Elizabeth Petrucelli

Author, Blogger, Educator

Category: unexpected outcomes

Termination

Eighteen months ago, I embarked on a journey. A journey I have never been on in 26 years I have been employed. I have been relatively silent about this journey, mostly to protect myself from embarrassment and my current employer. But like most things, opportunities present themselves and doors are opened which allow the silence to open into dialogue.

I am an educator. I have been a certified childbirth educator for over four years but I have been teaching childbirth education on and off since 2004. I have also served in the role of educator in various occupations so teaching isn’t new to me. Whenever I teach, it’s been important for me to share as much information as I can so people can make informed decisions about what I am presenting to them.

As a childbirth educator, it is not my job to sway a parents choice in one way or another. New parents have so many decisions to make and as their educator, I try to make that process easier by presenting all facts. I take great pride in having a diverse curriculum.

As a pregnancy loss advocate, I too try very hard to present all the options and choices families have. Options which are rarely presented to them by their care provider or hospital staff. Even though hospitals believe they have strong bereavement programs, they still miss the mark on some of the tiniest of options which parents should have the benefit of choosing because it can make all the difference in the world.

Care providers may begin to sway families in a particular direction because they feel it may not be important to the family or because it takes more time and/or effort to provide a particular option. It’s a huge disservice to families. I have written about organizations who are agenda driven and aren’t clear on the populations they serve. I have shared experiences from families who felt their care provider didn’t care. And today, I will share an experience that is so very hard to tell but really needs to be told.

I was fired.

I was fired for providing evidence-based information to students within a hospital prenatal class; which led to them asking questions during appointments with their care providers. Various complaints came from these care providers such as: “my patients are asking too many questions and I am getting behind in my patient load,” “I only allot five minutes of time per patient and they are asking too many questions,” “it’s not my job to inform them about ____,” “What kind of information is the educator giving because it’s not evidence-based,” and more. If you think that doctors enjoy educating parents on important topics, this study shows how doctors find less job satisfaction by spending more time talking with parents concerned about vaccinations.

I worked closely with my manager any time a complaint about my curriculum came up. So much so, that my presentations were reviewed and approved numerous times throughout my tenure. After receiving an update that I shouldn’t talk about delayed cord clamping (which is now a standard of care at nearly every local hospital), future complaints involved my education on circumcision. If a student asked about something that was too controversial or a topic my manager “implied” that I should not speak about, I was told to defer them to their care provider to ask those questions. Despite the changes, nearly every few months, I was pulled into my managers office because of the information I presented about newborn circumcision.

The information I provided was given to me by my manager from the hospital’s system “Up-to-Date.” My manager informed me that they didn’t care if patients weren’t choosing to circumcise but too many questions were being asked and I needed to stick with the evidence. Each time, my manager would review my presentation and approve it. I was sure to stick with what was on the slide during my classes but I couldn’t stop students from asking their doctor questions about the procedure.

After two years teaching at this hospital, I was fired. Patients were asking too many questions of their care providers. Were they upset that parents weren’t choosing newborn circumcision? Did they feel the patients were questioning their ability? If they weren’t going to present the real risks and benefits of procedures, who would?

I had worked for this hospital in varying roles for six years. I knew the in’s and out’s of the political environment there and I knew that doctors were to be kept happy at all times. Doctors must be catered to at all costs and were not subject to the same rules and policies that regular employees were. Doctors were special; they were to receive free meals, special lounges stocked to the brim with food, and were not subject to discipline if they were found stealing food or destroying property. The more prestigious their specialty, the more important they were and the more they got away with.

So it was no surprise that I would take the fall when these doctors complained about what their patients were learning in childbirth class if it didn’t fall in line with their opinion. In the last class I had, before I took the fall and was fired, a student kept asking if a doctor could force her into a particular procedure. I had been suspicious of her probing because she kept asking and other students were getting nervous. It seemed she didn’t have trust in her care provider. I explained that she should work closely with her doctor to ensure a mutual trust but ultimately, she cannot be forced. It’s assault, it’s against the law. That statement sparked an investigation and led to a meeting with HR.

But in that meeting, HR was only focused on the circumcision information. “We think you are teaching out of scope,” she said. “Really?” I replied. “I was hired to teach newborn care. It is well within my scope to provide the risks and benefits of circumcision. The information I provide was given to me by my manager and approved several times.”

