A Letter to My Doctor

The following letter  was written to be read at a medical school lecture regarding how to handle the delivery of a baby who has died in the womb.  I wrote this post specifically to be shared.   If you know of someone who would benefit by reading this, please share it with them.    In writing, I thought to myself how scared a doctor dealing with this for the first time must be.   I also thought about all the doctors who do it all wrong as well as the ones who get it so right.  My personal doctor was amazing, and I am grateful for her every day that she made such a horrible and heart wrenching experience a little softer for me.   However, during my five years inside the loss community, I have heard horror stories of doctors that make everything a million times worse, whether through rough treatment or terrible comments.   When asked to write this, I wanted to make sure that I was the voice of my community.  I wanted upcoming doctors to know the right way to treat the Heartbroken Mother.  I hope I was able to do justice to the experience and to shed a little light onto an undeservedly taboo subject.  

Update:  The Video of this letter is completed.  You can read the blog post and watch it here.
You can also download a resource sheet here
Update 2:  I was recently contacted to help create memory boxes.  I wrote a letter to a newly bereaved parent.  You can access that letter here.
Update 3:  I have created a printable PDF of this letter for downloading and sharing.  You can access it here.
Update 4:  For anyone needing a Spanish Version of the letter, you can download one here

Dear Doctor,

I know this isn't what you were expecting today. You didn't wake up and head into work thinking, "Today is the day I am going to have to tell a mother her baby has died." Your day was supposed to be full of heartbeats and moving ultrasounds, of spreading goo over a laughing belly, of getting your doppler kicked by unseen baby feet. Your day was supposed to be taking care of excited mothers. You should be congratulating not consoling.

Yet, here you are, trying with all of your might to find my baby's heartbeat. You move your doppler all around my swollen belly, but all you hear is the faint thumping of my heart, which is starting to beat faster because I'm beginning to figure out what's about to happen. The lump in your throat is almost too big to let you form the words, but you don't know what to say anyway. Who does? You're nervous and shocked, and you don't know how you're going to get both of us through this. Let me help you.

First of all, don't hesitate or stall in any way. I already have a million fears racing through my head. If you leave to go get another doctor without saying anything, I will panic. As hard as it is to get the truth out, please do it quickly. Tell me as much as you can as soon as you can, and don't leave me alone. I'm suddenly very, very scared and I need support. "I'm sorry. I can't find the heartbeat." Say it softly but clearly. Hold my hand. Look me in the eye. You'll see the fear rise, but you'll also see hope. At this point though, I still think there's hope, that you might be wrong. I think there might be more tests, more things we can check. It won't be until you take me to the ultrasound room and I see my beautiful baby oh-so-still, that it will hit me.
It will hit me hard. I will curl up and clutch my stomach. I will writhe on the table. I will scream a scream you have never heard and will never want to hear again. A scream full of more pain than you think a human soul can take. "Oh, my baby!" I'll moan. "Not my baby!" You might even see me shatter, breaking into a thousand shards of sorrow. You might not be able to keep it together either. It's okay if you cry too. Honestly, please cry with me. Please let me see you are human. Let me see that you care about my baby as much as I did...that you care about me. If you don't already know my baby's name, ask, and from then on, refer to my baby by her name. She is not a Stillbirth. She is not a Spontaneous Abortion. She is not a Fetal Demise. She is my child. Those may be terms you have been taught to use, and that's fine, but don't use them with me. Use her name. Please, use her name. 

I have been dreaming of my child's birth since seeing those two lines on the stick, maybe even before then. I have been planning it in detail for the past several months. And now, none of it is going to happen the way it should. Make sure I have time to process what is about to happen. Let me make as many choices as I can, but realize that there might be some choices I am unable to make. So much is being thrown at me at once. I am in shock and I don't know what I am supposed to do. Guide, but don't force. I will probably do anything you tell me to do.

Talk to me about making memories with my baby. As gently as you can, let me know that these next few hours or days will be all I have, and I will want to make every second count. At first, I might be uneasy because the thought of holding my lifeless child is too disturbing for me to think about. Reassure me that I will want to see her and hold her. Encourage me to have a photographer come to take pictures. Again, I will be hesitant, but tell me that those images will be my most treasured possessions later. Tell me I won't have to look at them until I'm ready, but I should get them taken for the day that I am. Give me the opportunity to bathe and dress her. Months later, after the shock wears off, I will regret not knowing what her belly button looked like or whether or not she had any birthmarks. I will regret not counting her toes or brushing her hair. If your hospital doesn't provide memory kits, let my husband know where he can run out to get some plaster to make hand and foot molds and some ink for prints.


