Behind the Scenes of a “Bad” Pregnancy Ultrasound

October is baby loss and miscarriage awareness month, so I thought I’d share a story with you about how I have been affected by this, both personally and professionally.

At 10 weeks, during my second pregnancy, I was told that my baby’s heartbeat stopped. Of course I was devastated, except that I did have a little nagging intuition that something ‘wasn’t quite right’ with this pregnancy which I had been hoping to disprove.

At the time, there was one sole physician at my practice, and I helped him with office procedures. He was away on a planned vacation, so it was up to me to cover the office. And, just to further add to my misery, my cat had escaped, my dad had received concerning test results and oh, it was my birthday.

I scheduled a D & C on a Friday because I couldn’t miss too many office days. I dropped my daughter off at my friend’s house then headed to the hospital with my husband, who didn’t know what to say, so he kept making jokes until I told him that I would punch him in the face if he didn’t stop. He stopped.

My sweet OB/GYNs (Drs Gennaro and Cahill) were there to do the procedure and, as always, were so kind and awesome. I tried to seem ok with it all, because oddly I didn’t want them to worry about me, and the procedure was uneventful. Once released from the hospital, I picked up my daughter (who was 14 months at the time) and we all headed home where my hubby asked if he could take a quick nap as this was “very stressful” for him (he actually is a great guy, but seriously?)

I returned to work that following Monday and my schedule was ironically crammed with pregnancy scans. I was wholeheartedly happy for all of the patients, as I knew most of them well and was part of their journeys so far, but there was an undercurrent of sadness for my own situation. I bottled up these feelings as they felt too self-indulgent and selfish.

Somehow, I got through that week, with my bottled-up feelings and conflicting emotions until that Friday. That day I did a pregnancy ultrasound on a patient and didn’t see a heartbeat.

We sat in silence for a bit while I searched, and she desperately wanted to hear what I desperately wanted to say. That all was ok. But I couldn’t. Because it wasn’t.

I felt my face get hot, my throat closed up and my eyes welled with tears at the same time that hers did. The words “I’m sorry” got caught in my throat, but they felt so inadequate that I didn’t say them. Her husband wasn’t there and she looked at me and asked if she lost the baby. I said that she had, and she just nodded. Then, eloquently, I said, “This sucks, this just *bleeping* sucks.” To my horror and amazement, she laughed and I cried at the same time. And not girl crying, by the way, but big, runny nose, unattractive, sobbing crying. Eventually, we both did.

They chose to have a D & C the following week, and I visited her in the recovery room and we chatted. She told me that I was so kind and caring, and I revealed what had just happened, as I felt like a fraud. I had used her experience to release my own feelings of loss, and for this I felt both empathetic and pathetic.

Ultimately, she conceived again, and delivered a healthy baby (as did I), and sent me a card thanking me for all that I did. How about that for grace. I’m not sure if I would have done the same if I was in her shoes.

I hear, from my patients and friends, that some clinicians are, well, not so great at delivering bad news and I can tell you, it’s not because they don’t care. It’s because they care too much. I am now actually grateful that I had this negative experience, as it has given me perspective that I tap into every single time I do a pregnancy scan. Now I don’t run from this discomfort, I lean into it. I allow myself to feel and absorb what this patient or couple is experiencing, and try to give them what they need, whether that is talking it through, not saying much, or sitting quietly while she (or they) cry and process the news.

I have also learned that people handle grief differently and no way is the wrong way. My husband tried to diffuse the situation with humor, then gave up and realized that caring for me and feeling what he felt was exhausting. I tried to make myself feel better by trying to make everyone around me feel better until it didn’t work anymore. My patient laughed until she cried.

If you have had this experience, you might have your own way of dealing with loss. And that’s ok. Just please realize that we, as your clinicians, may not say or do the ‘right’ thing, because we feel deeply for you and we handle this emotion in a variety of ways. Witnessing the naked emotion that is expressed when anticipation and cautious optimism becomes grief can be heartbreaking and can make us feel intrusive.

My fervent wish is that, as clinicians, we can learn to see our interaction at this time as a privilege and an opportunity to be the person that you need us to be.



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