She fell silent. After she explained their concerns, she presented me with two options. Resign or be terminated. I have never been terminated in my life. As a 40-year old woman with a military service-connected disability, I played the card. “I am not resigning, you will have to terminate me,” I said.

She then explained that she couldn’t fire me and would have to call me back in next week after talking with my manager. My manager was not on my side. She was tired of having to field phone calls about what I was teaching. There was a six-month period of time where I did not have her as a manager. I reported to a director and not once during that six-month period was I summoned to her to answer questions about what I was teaching.

My current manager had a bias against me. I don’t say this lightly but she did. Numerous times she talked about how I was a doula and that skewed my view of childbirth. She thought I was focused on “natural things” only and that I was against epidurals (never mind that I had an epidural at each of my births). She was angry when students called me in to support them through the death of their baby and required me to put up a flier for staff stating I was not employed by the hospital when I assisted families through stillbirth. So my manager was definitely not on my side and I knew she would do everything in her power to fire me.

I felt I had a good standing though. Not a single poor evaluation, 4 and 5 star evaluations from students, and of course, I had followed her requests and my slides had been approved by her. A week later, I received the call. “We could not come to an agreement from both parties,” said HR. “What is the solution?” I asked. She would call me in a few days.

A few days later, HR called with my manager where I was informed that I would be terminated because I present too much controversial information. I knew what she meant. My manager frequently stated that our patient population is “highly educated.” She stuffed that down my throat nearly every meeting. However, she hasn’t taught the classes and she didn’t hear their questions. Just because patients have high school diplomas and college degrees does not mean they know anything about childbirth and the procedures that come with it. They may have the means to look things up but they take a class to learn all they can.

I asked for a termination letter and received it. Then I applied for unemployment; which I also received for a short time.

The bottom-line was this; the hospital did not want their “educated” patients to ask questions. Even though my slides were approved and my manager stated that what I was teaching was great information, I was thrown under the bus when the pressure was too much for her. Instead of standing up to what her educators were teaching, she chose the easy way out. Fire the educator who encourages students to research and develop a trusting relationship with their care provider through asking questions.

By now you must be thinking that I am some sort of “intactivist” who is against circumcision and that I had to have been breaking rules or giving biased information. Students in my classes were taught the “evidence-based” information from Up-to-Date; the hospitals own resource center.

BENEFITS OF NEWBORN CIRCUMCISION
May reduce the incidence of urinary tract infections for the first six months of life.
May prevent certain sexually transmitted diseases such as HIV (although this study was done on adult African males circumcised as adults).
May reduce the incidence of penile cancer.
May reduce the incidence of inflammation of the glans (head of the penis).

RISKS OF NEWBORN CIRCUMCISION
Pain
Bleeding
Infection
Meatal Stenosis
Removing too much foreskin
Buried Penis
Loss to or damage to all or parts of the penis
Death (mostly attributed to infection and/or bleeding)

Students were informed of the statistics such as circumcision is on the decline in Colorado, that the AAP does not have an official recommendation and leaves it up to the parents, and that this is an elective procedure so double check with your insurance company to see if it’s covered and if your doctor performs the procedure.

Numerous times I had been called by students because their doctor would not do it and they needed a recommendation. They were referred to call a urologist when their OB or pediatrician would not perform the procedure. So you can see, the information I provided was not biased.

I still teach. In fact, this information is or has been presented at three other metro hospitals with no complaints. It is the culture at this hospital. A culture where they don’t want patients informed. They don’t want patients to ask questions or to research information. It’s a culture where “I am the doctor, therefore you will do what I say.”

I am not making this up. I have witnessed doctors making these statements to women and their partners during labor. I have seen doctors threaten patients with child protective services or calling law enforcement if they don’t do what the doctor recommends.

What’s the big deal with circumcision anyway? It’s just a snip right? Check out the video below and tell me if you think it’s just a snip? Wouldn’t you want to be fully informed before you subject your baby to this?

I have two boys. With my first, I was never informed about circumcision. I assumed it was a painless procedure where they just cut of a bit of skin. I had no idea that the foreskin is attached to the penis and they would tear it off. I had no idea the foreskin was functional. No doctor or childbirth educator talked with me about circumcision other than to say, “everyone does it.” When my son was returned to me after his circumcision, I knew something wasn’t right. I knew he would never be the same. I knew I had taken something from him and what I saw when I opened his diaper was shocking. It was an unexpected outcome.

