Coping With Grief - Obstetric ExcellenceIt was 4.00pm Monday afternoon. I was in consultation with a gynaecology patient in my office when my mobile phone rang. It was a call from the Birth Unit midwife.

A patient who was 32 weeks pregnant was attending a routine antenatal class at the hospital and mentioned to the midwife doing the class that she had not felt her baby move for 3 days. The midwife arranged for her to attend the Birth Unit immediately where foetal death in utero was diagnosed by the absence of foetal heart activity confirmed by the foetal monitor and then by ultrasound scan.

I was devastated when she told me. I attended and confirmed with my own ultrasound. I can recall so clearly the high pitched wails of grief by the mother refusing to accept that her baby had died. Her husband was bashing with his fist against the wall saying “this can’t be happening”, “this is just a bad dream”.

As an obstetrician, you have the joy of sharing of new life but you also need to support a couple when the pregnancy doesn’t work out. This can be emotionally very demanding. It does affect you. You grieve with them.

But you also need to compartmentalise this grief. It was not appropriate to mention the phone call contents to the gynaecology patient in front of me when the phone rang, even though she could see my change in facial expression when the midwife spoke to me. She asked me “is everything ok?” I also needed also to compartmentalise it when seeing the next antenatal patient and to be shared in her joy and expectation. Compartmentalising grief is a special skill you develop over the years that equips for coping with the lows and the highs of the job.

The baby died because of an umbilical cord accident where there was sufficient cord compression to cut off blood flow and so oxygen to the baby. It was otherwise a well baby of appropriate size. The parents could see this after the baby was delivered. This knowledge helps them with the grieving and helps them to accept that “it was not their fault” that their baby died.

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