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Friday, January 23, 2009

Pregnancy Loss Terminology

The other night, I was flipping through the channels, and I came across a movie showing a pregnant woman having an ultrasound. The doctor performing the scan said, "Did you talk to anyone after your miscarriage?"

The lady looked up and said, "It wasn't a miscarriage. She was stillborn. Anything after 20 weeks is considered a stillborn."

I almost cried when I heard that because those same exact words came out of mouth about two months after my loss when I went to see my endocronologist about my PCOS. The nurse asked me how I was doing since my miscarriage, and I answered with the above. I've heard others who have experienced a similiar loss say the same thing.

This made me wonder why we are so hung up on the terminology of pregnancy loss. Anything before 20 weeks is a miscarriage; anything after is a stillbirth. If a baby is born breathing at 22 weeks and above (I think it's 22 weeks), it's considered fetal demise due to premature birth. They are all losses, so I wonder why it matters so much what we call it.

I know why it mattered to me at the time. Honestly, I knew then as I know now that a loss is a loss no matter what stage it happens, but I felt like calling Jenna's death a miscarriage was negating everything that happened to me. At the time, I felt like a miscarriage was a lesser loss than what I went through with Jenna. When a person has a miscarriage, they don't have to make a decision about what to do with the body, writing an obituary, making plans for memorial service, etc. Most women who have a miscarriage never get to hold or see their baby. I think another part of it is that by calling it a miscarriage it was making Jenna less of a being than she actually was, if that makes any sense, and it just seems disrespectful to her.

Since that time, I've come to know that a loss is still a loss and hurts no matter what stage you are at in the pregnancy. But, I still have trouble not correcting someone when they say I've had a miscarriage.


Brenna's Mom said...

I know exactly what you are saying. I feel like people use the term miscarriage to make my loss seem somehow easier. Like a miscarriage isn't as horrible as a stillbirth. I cringe everytime someone says miscarriage. I held my baby. I burried her. We had a funeral. She was born. That is not a miscarriage.

Niff said...

I agree that words that essentially have the same meaning have different feelings associated with them. While I know miscarriages are difficult to overcome, I believe there's a large difference between stillbirth and a miscarriage - just as there's a large difference between fetal demise and stillbirth, or even miscarriage. I think those differences mainly lie in what you're grieving. People tend to grieve more when they've lost an experience as opposed to never having experienced it at all. If that makes any sense whatsoever.


StellZ said...

Wow. A someone who has had miscarriages, I am in utter shock at your lack of compassion for those of us who have had them. I never got to hold my babies. I did get to have a funeral, but I had to bury memorabilia, not my baby. I had to flush one baby down the toilet and send another to a lab for testing. How dare you. You are a selfish, selfish woman. You should be ashamed of yourself for implying my loss is less painful than your loss. You have never walked in my shoes, how can you say your loss is worse? How dare you say the term 'miscarriage' negates the loss. It's the only termonology I have to describe -- with the exception of 'spontaneous abortion' but then again that doesn't sound too pretty either. I just had to tell you that it hurts deeply because no one seems o understand the pain of losing a child, I was surfing around trying to find comfort and I thought that women who had lost babies would understand. They do, but you don't. Selfish.

StellZ said...

I also forgot to say that we women who have gone through miscarriages DO need to make medical decisions. Should I pass my baby naturally? Should I have a surgical procedure -- D&C? Should I take that pill to start uteran contractions? There are a lot of medical decisions. It's not like the movies where there's some blood and that's that. I suggest researching this topic before you consider miscarriages to be the lesser of pregnancy loss.

Mrs. Mother said...

Stell, I'm sorry you feel that way. I am not a selfish person. I have chosen to share feelings with others who have gone through what I did to let them know they aren't alone. If sharing how I felt after my loss makes me selfish, then so be it. I don't think having a miscarriage is insignificant, and if you had read my blog carefully, you would have seen that I said, "A loss is a loss and hurts no matter what stage you are at."

I'm sorry if I offended you. I am sorry for your loss. I do not think my loss is any greater than yours, however, I do think some people think a miscarriage is somehow easier to deal with than a stillbirth. Please read my blog again through less emotional eyes, and you might be able to see what I mean.

Brenna's Mom said...

Mrs. Mother~ I have all the compassion in the world for anyone who has ever lost a child, at any age. Another blogger said it best when she said that someone's miscarraige is the most horrible thing in her life because it's the worst thing she's ever experienced. My stillbirth is the worst thing in my life because it is the worst thing that has ever happened to me. My sister has a friend who's 3 year old daughter died. That is the worst thing in her life because it is the worst thing she's ever experienced. That doesn't mean that the miscarriage isn't horrible. But I think everyone here will agree that it isn't nearly as horrible as loosing your 3 year old. Nor is it as horrible as having to give birth to a fully formed child you KNOW is not going to live. It's all horrible, it's all sad, and anyone who has experienced any of it is changed forever. With that said, I do not think you are insensative or selfish at all. How many times do you have to say that a miscarriage and stillbirth are equally devistating?