This prompted me to learn more and as an educator, I wanted parents to be informed. I wanted them to know what to expect, not just with circumcision, but with any decision they make for their labor, delivery, and newborn period. Those decisions can affect them and their baby for the rest of their lives. How can a parent make an informed decision about any procedure if they are only given a one sided view or pieces are left out?

By the way, I also educate on how to care for the intact penis. I have observed five different newborn care educators and only ONE also educated on caring for the intact penis. Did you know that not everyone chooses to circumcise and if parents are not educated on how to care for their intact son, damage can be done? A patient population is being blatantly ignored.

We cannot leave out the bits and pieces to sway parents into a decision we believe is right for them because they may fail to research or understand it. They may not have known there were other options available to them because bits and pieces were left out.  Isn’t it a childbirth educators job to inform?

Use of a Fetal Doppler in Pregnancy

DISCLAIMER: I am not a medical professional. Please consult with your doctor or midwife if you have any questions regarding this information and opinion on the use of a fetal Doppler in pregnancy.

I want to address this fear-mongering article from Bustle. In the article, This New Pregnancy Trend Among Millennial Women Could Seriously Harm Unborn Babies, the author makes some “serious” claims. First, I want to pick apart the title. “New Pregnancy Trend,” “Millennial Women,” “Seriously Harm Unborn Babies.”

This is not a new pregnancy trend. Unless “in the last 15 years” is considered a new trend. When I was pregnant with my now 14-year old, home monitoring devices were around. Back then, it wasn’t easy to find a fetal Doppler to use at home, but I had a home monitoring device called Bebe Sounds Prenatal Listener. I could listen to my baby’s heart, record it, and also play music to my baby. It came with headphones and an adapter for my mp3 player or Walkman. We have really come a long way in the last 15 years!

I remember thinking it was odd that no gel was needed to hear my baby’s heartbeat but once I was far enough along, I could certainly hear him in there moving and the little thump of his heart. It probably was far into my third trimester before we could hear anything. Fast forward 10 years.

I had experienced one miscarriage before I became pregnant in 2013. I knew how easy it was to rent a home fetal Doppler and I wanted one. I didn’t want to rent one so I bought one on eBay ;the Sonoline B. Guess what, Walmart now sells them and they are cheaper than the one I bought on eBay five years ago.

This is hardly a “new pregnancy trend.”

The next claim in the title is that this is by millennial women. I am NOT a millennial and many pregnant women in my age group (35-45) are not millennial either and they use fetal Dopplers. In fact, many of my millennial friends would never and have not used a fetal Doppler. I dislike the authors use of a generation.

Just plainly say “women.” Does this mean that only millennial women are so ignorant they could not figure out how to use a fetal Doppler?

And finally, the author’s fear-mongering statement, “Seriously Harm Unborn Babies.” Wow! That’s a catchy title and unfortunately, it’s click-bait. In the article, there wasn’t a single bit of information proving that using a fetal Doppler causes “serious” harm. Yes. I purposely removed the word, “Could” from my picking apart because I guess ANYTHING “could” cause harm. This article was meant to scare women from using the fetal Doppler.

This Pop Sugar article calls it a new “fun” trend, so not fear-mongering. It’s also almost a cut and paste of the Bustle article.  For me, it certainly wasn’t fun although there may be women who use a fetal Doppler for “fun.”

Do I recommend women use a fetal Doppler in pregnancy?          NO

Why? I don’t think every woman needs or should have one.

But to scare women from using one is a disservice. Elizabeth Hutton, CEO of Kicks Count UK, even has a petition to ban the private sale of Dopplers. I love Kicks Count and I utilize their brochures, cards, and documentation in my childbirth classes. It’s important to assess your baby’s fetal movements and this can be a very bonding experience for the parents. I don’t agree with banning a tool, where if a mother is trained properly, she has a tool which can help her immensely.

Let’s talk about training, because in the article This New Pregnancy Trend Among Millennial Women Could Seriously Harm Unborn Babiesthe author claims that women are untrained and speculates that no woman can or should be trained. Instead, the article warns women not to use this tool because it can cause stress which is harmful for a baby (due to not finding a heartbeat) and it can cause reassurance when there is actually something wrong (because the mere finding of a heartbeat does not signify health of baby).

If the author is mistakenly referring to ultrasound Doppler or even fetal heart monitoring on a strip, then yes, there is more training that takes place, but not years of training as the article states: “Midwives and doctors train for many years to interpret what they hear through a doppler.” I took a weekend class on reading and assessing fetal heart tones as a labor doula.

