Midwife Nicola Oliver, from NeoHealth, explains why women continue to live with the grief from pregnancy loss in the latest Tell Me Why podcast with Maria Botros.
We know that it’s something people never get over, they just learn to live with it in a different way, says Nicola
Nicola: Studies have shown that the way doctors and midwives handle pregnancy loss can either exacerbate couples’ grief or help them through the grieving
We encourage people to hold their babies and use their names to acknowledge their baby as a baby, not a loss, says Nicola
Nicola: In these situations, couples are not just losing a baby, they’re losing their dream of being parents
See more videos at https://gulfnews.com/videos
Read more Gulf News stories here: https://bit.ly/2HLJ2km
We know that it’s something people never get over, they just learn to live with it in a different way, says Nicola
Nicola: Studies have shown that the way doctors and midwives handle pregnancy loss can either exacerbate couples’ grief or help them through the grieving
We encourage people to hold their babies and use their names to acknowledge their baby as a baby, not a loss, says Nicola
Nicola: In these situations, couples are not just losing a baby, they’re losing their dream of being parents
See more videos at https://gulfnews.com/videos
Read more Gulf News stories here: https://bit.ly/2HLJ2km
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NewsTranscript
00:00This is like a really big time of your life so what I always recommend women do is make a few
00:06appointments with different ones different hospitals depending obviously on what your
00:10insurance covers right but shop around see see if you can meet a couple of of doctors and you
00:17might think actually I really liked her I really gelled with her I feel comfortable that's strong
00:23um and you want to if you kind of know what direction you want your birth to take so some
00:32people know they want an elective cesarean birth okay fine some people want a water bath
00:38um you need to talk to them fairly early on about what your preferences might be because some
00:45OB-GYNs don't do water bath some OB-GYNs will say no I don't think you need an elective c-section
00:52you know you want their values and their like beliefs to be aligned with yours right and if
00:56they're not you're just going to waste your entire pregnancy fighting a battle that you're not going
01:00to win so we tried to kind of all these tests I retired
01:13actually I I just um I just thought of another question that's a it's a bit related is there
01:19such a thing as pregnancy brain because like I feel like I mean everyone I know in my life
01:24has been complaining about it so can you explain a bit more like what happens and how like how can
01:30you I don't know can you reverse it like can you can you work on in like enhancing your brain muscle
01:37so you your brain obviously there's so many hormonal changes right and um you know changes
01:44to our circulatory system there's our hormone like stress levels everything like this affect
01:50our brain right on a daily basis never mind if you're pregnant you know if you're having a
01:53stressful day you're more likely to forget that you're supposed to go there or if you've got a
01:58bit of pain you're gonna be not aware of like what you've said or what you've done perhaps
02:04of course yeah um baby brain is real it's been proven okay right by researchers um and when we
02:12have a baby our brain permanently does change in the way that it's almost like the brain is
02:23rewiring itself to be a parent so we know that people can be sleeping soundly and I could like
02:32walk in banging some pots together and they might not stir if the baby makes a little tiny noise
02:39like oh they're awake straight away yes like we are our brains are then in this kind of new
02:48state state yeah where the priorities are different to what they were before and
02:56it's perfectly perfectly fine to have baby brain okay you can't not have it if you've got it
03:02there's not really anything you can do the only thing I recommend to people who are really
03:06struggling with it is uh leave yourself voice notes like record stuff so if you especially when
03:12you go to doctor's appointments or you go to see your midwife press just say can I just record
03:17this because I'll forget it all amazing and then just then you can go home and listen to it
03:22I like that yeah because I always get people coming to me and they're like so the doctor
03:26said this thing and I can't quite remember what it was and I'm like I'm gonna need a bit more
03:30yeah I know I don't want to do it so I always tell them like record record everything that's nice
03:37and also if like your partner can't come to an appointment or you're just at work and you're like
03:43having a conversation you can't remember it write it down put it in I prefer voice notes I'm what
03:48I'm that person okay you know I'll send someone a 15 minute voice note oh yeah same with texting
03:52yeah same yeah um yeah so I things like that will help you okay and then in the postpartum I would
04:00just say for the first six weeks don't expect anything of yourself in that like I need to
04:06remember to go here there I need to remember do this and this it's like just be in that
