I pray you never need this post but I also know that it is likely someone will. I know far too many families who have gone through the grief of losing a little one and there really aren't many resources to help people know what to expect during a miscarriage and how even in the midst of their grief they can make choices that will honor the dignity and reality of the hidden precious little person that they mourn. If you are reading this because you have had or are having a miscarriage, I am so very sorry. Please contact me if you'd like me to pray for you. This post is primarily meant for those experiencing a loss before the age of viability - around 22 to 24 weeks, though many of the advice and words can apply beyond that.
Something that is personal to me is the way that we as individuals, as a Church, and as a society respond to miscarriage. If we believe what we say, that a unique human person is created at conception as science shows us, then the death of that person no matter how early, should be treated as such. Whether it is our own loss or someone close to us, being a people who value every human life means that when it comes to miscarriage we need to respond accordingly. I don't believe we will be taken seriously as a pro-life people until we adequately respond to those around us who are grieving their unborn children.
In a few days I will share my suggestions on how we can offer comfort to a family who is grieving the loss of an unborn child but for today I'd just like to focus on the couple experiencing a miscarriage themselves.
If You Are Having a Miscarriage:
There are several ways a miscarriage can happen. Sometimes a miscarriage in the very early weeks is quick. You had a positive pregnancy test and then a few days later begin to bleed. This is what is referred to as a chemical pregnancy. It is just as much a miscarriage as if it happened further along but unfortunately, it is treated as routine and there are no visible remains of the baby. Sadly, this can even happen without a mother's knowledge since it often occurs right around the time that she would be expecting her period. When a miscarriage happens further along, sometimes the bleeding or cramping begins first and indicates a problem. Other times it happens that at a routine ultrasound a couple is shocked to find that the baby has no heartbeat and passed away sometime before.
However it happens, it is wise to know what to expect beforehand since in the moment there is so much going on and it is such an emotional time. You do have choices during this time and while no one likes to think of something like this happening, it is good to be prepared on how you can handle it and the choices you can make to help you honor the life and dignity of your precious baby. I've heard so many women mourn the fact that they didn't know what to expect and regret how everything happened and wish they could have made different choices. Having even a small idea of how you would react if this happens to you will help you make choices that will not only bring you some comfort but also give your baby the respect and dignity that he or she deserves.
If You are Pregnant:
• Don't be afraid to share the news of your pregnancy, even if it is early. Now, I completely understand why some people do not, especially those who have little support or who have undergone the pain of multiple losses. However, if the unthinkable does happen, it can be a tremendous comfort that other people know. It would've felt so bizarre to me when our baby died if no one else knew of that little person we had lost. If I had to feel I had to hide that grief I think it would have added pain rather than being comforted by those who loved me and who also loved this baby. I felt that it recognized the baby's dignity to tell the world that this little person existed as well as gave me the freedom to withdraw and deal with my grief for a while. Again, this is a personal decision but I think it is a beautiful witness to life that even if tragedy occurs, we acknowledge the reality of our child to others.
Finding Out about a Miscarriage:
• If you are pregnant and begin spotting or cramping in the early weeks, call your midwife or doctor. Usually an ultrasound is ordered to figure out what is going on. If the ultrasound shows that the baby has no heartbeat, the doctor or midwife will tell you and they will estimate at what week the baby stopped growing. The bleeding is the beginning of you passing your baby. If there are no signs of dangerous hemorrhaging then you will hopefully be sent home to complete the miscarriage. If the baby is still alive, find out if they can see what is going on and find out what you can do if anything to help protect the life of your baby. Get home, rest, hydrate, pray, do as little as possible physically.
• Whether it was a routine ultrasound or ordered because of bleeding, make sure you have the ultrasound technician print a picture of your baby for you. This picture will be the only photograph you ever have of your baby. This shouldn't be a problem but I have heard a few stories of technicians denying this request because the baby has passed. This is unconscionable. If for some reason this happens, fight for that picture. Having even that one photograph of our baby displayed in our home has been such a comfort to me that he or she is part of our family and not forgotten.
• If you discover at a routine ultrasound that your baby has died, if at all possible, go home and wait for the miscarriage to happen naturally. This may take a days or weeks. As long as there is no sign of infection, you do have this choice. It is incredibly difficult but often it is a far preferable option to having the remains manually removed which I will discuss below.
The Miscarriage Labor:
• Often, if the passing of the baby begins on its own, it will feel like a mini labor. There will be cramping and intermittent contractions that grow in intensity until the baby, the yolk sac or placenta and the tissue are expelled from the uterus. It is likely there will be bleeding, possibly a lot, during all of this. It may seem weird now but in order to ensure that your baby's body does not get flushed and receives a dignified burial, use a bowl to catch anything that is passed. You may be able to see the baby's body which is a tremendous blessing but it may be too small or have already begun to break down and you may not recognize anything. Either way, you can still treat the remains with respect. For many reasons, I find it much preferable to miscarry at home rather than at a hospital or doctor's office. Once this has happened the cramping should mostly subside and your bleeding should ease a bit. It's normal to bleed for a few days afterwards as long as it is not heavy. At some point you will want to tell your doctor or midwife and they will likely want to examine you to make sure that everything came out to avoid any complications.
• If you go through the miscarriage at the hospital, know that they will likely have to take the baby's remains to pathology. You will have to undergo exams and questions and are vulnerable to the beliefs and moods of hospital staff who may or may not understand how difficult this is for you. If you do decide to go or have to go the hospital, a Catholic hospital can be a really good choice. Most Catholic hospitals should recognize that the remains are yours and will turn them over to you several days later for burial if you desire. (Know that this can be a frustrating process sometimes.) Some Catholic hospitals also claim to provide a general burial place for the remains of babies within a diocesan cemetery for those who don't claim their baby's remains. Don't be afraid to ask questions. You may feel weird or uncomfortable but if it is possible, your baby deserves a decent burial.
