Subscribe to The Podcast by KevinMD. Catch up on old episodes!

Nurse practitioner Maria Petty shares her experience with miscarriage in March 2023. She discusses the support she received from an early pregnancy assessment clinic, the importance of self-compassion, and practical tips for coping. Maria also touches on the role of faith and community support, as well as fertility awareness.

Maria Petty is a nurse practitioner.

She discusses the KevinMD article, “5 things that are helping us through a miscarriage.”

Careers by KevinMD is your gateway to health care success. We connect you with real-time, exclusive resources like job boards, news updates, and salary insights, all tailored for health care professionals. With expertise in uniting top talent and leading employers across the nation’s largest health care hiring network, we’re your partner in shaping health care’s future. Fulfill your health care journey at KevinMD.com/careers.

VISIT SPONSOR → https://kevinmd.com/careers

Discovering disability insurance? Pattern understands your concerns. Over 20,000 doctors trust us for straightforward, affordable coverage. We handle everything from quotes to paperwork. Say goodbye to insurance stress – visit Pattern today at KevinMD.com/pattern.

VISIT SPONSOR → https://kevinmd.com/pattern

SUBSCRIBE TO THE PODCAST → https://kevinmd.com/podcast

RECOMMENDED BY KEVINMD → https://kevinmd.com/recommended

GET CME FOR THIS EPISODE → https://earnc.me/tgLdQW

Powered by CMEfy.

Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast and get CME for this episode by clicking on the CME link in the show notes. Today we welcome back Maria Petty. She’s a nurse practitioner, and her KevinMD article is titled “5 things that are helping us through a miscarriage.” Maria, welcome back to the show.

Maria Petty: Thanks for having me, Kevin. Great to see you again.

Kevin Pho: Now, for those who didn’t listen to our first episode together, and we’re talking about a year ago, just briefly share your story and journey.

Maria Petty: Sure. I’ve been a nurse practitioner since 2012. I grew up with my mom and dad, and then with my mom and grandparents, with my dad still very much involved in my life. I think seeing my grandparents manage their chronic diseases, my grandmother was on dialysis and my grandfather had type 2 diabetes, influenced my decision to become a primary care nurse practitioner. I’ve worked in hospice, palliative care and skilled nursing facilities, and most recently in primary care at the VA, since 2017.

Kevin Pho: All right, so tell us about that perspective. You’re now a primary care clinician, but you’ve also had experience in a lot of other areas that most physicians actually haven’t. Most physicians go straight from residency into an outpatient setting, but you had the benefit of working in a variety of settings. Tell us how that has influenced your perspective now that you’re doing primary care.

Maria Petty: Thanks so much. I think seeing older adults, and unfortunately some younger adults, in the hospice and palliative care setting, then seeing the management of more acute issues, such as pneumonia, in the skilled nursing setting, and then getting to see outpatients, a lot of times a healthier group of patients, though unfortunately not all of them, has given me a perspective on different needs across the spectrum of illness. Especially now, being at the VA and able to access a lot of the resources available there, particularly home care and social work, has been a great benefit to me and a great learning experience, being able to see patients going through multiple conditions in multiple settings.

Kevin Pho: All right, so let’s talk about your KevinMD article. It’s titled “5 things that are helping us through a miscarriage.” How did your article come together?

Maria Petty: Thank you. Unfortunately, my husband and I had a miscarriage in March of 2023, about six months ago. We’re very blessed to have each other, and we have two healthy boys, who are two and a half and four years old. I’m blessed to have medical knowledge, and I have a friend who’s an OB/GYN, but it was still hard for us, even though we had a lot of blessings and support and really tremendous care from our team. So after the initial grieving period, I really wanted to process and write down my thoughts, and also share what helped us, in the hope of helping others. I do want to thank you, Kevin, because I think having a formal way to share such thoughts is really beneficial and really motivating for me. It gives me a reason to really write these things down.

Kevin Pho: So tell us about some of the things that did help you through this very difficult time.

Maria Petty: Thank you. My OB clinic has what’s called an early pregnancy assessment clinic embedded within the regular OB clinic. They actually call it PEACE, the Pregnancy Early Assessment Clinic. I’m a Cleveland Clinic patient. It’s basically OB/GYNs and nurses who are used to seeing patients who’ve had a miscarriage. When I went into the office and it was confirmed that I was having a miscarriage, I was immediately referred to a nurse, who was great. She went through a bunch of signs and symptoms and things to watch out for, and she gave us her number to call with any questions. I was immediately given an appointment with an OB/GYN, who saw me the next day and prescribed medication to help everything else pass.

