Medical Matters: One in five pregnancies is estimated to end in miscarriage. Yet how often do you hear of a couple who have had a "miss"? There is still a tendency not to discuss early pregnancy loss, even though the grief experienced by those of us who have been through it is very real indeed.
In a miscarriage a baby is born dead before the legal age of viability; in the Republic this means intrauterine death before 24 weeks. In practice most miscarriages occur early in pregnancy.
There are different types of miscarriage. In complete miscarriage all the product of the pregnancy is passed from the womb. An incomplete miscarriage is when some of the baby's remains stay in the womb, usually requiring the mother to have a dilatation and curettage, more commonly known as a D and C.
Even in the relatively early stages of pregnancy a woman may pass a readily distinguishable baby: a tiny package inside a sac. All others may notice is a slight spotting. This may occur when the miscarriage involves a blighted ovum, a pregnancy in which the gestational sac is present but within which the embryo does not develop.
No matter what the cause or stage of pregnancy, miscarriage is a loss for both mother and father. When a group of women who miscarried between four and 20 weeks were asked how they felt, the depth of their loss was marked.
More than two-thirds cent said they experienced their babies as whole and living human beings; four out of five felt a part of them had died. Almost half doubted they would ever get through their grief.
Unfortunately, many women (and men) find that the reaction of health professionals, clergy and others leaves a lot to be desired. Doctors sometimes hide behind the mechanics of medicine. Relatives and friends often do not know what to say. Phrases such as "you can always have another one" and "sure, you have your whole life ahead of you" are more likely to irritate than console.
Which is why a book published today, Miscarriage & Stillbirth: The Changing Response by Bruce Pierce, is so important. One of the most empathetic books I have read on grief and loss, it manages to be an all-in-one resource book for families, healthcare providers and those in pastoral ministry.
A former Church of Ireland chaplain at the Adelaide & Meath Hospital, in Tallaght, and now chaplain at Toronto General Hospital, in Canada, Pierce addresses the importance of marking the experience of pregnancy, however short it may have been.
Outlining the ways people respond to the bereaved, he suggests following the path of compassion and empathy. "This is an approach of listening to the story, many times if necessary, and simply saying: 'I'm sorry'. Many parents have commented on how they valued the request to tell their story about their baby," he writes.
If you have recently gone through the trauma of miscarriage or stillbirth he suggests that you:
keep telling your story to family and friends;
use a support group when the time seems right;
write a journal of your experience;
limit life changes and be open to help from others.
What does he say about loss for the father? "Following miscarriage or stillbirth, many fathers can feel isolated and left out of what is happening, with their needs being ignored . . . . Men tend to be more stoic and less expressive, but what is experienced may well be anger . . . . Interestingly, men show higher scores than women on measures of anger, aggression and denial."
He has useful words for healthcare professionals. "Some adopt an attitude of 'unemotional professionalism', which may well serve to block their own grief and the sense of loss in terms of their efficacy following the death of a baby. Research has shown that patients who received personal ongoing follow-up from their physicians were considerably more likely to be satisfied with the nature and type of information provided and the care they received."
Whether you seek to understand the churches' positions on baptism for a baby lost in pregnancy or to know what to expect from a support group, it's all here, written in an easy and compassionate style. I cannot recommend the book highly enough.
Miscarriage & Stillbirth: The Changing Response by Bruce Pierce is published by Veritas, €12.95
You can e-mail Dr Muiris Houston at mhouston@irish-times.ie. He regrets he cannot answer individual queries