I must be selfish because I do not agree with you. I do think that a stillbirth is much more horrible than a miscarriage. I know it's bad- but it is incomparable. Just as a stillbirth is incomparable to the death of your living child. There is no comparing it. If that makes me selfish, then so be it. (Besides it's your blog- you can be as selfish as you want to be!)

StellZ said...

Brenna's Mom: How can you negate the loss of your own child by saying it is less devestating than the loss of a 3 year old? No it's not. As I stated in the post above, the passing of a 3 year old is not worse than the passing of a 2 year old. or a 6 month old. Or a 1 day old. Or a baby in the womb at 20, 14, 7 weeks.

It is the loss of a child. No matter what age that child was, he or she was alive and loved more than anything.

It is VERY hurtful for me to hear this. I lost my baby girl at 14 weeks. She was beautiful and perfect. I never got to hold her. I never got to say goodbye. She was a "miscarriage". I also lost a baby at 7 weeks. They were equally horrifying to me. They were both my babies.

I hope one day you can see through your pain to see that others are in pain too. Just because a loss was not experienced the same way/time you experienced it does not make it any less painful.

Brenna's Mom said...


I did not mean to hurt anyone's feelings in any way. Everyone's loss hurts them. No matter how early it was. A baby doesn't have to be fully formed to be wanted and loved. We all hurt from our losses.

The only thing I was trying to say is losses are different. The person I know who lost her 3 year old happened to suffer from infertility and tired for several years to have her daughter. She suffered several pregnancy losses before her daughter was born. She said that when she was suffering from infertility and loosing babies it was awful, heartbreaking. The worst thing that ever happened to her. But she said that loosing her 3 year old was unimaginable pain. She said herself that it does not compair. At that time her miscarriages were the worst thing she ever endured, but after loosing her 3 year old she said her perspective changed. It was not the same pain. For her. That is all I was saying.

Your losses are not any less because you didn't hit the 20 week mark, I know and understand that.

Liz said...

A loss is a loss. My baby was born at 18 weeks, I delivered her, her dad and I held her, we loved her and we said goodbye to her. My early losses (9 and 10 weeks) were different to me. Different experience (D&C), different recovery, different grief.

I don't consider my early losses lesser, because they were as wanted as Shannon and, technically, because Shannon was only 18 weeks old when she died, they called her a miscarriage, which really personally bothers me. I don't consider her the same as my other losses because her loss WAS different. Not more, but different. I fully understand, from my experiences of the past year, and the full-term loss moms that I've met, that my loss of Shannon IS different from their full-term losses because it is. There is nothing more to it than that. That doesn't diminish, in any way, the pain I feel, but each loss is different because it is our own.

I've found that there is a lot of thin skin on this terminology issue. We all lost our wanted pregnancies. We all hurt. No one is selfish.

Michelle said...

My first pregnancy was a blighted ovum ending in a miscarriage/D&C. At the time I know that I was thoroughly devastated. I had every hope and dream for that child.

After giving birth to a healthy baby boy 3 years ago, we went on to have a stillborn baby (20 weeks) this past summer. I think I have had a harder time dealing with this loss because I now know exactly what I'm missing. I see my son and dream of what my daughter would have become had she not become tangled in the cord.

I agree with Liz. My losses were different - one was not more painful than the other at the time they happened. Honestly, I think all of the stupid terminology should be thrown out the window. If I had lost my daughter at 19 weeks I wouldn't have been any less devastated than at 20; why is THAT the cutoff anyway? Did my child become somehow more of a child at 20 weeks? I don't think so.

I really don't think anything good comes from comparing losses. They all hurt and change us forever.

Kristi said...

I totally agree with Liz. Loss is loss and loss is different every single time. We grow and learn what works and what doesn't for us. I have lost seven babies, some earlier than others - 3 2nd trimester and 4 during the 1st. But all very painful. I labored, delivered, held and loved my son. He was born. He was still. Yet, he was a miscarriage.

Where I live it's based on weight, not gestation. So, since T18 babies are typically smaller, a T18 baby, in my state may have to be much older than the general rule of 20 weeks to be considered a stillbirth. Where you live shouldn't have any impact on the amount that you're "allowed" to grieve or how deeply you get to feel that loss should it? Just as I don't think that someone who experiences a loss at 20w1d is all that different than someone who loses their child at 19w6d.

I agree that what you had to go through was horrible for you so your experience and loss is different than anyone else's.

Selfish, I don't think so but it's very hard as someone on the "other" side of the line to constantly feel like I'm being told that I didn't earn the right to feel the way I do about my babies because they were "just" miscarriages.