04:10postpartum period and get through it however works for you and then figure the rest out
04:16and I think it's part of the support that you get from your your family and your friends
04:19to cut you some slack I mean they need to know that you know what I have a human being growing
04:24inside of me so like just take it easy when I can you start there going I'm literally making
04:28like some ears right now exactly ears are growing so true okay so um in terms of the OB-GYN what
04:37should women expect from their doctors and what kind of questions should they be asking and what
04:44kind of tests should they be um you know uh requesting from their doctors and like just the
04:50follow-up the nature of the follow-ups with their OB-GYNs what should they be looking for
04:56so usually people see their OB-GYN when they first find out they're pregnant so usually around
05:03eight to ten weeks could be sooner some people like know five or six weeks you know right um
05:10but that first contact you want to just get a feel for your OB-GYN so
05:18what you should expect is somebody that you feel like you gel with okay and it's okay if you don't
05:23feel that you can find someone that you do so once you choose one you're not like you're not
05:30obligated to stay with them if you're not particularly happy right right um and this is
05:35like a really big time of your life so what I always recommend women do is make a few appointments
05:42with different ones different hospitals depending obviously on what your insurance covers right but
05:48shop around see see if you can meet a couple of of doctors and you might think actually I
05:53really liked her I really gelled with her I feel comfortable that's strong um and you want to
06:02if you kind of know what direction you want your birth to take so some people know they
06:08want an elective cesarean birth okay fine some people want a water birth um you need to
06:16talk to them fairly early on about what your preferences might be because some
06:21OB-GYNs don't do water birth some OB-GYNs will say no I don't think you need an elective
06:27c-section you know you want their values and their like beliefs to be aligned with yours
06:31right and if they're not you're just going to waste your entire pregnancy fighting a battle
06:35that you're not going to win right um and that's not something we need to do in pregnancy um as far
06:42as tests and stuff go they if generally for the most part for most people there's not a lot of
06:49tests that you need okay you'll have occasional blood tests to check your iron levels there's the
06:56NIPT screening okay um they will check they will offer you a test for gestational diabetes
07:05things like that but for the most part there's not a lot that we need to do unless there are
07:12other complications that you have medically prior to pregnancy right then you know that if
07:19that's you your pregnancy journey might look a little bit different to the next person's um but
07:25overall um it's not a time we need loads of tests and things you know you will usually
07:33expect I'd expect if you're going to see an OB-GYN regularly you'll probably get an ultrasound
07:38every time um which is how it's done so right if some people don't want an ultrasound every time
07:47which is so fine okay you don't have to um to have everything as well you like if you're not
07:53sure why your doctor's offering you a test and you talk to them about it if you're not getting
07:58the benefits the risks the alternatives and time to go away and think about it then that that's not
08:07appropriate care yeah yeah yeah so you should always come away from your OB-GYN you're thinking
08:12all right like they offered this they explained why I've spoke to my partner about it and actually
08:18yeah we think this is a test that we will be happy to have okay um and it's really important
08:26to remember most for the most part OB-GYNs aren't there in your labor oh yeah they will come for
08:35the end part they'll pop in obviously and if there's a problem they'll be there in a heartbeat
08:40right but you will be cared for on the labor ward and I strongly advise people to make sure that a
08:47the labor wards in their hospitals has midwives not just nurses because midwives are trained in
08:53birth right specialized yeah exactly like so I'm not I'm not a nurse some people are nurses and
09:00midwives I'm not a nurse I went straight in to do just do midwifery like that was it um so
09:08I would always ask your OB-GYN as well what their cesarean birth rates are
09:14and what their induction of labor rates are now is that that tells us what their rate of
09:21intervention is okay and it's it it sounds like you're like well why does that matter
09:28well it matters because we know that generally most interventions um in in maternity care these
09:35days are not indicated so we want to know like if I'm making a decision and I've got a birth plan
09:45is it going to be respected or am I going to be pressured into perhaps booking this c-section
09:50because you know if you're being told I had a patient um maybe eight months ago and she was
09:57being told from 37 weeks the baby was far too big far too big she needs to have an induction
10:03and the seed had been planted and in the end she actually changed her provider
