Miscarriage. It drops into conversation like a bomb and silences everyone. It is a source of silent shame and deep pain. It is the death of hope and potential. It is a "personal problem" and a "woman's problem." It is tremendously common and yet deliberately hidden.
I was called into one of the small Emergency Department rooms early in the morning. My patient was lying in bed, covered in warm blankets. She was pale and tired. She had been there all night. She asked if I would hold her hand. She was alone.
We sat in silence for what seemed like hours. She said, "I didn't even really want it, you know. I was still trying to decide what to do with it." I waited in silence. "But its even more confusing, now that it's gone. I feel like I should be happy or sad. But I don't know what to feel."
I continued to hold her hand. I said, "What are you feeling?"
"Like I am missing part of me."
I decide to take a risk, saying, "Do you want to say goodbye?"
She started to cry and nodded. I stepped out of the room. A small specimen jar at the nurse's station contained the products of conception. I wrapped the jar in a towel. I cradled it gently in my arms as I walked back into the room and handed it to her.
She cradled the bundle and wept over it. She whispered for a few moments and then handed it back to me. Still holding the bundle gently, I left the room and returned it to the RN. I returned to the patient who was sleeping now. I stroked her hair off her forehead gently and turned to leave the room.
I said very little words in this interaction, but I made deliberate choices as pastoral interventions. I carried her fetal remains as an infant, wrapped in a towel, and handed them to her as such. I recognized the need for a small memorial service of sorts. This moment of ritual and of saying goodbye was just a few moments in the timeline of her hospital stay, but I hope that it made a difference. I hope that she had the time to say what she needed to say to her potential child and that moment, while filled with pain, was filled with humanity. A fetal demise is not just a biological process, it is a death and requires ritual and attention.