If stress is going to be cited as harmful for the mother and baby, raised blood pressure for mother and premature birth (which is a stretch to say the least), what about the mother who has chronic anxiety in her pregnancy because she is a loss mother and is in a constant state of worry over the health of her baby?

If a mother couldn’t find the heartbeat on her home fetal Doppler, she would have acute stress and need to see her OBGYN or midwife for reassurance (this is a good thing). Once the mother receives reassurance that the baby is okay, her stress would diminish. Many pregnancy after a loss mothers are under chronic stress. Chronic stress would more likely lead to raised blood pressure and potentially, prematurity. If a woman had a tool which could potentially reduce that chronic stress, wouldn’t we want that available to her? Now you are saying that doctors should then prescribe a home fetal Doppler. I will agree with you there.

The final concern is that a mother may “think” she hears the heartbeat when it’s actually placental flow, her own heartbeat, or hears the fetal heartbeat but there could still be something wrong and she is reassured when she shouldn’t be. This is the biggest concern for me and I have experienced this first-hand (although my baby was fine).

This is where a little bit of training would be beneficial on the use of home fetal Dopplers. In addition, doctors and midwives who know their patients are using them, should have serious discussion about fetal Doppler use and when to be seen. I can’t tell you how many times I was told, “If you feel like there is something wrong, or your baby has reduced movements, come in.” Let’s not forget that there are plenty of You Tube videos out there to show women how to use a fetal Doppler.

I would have been in the doctors office every day, all day. 

It’s really not feasible or realistic for women enduring pregnancy after a loss. And with my insurance, after hours requires a visit to the ER as no urgent care is available for pregnancy so once 5-o’clock hits, it’s ER time or suck it up until morning (which can be fatal for a baby).

How about training women how to use the fetal Doppler. I know I have said this before. Instead of avoiding the conversation because you don’t want the mother to use the fetal Doppler and if you talk about it you will encourage her, have that difficult conversation and help her to know when something isn’t right and she needs to seek care.

It didn’t take much training for me to learn what I was hearing; my baby’s heartbeat (fast or about 130 beats per minute in my last pregnancy and 165 in my second living pregnancy), placenta (more of a whooshy sound with heartbeat), and what was my heartbeat (much slower or around 60 beats per minute). I was always sure I heard the heartbeat but just because I heard it, didn’t mean everything was okay.

We can teach women that just because they hear the heartbeat doesn’t mean everything is okay and that they should also seek care if there is a concern such as reduced fetal movement or their intuition tells them there is something wrong. I surveyed labor and delivery nurses, who work in different parts of the country, on how much training they received on the use of the fetal Doppler. It ranged from “on-the-job” training to “I don’t remember being trained in nursing school,” and “we had training in nursing school and on rotation.” Nurses did have a competency to complete each year while on labor and delivery.

The article implies that women are not trainable, nor should be trained on how to distinguish their baby’s heartbeat from their own or the placenta. I disagree and believe that fetal Doppler’s can be a very effective tool at lowering chronic stress in pregnancy after a loss or in any woman who is experiencing chronic stress in pregnancy related to the unknown of the health of their baby. Women should be directed to visit their care providers with questions on fetal health, with reduced movements (COUNT THOSE KICKS!) and if their intuition tells them something is wrong.

If we can combine the use of a fetal Doppler with the instructions women are already given in pregnancy on when to see their care provider, the use of a fetal Doppler can be helpful for the woman.

DISCLAIMER: I am not a medical professional. Please consult with your doctor or midwife if you have any questions regarding this information and/or concerns about your baby’s health.

Naivety vs. Faith in Pregnancy After Loss

Photo credit: Mike Hansen

Photo credit: Mike Hansen

I had an immense amount of faith during my pregnancy with G. When G was stillborn, I lost all that faith. I couldn’t understand why this happened and more importantly, why this happened to us. We were devote Catholics. We prayed for this baby. How could God have taken this baby? So when we became pregnant after G, I struggled with my faith. I couldn’t deal with the feeling that I had no control and attempted to control what I could (within reason). When L was born, I thought my faith might return but it didn’t come back quite like I expected. Am I changed forever? A.M.

What is the difference between naivety and faith? Did A have faith or was she living in the world of naivety which nearly every pregnant woman who hasn’t experienced loss live in? I have blogged about the loss of innocence before and this post really isn’t that different except I am using different words; Faith and Naivety.

Let’s define both.

Faith – Complete trust or confidence in someone or something.

