pregnant after Blair’s stillbirth isn’t surprising to me. It’s pretty realistic that there are some medical professionals that take the time to read their patient’s charts and some that don’t. There are also persons who might see the “FDIU” (fetal death in utero) very clearly in their charts but make a choice on whether or not to discuss the patient’s wellbeing. If at all possible. I would love for staff of all levels to be able to recognize their patients who are pregnant after stillbirth so that more sensitivity can be given to them. Ask us how we’re doing. Ask what our babies names are. We remember. We would love for you to remember with us. Standing in doctor’s offices and waiting to hear about the health of our new babies takes all of the strength we have. It means the world to us when you acknowledge our very missed babies and check in with how we’re feeling. Thank you to the medical community that just ”gets it” - and “got it” for me. You bring dignity and compassion to mothers like myself who are trekking the difficult road of navigating the hope and fear in new pregnancies post stillbirth.