10:09okay and she was like look if the second person says this then okay these two things match up
10:13right right and she went on to have a spontaneous birth in the water baby was something like 3.2
10:20kilos oh perfect which is perfect just like bang bang in the middle of normal yeah um but you know
10:26it's things like that so you want to kind of know what their intervention rates are because you don't
10:32want to be offered intervention to suit a hospital or a doctor preference right because it's your
10:40body it's your baby yeah it's exactly what you said you just want to make sure that your doctor
10:45is aligned with what you I mean you both match in terms of like values and like we're all adults
10:51right sometimes we don't gel with each other and that's so fine and that's fine yeah we're adults
10:55and we just go all right exactly and it's not a one-size-fits-all exactly I mean I find whoever
11:00I'm comfortable with and while you were mentioning it I felt like this is with any doctor I feel like
11:04there are some doctors exactly it doesn't have to be an OB-GYN like just any doctor in general
11:08okay my next question addresses um a sad reality uh that we I mean we witness with loved ones or
11:18some people have actually witnessed it personally which is pregnancy loss um I had a friend who
11:24recently went through that there are these influencers um Alexandra and John uh Bufford
11:31who also went through a loss and it's it was a big deal because obviously they have a huge
11:36followership and I don't know them personally and it hit me really hard and I think it's just
11:41one of the saddest things um to hear about and to go through um how do you first of all how do women
11:50deal with that and how do you help women deal with that I mean it's a hard question question
11:58to answer like how do women deal with it yeah because initially they don't okay and I wouldn't
12:05ever expect anyone to to deal with it initially you know it's it's a shock so we know we have like
12:12the seven stages of grief now there was five now there's seven um and we know that
12:18when we know that it's it's something people never get over ever um they just learn to live
12:26with it in a different way so it's never something that is gonna be out of their mind um especially
12:33if it's they then go on to have subsequent pregnancies um these couples need a lot more
12:42couples need a lot more time dedicated to them a lot more reassurance a lot more tlc just that
12:50continuity of care um there is basically all the evidence tells us that the way we
13:01as as midwives as doctors as nurses the way we care for families couples in this
13:09period when it initially after the loss has happened we can either exacerbate their grief
13:15if we handle it badly or we can help them with their grief we can help them move through that
13:22grief journey that little bit easier okay so it's um it's it's a difficult thing to to talk about in
13:34in respect of like the healthcare system because there isn't really any official
13:44guidelines like guidelines to follow right you know like there just isn't um and that's what
13:52people like healthcare workers that's what they need a lot of us are very prescriptive people
13:58like you know if there's a guideline people will follow it um and things that we know make a
14:06difference such as um encouraging people to spend time with with their baby or using their baby's
14:15name doing hand and footprints lock of hair all these things that if we can do we know that those
14:22make a massive impact on the grieving process they make a very yeah because we're acknowledging
14:28their baby as a baby not a loss you know um and any loss is a loss so some people feel like a lot
14:37of women struggle talking about their loss when it's a miscarriage when it's right i don't know
14:42say it's eight weeks for example yes and people almost you know they're worried it won't be
14:49validated if they're speaking to others about it right but you're not just losing a baby you're
14:55losing your dream of being parents you know people already know what stroller they're going
15:01to have they're imagining taking their baby to meet their grandparents yeah to summer holidays
15:06to school to what would the baby be when he or she grows up yeah all of that happens and a lot of it
15:11happens as soon as you see the stick say positive oh absolutely you know absolutely and it's like
15:19your body just releases these mother motherly you know hormones i don't even know what to call them
15:26but you instantly become a mother and i think it's um it's it's a really sad reality but um
15:33while you were talking about that i actually spoke to an infertility expert or fertility expert
15:38who was saying that women who have been trying for for months or years to conceive
15:45who aren't even pregnant but like the stick will say negative more than a loss so imagine you know
15:52when it's a positive and the baby's gone so i can only imagine how difficult that must be
15:58um i actually want to get a little personal i want to know how you deal with it i mean you build a
16:03relationship with these mothers and and these babies before they even come out and i mean how
16:09do you deal with it as a midwife so it's i mean i am a bereavement midwife um that's something
