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Reclaiming Miscarriage: 5 Things Every Doctor, Midwife, and Pregnant Woman Should Do

January 31, 2017

Talking about miscarriage is difficult, even though it’s something countless women have experienced. In an effort to raise awareness about miscarriage and the grieving that goes along with it, contributor Holly Ellis Spiegel shares her story and advice for those dealing with a pregnancy loss. 


Hi Baby – We are very sad. We’re going to say goodbye to you today.

This was only the third entry in my pregnancy journal just over 2 years ago. I’d known I was pregnant for a little over 3 weeks, but the 8-week sonogram showed no heartbeat.

Seven months later, after another 8-week scan, I wrote:

Hello Little Bird – You’re still in my belly, but you don’t yet have a heartbeat. That’s not good, but the doctors aren’t giving up yet… If you need to go, tiny one, I understand. But if you want to fight, I’ll fight alongside you. I love you so much, angel. Please be a fighter.

I lost that baby a week later.

Even now, as I listen to my four-month-old son squeal and blow raspberries on his play mat next to me, it’s easy for me to reflect on how desperately his Papa and I had wanted him, how eagerly we waited – month after month – for that second pink line, and how crushed we were when we had to say goodbye to his 2 siblings before we finally heard the sweet music of his heartbeat.

Obviously, pregnancy loss is devastating for every mother and her partner. I was comforted by the stories of friends and family who reached out to me after I shared the news of my second miscarriage, and talked about their own experiences. At the same time, I wished that I had heard them before, so that I wouldn’t have had to wonder – even for a second – if there was something wrong with me. Thankfully, more and more (and more) women who’ve had miscarriages are choosing to speak publicly about it, chipping away at the stigma and shame often felt by the 1-in-5 women who lose their pregnancies in the first term.

But what is still needed is for the medical community to speak about miscarriage and all pregnancy loss in a new way.

After my losses, I joined a private Facebook group for women who were trying to conceive; many of whom had been through miscarriage. I asked them about how they were informed they were having a miscarriage. While some doctors and midwives did offer a sympathetic ear, many were callous and dismissive:

Debra: the doctor at the ultrasound center came in after our scan and started by saying, “well, bad news…”

Erin: The doctor just said, “it looks like you’re having a miscarriage.” That was it. No “I’m sorry,” no “I know this is hard,” no sympathy.

Caroline: The midwife didn’t explain the situation to me clearly, or really at all; she just told me “it could go either way” and “don’t Google it.”

Cleopatra: I was so naive with our first BFP that I just assumed everything was ok and never thought about loss as I didn’t think that it could happen to me. I was in a bubble of happiness assuming everything was ok.

Here’s how the medical community can help their patients facing a pregnancy loss:

1. Early Awareness: When OBs get that call from their patients, breathlessly announcing “I’m pregnant!” The doctor should find a way to work into that first conversation: “remember that many early pregnancies end in miscarriage. If it happens to you, don’t worry. You didn’t do anything wrong, it’s just a sad thing that happens, though we don’t always know why. The odds are very good you’ll get pregnant again and have a healthy baby.”

2. A Sympathetic Ear: When a miscarriage happens or is detected, doctors and midwives would do well to put themselves in their patient’s shoes. While this may be a daily routine for you, it could be the worst thing that’s ever happened to her and her partner.

In my case, I tried to take it as a comfort that the doctors were so casual about telling me – it was an indication that they see this every day, and that it wasn’t a big deal. But what I wanted them to acknowledge was that this was a big deal to me; it doesn’t happen to me every day. The Miscarriage Association of the UK has an excellent video of patient interviews and comprehensive advice for medical providers.

3. A Doula for Every Pregnancy: All OB and midwife practices, and abortion clinics, should offer referrals to bereavement doulas, counselors and support groups. If possible, have one on location on the days when these procedures are performed.

For my second loss, I was given the option of having the embryo removed at a clinic that normally performs abortions, since the procedure (a dilation & curettage) is virtually the same. The doctor met with my husband and me in advance and was kind and sympathetic, reassuring us that even two miscarriages in a row was perfectly normal. However, when I lay down on the operating table and allowed a few tears to fall, the same doctor escorted me out of the room, telling me to pull myself together; saying that he’d be putting himself and his clinic at risk for a lawsuit if he put a crying woman under anesthesia for what was essentially an abortion. As a pro-choice advocate, I completely understood and wrestled to squelch my emotions until I left the office, but I still felt robbed of the right to mourn my loss. My stress would have been greatly eased by having someone at my side, quietly holding my hand before, during and after the procedure.

4. Revise the Book: Include a full chapter (not just an appendix) about miscarriage in every pregnancy book. Emphasize how common miscarriage is and that it is very rarely caused by something the pregnant woman did or didn’t do.

Putting the miscarriage reference in the back of the book makes the women who have miscarriages feel like what happened to them was a rare malady, something that should be kept secret, rather than a common, normal process in having a healthy pregnancy. As new mom Debra told me, “I know they don’t want to scare women, but we need to know how common miscarriage is. I never thought it was common enough to happen to me, yet it happened to me twice.”

Because miscarriage usually happens so early in pregnancy – and often at home – it’s hard to have enough research to know how it is caused. But putting as much solid information as possible in the pregnancy books, apps and podcasts that pregnant women digest with such ferocity, reinforces that it is common and they should not feel like abnormal exceptions to the healthy norm.

5. Speak Out: Lastly, encourage women who’ve had miscarriages to reach out and share their grief. Very often, they will find that the friends they reach out to have also had losses, or at least know someone who has. Finding others who’ve had this experience tells them “you are not alone. There’s nothing wrong with you. This is sad, but sadly normal.”


Holly Ellis Spiegel is a writer and freelance film and video producer based in Brooklyn. She’s produced four feature films including the Sundance-selected Prairie Love and countless videos for parents and families on CafeMom and other outlets. She is also a new mom. See her work at hollylynnellis.com.