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“Miscarriage” and “Stillbirth” — Why I Hate those Words

May 14, AD2013 15 Comments

We need language to communicate ideas and concepts and sometimes I have to use those words just long enough to establish a rapport with a person – a newly bereaved parent, family member or to teach a student or staff member. No sooner do the words exit my mouth do I explain why they won’t hear them from me again.

Both words speak only of processes (and badly at that) nothing of loss or pain or grief.

If I could purge one single phrase from our culture it would be “just a miscarriage”. How many times have you heard that phrase? Yet there are so may instances where it is anything but “just” as if that word is somehow going to temper the pain. What if the mom has been infertile for 15 years and this is her first conception? What if the dad has died or lost his fertility? What if she is older and knows her chances to conceive again are slim? What if she had invested herself in this pregnancy 100%? Or yet, what if she simply — for no reason that she needed to explain to the world — loved her baby?

When I had a loss at 9 weeks, I had already made some life decisions based on the expected arrival of that baby and undoing those decisions and my attachment was hard.

During all four of my pregnancies, I thought about the baby/pregnancy at least once a minute every waking minute and sometimes in my dreams. If I was awake 16 hours a day, then I thought of that baby 960 times a day, 7 days a week for 9 weeks, a total of 60,480 thoughts of the baby who died at 9 weeks gestation. Why is it that an entire culture who watched Titanic and saw Rose and Jack have a 1 week romance (and fully bought the premise that she loved him forever) then reject the idea that a woman who carries within her a baby who lives for 8 or so weeks would have enough of a bond to spark real, deep grief?

Remember also that medically, loss up to 20 weeks is considered “miscarriage”. If you have ever seen a 19 weeker, you would see a person with completely human form, often lovely in appearance, toenails, ear lobes, nose, the whole deal. I have dressed many “miscarriages” in clothes and hats for their mothers who love them very much. For parents, there is not generally a magical moment at the beginning of the 20th week that sparks love that didn’t exist before. They loved their 19 week baby as much as a 21 week baby and it is a cruelty of our society that we think any of this should make a difference.

Stillbirth. What a ghastly, inadequate word.

We use it to describe deaths prior to birth between 20 and 40 weeks gestation. People assume that this death shouldn’t be as bad as a neonatal death because the baby didn’t take a breath outside the womb. There is a common misconception that the mom and family hadn’t really bonded with the baby yet. When you carry a living being around in your guts for that long and allow them to kick you from the inside you are regularly reminded that they are real and alive and have a place in your life.

Add to it the foolish idea that the death should somehow hurt less because they aren’t born? Even in terrible circumstances when people learn that a loved one has died, their grief is not compounded by the realization that they must follow through with an unavoidably painful process because their deceased beloved relative is inside them.

I have a good friend who coached her sister-in-law through the birth of her deceased baby and the mother said, “I don’t want pain medication, I want my body to hurt as much as my spirit does.” And too often my dear ladies return to a world that does not respect the magnitude of their pain and loss and has no idea how to support them. This often becomes (for the parents and family) severely disenfranchised grief which is very hard to heal from.

So what do I say if I don’t say “miscarriage” or “stillbirth”? I say “pregnancy loss” and “infant death” and when it crosses over from one to the other is for the mom to define. Whether a baby dies just before of just after birth (although very important in which paperwork we fill out) makes no difference to me in terms of how I refer to the baby or treat the parents and family.

When I speak to families, I give them “permission” (not that they need if from me) to never say those words either. I walk with them in a process to figure out what words describe for them what happened so that when they run into a friend at Target who asks about the baby, they will feel some assurance that their answer is true to themselves. This often sounds something like “the baby died just before she was born” or something similar that honors the baby no matter the details.

I encourage you, in your interactions with those who suffer perinatal death, to open a dialog with them on this and help them find the right words to honor their child(ren) and their feelings.

© 2013. Tammy Ruiz. All Rights Reserved.

Photography: See our Photographers page.

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About the Author:

Tammy Ruiz Ziegler has been a Nurse for 30 years and spent most of her career in Neonatal Intensive Care. For 10 years, she has been a Perinatal Bereavement Coordinator - caring for women and families suffering miscarriage, stillbirth, neonatal death and SIDS. Part of her work involves assisting parents in preparing for births when the baby has received the diagnosis of a life limiting condition (often called "Perinatal Hospice"). In addition to her Nursing education, she studied (but did not become certified in) Clinical Pastoral Education at a Catholic Hospital in the midwest. She has been on EWTN and speaks regularly to Physicians & Nurses on the topic of perinatal loss care. Her work has been translated into Polish, Spanish, Czech, French, Italian & Japanese. Her career was both fragmented and enhanced by having 14 different jobs because of moves for her husband who was an active duty Officer in the USMC. She has 3 quasi-adult children and one super-cute grandchild. A convert to the Catholic Church, she was widowed after 26 years of marriage but recently married a man she met when they were both children.

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