16:15that i've done quite a long for a long time in my career and i where i used to work back in the uk
16:24it was um an incredible place that had specialist bereavement midwives so i learned off them and
16:33um you know very big hospital very big inner city hospital you get exposure to these things so
16:41i think what i realized was it's not for everybody and that's okay it's a certain part of the career i
16:50enjoy it in a way that i like to be able to like help these people this these couples carry the
16:56burden a bit okay that's what i like obviously no part of it is ever fun it's not a fun part of my
17:03job but it is a really really important part and i personally yeah i like to build a relationship so
17:13i have written bereavement policies i have implemented bereavement training in previous
17:20um hospitals that i've worked at because they don't exist yeah these things don't exist and
17:27they have to because um we know that pregnancy loss in general is is quite a high statistic
17:36yeah and they're just the ones that are reported the ones that we know absolutely and i will go to
17:44either be with these these couples as they birth their baby do all the memory making afterwards
17:52i will go to their house post postnatally when they've gone home and they've got an empty nursery
17:59no baby and just talk to them and often when you have when you provide that you're one of the only
18:06other people that's seen their baby right so it's something that is that you have in common
18:12a higher number than i would ever like but i still talk to many of the bereaved couples
18:18that i've cared for whilst i've been in dubai wow um like frequently it's just like a bond
18:25that you don't really ever lose um absolutely um but yeah for me i think making the difference
18:32making it easier for them to carry because they'll carry it their whole lives i just hope
18:37that's what keeps me doing like that part of the job oh absolutely that is rewarding and
18:42so rewarding part of like helping them get through it and actually trying to conceive again and you
18:49know helping them through that second journey yeah and reassuring them and i mean that is
18:54rewarding as painful as it may be um but it's it's it's it's it's it's it's it's it's it's
19:01yeah and reassuring them and i mean that is rewarding as painful as it may be it is still
19:07rewarding yeah okay um we've we've taken so much of your time but i just feel like this topic just
19:13never ends oh yeah i can talk about it for years i know exactly and there's so much to address like
19:19with postpartum and and and how to know the difference between postpartum and baby blues and
19:25because i know a lot of my friends were actually confused and they thought it was just baby blues
19:30and then you know six months down the line they were diagnosed with postpartum depression um so
19:37that's actually my next my next question how do you know the difference and how as a mother do
19:41you know when to get professional help um so baby blues they usually last a couple of weeks
19:52two to three weeks you have a severe hormone drop when you give birth huge there's not another like
19:59it in in our lives okay um and not only do you have this hormone drop but you have given birth
20:09to this baby and you have either had your vaginal birth or you've had a cesarean birth
20:18both of these things are physically demanding emotionally demanding
20:24but we send you home after two days with this tiny little newborn and we're like okay
20:30look after this yeah so you've got that on top of what is a huge physical recovery
20:37oh absolutely um so the baby blues they can happen they're normal but
20:45if you're not coming out of the other side after two to three weeks and you feel that your mood is
20:51persistently low you have like feelings of anxiety like is the baby breathing um
20:58oh what if you know what if i put the baby in the crib and the crib collapses you know
21:03kind of all these thoughts that you think i know that's not going to happen but it's going to
21:08happen um not wanting to be around your support network be like being withdrawn and closed off
21:18um anything like that like loss of appetite yeah um loss of appetite uh sleeping a lot
21:29or not sleeping at all and i mean like you know insomnia not just my baby's awake and i'm awake
21:36we're talking about really not sleeping at all and a lot of the time the first people that see it
21:41it's not us it's our partners or our close family or friends the people that see us every day
21:47yeah um and i would always recommend if partners identify that that they they have that conversation
21:56they may well want to reach out to a different family member sometimes it's difficult to have
22:00that conversation with your partner but um one of the things that we know puts people at risk
22:09of postnatal depression is if they have some sort of anxiety or depression or any other mental health
22:14issues prior to pregnancy right right which is also something to look out for i mean to pay
22:20extra attention to sorry you know um yeah so if that's the case what i would usually suggest is
22:28that they go and see um like a perinatal psychologist in the pregnancy if they feel like
22:40it might be something that they're starting to feel come back the anxiety's got worse or