They were all extremely competent, but also extremely compassionate. They were really there for us, listened to us and really validated the loss. Unfortunately, I’ve had some friends tell me that they were kind of dismissed: “Well, OK, I’m sorry you had this miscarriage, but if you’re not having severe bleeding and you don’t have a fever, you’ll recover on your own. Good luck, and call us if you need us.” But they were very proactive in the PEACE clinic. They reached out to me by phone at least two or three times just to check in, and I had at least two video visits and an in-person ultrasound a few weeks later, just to make sure the rest of the products of conception had passed and that I wasn’t having any infection or other complication.

Kevin Pho: Did you know what to expect after the miscarriage? Talk about how this clinic guided you through that process.

Maria Petty: Sure. I didn’t really know. Well, I guess I knew a little bit what to expect. I was having some bleeding, heavier than could be expected, so I figured this was probably what was going on, and of course I looked things up on my own. But I didn’t really know that there are different options. Sometimes people just wait and see, and there are medications that can help your body expel the rest of the pregnancy. I was at 10 and a half weeks, but people who are later in their pregnancy sometimes have to have a dilation and curettage in the operating room. So having somebody really talk through all those options was helpful. I opted for misoprostol, the pill. My body was able to pass everything mostly on its own, but having the pill to help everything else come out was helpful, I think.

And not to be gross, I know you’re a physician and have heard many things, but it’s a lot more blood and tissue than I expected. So having somebody be honest with me about that, and honest about the severity of the cramping, let me know what options were available and when to seek emergency care. There was a lot of bleeding, but it didn’t pass the threshold where, if you soak more than two pads in an hour, I think it’s more of an emergency room type of thing. Just having somebody really go through all that was helpful.

Kevin Pho: One of the things you mentioned in your article that helped with the healing process was mindful self-compassion. Tell us exactly what that is.

Maria Petty: Oh, sure. Thank you. Yes, other things helped me, too. I speak with a psychologist every few months, and she’s been very helpful as well. She recommended a book called Mindful Self-Compassion, by Dr. Kristin Neff, and it was very helpful. I haven’t finished it yet, but just in the part I read, she spoke about how common it is for us to try to just get through, to just push through. I was really trying to do that: “OK, I’m so blessed. I have my kids. I’m going to be all right. I have my husband. I have my family.” But I think acknowledging that this does hurt, that this is a loss, helps, and even using physical tools to soothe yourself, like actually putting your own hands on your heart and saying, “I am loved.” Some people use the first person, like “I am loved,” and some people speak more to themselves, like “May you be at peace. May you be well.” Admittedly, it felt a little strange at first, but I think practicing some of that really did help: just breathing, putting your hands on your heart and trying to ground yourself, especially in the moments when you’re feeling worse.

Kevin Pho: What other techniques did you use to help you heal during this period? Another thing you mentioned was journaling. How did that help you?

Maria Petty: Sure. Journaling, both informally and in writing this piece for your website, just helped me make sense of everything, to have a narrative of what happened. I think it just helped me process it. I also know a lot of people don’t talk about their miscarriages; they prefer to keep it private, and I can certainly understand that. But I did talk about it. I told my parents and some friends at our church, and people told me, “I’m praying for you, and I’m sorry for what you went through.” So many people came out and told me that they had had a miscarriage and what they went through, and I thought it really helped me. I think I’m the type of person for whom the community and the prayer and all of that were very helpful.

Kevin Pho: For other families who may be going through a similar situation, what are some pieces of advice you could share with them?

Maria Petty: Sure. I would advise them, if they’re comfortable, to reach out to other people who have experienced this, and to their OB office to see whether there’s an early pregnancy assessment clinic within the office or somewhere else they could be referred to. I listed some resources in my article, hyperlinks to places where somebody who doesn’t want to talk about it but wants to read more can go. There are various websites, from various religious perspectives and from non-religious perspectives. Children’s Hospital of Philadelphia, where I had one of my clinicals when I went to the University of Pennsylvania, has a comprehensive list of resources for people who have had not only pregnancy losses but also the loss of a child.

Kevin Pho: We’re talking to Maria Petty. She’s a nurse practitioner. Her KevinMD article is titled “5 things that are helping us through a miscarriage.” Maria, share some take-home messages with the KevinMD audience.

Maria Petty: Sure. If anybody listening has gone through this, please know I’m sending my hugs and prayers. And if you’ve never heard of an early pregnancy assessment clinic, or of fertility awareness, I would certainly encourage you to check out the hyperlinks in my article. And to the other clinicians out there, to all the OB/GYNs who see patients who’ve had miscarriages or other losses, and all of us see patients with losses: Thank you for what you do. Those moments of eye contact and compassion, even brief ones, were so meaningful to me in a tough time, and I hope we can all encourage each other to give that to our patients.

Kevin Pho: Maria, thank you so much for sharing your story, time, and insight, and thanks again for coming back on the show.

Maria Petty: Thank you so much.