Naivety – Innocence or unsophistication.

actually had both faith and naivety. Her first pregnancy was full of innocence. Innocence that bad things don’t happen to babies. Babies don’t die. Faith that babies don’t die, that her trust in God will bring her a living, breathing baby. There are both aspects here but something happens when we lose a child or experience great loss. We lose the ability to channel that faith and the innocence is complete gone.

A may struggle to have complete faith again. This is not a lack of trust in God but a lack of trust/confidence that her Divine Father will provide her a living child. Her Father will provide but what will the provision be?

A will likely never enter another pregnancy naive or with that innocence that all will turn out well.

Channeling our faith with subsequent pregnancies can be difficult but we must try. If we don’t have faith in God, if we are spiritual but not religious, if we carry no spiritual beliefs at all, then have have faith in the child within your womb. They are there, present in this moment and we must carry some faith in that living being will continue to grow and be born alive.

Faith does not equal control, nor does faith equal religion/spirituality. Even though faith is most often associated with religion/spirituality, please don’t think that this post could not relate to you or your experiences. It is a belief, a trust, and faith that we will have a living child following our pregnancy.

But let’s return to A for a moment. To answer her question, she is likely changed forever. Most of us who are touched by pregnancy loss are changed forever in much the same way people are changed after losing a child of any age. We look back, we worry, we wonder, we protect, we question, we are cautious.

I experienced something similar as A. I became extremely faithful during my pregnancy with Ruby. Because I felt like I would lose Ruby at any moment, I thought that prayer could save her. I somehow believed that a lack of prayer could result in her being taken from me so I prayed more than I ever had in my life. It was my “control” and if I didn’t pray enough or the right way or even the right prayers, I was not worthy and my baby would be taken.

So when Ruby passed, I was not only devastated but found myself feeling unworthy of God’s love. I prayed, but he took her anyway. I was not “good” enough. I was His daughter who didn’t try hard enough. I wasn’t faithful enough to Him so He would allow her to stay with me and be born alive.

But that’s not what faith is about. Even if we remove the religious/spiritual aspect of faith, merely having it, does not mean that what we believe in, hope for, trust in, will happen. Does that mean we should no longer have faith? No, but it’s definitely more difficult to have faith when faith had been crushed in the past.

So how do we gain that faith back when we journeying through pregnancy after loss? How do we love again? How do we have hope again. Ah, those words.

Photo Credit: Flickr (Andreanna Moya Photographer)

Photo Credit: Flickr (Andreanna Moya Photographer)

We start small. We have to come to an understanding that we don’t have control over much of our pregnancy and how our baby develops. We embrace the things we do have control over (choosing a doctor, choosing a place for delivery, choosing a way to monitor our baby, choosing how many ultrasounds, choosing which diagnostic testing), and we bond anyway. That bonding is oh so very hard but we must try to bond anyway.

It will not hurt less if we don’t bond for we are already bonded. It’s hard to lower that wall of vulnerability, of opening our heart to such hurt if our baby dies anyway but we must try. We must try to show our baby, this new baby, all our love no matter how scared we are and how hurt we are.

I know it’s easier said than done. I have been there. I walked that journey and lost another. But I left that loss journey with better coping and more love for my child than I could have ever imagined. One of the ways I encouraged bonding was I committed to writing a note to my baby every day. I wrote whatever came to mind. I didn’t think too much about it.

I decided I would write the note to my baby on a white erase board. I then took a picture of the note on the board which ended up being our son’s memory book. This is an easy project but you must commit to it. This made me think each day about my baby and what I would want to share with them. It was perfect and if I were ever to become pregnant again, I would do this again.

There are other ways to bond, such as taking a bath, listening to music, taking a walk, getting a massage, etc but when you do these things you commit to thinking about your baby, talking to your baby (even if only in your head), sending vibes/energy to your baby, positive thoughts, etc. It’s not easy and the first few times might feel awkward and forced. This is okay. Just keep trying.

You may not ever feel normal again during pregnancy after a loss. You may not ever return to the innocence that you made it to a “safe zone” and you will bring home a living baby. You may not ever fully have the faith and trust in the pregnancy process but have faith in your child. Have faith that the child within your womb is yours and is meant to be there no matter how long or short that time is. You were chosen to carry your child. That is honorable.

– Breaking the silence of First Trimester Miscarriage

My Wanted Pregnancy – Aborted

miscarriage in ultrasound roomFirst I want to state for the record that this post is NOT ABOUT ABORTION. It is about abortion terminology and the topic will still be quite controversial in nature.

