You Have Permission to Grieve

My husband and I had been trying to conceive for a few months. So, we were overjoyed when we saw the double lines on the home pregnancy test.  As a practicing high-risk OB/GYN (also known as a Maternal-Fetal Medicine Specialist) I had ultrasound access at my fingertips. I experienced mild cramping a few weeks after the positive pregnancy test, so, naturally, I had an ultrasound done. I watched as a bit of sac came into view. The sac had a tiny baby that was the size of a pea—but there was no heartbeat. I thought to myself, “well, it’s just too early; I’ll just wait a few more weeks.” Commonly, it is not easy to see a heartbeat that early, especially considering the fibroids in my uterus. So, I was not concerned.  I went home and shared the ultrasound images with my husband. We were ecstatic.

Two weeks later, I had another ultrasound. This time, the little pea was gone. There was just an empty sac. My pregnancy hormone levels had dropped. I knew exactly what this meant… I had experienced a miscarriage.

Because I was a “professional,” I went to the restroom to clean up the gel from the ultrasound probe and commenced seeing the 31 patients scheduled in my high-risk clinic. This was just another Tuesday.  I worked the remainder of the week. And on Friday, I underwent a dilation and curettage -a procedure done to treat miscarriages. I rested over the weekend and resumed work the following Monday. 

I did not shed a tear.  

Weeks later, I received the “pregnancy loss” folder in the mail— a folder that I helped create for patients who go through this experience in my hospital system.  For the first time, I was a heartbroken patient.

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I broke down in silence. 

Sadly, my story is not unique. According to the March of Dimes, 10-15% of pregnancies end in miscarriage in the first trimester. The loss rate is even higher in women with other comorbidities and advancing maternal age. According to the American College of Obstetricians and Gynecologists, half of these losses are attributed to chromosomal abnormalities. However, often, no known cause is ever discovered. Once women get through the pregnancy, the risk of loss is still present, particularly for minority women. 

The risk of neonatal loss (also known as child loss within the first 28 days of life), as well as infant loss (loss within the first year of life), are highest among non-Hispanic Black women. Overall, neonatal and infant mortality rates have decreased. Still, the most recent National Vitals Statistics Report shows that the loss rate for Black infants is more than twice as high as rates of Caucasians (10.75/1,000 live births compared to 4.86/1,000 live births) and almost three times as high as non-Hispanic Asian babies (3.63/1,000 live births).

Regardless of the cause of the loss, timing, or ethnicity, too many women grieve in silence. With the loss of Chrissy Teigen and John Legend’s little son Jack last year, I instantly thought about how they must feel. It brought me back to how I felt when I lost my first child. But Chrissy did something I did not do. She gave herself consent to grieve and grieve publicly. Her published images allowed the world to palpate her pain and mourn with her. It, unknowingly, gave me – and so many others – permission to express ourselves and not care about the judgment we might face.

Each year in October, I celebrate my lost life and the losses my patients have suffered. We, as grieving parents, celebrate the existence of these pregnancies, although, in some instances, not even our closest family members knew they ever existed. Due to my own firsthand experiences with pregnancy loss followed by multiple life-threatening pregnancy complications, I started Pregnancy Pearls with Dr. Plenty, which is now a podcast, to help women get the answers and support they need to navigate safely through their pregnancies. This is my first step in being brave, like Chrissy Teigen, telling my story and helping women share theirs as well. I encourage all women to express themselves for continued self-healing, particularly during the critical month of remembrance.

Dr. Nicole Plenty is a double board-certified OB/GYN & Maternal-Fetal Medicine Specialist.  She is also a wife, mother, blogger, podcaster & patient advocate. Her website is [email protected], and she can be followed on Instagram @pregnancy_pearls.

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