My first miscarriage was the Mother’s Day weekend after the boys died. I had a presentation to make for work and just before it started, I went to the bathroom to get ready. I spotted blood and had my coworkers take over while I went straight to the emergency room. Just 8 months after the boys died, I was still raw and grieving their loss and wasn’t in the best place emotionally to begin with. Faced with another pregnancy failure, the emergency room was the wrong place to be. The doctor I saw was not sympathetic, although I think he thought he was. It’s a teaching hospital, so he was a resident, and he made a joke about not being all that good with an ultrasound. He said that he could not find a heartbeat, but that it was possible that was due to his poor skill, and I’d just have to make an appointment with my obstetrician sometime next week. He also said two things: “Either you’re having a miscarriage, in which case I’m afraid there isn’t anything I can do to stop it. Or, you’re not having a miscarriage, and there’s nothing to worry about, go home and rest and talk to your obstetrician next week.”
Often we set out to make a difference in the lives of others only to discover we have made a difference in our own. Ellie Braun-Haley
Even if he wasn’t able to see my full chart, he should have been able to see that my obstetrician was the high-risk specialist. And the mere fact that I decided that this was important enough to come into the emergency department should have been a signal that, at least to me, this was an emergency. This is what the patient-centred care movement is all about – it is the patient who decides, not the doctor.
Emergency rooms should be designed to care for people in both physical and psychological crisis. For many loss moms, Mother’s Day is a day of heightened emotional pain. If you’re in crisis, you should expect your health professionals to care for you and deliver appropriate medical care. The doctor may have been telling the truth when he said he couldn’t stop my miscarriage from happening, but he could have been more compassionate in recognizing the emotional impact this was having on me.
If you had poor care during your miscarriage, you can help to enact change. Contact your hospital’s patient advisor or ombudsman to let them know about your experience. There is research available that shows several options to improve care, such as having a nurse practitioner in the emergency room[1], or obstetrical nurses[2], or referral to the obstetrical unit right away[3],[4]. Approximately 1-2% of emergency room visits are for miscarriages or threatened miscarriages, so this is a fairly frequent thing for these doctors to see.
This is a tough weekend for a lot of us. Some of us do not have living children. Some of us have lost our mothers too, making this weekend twice as hard. It is easy to feel left out of the celebrations. As I lay in bed that first Mother’s Day weekend, I wasn’t yet strong enough to face the world. I was angry and hurt. Making meaning of your miscarriage can be a step on the path to healing. If you can commit to helping improve care at your local hospital for the next woman, you’ll have made a difference. By choosing to take a small step, I was able to join the celebration again, to feel part of the connected whole. I may not have the power to stop a miscarriage, but I do have the power to change the world.
What are you doing to change the world this Mother’s Day? It can be as awe-inspiring as Katy Larsen’s Delivering Hope or as simple as resolving to get out of bed on Sunday and not let the day get you down. Post your ideas here to inspire other loss moms!
[1] Webster-Bain D. The successful implementation of nurse practitioner model of care for threatened or inevitable miscarriage. Australian Nursing Journal. 18(8):30-3, 2011 Mar.
[2] Bacidore V. Warren N. Chaput C. Keough VA. A collaborative framework for managing pregnancy loss in the emergency department. JOGNN – Journal of Obstetric, Gynecologic, & Neonatal Nursing. 38(6):730-8, 2009 Nov-Dec.
[3] Adolfsson A. Tullander-Tjornstrand K. Larsson PG. Decreased need for emergency services after changing management for suspected miscarriage. Acta Obstetricia et Gynecologica Scandinavica. 90(8):921-3, 2011 Aug.
[4] Wilson W. An A&E nurse’s fast-track for potential miscarriage patients. Accident & Emergency Nursing. 8(1):9-12, 2000 Jan.
Amanda Ross-White is the proud mother of four beautiful children, including her twin boys Nate and Sam, who were stillborn in 2007. She is eternally grateful to watch her rainbow children, daughter Rebecca and son Alex, grow around her. She is also the author of Joy at the End of the Rainbow: A Guide to Pregnancy After a Loss, which won second place in the American Journal of Nursing’s Book of the Year Awards (Consumer Health).
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