Should the word abortion be used to describe miscarriage? I touched on this point in my book It’s Not Just a Heavy Period; The Miscarriage Handbook, because the term miscarriage is not actually a medical term. In my book, I explain this to my readers so they understand their chart and the words used by their care providers may not reflect their feelings of miscarriage.

When we lost Gus, the diagnosis was “missed abortion.” What does that really mean anyway? The term abortion is often associated with negative connotations. When performing a search on Google with the keyword “abortion” the first ad on the page which took up the entire right side was for Planned Parenthood. The first definition that appeared was, “Abortion is the ending of pregnancy by removing or forcing out a fetus or embryo from the womb before it can survive on its own.”

I searched the next seven pages looking for anything that related abortion and miscarriage together and found nothing; only abortion support for women who were searching for options on how to end their pregnancy. With 1 in 4 women experiencing “spontaneous abortion,” aka miscarriage, one would hope that through a Google Search, they would learn something about miscarriage and not just the mainstream term used for abortion.

When researching the ICD-10 codes further, if you search “abortion” and choose “legally induced abortion,” you will find pregnancy loss listed as a Disease Synonym, along with complete abortion and complete pregnancy termination. Pregnancy loss is also listed under spontaneous abortion but not under missed abortion. When performing a Google Search for the definition of pregnancy loss; the first definition states “defined as a miscarriage or also known as spontaneous abortion and pregnancy loss, is the natural death of an embryo or fetus before it is able to survive independently.”

Ok. Natural death is a keyword here. Not sure why the ICD codes would place pregnancy loss under legally induced abortion when this is not a natural process. But here is another term that many of my friends fall under. Habitual Aborter (who wants to be called this no matter the reason)? Yet with ICD 10-coding, the name will change from “habitual aborter” to “recurrent pregnancy loss,” which in my opinion, is much more fitting as they would never call someone who legally aborts more than one baby a habitual aborter. There was no such change with miscarriage in the ICD-10 coding. It will remain “spontaneous abortion.”

So here’s the concern, many women do not want to see the term “abortion” in relation to their miscarriage. Abortion is associated with “unwanted” although that is not always the case. The term abortion is so negative; it is associated with less compassion and empathy. Seeing the word on paper might suggest to the medical professional that the woman is experiencing a medical event and nothing more. The woman may not feel as if she has the right to grieve her “aborted” baby which can lead to more confusion and a delayed healing process.

The recommendation is to change the terminology. This article suggested in 1998 that the terminology be changed but this is not a US recommendation. The Dutch and the English have already recommended or revised the terminology used for pregnancy loss and have turned away from the term “abortion” to describe what many refer to as miscarriage. Why hasn’t the US followed suit in changing this medical terminology?

In addition, many other countries use the terms womb and foetus when describing abortion and miscarriage whereas US terminology uses uterus and tissue or “products of conception, regardless of gestational age. Terminology is certainly important as it can validate a woman’s actual experience. Using the term tissue, would be incorrect beyond the first week of gestation. Gus and Ruby were not tissue they were a fetus and embryo respectively. Why does the US not recognize the words fetus and embryo when describing what forms and develops in the uterus after the union of an egg and sperm?

Moving on, I performed another search on Google, “where did the term abortion come from?” Article after article described the process for ending a pregnancy early. Doctor induced abortion, medically induced abortion, mother induced abortion, partner induced abortion, how to induce abortion, laws from centuries ago around abortion as far back as the Code of Hammurabi!

But where was the information on miscarriage? Sure, Wikipedia mentions spontaneous abortion as miscarriage and has a whole page on miscarriage but miscarriage is not a medical term. My chart will forever state, “missed abortion,” as if I “missed” some sort of an appointment. My chart does not reflect much of the emotional experience I had; the devastation of having to say goodbye to another child. It does not reflect “fetal or embryonic death.” It does not reflect stillbirth (the term for fetal death).

Miscarriage does not come with a death certificate or any certificate. No recognition of life. There is nothing; just the term abortion, putting all women who experience the loss of their pregnancy; whether it was wanted or not, forced or not, into the same category. A medical event and nothing more. Should the US medical community change abortion terminology? What are your thoughts?

– Breaking the silence of First Trimester Miscarriage

Wikipedia is not reputable or scholarly source; however, the general public sees Wikipedia as a resource and authority on what is searched there. Wikipedia was not the only source used for this post, please click on the links provided above. 

