The midwife used eye contact and helpful gestures by simply involving her in her own
experience and at the same time the midwife recognised the uniqueness of the situation.
The care and support determined by personal significance of miscarriages are unique and individual to each woman. Interpersonal stress is clear when the woman cannot synchronise grieving. There is no pattern for every person’s response to death of their baby as grief for each individual is intrinsically unique. (Midwifery and Obstetrics, All Wards and Departments, February 2007). By using her own experience, the midwife developed a level of trust with the woman. I now see it as a profession with an immense personal involvement. The concept of partnership between the woman and the midwife is essential and is based on a mutual trust (Guidelines for Midwives, September 2001). I remained silent throughout the situation as I had not yet developed competence involving miscarriages.
Any type of experience involving a miscarriage is thought-provoking and will initiate an emotional response. My feelings were sympathetic and distressed. I was perplexed at the situation and did not understand how to deal with the incident. I felt I couldn’t provide any form of comfort as both the woman and the midwife had experienced miscarriages. The midwife held the woman’s hand sympathetically but also encouraged the woman. Hope for the future is all she could provide. In closely involved situations like this, midwives may feel the isolation and loneliness that the grieving mother experiences (Mayes’ Midwifery, 2004). I could feel the pain in me, penetrating through my body. Emotions are also felt physically and we carry them in different parts of the body (Mayes' Midwifery, 2004) i.e. I felt sadness in my stomach and heart. I felt inadequate as if I had nothing to offer in the situation. I could not relate to the woman in the same in-depth approach in which the midwife had. My main thoughts from this experience were how the woman felt. Surely this was agonising pain that I’ve probably never felt before and from the experience I hope I never will. I think the importance of the experience for me was the invaluable knowledge I received from the midwife. There are no guidelines or rules on assessing grief, only policies relevant to this type of care. Each midwife has a different way of caring for each woman. There is no one person better equipped to care than an other. Each midwife should have something to offer. As midwives, we offer ourselves and in doing so we learn from grieving families. As this was my first experience, I felt as though I had nothing to offer. I believe that the pain I felt will always be there in these situations, but I hope I can resist the pain to that profundity in experiences in the future.
Although it seems obvious that the negatives extend beyond the positives in this experience, it presents itself with optimism for the future. Supportive encouragement form the midwife represents hope for the woman. Bereaved parents are deeply grateful and remember the care they received throughout their lives (Mayes’ Midwifery, 2004). They never forget the understanding, respect and genuine care, clearing shown by the midwife that they receive from caregivers who become as important to them as other memories in life (Midwifery and Obstetrics, All wards and Departments, February 2007). The situation gave me a chance to reflect and understand the issues relevant to the experience. From my work placement, I have become more confident and understanding to these fragile circumstances. I have developed a broader view of the world and life. The woman however is left in a fragile psychological grieving state. It is unknown to some women how to overcome the situation. Delayed grief can sap your energy and can leave its mark on you for longer than can be imagined (Self Care for Parents, 2000). As midwives we can only hope that the women can progress though life but we can only do so much in the profession. I did not understand exactly how the woman was feeling when she left the hospital that day. I could only presume that she was riddled with grief or else in denial of the event. On another unpleasant note, for myself I realised that these situations were frequent. About 15 – 20% of pregnancy ends in miscarriage (Midwifery and Obstetrics, All wards and Departments, February 2007), a deplorable amount of pain and grief that woman around the world have, are and yet to endure. For me, it is one of the world’s most pessimistic effects to life. I have learned the real loss of a living infant to the mother of a child and the experience of it portrayed its realism. The mother had developed a close motherly bond with the infant. Death does not invalidate the relationship with a child (When your baby dies through miscarriage or stillbirth, 2002).
The experience for me itself was presented in an unusual analysis. My expectancy of the situation didn’t advocate itself in a nonplussed grieving approach but in a more senseless emotionless experience that presented knowledge, skill and attitude on my part rather than the subject being utterly unapproachable. Unrecognised losses such as the death of a foetus should come to the attention of staff. A good account of the problem and sensitive support should be implemented (Studies of Grief in Adult Life, 1996).
Miscarriage is defined as a loss of pregnancy before 24 weeks’ gestation. It is a devastating experience for anyone who undergoes this experience. Quantitative and qualitative data were collected from 79 women admitted to a large London hospital. Seventy-two percent of women positively rated their experience of hospital care (Grief in miscarriage patients and satisfaction with care in a London hospital, 1999). This percentage is relatively high but I feel it should be 100%. When a woman becomes a child bearer, she is entrusted with the precious life of a child to carry and care for but the miscarriage or early pregnancy loss of this life is just ended before it could even begin (When your baby dies through miscarriage or stillbirth. 2002).
I feel I could have performed better on the day and time of the experience. I remained
silent and just observed the bereaved mother. I should have encouraged the grieving process. Not many years ago it was considered inappropriate for mothers to grieve over the loss of their baby. Grieving is now considered a long-term healthy option (Mayes’ Midwifery, 2004). I could have assisted the midwife in the comforting of the woman even by standing nearer or offering simple gestures of kindness such as asking if there was anything I could get her. I should have been more prepared and aware. I needed more research and education on the topic. Education facilitates learning and understanding and promotes the development of skills and resources. This integrates theories into practice (Mayes´Midwifery, 2004). My knowledge and understanding of the topic was limited and I had no skills on caring for the woman. While saying that I do have the skills as a human being to care for people in times of need there are no set rules to follow in caring for people at such sensitive times. Each individual is unique and as a midwife I should be able to recognise varied feelings and have a sense for each woman’s individual needs (Mayes’ Midwifery, 2004).
I feel I portrayed an inadequate approach as for me it was an atypical experience spontaneously introduced to my coursework. I felt pain and sympathy for the mother but did not voice my empathy. I did not want to jeopardise the unfamiliar situation, even though I wanted to help by giving words of comfort. My mind could not think beyond the pain the mother must have been feeling. Next time, I would definitely use a more comforting approach. Perhaps I would sit on the bed as the midwife had, and maybe hold the woman’s hand too, if suitable. I think that to provide effective comfort, good eye contact and body signs are necessary. I feel that I have progressed and am able to overcome the situation and deal with it in a more professional manner. No matter what the circumstances are, losing a child is a shock to the entire body. Grief will flood every part of you – emotionally, physically and mentally (When your baby dies through miscarriage or stillbirth, 2002). I know not to introduce hope for another baby or suggest moving on and forgetting about the baby. These are only the indicators to suggest the baby never even existed. I would not fail to communicate as I did in the situation and I would be more prepared next time I encountered a miscarriage.
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