There are so many practical details to consider following the loss of a pregnancy, even though nobody wants to think about them. For example, the painful process of removing yourself from a baby registry (hopefully, you have assigned a close friend this task), or withdrawing from birth classes. Each task that follows babyloss can be a painful reminder of the many exciting aspects of having a newborn that you will not be experiencing for the time ahead. It's so important for you to allow yourself grace as you navigate these emotions.
One essential practical piece of your care that should not be neglected is following up with your obstetrical provider, or potentially finding a new one. While I've been thrilled to hear that many OBs provide compassionate care after babyloss, I've also been dismayed to hear that some loss mamas are very unhappy with their providers. Usually the reasons are the same across losses: some OBs are too busy to spend the time needed to support a grieving mama pre and post-loss; some appear judgmental about the decision to terminate, if such a decision was involved; some don't talk about the loss; some just appear disinterested or uninformed. While it is understandable that OBs focus on care of the body, and, yes, are very busy, a little compassion can go a long way. While I always recommend that babyloss mamas seek therapy after this heartbreaking experience, it is also reasonable to explore finding a new obstetrical provider if you are feeling dissatisfied with the care that you received.
So, where should you begin? First of all, it might be useful to make a list of what you liked and disliked about your OB. For example, they might have had a convenient office location, but maybe they were a private provider and maybe were not used to working with experiences like yours. It's possible that when you experienced your loss, you were referred to an unfamiliar system for your care. So, perhaps you're looking for a provider that is situated in a medical system that provides continuity of care across services. Alternately, maybe you're more comfortable with a private local office that provides a more intimate experience, even if it means being referred out at some point. Of course, it's always useful to check with your insurance provider to determine who is in-network, and who you might be paying a little more for out of pocket. It's also helpful to make a list or priorities that reflects what's most important in an OB. After babyloss, you may want a provider that has a reputation for spending more time with their patients, even if you'll have to spend more time in the waiting room. You may also want to consider working with an office that provides midwifery services, as some patients feel that these healthcare professionals offer a holistic approach to women's health care. Midwives can be a valuable asset to obstetrical care, and some can work within the same office as medical providers, as is the case at Penn OBGYN and Midwifery.
It can be useful to ask your local friends about what they liked and disliked about their obstetrical care, and, if you ended a wanted pregnancy due to fetal anomaly, you might follow up with any providers' offices that you worked with at children's hospitals or maternal-fetal medicine specialists to see who they partner with. Most of all, it's helpful to "interview" a future OB before signing up to work with them. Don't be afraid to set up an appointment for an informational interview: providers should work for you, and be willing to talk about their philosophy and approach to care. Furthermore, they should understand that you will be coming to their office with special needs in the wake of your loss, and may need a little more of a "high touch" atmosphere where you feel as though you are more than a number in a busy system.
Here are some questions you may want to consider asking:
1. How familiar are you with the needs of women who have experienced babyloss?
2. What is your approach to working with women who have experienced babyloss?
3. Does your office provide resources or referrals to therapists or other supports for women who have experienced babyloss?
4. How comfortable are you working with women who have experienced babyloss?
5. I am planning on becoming pregnant again, but I am feeling anxious and overwhelmed about it. I want a provider that will take a bit more time with me to reassure me and give me all the answers to the questions I have. Can you do this?
6. What is your policy for patients who call with medical questions during the day and after hours? How quickly do you get back to them?
7. If I cannot reach you when I have a question, who can I get in touch with?
8. Do you deliver your patients, or do you refer to a hospital or other provider(s)?
9. If something goes wrong with my next pregnancy or any of my care, will you help me navigate my options openly and honestly?
Feel free to add to this list. Interestingly, I've known a few women who have actually preferred to work with providers who may have less traditional "bedside manner", but also offer all care options without bias, and comprehensively. In the wake of your loss, you may wish to consider what could have worked better in your last pregnancy: did you feel as informed as you could have been? Were you able to access your provider postpartum when you had questions or concerns?
You may also wish to stay with your current obstetrical provider, even if the experience wasn't completely fulfilling. Sometimes, familiarity can be comforting. If this is the case, I advise you to schedule some time with your OB to provide feedback about what worked well and what needs improvement. Hopefully, your provider will want to hear what you have to say, because your voice matters.
It's also important to work with a therapist as you navigate this new territory in the wake of your loss. In particular, if you are considering getting pregnant again, check out the tips in Pregnancy After Babyloss that you can expand upon in counseling, in addition to tips on Sex After Babyloss and Babyloss and Anxiety that may affect your approach to searching for obstetrical care.
