I will never forget the doctor who told me that Orla had died. I cannot bring her face to mind, bit when I saw her coming out of a hospital room some months later, I knew instantly who she was. I remember her gentle tentativeness, her hand touching my leg, the sound of ‘I’m so sorry’. I remember her administering the pessary to induce labour and her willingness to sit and talk through the procedure. She was young, probably quite early in her career. But she was kind. I can’t say the same for every person I came into contact with, and I know that so many parents have had very varied experiences. However, I am grateful to have had someone who was able to show compassion at the time that I needed it most.
As someone who provides consultation and supervision to a range of professionals, I know full well how little emotional support is available to many medical staff. But reading This is Going to Hurt (Adam Kay’s book) sucker punched me with it even more. Every single day, the staff that we so value in the NHS are dealing with life and death. New life and death. Death before life begins. And yet they are often given little space to process or debrief.
Those caring for us within a healthcare setting are humans too. They have feelings and are affected by the loss of a baby. Maybe we don’t always see it, or we can’t see it because we are too overloaded with our own distress. In this letter, Ria poignantly explores the experience of loss from a doctor’s perceptive when caring for those who don’t get to take their babies home.
Ria is a doctor who works in Obstetrics and Gynaecology. Part of her job involves caring for parents during complicated pregnancies and births. You can find her on Instagram at @thedoctormummy where she talks openly about the challenges of working in the NHS and all things motherhood.
To the parent whose baby has died (from the doctor who cared for you),
I’m that face you probably won’t forget. I know this, so even if I’m on hour 13 of a 12-hour shift, I try to balance my expression between active listening and empathy. I know how much people remember the body language of the doctor interacting with them. Please don’t feel like you have to hold back. I’m comfortable with you crying, or being angry, or anything in between. There isn’t a correct way to respond to one of the worst things you’ll ever go through.
As a doctor, it’s my job to constantly question and learn to improve my practice, to provide better care. Part of that is working on the language I use when talking to you about your baby. I’m trying to choose my words carefully, because seemingly innocent phrases like “I’m sorry you lost your baby,” now seem incredibly insensitive. You weren’t careless, you didn’t lose your child. But then I still stumble sometimes, because I wonder whether saying “I’m sorry your baby has died,” seems too blunt. It’s not your job to care, but I ruminate about this every time I talk to a family. I haven’t had any specific training in how to or how not to do this. I use the good and bad experiences I’ve observed, with emotional intelligence, to try and make sure I am sensitive and appropriate. I’m sure I don’t always get it right. I’m always trying to do and be better. One thing I’ve learned from reading the experiences of parents who have experienced the death of their child, is to always ask your baby’s name, because whether or not your child is deemed worthy of a birth certificate, they are your child.
I’d like to think I’ve always been a compassionate person, but since becoming a parent my emotions are definitely more heightened when talking to parents about the death of their child. I am always professional, years of NHS training have taught me how to remain composed. But I have definitely cried when a woman is told there is no heartbeat, or when a parent says goodbye to their baby. It makes me appreciate what I have even more.
This will sound selfish, but I wish we were better at debriefing as doctors after a baby dies. It varies depending on the hospital, but the midwives seem better at supporting each other. Sometimes I go into a room, am involved in diagnosing the loss of life, and then get whisked away to another situation. No time to process, no time to talk to a sympathetic colleague. I try not to take work home with me, but there are always families who you remember.
I hope you don’t find it insensitive that I’ve congratulated you on the birth of your baby. You may not be taking your baby home with you, but you have still become a parent, and I believe that that deserves recognition. And if you decide to go through the rollercoaster of emotion that is pregnancy after bereavement (am I just dancing around saying loss for the sake of it?), I hope you have good care, from a team that recognises the impact your baby had and has in your life, no matter how long your child lived.