If I knew then……

November 27, 2018
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by Lindsey J. Wimmer, RN, MSN, PHN, CPNP, CPLC – Founder & Executive Director of Star Legacy Foundation

Dealing with platitudes is a common part of the grief experience.  Many well-meaning people say them in an attempt to make grieving individuals feel better.  We frequently hear things like “it was meant to be” or “things happen for a reason”.   These two phrases, in particular, emphasize a fatalistic view of the situation. In other words – this is what was going to happen and was supposed to happen regardless of what the people involved said or did.

Aside from the emotional impact those comments may have, I am concerned about the impression they give to the grievers and anyone around them.  When we hear these phrases, we are being told that the outcome was inevitable and completely unpreventable.  But in many cases, that is just not true. 

This perspective may bring comfort or diminish feelings of blame or guilt.  And those are great gifts.  But it also prevents us from making improvements for future families.  Why would we spend any time, money, or energy trying to prevent something that is going to happen no matter what??

Fatalism is easy and safe.  There are many people who are quick to agree with those thoughts, it absolves guilt or perceived guilt, and it doesn’t require any work. 

Fatalism is a convenient excuse to do nothing. To truly solve problems we must commit to finding answers.  ~unknown

On the other hand – it is difficult to wonder if the outcome might have been different.  It also makes us vulnerable.  If we think it is possible to do better, we are obligated to put in the hard work of getting there.  And we are forced to address the emotions that come with that approach. 

It makes me sad that so many people are distraught by simply considering the possibility that many stillbirths might be preventable.  It doesn’t place any responsibility for things in the past. 

One of my favorite quotes is from Maya Angelou.  She said “I did then what I knew how to do.  Now that I know better, I do better.”

This speaks to me because it means we need to give ourselves the grace to judge our past actions based only on what we knew in that time – both individually and as a scientific community.  But, once we know more, then we are accountable for using the new information to improve. 

I never blame mothers who worry they didn’t push hard enough, go in when they had a certain symptom, or know about a risk factor.  They often carry this guilt, but I want to reassure them that they could only work with the knowledge they had. 

Watching their pain should make us want to learn from these tragedies for the purpose of sheltering others from the same experience.  Wishing they knew then what they know now can be the motivation to improve our system.

Families aren’t the only people prone to fatalistic views.  Health professionals often feel the same way and may be the ones telling families and our society that prevention isn’t possible.  I don’t blame them either.

Many of them are taught this philosophy in their training.  And it is safer and easier for them, too.  Poor outcomes affect them emotionally.  Physicians often tell us that they process in their minds the same ‘what-ifs’ that the parents do.  The guilt emotions are even heavier if they have to think that the deaths may have been preventable. 

The elephant in the room is the fear that emotional feelings of guilt might be tied to or interpreted as legal liability.  The safer and less stressful approach to that reality is to reside in the belief that the result was inevitable. 

Unfortunately, progress will never be made if both families and professionals choose to stay behind the curtain of fatalism. 

Think about the current treatment options for cancer, heart disease, diabetes, HIV/AIDS, etc.  It would have been very easy to say that all of these things are not preventable or treatable.  But brave families and professionals had the courage to ask – what if it is treatable or preventable? 

These questions are not criticisms or accusations.  They represent empathy, curiosity, and the desire to improve the world around us.  They are not a reflection of what has been done in the past – only what might be possible in the future.  They encourage us to make something positive happen from a horrible situation. 

This is where the status of stillbirth is today.  I am beyond grateful for the families and professionals who have been putting in the hard work of asking these tough questions.   We need more of them.  They are dedicating resources to ensuring that future families and health professionals know better in the future.  Because, if they know better, they can do better. 

One Comment

Marcia Farris

I understand what you are saying but my grandson was born with a true knot and his cord around his neck. This cut off his life. My daughter had been to the dr. on Monday and everything was perfect. How could we have known anything like this was going to happen. He was also having ultrasounds once a week and they where fine. I and my daughter are both devastated and don’t know what else could have been done. The dr even said on Monday he was sounding perfect.

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