The Urge

Image courtesy of cooldesign at FreeDigitalPhotos.net

Image courtesy of cooldesign at FreeDigitalPhotos.net

WARNING: SEXUALLY PERSONAL (TMI)

There is this intense urge that I experience every few months. Most women experience this urge once a month but as stated in previous posts, I do not have regular cycles. No one told me I would experience this. It’s not something I have read about in books either and of course, having no biological direction on fertility as a child, I never heard of this phenomenon back then. Everything that I have read talks about a subconscious desire or discusses a drop in oestrogen that leads to testosterone becoming the prominent hormone but I can tell you that what I feel, is NOT subconscious. Hormonal, maybe; subconscious no.

So what gives women an overwhelming urge to get pregnant while ovulating?

This could be considered a survival mechanism. I read a few websites that talk about how this is purely biological in nature in order for the species to survive. Other websites discuss how the cervical changes and fluids make a woman’s libido go into hyperdrive, but what I am experiencing doesn’t really fit into some of these categories.

My “drive” isn’t really sexual in nature. I don’t desire to be with my husband. It’s not about being “horny.” This is deep. This is purely, “I need your seed.” Maybe that seed turns into something? Maybe it doesn’t? But my body is SCREAMING and it only gets louder as we approach the big O day! The O is ovulation by the way!

So what do we do? We just buried Gus. I wasn’t even sure my fertility would return and as awesome as it is to know it’s still there, I secretly hoped it would not return because I am again faced with the “should we or shouldn’t we” question. So here we are…with the NFP challenge before us. This is what separates the practicing Catholics from the non-practicing.

It would be super easy for hubby to slip on a condom or for me to pop a pill. It would even be easier for me to alter my fertility through the use of an IUD or a surgical procedure but there is no way we could do it. The one time we used a condom was just awful emotionally. We both felt horrible and as if we “used” each other purely for pleasure.

Sure, sex is awesome but that’s not all that sex is about. It’s not merely for enjoyment much to society’s belief. And I am a Catholic which I know isn’t popular so I truly believe that sex is way more than enjoyment.

I am learning to embrace my fertility. I am learning to embrace something I have never experienced before. I am working my way through these challenges through faith and prayer. 22 years of infertility and I know my body well. I know when my body ovulates and that is freakin’ awesome but this urge. The urge that is SURGING throughout my body, through my arms, through my legs, through my head and into my heart is telling me…PROCREATE!

But I know, that in two days, when ovulation has passed, I will feel happy. I will be thankful that pregnancy and another baby is not a possibility. At least, not right now. This is my test right now. This is my test to see if I truly want another child or if this is merely a physiological process and God’s divine plan for our bodies.

Can hubby and I keep our hands off each other?

The Price of False Hope: You won’t believe what the pastor said!

I have attended the births of families whose babies had a fatal diagnosis and have sat with them in the NICU throughout days or weeks as they prayed and hoped their baby would beat the odds. It’s such a difficult time for a family and I am honored to be a part of that experience. I am seeing a trend though, that is haunting me. I don’t know what started this such as pastoral training which says this is a good way to help a family cope or not but some pastors are saying very damaging things. Recently, I sat with a family as they prepared to say goodbye to their baby.

This family BLED hope that their baby would survive. Hope so strong, the room felt sacred. The room felt as if God himself was in the room, providing the comfort this family needed. If you were in that NICU room, you, yourself, would have been filled with the hope that emanated from this family.

“Prove the doctors wrong,” they said. “Our baby will survive this.” These are such common statements and thoughts among NICU families. We need hope, without it, it’s very hard to go on.  Despite nearly all odds being against survival, this family had complete hope. I was moved beyond words. I felt it within my blood. This baby WOULD survive.

I sat with this family as they held their baby for the first time. As the bereavement doula, we began to talk about options; about the “what if the baby doesn’t survive.” “Slow,” I said. “There is no rush to decide right now but it may feel rushed if/when baby passes.” The thought of the baby passing was overwhelming to them. I could understand. We as parents, are not designed to bury our children, especially our children that have seemed to have just started life. If those options are discussed, families may feel it lead to that outcome. But that is not the case, sometimes baby’s die.

Elizabeth PetrucelliTo accept does not mean to lose hope. To accept does not mean giving up. To accept does not mean we are no longer trying.

