I’ve been an OB/GYN for more than 16 years, and there is a real possibility that I will deal with grief and loss every day.
That surprises some people. I frequently hear some variation of the following statements from my patients. “I would love to do what you do!” “I bet your job is always so happy!” Unfortunately, it is not always happy and joyful. In fact, there can be a significant amount of grief and pain in my everyday clinic. I often tell my medical students that in every job you take the good with the bad. In my case, the bad is pregnancy loss and fertility issues.
Every time I walk into an exam room, there is a chance I won’t hear a baby’s heartbeat. Almost 1 in 3 to 4 pregnancies ends in a loss. Sometimes, it’s very early before a woman even realizes she is pregnant. Less often, fortunately, it’s late in the course, after the nursery is decorated and the baby showers have occurred. We can diagnose a pregnancy from when the sperm and the egg meet, and once that occurs, many couples see and imagine that tiny person. No matter when a loss occurs, it’s usually unexpected and devastating.
Most couples want to know why a loss has occurred. Most of the time, I cannot tell them. There are many medical reasons for a loss. But most of the time, couples just want to know what they could’ve done differently to change the outcome. Usually the answer is ... “nothing.”
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This is easier to understand in our heads than to understand in our hearts. Usually there is nothing anyone could have done positively or negatively to change the outcome. Many times there just isn’t anything I can say or do to make the situation better. This is obviously heartbreaking to me as a physician. I hold a lot of hands and hand out a lot of Kleenex. I try to support the best I can. Certainly, when the couple came to the appointment, they anticipated talking about a healthy pregnancy, not dealing with the grief of a loss.
I can also give other unfortunate news at an appointment. I’ve told couples their baby has a complicated birth defect, or their baby has a chromosomal abnormality, or their baby is going to be born weeks earlier than anticipated. All of these diagnoses are a “loss” in a certain way, as the parent’s expectations of the “perfect pregnancy and baby” have been dashed. There is grief in this aspect as well.
As a physician, I never want to deliver this type of news. And often, I don’t feel like I do it very well. There isn’t a good way to tell someone their baby has passed away. I just try to be as compassionate as I can and answer their questions to the best of my knowledge. Sometimes, there are just no good answers. I also let them know I will be there to support them through this time of grief and loss.
Another aspect of my practice where there is grief and disappointment is when a couple experiences fertility issues. Many times these issues are unexplained. These couples try so hard and so long for a family and are often met with miscarriage and disappointment. As a physician, I feel frustration as well that I cannot always assist them in this dream.
How do couples deal with this debilitating loss and grief? All do so differently, even between the two persons in the couple. There is no right or wrong way to deal with the loss and no time frame to complete it. Fortunately, there is a group in State College that helps couples deal with the issues surrounding pregnancy loss, stillbirth, infant death and/or fertility issues. It is HEART of Central Pa. I have had the privilege of being involved with this group for many years. HEART is a caring environment to talk with others about loss and grief and possibly growth and how to come out on the other side.
So, yes, generally my job is a happy one. It can be particularly rewarding when one of our couples, who has experienced loss or fertility issues, has a successful pregnancy outcome. In this time in November of giving thanks, I am thankful to be able to help couples through their grief and that there are resources available in our community to support me in this endeavor.