Saturday, February 14, 2015

Advice from a Pharmacist: What YOU can do when someone has a miscarriage

Today is Valentine's Day, a day of love and the celebration of love. There will be many babies conceived tonight, but not all will be born. And that's why I share my thoughts with you today... advice from a pharmacist FOR pharmacists, but the same ideas are for anyone who knows the mother of an angel.

A few years ago I had a close friend lose a baby. She was so thrilled and so happy. I look at photographs of her at the time and her face was just beaming. It was so thrilling and exciting. But tragedy started when she started to spot. She reached out to me for help and I didn't know what to do. I am a doctor of pharmacy, but I didn't know what to do. It was all very heart-wrenching and sad, and I just can't believe that I didn't know what to do and didn't try to help her. To this day and with all my heart I regret my actions (and inaction) at the time. 


As pharmacists, we are in a unique position as healthcare providers, especially community and/or retail pharmacists. We are literally open to the public every day and have a responsibility to help those in need. Although not very common, there are occasions where you will encounter a patient that recently had or is having a miscarriage. They often come to the pharmacist for advice because we are so accessible and are in the top five most trusted professions. We have a duty to be ready to help in any way we can. 

As pharmacists we know what medications to avoid in pregnancy. We can also recommend anxiety medications, depression medications, and even know what the doctor needs to prescribe if the bleeding gets out of hand, but... that's academic. Often its the patient trust for the pharmacist and she wants a shoulder to lean on and a listening ear. But what do you say? Our training is in medication, not psychology. 

Here's some hints and tips from what I've learned:

1. If you're in the pharmacy, take her to a quiet spot... the waiting room, or somewhere private away from the noise and listening ears. You want to give her 100% of your focus and time. The metrics can wait. THIS is no longer about some guy getting his generic Lipitor filled in 3.5 minutes. This is a genuine opportunity to help someone, and that's WHY you went into pharmacy in the first place.

2. LISTEN to her. What she's going through right now is uniquely tragic to her. This is something she may have never experienced before and the depths of complete despair are deep. She wants to unleash her feelings of sadness and disappointment. Let her do it and be supportive. Let her direct the conversation. Don't interrupt.

3. NEVER say something like "You can try again" or "Everything happens for a reason." Why? Because you don't know that. You don't know the situation, and moreover, the little spirit and life that was lost cannot just be replaced like a car part. He or she was a unique individual with his or her own personality. You wouldn't suggest to your grandmother that she can "try again" when grandpa passes away, would you? No. Let her grieve and mourn the unique soul that was lost.

4. Don't say "I know how much it hurts." Instead, listen to her as she tells you how much it hurts. Even if you've had a miscarriage yourself, you still don't know her unique situation. Be gentle, be kind. Pain of the heart is the worst kind of pain. She may dream about the loss all night long, then wake up and think about it all day long, wondering what she did wrong, wondering why God kept her from having children, wondering "Why me?" until she cries herself to sleep at night. Empathize with that pain.

5. Don't say "It's part of Mother Nature's or God's plan." That may very well be, or it may be that God wanted her to have that baby just as much as she did. We don't know everything about this life. It's a good bet we know even less how it works on the other side. If she is having a crisis of faith, be supportive and try to understand it from her point of view as she finds answers for herself. You couldn't possibly have answers in this regard, only opinions, and she doesn't need those.

6. NEVER tell her to stop feeling sorry for herself. A little life, full of love and personality, was just lost. She will always, always wonder what this little person could have been in her life, someone to hold and cherish and raise. That's NOT something you just get over. In fact, you NEVER get over it, you only deal with the pain. So never say anything like that. A better thing to say is "Nothing in the world could have prepared you for this and I'm so sorry you have to go through it."

7. If would be easy to just say you can't imagine their pain. Instead of that, try to imagine what it would be like to have a little person growing inside you. Imagine the excitement, thinking of a baby name, buying little socks, building a crib, etc. Then imagine that all taken away from you. Now do you understand why this is so hard on her? Now you'll want to hug her and hold her and console her if she's willing.

8. Refer as necessary to people and organizations equipped for this tragedy. A good place to start is HERE.

I don't pretend to an expert on the subject, but I'm a pharmacist and as a healthcare provider, I want to be ready for the next time this happens to me. You may never have this happen to you, but be prepared in case it does happen!

Also remember...


8 comments:

Pierre said...

Beautiful post! Thank you And yes, Dads hurt too...

Something else to tell her if she is close friends: "I'll be there for you if you want to talk. Even at 3am." also, Can I be any help "for anything practical" and painful. Papers, getting rid of baby clothes if she wants, etc...
But don't press her. let her be free.

Anonymous said...

So well written & thoughtful! As someone who has experienced a stillbirth & a miscarriage within a 7 month period, your points are right on! And especially liked "A Dad Hurts Too". Too many times the Dad is overlooked, and we should be just as concerned about his well-being, as much as the Mom.

Anonymous said...

I miscarried twins in August. We've done four unsuccessful IUIs since. Everyday is hard. Everyday is pain.

Anonymous said...

Yes, miscarriages are hard for some, it didn't bother me any when I had one but i didn't even know I was pregnant so I guess I didn't have time to become attached...but when my friend's baby died of SIDs, I cried a lot for her and that baby, that was very hard...

Anonymous said...

Thanks for the beautiful post! I have had 4 miscarriages. The challenge with miscarriages is that other people think it's no big deal, since the baby was so early. They never stop to consider how it changes the entire structure of the family involved. If those babies I lost had in fact survived, my living kids would be different people, since they'd be shaped by having several siblings, not just one. DH and I would be different parents for not having known this kind of loss. Those are some pretty big impacts from something most people consider negligible. Thanks for trying to educate people!

jewelRph said...

This brought tears to my eyes...Thank you for your empathy and for reminding us how we as Pharmacists are healers and not just pill pushers.

Anonymous said...

This was a very interesting, and useful post, brought no doubt from insightful reflection.

This set of strategies is a practical way to deal with many new and weighty 'diagnoses' from cancer, to schizophrenia. Rarely does any 'medical condition' come from out of the blue, and people need care and the elixir of time to deal with life-changing events. And, yes, as pharmacists, we are expected to come up with these on our own--they're not part of pharmacy school syllabus!

I think the biggest thing is to recognize that this sort of thing requires setting aside personal time with the person dealing with these events.

Carol Bell, PharmD, MS said...

Thank you very much for this post. It's most helpful, thoughtful, and caring.