The room is almost always quiet. Whether it is early in pregnancy or near the end, you can feel everyone holding their breath waiting to hear it. And then it doesn’t come. There is no heartbeat. You take a deep breath to explain what you see but everyone in the room already knows. And then the silence is broken. Sometimes with sobs, sometimes with sniffles, sometimes with a deep sigh. My heart never fails to break in these moments.
October 15th was Pregnancy and Infant Loss Remembrance Day. The term “rainbow baby” refers to a child that is born after a woman experiences a miscarriage, stillbirth or the death of her infant. I am privileged to know and journey with many of these mothers. Their heartbreak is overwhelming to consider and at times their grief is immeasurable. Yet these mothers and their families are a treasure to care for. About 20% of pregnancies end in miscarriage. That’s 1 in 5. Stillbirth occurs in about 1% of pregnancies, which is about 24,000 babies in the US every year. That means if you’re reading this then you know someone who has had a miscarriage and many of you will know someone who has experienced a stillbirth or the loss of a baby sometimes in the first few months of life.
These women share many different versions of the same story. They are ushered into a sorority of sorts that they did not choose and would endure any amount of pain to be removed from. For most of the women I know, they will tell you about arriving for an early prenatal visit with hope and anticipation and leaving in heartbreak. Some of these brave women will tell you about that” longer than it is supposed to be” ultrasound in the middle of 
their pregnancy and the even longer wait to hear from the doctor that all is not well. But their wait isn’t over. Instead, it has just begun. They wait to see how many weeks they will continue to feel their baby move, how many more appointments they will continue to hear the quick and swishy heartbeat until the disease or malformation takes its toll. And the women who lose their soon to be born or recently born child, their grief is so heavy you feel it long after you have left the hospital. They are often left with little explanations of what has happened and uncertainty of what is to come.
As if this wasn’t enough, women who experience pregnancy loss are often met with painful messages from people telling them that God brings tragedy into life for some twisted purpose of growth or need. We feel the need to explain away the parts of life that make us most uncomfortable. What follows these messages is silence. Why? Because we find it difficult to speak about the parts of life that disturb our sense of our cultures best expectations. We seem to have no idea how to walk alongside this deep sense of loss and grief.
Rainbow babies are the ultimate symbol of hope. These precious children do not replace the ones that are lost. But they do give us a daily reminder of the grace that continually winds its way through our lives.
In the Bible a rainbow is a symbol of covenant and commitment. Families who have lost children deserve our commitment to honor them by acknowledging and remembering their past and holding a candle of hope for them for their future. Ask them about their grief. Have them tell you about the child they lost. Sit with them in the quiet and tell them you are deeply sorry for their loss. And mean it. When you sit with them in the silence you will begin to hear the story. What you will find is a group of women who will change your life with their courage, their strength and their hope.
Gynecology & Theology 
“My baby was real.” This is what I heard myself telling a close friend. Your conclusion is so exactly right. Ask. Listen.
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What a perfect title for this amazing article. I remember that the most in the deliveries I attended that involved these precious families. I have been there myself twice with 2 different physicians. One did tell me “oh there was probably something really wrong with the baby it’s best that this happened” which crushed me. The other doctor sat in silence and after hugging me told me he was so very sorry for the loss of my baby. The fact that he called it my baby was one of the only moments that brought me peace. Simple acknowledgement that I had lost a baby a real baby to me made me feel like he genuinely cared. Thank goodness for online support groups where women can tell their stories. I found a common thread where they thought their bodies had failed them or that they had caused the incident by silly things like taking Tylenol, exercising, or even drinking too much soda. Encouragement to tell their story and helps so much. It breaks the silence of the suffering alone. Bless you Dr. Smith for your kindness and compassion. Miss working with you.
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Please include ectopic pregnancy as it is not usually recognized as pregnancy loss and often is misrepresented as a miscarriage. Thankyou for the article and for recognizing the pain of pregnancy loss
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of course. Ectopic is a form of miscarriage. My apologies for not clarifying although I tried to make pregnancy loss inclusive as possible.
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Beautiful Post.
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I have preached over 250 funerals in the past 10 years, at least 10 have been children under the age of 5. Most of those were either stillborn or lost in the third trimester. I have a very theological view of death. I know and trust what the Bible says about being present with the Lord and every tear being wiped from their eye and the Kingdom of Heaven belonging to such as those but every time to stand at a graveside and see that little casket or a mother weeping, all of that theology doesn’t make it feel natural or fair. I’ve heard people do the very thing you mentioned in this article and say things like, “Everything happens for a reason…” as if God not only allowed this but caused it to happen for some greater will. What an audacious claim. Who hath known the mind of God? You give a beautiful picture here of a moment that a few of us have had to experience not only once but several and in your case many times. That moment when there are no words that could take this pain away. All you can do is hurt with them and weep with them and tell them you love them. One of my favorite pictures in the Bible is when Jesus shows up 4 days after His close friend Lazarus had died. When He arrives Lazarus’ two sisters run toward Him and I picture them whaling and beating on His chest and asking Him why He didn’t show up and heal their brother. Jesus doesn’t say a word. The Bible simply says “Jesus wept.” There’s power in that silence and in that moment. That’s when the Spirit whispers a hope into their broken heart unlike nothing our words could ever do. Thank you for this. I’ll treasure this article forever.
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