During labor and delivery, spend as much time with me as you can. I know you have other deliveries today. Happier deliveries. But, I need you just as much as those women. I might even need you more because once I am finished delivering my baby, my time with her is almost over. Don't forget about me. I already feel so alone. Don't tell me I can "try again" or to be grateful for the children I already have. It's not comforting, it's insulting to the child I am about to deliver. Encourage me to push like you would anyone else. Remember that my husband has lost a child too. He's going to try to be strong, but on the inside, he is falling apart. Let him do the things a father would normally do. Ask him if he wants to cut the cord. Even though our outcome is very different from the other families in the maternity wing, please don't treat us differently. While there might be extenuating circumstances that won't allow for complete normalcy, let us have the most normal delivery you can.

Before she comes, prepare me for the silence. Prepare me for what she might look like. Let me know she might be discolored. Some of her skin might be torn. She's not going to look like the baby I expect, but she is still my baby. When all is said and done, I will still think she is beautiful. When she is finally born, I will cry with sorrow and emptiness, but those cries will also be filled with love. I will cry for her loss, but I will also weep for her beauty. 

When my baby is born, treat her with respect. Hold her like you would a live baby. Pass her to me like you would a live baby, gently and with tender care. Tell me how beautiful you think she is.
If your hospital has a Cuddle Cot, show me how it works and let me keep her with me for as long as I'm able. If not, assure me that I can see her whenever I'd like. Bring her to me. Let me hold her. Encourage family members to hold her and to take pictures, even the children, but allow my husband and I some alone time with her without the insanity of everyone else.
My room will be The Quiet Room. It will be a room of hushed voices and sideways glances. A room with a giant elephant taking up all the space. I want to talk about her, but no one will. Ask me about her. Ask me how I came up with her name. Ask me about my favorite part of my pregnancy. Let me talk about her. Nothing you can say will make this better. There are no words more meaningful than "I am so sorry". Tell me you're sorry for the loss of my child. Tell me it was not my fault. I won't believe you, but tell me anyway. Give me information for grief counselors and loss groups, maybe help me arrange mental health care if you can. Give me a hug. Say her name one more time. 

I will leave the hospital empty and broken. My arms will feel impossibly heavy without a baby in them. I won't know what to do with myself once I get home. Send me a card a few days later, letting me know you are thinking about me and my baby. Write her name. I will appreciate your kindness and feel like my child mattered.

At my postpartum checkups, be gentle with my body. I already feel betrayed by it. Ask me how I am. I'll tell you I'm doing fine. I'm not. Again, give me more information about counseling or loss groups. I feel isolated and alone. I need to find others like me, even if I don't know it yet. Help me do that. Again, tell me it was not my fault. Please, don't bring up religion regarding my loss unless I do first. I might not be religious, and talks of heaven or angels might hurt rather than comfort. Don't try to rationalize what happened. Just acknowledge how much I must hurt. Use her name one more time. Every time someone else says her name, it seals another crack in my heart. 

It is possible there is a clear-cut reason for my baby's death, but it's also very possible there is not.  I will have many questions, and some that you might not be able to answer.  Please, give me all the information you can.  Don't dumb it down for me, but don't use "doctor's speak" either.    I want to believe this was a one-time tragedy and that my body is not broken.  I need to know what this means for future pregnancies if I choose to have them.   Trying again might be the first thing on my mind, or it might be the last, but either way, knowing where to go from here is important to me.

Know that I am grateful for you, even if I don't say it. Know that your kind words and gentle bedside manner mean more to me than you might realize. Know that your acknowledgement of my baby as a real person who mattered is the first step in my healing process, and that how you treat me as a mother and her as my daughter will stay with me forever. 

I didn't want your day to end up like this. I didn't want my child to come home with me in an urn. No one thinks this will happen to them until it does. When I go home, you will go back to your normal routine of delivering babies with heartbeats, but you will be forever changed. You might, every once in a while, notice her face or name drifting across the white space of your brain, and I hope you do. I hope you think of her, even just one more time, because I think of her every day. I always will.

With Sincere Thanks, 
The Heartbroken Mother

This is one of many beautiful pieces of art by Louie Ejanda.   To purchase a print of this artwork or others, click here