I will never forget her radiant face on the first day of her prenatal visit. Brianna* was the mother of a 2-year-old, pregnant with her second child and bubbling with excitement. Her medical history was not complicated and she was young and healthy. I gave her an order for a routine ultrasound so that we could determine the exact age of the baby. The report was within normal limits. Everything was fine until she returned for her second prenatal visit.
The day was crazy. The staff had overbooked my schedule again. My one saving grace was listening to Brianna play with her son as she waited patiently to be seen. Her toddler squealed with delight as she tickled him. It was nice to hear laughter flowing from an exam room. It soothed my tattered nerves. When we finally reached her room, I apologized profusely for the delay. She beamed and told me not to worry. She had enjoyed playing with her son.
It was supposed to be a routine exam. I asked my assistant to pass the Fetal Doppler and placed it on her abdomen. There was no fetal heart tone. I scanned her abdomen completely and then felt a sense of dread. Not her, I prayed silently. Please, not her. Brianna looked slightly concerned but not panicked as I explained that an emergency ultrasound was necessary because I was not able to hear the baby’s heartbeat.
Nothing in medical school or residency training adequately prepares you for giving patients bad news. The ultrasound report stated that her fifteen week fetus was dead. There was no cardiac motion. When she returned to my office the next day, her once smiling face was now somber. She wailed for 20 minutes after I told her the dreadful news, rocking back and forth in pain. “He’s gone,” she kept screaming. “He’s gone.” We asked her friend from the waiting room to please come to the back to console her. She sobbed, she wailed, she cried. It was obvious that she had bonded with this baby albeit at such an early prenatal stage.
I felt powerless and helpless as I attempted to explain that in most cases of such an early fetal death, there was probably something genetically wrong with the baby but that it shouldn’t happen again. But of course, that didn’t remove the emotional pain. What does? Time, perhaps? I shared my own trials with Brianna to let her know that no one is exempt from pain but it doesn’t last forever.
Sorrow may last for a night, Brianna. But joy will eventually come in the morning. Hold on, Brianna. Please hold on. Better days are coming. Please, just hold on.