As this family wavered in and out of acceptance a pastor entered the room with a message. The message was similar to others I have heard this past year. The pastor interrupted my time with this family. Looking back, I should have finished and asked the pastor to wait. I should not have relinquished my seat for this pastor. The energy this pastor brought into the room disrupted mine so much so, that I felt the need to retreat. Was the devil pushing out God?

As I departed, the pastor was sure to state that they were there for only positive talk. There was no need to talk about if the baby passed because the baby wasn’t going to pass.  The pastor was so sure the baby wouldn’t die with these words “I am a messenger from God. And God has told me your baby will not die. I am here to tell you this.”

Was this false hope? Was the pastor disguised as a messenger from God but was really a messenger from the devil? I had hope this pastor was really a messenger from God to bring relief to the family that their baby would survive. I didn’t want to think anything different because now, there was even more on the line. If this pastor was wrong, I couldn’t imagine the extra pain this family would endure.

I waited outside the room when another message was relayed to me about what this pastor said. “God is not an indian-giver [sic]. He did not give this baby to you only to take the baby away.”

I nearly fainted after hearing these words. Where was this pastor coming from? Does the pastor not know the Bible? “For we are all God’s children” (Galatians 3:26). A friend of mine who lost her son to terminal brain cancer gave me very comforting words following my own loss of Ruby. “Our children are not really ours. They are on loan from God. We may have them a short time or a long time, but ultimately, they return to their Father.”

We do not understand our earthly life. We are not meant to. Our eternal life is what we are to look forward to, but how can we look forward to that when we have to experience such immense suffering? Won’t God spare us this suffering? Some are spared but not all. No one knows why. Why would this baby be created and born only to be taken from the loving arms of mother and father?

It’s a mystery.

Their baby did pass. They accepted their baby’s diagnosis and removed their child from life support as so many other families do. I had been with this family for days and I felt as if this pastor did them such a disservice. This family had faith but to hear it from someone considered to be an authority, was devastating after their baby passed.

Through my work with this family following the burial of their baby, they were so angry with God and the pastor. They felt completely betrayed having heard from a “messenger from God.” Why would a pastor introduce themselves as a “messenger of God” here to tell them that their baby will live without a shadow of a doubt? I keep hearing these kinds of statements. I just don’t understand and neither do the families that are heartbroken.

Have you heard similar statements during your journey? How did they make you feel?

What if doctors changed this in relation to miscarriage and stillbirth?

Woman Grief - labeled for reuseMany families who experience miscarriage or stillbirth want to have genetic testing done both on themselves and on the baby. They want to know “why” this horrible experience happened. When it comes to miscarriage, many women are told that they must endure three miscarriages before testing will be done. They are rarely given the option to pay for it themselves nor are they told about private labs that provide testing.

With both miscarriage and stillbirth, there is only a 50/50 chance of any “diagnosis” being found. It is just as rare to receive the “why” as it is to be told, “your baby was perfect and we don’t know why.” Even with a reason, many families don’t find peace. “A knot in the cord, a genetic anomaly, a congenital defect,” are just some of the reasons families are given for their baby’s death. “What can we do to prevent this from happening again?” the family might ask?

“Nothing,” the doctor replies. “We can do genetic testing earlier and then you can decide how to proceed.”

Of course, there are probably other options that we won’t discuss here such as embryo selection.

Hearing that your baby was perfect may not bring peace either. “If my baby was so perfect, my baby would be with me,” explains a grieving mother.

Each mother might be left with doubt. Doubt about her health, doubt about her body, concern for what she did or didn’t do during her pregnancy. “Did I eat something bad? Did I exercise too hard? Was the shower too hot? Did I breathe in too much gasoline at the pump? Was I exposed to something that caused this?”

Doubt! It’s a horrible part of the grief journey. It’s almost always there.

What if instead of saying, “your baby was perfect,” doctors began to say, “We do not yet have the medical technology to find out why your baby died.” This statement alone, can reduce much of that doubt. This statement alone suggests there still might be a reason. Because there very well could be a reason.

What if?

Would hearing this statement have helped you on your grief journey? Would hearing this statement leave us in the same place we were before? We want a reason. We need a reason. Even if it’s not a reason we are comfortable with, it’s easier to say, “my daughter died because of low progesterone, vs. she was a perfect embryo and we don’t know why.”

“Why” was something I was looking for and paid for, yet did not receive. There were issues with why I didn’t get a “diagnosis.” I have my speculations but I couldn’t have it confirmed. “Maternal tissue only” was presented to the pathologist.

So what do you think? Would changing the words help you find peace?

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