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Loss.

Recently I had the misfortune of having two women who were close to me experience a pregnancy loss within the same week. Both were about 11 weeks of pregnancy. I had not even thought about this in quite some time, but these women were asking *ME* for answers. Neither of these mothers had any clue what to expect beforehand and worst of all to me, although I've birthed many babies and teach childbirth education, I did not know what to tell them or how to help either!

When these mothers suspected trouble, they call their health care providers who did not feel the need to see them; "there was nothing they could do this early in the pregnancy." Both women had subsequently gone into the ER to see what was happening and were sent home without answers. They were given no information on what to expect. Both "gave birth", unmedicated in their own homes without someone who knew how to help. I was surprised that both women, who each had two previous, unmedicated births, described the process as more painful than having a full term baby! Afterward, the health care providers did not suggest a visit until one month later. They gave no instructions on after care. The women were left with grief, pain, some physical problems, and lots of questions.

It doesn't matter how long a woman knows she is pregnant; to learn you are experiencing loss of a pregnancy is heartbreaking. I remember a woman who found out in the ER that she had been pregnant and was losing the baby. She grieved for months (or more). Even when mothers have not felt the movement of the baby, they still grieve. They grieve for the loss of dreams, the loss of what could have been. How do you tell the family and friends about it? Sometimes family and friends respond, "You can have another baby," or "There was probably something wrong with the fetus anyway," trying to be helpful. These are ultimately hurtful comments in the woman's eyes. Sometimes, the people around them aren't aware of the loss, The family may have not shared the blessed new and are not yet showing. The woman grieves alone, in silence. Partners grieve too, though their grief may be forgotten. They grieve differently than mothers or at different stages. With early pregnancy loss there are no locks of hair, no tiny footprints, no precious pictures for the parents to hold. Nothing. Some parts of the world have no resources for support of a pregnancy loss, and this is one area where the best support comes face-to-face, heart-to-heart.

There is little printed information available about what to expect while the loss is occurring. Many mothers do not want to take pain medication, "just in case." They don't want to give up on their pregnancy. They also have no idea how painful the process will it be or how long it will take. Tough decisions have to be made by those unprepared and possibly in a state of shock, such as what to do with the remains. What are the warning signs that indicate something is going wrong?

More could be done to help women through this sad experience. It would be such a wonderful service to train "pregnancy loss doulas" who can help a woman through the process, sit by her side and be there to offer support and resources afterward. This would be a special person and would require particular education. Until then, it is up to us to be prepared to offer information and support to those in need.

by Terriann Shell, IBCLC ICCE FILCA

Terriann Shell represents us on the ICEA board of director's and chairs the Lactation Advisory Committee and is from Big City Alaska.
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Title Annotation:Meet the Board
Author:Shell, Terriann
Publication:International Journal of Childbirth Education
Article Type:Column
Geographic Code:1USA
Date:Apr 1, 2012
Words:627
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