Pregnancy After Loss: How to help anxious patients through their appointments.

For women and birthing people that have previously experienced pregnancy loss, becoming pregnant again and attending scans and appointments can be an anxious time, and these appointments can be triggering. They are often stark reminders of what can, and what did, go wrong.

The kind of care that women or couples receive from their GP, hospital or community staff can make a real difference to how they cope with the experience of pregnancy after loss.

Here’s how you can help your patient, and perhaps their partner, through their scan or appointment:

Prepare for the appointment

It’s important to check and know your patient’s history before you start the scan – its vital to how you effectively communicate with them. This can also help you anticipate how they may be feeling, due to their medical history. They may have had previous experience of pregnancy loss, or might have details their pronouns, for example, which you will need to take into account.

Conduct the appointment to your patient’s preferences where possible

After preparing for the appointment, it’s important to take steps to make your patient as comfortable as possible.

You can do this by checking if there is another scan room that you can hold the appointment in, which isn’t the one they received bad news in. You could check with your patient and see if they’d like a loved one in the appointment, or if they’d like a chaperone.

Some patients prefer to have the monitor off, and in the event of a transvaginal exam, it’s important to check if they would like their support person or chaperone to remain or leave for this.

We recommend that you always ask if your patient would like a scan photo, whatever the outcome of their scan. Some people like to have this as a memory either way.

Practice active listening

You may find that your patient tells you how they’re feeling, and of any previous losses. If this is the case, it’s important to them that you show that you’ve heard and acknowledge these things.

Sometimes, all someone wants to hear is “I’m so sorry for your loss. Is there anything we can do to make this appointment a little easier for you?” There may be nothing you can do, but if there is, this will make a huge difference to your patient, and their experience.

Whilst your patient talks of their situation, be sure to mirror their language, and use the terms they prefer. For example, they might refer to the pregnancy as ‘my baby’ – if so, mirror what they say when referring to their previous and/or current pregnancy.

Be compassionately clear

When anxious or highly stressed, some people can find it difficult to process information, or take in exactly what you’re saying. If your patient or partner seems nervous or similar, try to be as clear as possible – explain what you’re doing, what will happen, how it will feel. If they ask questions, or are nervous about their pregnancy’s health, take the time to reassure them.

Keep checking in

If your patient seems anxious when they come for their appointment, it may be helpful to them if you check in with them throughout the course of the appointment or scan. They may be triggered from past experiences or previous pregnancy losses, and these feelings may be and flow throughout.

Gently ask them how they’re doing, and acknowledge that if they’ve brought a partner, that they may find the experience difficult too.

Support for you:

We recognise the stress and exhaustion that comes with working in healthcare. If you’re looking for some support, our Professional Pause sessions may be for you. Facilitated by The Ectopic Pregnancy Trust and the Miscarriage Association, these Zoom sessions are a safe space for reflection and peer support.