22:47you know you're through the pregnancy and the depression is it's quite quite heavy for me so
22:53doing that and making a plan with your with a psychologist for the postpartum um and also having
23:00a postpartum plan in general reduces the severity of baby blues so we plan for our birth people have
23:06a printed birth plan but what i usually advise is i'm like print out write and print out a postnatal
23:13plan so even if it's something as simple as having your emergency contacts you know like who can i
23:20call in if baby won't feed and i am absolutely up the wall and my husband's back at work like
23:27who are the people that i'm calling them right um who can i call to drop me off some dinner
23:35or you know one of the best things people do is they make you know big pots of food and just drop
23:43them around leave them on the doorstep that is like one of the best things you can do in the
23:46postpartum but who are these people that you could ask for that you know are you going to use a
23:50night nurse are you going to use a nanny who are the people that like who are they let's meet them
23:55before so i know who's coming into my house all of these things can really really reduce
24:01um the severity that's a that's a really good one i think we uh we seldom think about those
24:07aspects and it makes sense to do it before you give birth because after giving birth you're not
24:12in the right state of mind to sit down exactly you're not going to be able to plan out everything
24:18so i i like that i really really like that okay my last question i promise um what is your advice
24:25for women trying to conceive and i think i'm asking this question because i'm not even a
24:31mother and i'm still maybe not at that stage but i i get anxious just thinking about it because
24:37again we go back to hearing all these stories of you know people's experiences be a good or bad
24:44and wanting the good and not wanting the bad and obviously overstressing something that you're
24:49still not doing like i'm still not at that stage but i do get anxious and i think about
24:55oh my gosh what if i i give birth and like i don't know what to do and what if something happens
24:59to the baby overnight and these that anxiety it's real and it gets the best of us yeah so what's
25:06your advice for women trying to conceive at the moment so if you're trying to conceive or you're
25:11thinking about it in the next sort of six months you're gonna start taking control of what you can
25:17control so by that i mean increase your exercise if you're trying to conceive you don't need to
25:22be going curt raisy exercise wise but we want to be doing like functional fitness right um and
25:34maintaining that for at least three times a week i'd say okay some people like people like to train
25:41more usually so fine keep that going if you haven't i would suggest looking at some classes
25:48that you might find interesting whatever that exercise is right doesn't matter but what we want
25:52to do is we want to put our body in an optimal position for conception and being active is going
25:58to help that um take folic acid okay three months if you can three months before at least and what
26:09we're doing is where again we're just trying to like make the conditions so optimal for when we're
26:14ready um also give yourself time it takes time for most people to conceive a baby you know it's
26:29some people say oh yeah like we you know it's the first time we just got pregnant yeah and you're
26:35like okay great but that you're the exception not the rule yeah um but we know that women are having
26:41babies later and later in their life and there is a lot of fear mongering at the minute about
26:49your age and you're pregnant like trying to get pregnant your fertility decreases and
26:54i see i see all over social media and it's all to sell you sticks that you use to tell you
27:03your amh levels right all these things like let's see what your fertility is like and i'm like you
27:09don't buy into any of that on the on the internet right if you really want to know
27:13what your fertility is like if it's just going to set your mind at ease to know
27:16what your levels are how does that look for you you go to see a fertility specialist
27:21absolutely don't buy random stuff on social media um because when we use standalone tests
27:29with standalone values and no context they don't tell us anything but they can fear manga yes in
27:36women and we that's what's happening i don't know what it is some sort of like epidemic at the
27:42minute on social media about fertility and buy this kit to test your fertility and yes no go
27:48go to a fertility doctor right um and also it's not just important for you if you're trying to
27:55conceive you also have to think about your partner because if one of you is is doing everything they
28:02can to optimize it but the other isn't that's still not very optimal right right absolutely
28:08nikki thank you so much for everything thank you for having me for your time we're definitely going
28:13to bring you back because i feel like there's so many questions that i haven't gotten a chance to
28:17ask but um obviously you have better things to do so uh we're gonna let you off the hook but
28:23we're gonna bring you back thank you so much thank you
28:42you