Saturday, September 13, 2014

What if your Sailor has a miscarriage?

A human embryo at about six weeks after conception, i.e. eight weeks from the last menstrual period (LMP), image from Wikipedia Commons
While on deployment a few years ago, one of my Chiefs received a phone call from his wife, and I could tell from his facial expressions it wasn't good. So after a bit of time, I stopped by his room and asked him what happened. With a long face, he replied "My wife just called me to let me know she miscarried."

Honestly, I didn't know what to say. As a married man, I had two children so far with no miscarriages. Everything I had read online and at my church (which was mostly medical) told me miscarriages happened for a variety of reasons, normally because the baby wasn't going to make it even if born. Somehow those words were comforting to me, but all I could manage to tell Chief was "I am so sorry for your loss, can I do anything for you?"

The question of what you do as an officer when one of your Sailor's (or their spouse) has a miscarriage would come up on occasion, but it never seemed to make it into leadership training or any serious discussions I had with my mentors.

That all changed a few weeks ago. I walked out of work after a great day, jumped in my car, turned on my phone and called my wife (after I left base) to let her know I was coming home. She was very cold on the phone, so I figured she was just busy with our three kids. I walked into our house to see her curled up on the couch, wrapped in a blanket with a blank expression on her face.

That's when I found out my fourth baby wasn't going to make it into this world.

It hit my family like a ton of bricks. My wife had gone in for a routine ultrasound that day and neither of us had any indications that anything was wrong. She was so distraught when the doctor told her that her baby was dead that she called our CDO to try and reach me, but apparently the CDO couldn't be bothered to find me. So, tears in her eyes, she drove home with three kids and waited for me to call her while I continued to work in almost blissful gnorance. (As a side note, CDO training was conducted later).

Calling work was tough. Explaining to my boss what happened over the phone without choking up was tough too. My boss told me to "take off and call back when I knew more," which was her way of giving me the leeway to figure things out. I thought I'd be back within a few days, but it wasn't until almost 10 days later that I walked back into the office.

First came the doctor visits. My wife wasn't miscarrying naturally so she had to have surgery. We walked in for surgery at 0800 and didn't leave until 2030 at night, during which my friends kept my kids at home and worked shifts to take care of them. Then I played mom and dad for a few days while my wife recovered, with my neighbors kindly bringing me meals to help minimize the cooking I had to do.

Then came the funeral arrangements. As a Catholic I believe life begins at conception, so my baby had to be buried. Finding a funeral plot, making cremation arrangements, and signing documents was hard. Simply driving through the cemetery brought my wife and I to tears. As it stands now, our baby is going to be cremated and buried next to my grandfather, with specific instructions in my will to be disinterred later and reburied with my wife and I.

Lastly was the strangest part: how do we tell people? We had announced baby #4 to everyone, and yet now that wasn't happening. I knew some people that hadn't said anything, almost in the hopes it wouldn't come up again. I didn't want that, so I first called both of our parents, then sent it via email to our close friends, then an email to folks at work, and eventually put it out on Facebook to ensure everyone we knew knew about it. I didn't want anyone to not know and say something awkward, and I wanted people to feel they could talk about it with me.

Because there is such a lack of non-medical information about miscarriage out there, and certainly nothing for military officers, I wanted to offer some thoughts on what you should do as an officer when this happens to one of families under your care.

1. Don't worry about words. Your Sailor's family is going to grieve, and there is nothing you can say that will make it less painful. Don't rationalize it, don't justify it, and please don't say things like "you can try again..." (whomever gives that advice out, trust me, I didn't want hear it, I just wanted my baby). Offering your sympathy and prayer is plenty. It may seem like very little, but as someone on the receiving end, the knowledge that someone cares enough to perhaps offer a prayer for my now deceased child means a lot.

2. Think about food and kids. A grieving couple is going to struggle with basic stuff like meals and childcare. If you have people that want to help, coordinate a meals support and child care help. Without my friends watching my kids and providing us meals, I wouldn't have slept while supporting my family, and potentially I would have been unable to properly care for my wife.

3. After one day, work out a schedule, including paperwork. The Navy will provide death benefits for stillborn infants under FGSLI IAW MILPERSMAN 1770-250 ( Your Sailor is not thinking about this, but a few days after he/she figures that out you need to recommend they contact BUPERS for assistance. After a day to allow for the initial shock to wear off, work out a schedule. It may seem cold at first, but having a schedule of how things work will actually help your Sailor and his/her family bring closure to the situation.

4. Counseling may need to happen. Every hospital has grief counseling of some kind. If needed, get your Sailor there. They are NOT going to lose their clearance over grief counseling (Per DNI directive: If this was supposed to be baby #1, be on a sharp lookout for stress. A first miscarriage causes many women to simply shutdown and feel like they can never conceive children. This pops up as additional stress on the husband through a loss of sexual intimacy and stress that he may never get to hold his own children. This is going to affect work output and the health of your Sailor's family. A counselor is the best solution here, and you may need to insert yourself to get the couple to seek help.

5. Encourage your Sailor to talk about it. A lot of people want to sweep a miscarriage under the rug. Honestly, it's a bad idea. There needs to be more discussion about miscarriage and what happens. Being able to talk to people helped get me and my family through it. In the end, talking about the miscarriage actually brought me closer to many of my friends, neighbors and certainly with my wife and children. Not talking about it builds up a lot of tension that may get released in some other negative form, and it doesn't set boundaries for people at work, who won't know what's OK and not OK.

6. Get smart on what happens. Do you know what a D and C (Dilation and Curettage) is? If not, ask a doctor or plug it into google. The internet makes understanding the process of what is happeneing available at the tips of your fingers, and doctors will normally take the 5 minutes to explain what is going on. Especially if you are single, become educated on what is going to happen to your affected Sailor's family, as it will help you connect with them.

7. Don't let the hospital off the hook. Sadly too many hospitals and doctors are very cold in their approach to patients. Many treat the baby as nothing more than a bag of flesh. Couples that ask for the body afterwards are sometimes met with opposition (we did not, thankfully). If your Sailor complains about treatment, get an ICE complaint ( filed promptly and follow up. Do NOT delay on this, as time is not on your side, and without a formal complaint you are not likely to see any real change.

8. Get back to normal. You can't baby your affected Sailor forever. After grieving you need to return to normal. Getting your affected Sailor back in the game and refocused on the task at hand will help that Sailor overcome this event.

As a naval officer you will eventually have a Sailor with a miscarriage. Something like 20-25% of pregnancies end in miscarriage, and with a naval force that consists of about 60% married personnel, it's simply a matter of time. As a Naval Officer, you should know when your Sailors are expecting children and you should put some thought towards what to say should things go wrong. Being ready will help you get your Sailor through a rough spot. Remember that you are likely part of their family support for the first few days until their regular family can come into town. Don't take that responsibility lightly.