Following the stillbirth of my son in 2005, I considered how my relationship with my doctor would be altered. In the wake of loss, my needs had indeed changed. I was confused about how to open a dialogue that allowed for discussion of fear. I briefly considered changing practices. In some ways, this seemed easier.

It is not unusual for women to consider changing health care providers following loss. Most women understand that their provider was not responsible for the loss. Still, it is painful and complex equation combining the memory of sorrow and loss with an unfurling hope that a future outcome will be different.

But when I looked back, I remembered my doctor and her kindnesses too numerous to mention here. She had been there as I labored — as I fought against the foreknowledge of death and its inevitable, accompanying and clanging silence. She had been the still point in that transcendent grief that threatened to swallow me whole. There emerged in that delivery room a singular bond for which I have never known a name. I did not really want to switch. It is true, though, that doing everything all over again in the same setting can feel powerfully re-traumatizing. Even as I returned to my doctor, I dreaded facing down that particular ultrasound machine. I hated the magazine articles in that same waiting room, that told me, in meticulous detail, how to completely decorate a nursery by the time a baby was born. And still, I did sit there and read them – a moth to flame. As if.

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It is important to re-define your relationship with a health care provider following a loss. Your loss may have affected the surge of optimism and excitement that can accompany pregnancy. Mourning that shift is your right. However, due to the complexity of the overburdened American health care system, time is limited and medical choices nowadays may be fewer.

Some practices are unable to accept new patients. Health care providers are under pressure their patients may not always fully consider. Meanwhile, patients coping with loss will often need additional support in a subsequent pregnancy. Threading the needle of these two realities requires mutual respect, patience, and communication.

Enabling a dialogue between a woman and her health care provider is critical. Some health care providers encourage their patients to tell their story so as to identify particular trigger areas to address. Taking the time to map a past pregnancy may help to ease anxiety about a future pregnancy.

Here are three questions to frame the discussion. For those women who are medically advised to seek another practice (such as high-risk obstetrics) these questions may also be used to guide a discussion in interviewing health care providers.

Conveyed medical information. Has my health care provider explained, to the best of medical knowledge, what happened that might have caused my loss? Has my doctor allowed me to ask questions?

Meeting you where you are. Has my health care provider taken the time to understand how I, personally, am processing my loss? For example, if I feel sad, are these expressed emotions met with empathy? If I take comfort in medical knowledge, have all tests been explained me? If I want to tell my story of loss, has s/he made space for that to take place? Have concerns that grew out of that exercise been adequately addressed?

Office accessibility. Does the health care provider feel accessible to you? Are you confident that you could reach a health care provider quickly if you had questions or needed reassurance?

If you are not satisfied with the answers to these questions, by all means, give yourself permission to look elsewhere. If you feel that you can work with your doctor in a post-loss landscape and wish to try, allow for shifting needs and responses.

Medical professionals take loss hard too, albeit in a different way: this aspect of their job impacts them. Deeply. Where possible, continuing to work together can have unforeseen benefits for both moms and health care providers.

Practical benefits include avoiding long waits at medical practices with staffing deficits, or the hassle of insurance coverage differences. Intangible benefits exist as well – up to and including the fact that the converse of re-traumatizing is healing – that is a different ending to the same story.

 

This article originally appeared on BabyCenter.

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