This post was originally published at https://alexandrapalmerdoula.wordpress.com and has been republished with permission in honour of Canadian Infertility Awareness Week.
This is not medical advice. It is for information purposes only. Please seek out a doctor’s advice regarding miscarriage.
A miscarriage is the spontaneous loss of a pregnancy before the 20th week of pregnancy. Most miscarriages happen in the first trimester, but they can occur at any point during pregnancy. Miscarriage is also known as spontaneous abortion.
As with all matters concerning pregnancy, there are a number of ways a woman may want to handle her miscarriage. Some women find comfort in burying or cremating the remains of the miscarriage; others don’t consider their fetus something to be mourned and prefer that it be handled alongside other medical waste.
This is not about politics; this is about a woman’s right to choose. This article focuses on women who are experiencing a hoped-for child and pregnancy. This in no way reflects on the medical care needed to access safe abortion or the difficult place women find themselves when advocating for recognition of loss while others advocate for recognition of autonomy. This is about choice.
Miscarriage is unfortunately a common experience for many women, with up to 20% of all pregnancies ending in miscarriage. For some women, the idea of simply disposing of the tissue can be upsetting, and they may wish to preserve it instead. There are many reasons why someone might choose to preserve a miscarried fetus. Some women feel that this helps them in the grieving process by giving them a physical reminder of their lost baby and allows for burial options. Others find it helpful to have the tissue available in case they wish to have tests performed.
Whatever the reason, if you miscarry at home you will need to keep the tissues cool as soon as possible. This will help to slow down decomposition, allowing you a bit of time before decisions will need to be made. Ideally if you have saline solution that would be the best choice to place the baby in but not many people have this at home.
There are many risks associated with preserving a miscarried fetus at home. These risks include infection, damage to the fetus, and emotional trauma. This is your choice, and you are ultimately in control.
If you have miscarried and are under 20 weeks, you have some options depending on the laws in your area. The main decisions you face are if you want to bury your baby in a cemetery or have it cremated, alternatively you can also bring it to the hospital for them to cremate usually with other miscarriages. If you consider it tissue you can contact the hospital in regards to disposal if you do not wish to test the tissue. Burial or cremation of a miscarried child would require a letter of content from a doctor.
If you miscarry at home and there will be time before you get to see a medical professional, you will need to keep it cool. One option is placing the tissue in a Ziploc bag and then into a container with a bit of tissue around it then placed in a larger container surrounded by ice and kept in a cool place until you can see your doctor.
Check local regulations many hospitals have programs for cremation and burial of mischarge and stillbirth. Call your local hospital to find out your options.
Strainer/colander, squirt bottle/cup, gloves, small plastic container, small Ziploc bag, saline solution in a second container 3/4 full (recipe below).
Once you start spotting, bring the miscarriage kit into the bathroom with you.
Fill the squirt bottle or cup with saline water.
Put on the gloves.
Place the colander in the toilet before you sit down and make sure you catch all the clots.
Strain your urine stream, clots, and everything expelled from your vaginal area.
Use the squirt bottle cup to rinse the blood off the contents in the strainer.
If there are any contents in the strainer, examine those contents.
Discern and distinguish blood clots from placenta, sack, cord, and baby.
Your baby may not look the same due to chromosomal abnormalities or decomposition.
This may take many trips to the bathroom.
Finding your baby’s body is not 100% guaranteed this is only the way I have found most useful.
Support person – It is unwise to deliver your baby alone; someone should be with you (if possible).
Phone – In case of emergency.
Camera – Take pictures.
Sheet of tinfoil/plastic wrap/wax paper – A place to lay, clean off, and look at your baby.
Tweezers/Toothpicks – To clean off baby.
Clear Glass Container – Filled with saline solution it can enhance baby’s features so you can view him or her more fully.
Water – It is important to keep hydrated.
Gauze – Use in lieu of a towel/wash cloth, softer. Can also be placed between baby and fabric/cloth/wrap to absorb fluid & moisture.
Towels – To catch/clean up fluids.
If you do not find the baby, clean the colander, and let it air dry. Discard gloves and place the colander back until the next trip to the bathroom. Start the process again on the next trip to the bathroom.
Placing the fetal tissue submerged in a saline solution will slow down decomposition. A clear receptacle will allow you to see your baby better if you choose.
People who suffer miscarriages suffer no less than people whose pregnancy loss is classified as a stillbirth. The area is little researched, but the experience of miscarriage has changed a lot. People now experience an early-stage pregnancy as a baby is in part due to the use of ultrasounds, especially early on, and the greater sharpness and clarity of those images makes the baby real much earlier than ever before.
Death doulas, also known as death midwives and end-of-life guides, are non-medical workers who provide services that include physical, emotional, logistical, and sometimes spiritual support in end-of-life care. Death doulas provide services that allow individuals to reclaim their relationship with death, often by assisting their loved ones through the grieving process, by helping organize one’s affairs before death and by providing information about funeral planning.
The doula does not take the place of medical professionals, hospice care, or the comfort of family and friends. Rather, the doula’s role is to help the family navigate through the unfamiliar territory.
A doula is an experienced guide, someone who provides choices that gives back some control in a situation where families have very little. Hiring a doula experienced in miscarriage can help normalize grief and support the family in their best outcome for the circumstances.
I hope that this article helps those facing the overwhelming experience of pregnancy loss by providing information and choice.
***It is important to speak with a medical professional after a miscarriage as they will guide you in your specific circumstance.
***There is no sure way to know if a miscarried fetus is healthy just by looking. It can’t be said enough to always speak with your doctor after a mischarge before taking any action.
It takes a village.
Anyone interested in becoming an infant and pregnancy loss doula can register for HHA's IPLD certification program here.
Alexandra Palmer is a graduate of HHA's Infant and Pregnancy Loss Doula certificate program. She is also a counsellor, death doula, and speaker with over 25+ years of experience in social services. You can learn more about her at https://alexandrapalmerdoula.wordpress.com/about-me/