• If the baby has died but the labor doesn't seem to be starting on its own, you will likely be offered medical intervention. Sometimes this is medically necessary. If this is the case, a pro-life doctor is invaluable during this time. The standard medical procedures for a miscarriage are a D&C (dilation and curettage) or a D&E (dilation and evacuation). Both of these are methods to remove the baby and tissue from your uterus surgically. The cervix is dilated and in a D&C the remains and the uterine lining are scraped out. In a D&E, the baby's body and uterine lining are suctioned out. In both these instances the remains are usually sent to pathology labs to ensure that everything was removed. While these should be under anesthesia, they can still be painful procedures and you have the right to know that they run the risk of scarring your uterus or cervix which can cause complications in future pregnancies or births.
IF you decide to go this route, PLEASE make sure that you have at least one more detailed ultrasound and are absolutely one hundred percent certain that the baby has died. A friend of mine was pregnant and an early ultrasound showed no heartbeat. Because she used NFP, she was convinced that her conception date was later than what the date produced by the doctor's office chart based on her last menstrual period since her cycles were not 28 days long. The doctor encouraged her to get a D&C and thank God she refused and decided to wait it out because she was right. Her baby was too little to show a heartbeat and she had a healthy baby boy nine months later. If she had listened to the advice of the doctor, they would have aborted her baby. I don't share this to give false hope during an already vulnerable time but I feel I must if I have even the smallest chance of preventing a tragedy like that. If you choose a D&C or D&E please be absolutely certain that the baby has died.
•After your miscarriage, you may still feel pregnant for several weeks. It feels cruel but it sometimes takes a while for the HcG to be out of your system.
The Remains of the Baby:
• One of the corporal works of mercy for Christians is burying the dead and this extends to our unborn children as well. If you have the body of your baby you have several choices. You can buy or build a simple wooden casket for the baby's body. This doesn't have to be fancy or even a "real" casket. When our baby died, my husband built a simple wooden box. Please know that unless the baby's body is refrigerated in between the time of the labor and the burial, it will start to break down.
• If the hospital has the remains, arrange to pick them up unless you have a Catholic hospital that will be burying the remains for you and you prefer that.
• It is possible to have a funeral Mass offered for your child. Our priest was a blessing in that he held the funeral for our baby and then also said the prayers by the graveside in the cemetery behind the church. Call your priest and ask to schedule something. The priest may also offer a special blessing for the parents after a miscarriage.
• You may bury the baby at a cemetery or simply in a special spot in your yard. Many Catholic dioceses have a place in one of their cemeteries set aside for unborn and stillborn children to be used by grieving families, sometimes even free of charge. This is a wonderful option, however you often will not be able to place a marker and the baby is buried with other little ones who have died. We chose to buy a plot at our parish cemetery as well as a small tombstone so that we could have a special place for our little one.
Acknowledging the Reality of Your Baby:
•Name your baby no matter what age they died. It is so comforting to know that your baby has a name and to be able to ask that baby's intercession for your family. It is also helpful for siblings to have a name to connect with their brother or sister in heaven and to ask for their prayers. You can even do this if it has been years since you lost your baby.
•If you do have other children, talk about their sibling. They have a right to know about their sibling and if they need, to grieve that person as well.
(Weird I know, but hey, at five years old that's how he wanted to show his little sibling in heaven his love.)
• Allow yourself time to grieve. A miscarriage is a big deal. It's not just a lost dream or an unfortunate health issue. It is the death of your child and you deserve to mourn it as such. It's okay and right to be sad. It's okay and right to take a while. It's okay and right to not feel like yourself for months or even years. You will heal. You will never forget your child. The rawness will likely wear off (and that's okay and right, too) but it's okay to feel like there is always someone missing.
• Don't be afraid to talk about your baby and accept help from those who love you.
• Allow yourself time to heal physically. Depending on the circumstances surrounding the death, you also need to remember that your body may need time to heal. Give yourself time to rest, make sure you stay hydrated, and take care of your health. Some women bounce back right away but others may take several weeks to feel normal physically. Give yourself room for that.
• Add your child's name to The Book of Life at The Church of the Holy Innocents in New York. A perpetual candle is lit in honor of these children and Mass is offered for them on the first Monday of every month.
•Have a Mass said for them at your own parish.
•Contact the Respect Life office in your diocese to find out if they offer special Masses for grieving parents.
• There are also countless small ways to remember your child that are still very comforting:
-Hang a Christmas ornament or hang a stocking in their memory.
-Display their ultrasound picture in your home.
-Keep any mementos of your child such as the ultrasound picture, the positive pregnancy test, or cards in a special box.
-Plant a tree or flower in their memory.
-Participate in Pregnancy and Infant Loss Rememberance Day.
-If you feel called, share about your experience with others.
-Make a donation in their memory to a crisis pregnancy center, your parish, or any charity that is personal to your family.
I know many people reading this have gone through the grief of losing a baby. Would you add or change anything I've written? Was your experience different or do you have suggestions on more ways that a couple can handle miscarriage from a Christian perspective? What do you wish you would have known or what would you change?
One of my favorite posts on this topic is from Melody here. If you would like further reading on handling miscarriage, I highly recommend it as well as her other posts on pregnancy loss. Some other wonderful links:
Lost Innocents A tremendous resource for anyone experiencing a miscarriage