At last, we'll no longer treat loss of a baby with cruel indifference
'The words 'one has died, that makes it easier' still ricochet around my brain'
Published 15/08/2016 | 02:30
When I was pregnant with twins in 2002, the obstetrician checked my ultrasound before I had an amniocentesis. The words "one has died, that makes it easier" still ricochet around my brain. Dumbfounded, two prospective parents left the hospital, holding hands.
In the car, I wondered was I a bit sensitive, perhaps that's how it is in hospitals - pragmatic, detached.
Three weeks later, we were called back for the results. Once again, we left hand-in-hand, bewildered, now two would be dead.
Fourteen years later, I have not recovered from that experience. I realise now, with all the talk of the new 'National Standards for Bereavement Care following Pregnancy Loss and Perinatal Death' this week, that my grief was worsened by the lack of hospital services for bereaved parents.
I wonder why the concept of 'put yourself in her shoes' never occurred to anyone in a maternity hospital or the HSE before now.
In my case, the doctor who did the scan knew the tragic news before telling me. Why not have a sympathetic, trained person on standby? In 2013, there were 500 perinatal deaths, including 301 stillbirths. Each year, there are an estimated 14,000 miscarriages in Ireland. It is by no means a unique situation to have a stillbirth, a miscarriage, or a diagnosis of fatal foetal abnormality.
So why has it been so ineptly, unprofessionally and, frankly, cruelly handled thus far?
There is nothing new in these guidelines; a similar system was in place in Belfast in 2002 when, due to our draconian laws against pregnant women, my partner and I left this jurisdiction.
We found a sympathetic welcome, consolation and compassion in a Belfast hospital. After my delivery, in a room far from the sounds of babies, a bereavement counsellor attended me. She had kind words and information on burials and future counselling.
Alas, I was returning to the Land of the Hypocrites south of the Border and her offer was to no avail. A nurse gave me a card with tiny footprints, items an expectant mother would never think of, but would be glad of over the years. We returned to Dublin with baby Tom in a small, pearly-white coffin.
The logistics of leaving a hospital with a coffin are something the guidelines will have to finesse.
Bereaved parents cannot leave by the front door. But the back door is usually where all the bins are. The father should be able to bring the car close by. Small things like free parking are suggested in the new guidelines. Walking through a car park with a coffin is not nice.
I had complications after my delivery, because of the twin tissue, and had to be admitted to hospital in Dublin two weeks later. I was left waiting in a corridor seated alongside heavily pregnant women who were looking forward to their scans. I had to deal with questions from a nurse about miscarriage; it was too traumatic for me to explain the truth in a country where the decision I had taken is banned.
Every step of the way, despite private health care, there was not a shred of common sense, never mind compassion. The only mental-health option offered was a consultation with the perinatal psychiatrist at the National Maternity Hospital.
He is only one of three specialists in Ireland and it took almost a year to get an appointment. By then, I had buried myself in study and my memories in a shallow grave. It cost €180 for an hour, I couldn't afford another visit. That was Dr Anthony McCarthy, who, I am glad to say, challenged the ironic Protection of Life During Pregnancy Act 2014.
He attacked the idea of putting vulnerable women under more pressure by being assessed by a panel of six experts, and said: "If a woman is seriously distressed and depressed in pregnancy and potentially suicidal … the idea that you would bring her through a forum … almost an inquisition, where she would have to tell her story in front of six people, is frankly abusive, it's truly idiotic."
So, 14 years after I made public that hospital visit 'outside the jurisdiction', the Health Minister and the HSE launched a 'significant step' and 'commitment to compassionate care' following pregnancy loss or perinatal death. But just weeks before the publication of these new standards, the grieving parents of fatal foetal abnormalities were omitted from the counselling budget. These parents are now included and I believe that sympathy and a counselling plan must come at the time of diagnosis; it should not be up to the woman to try and find help when she returns to Ireland.
The proposed bereavement team will include a dedicated clinical midwife, obstetricians, paediatricians, neonatologists, chaplains, social workers and palliative-care staff. This will be good news for Pro-Life campaigners, as they have reported that some women have been encouraged by doctors to terminate in cases of fatal foetal abnormality.
Approximately, 12 women a day leave Ireland for terminations abroad. Perhaps if we had a referendum to repeal the Eighth Amendment and provide direct compassion for all crisis pregnancy within our own community, this travelling would not be an additional issue for women.
The new guidelines are welcome; they are, at the very minimum, what a modern country should provide.
As guidelines, they are not worth the column inches, unless their implementation is fully owned. That not only means specialist personnel training, but also structural changes to hospitals where waiting rooms and entrances are separate to 'healthy pregnancies'.