This ob-gyn clinic treats pregnant women having 'rainbow babies' after miscarriage or stillbirth. Here's why that's important.
Miscarriage happens in up to 20% of known pregnancies. Most of them — 80% — happen in the first trimester, according to March of Dimes. But in some cases, the loss of a baby happens at 20 weeks or later, which is considered a stillbirth. While it’s a heartbreaking loss at any stage, it can be particularly painful and shocking when it happens late in a pregnancy, when many women believe they’re in the clear. Rachel Gould sadly knows this firsthand.
She was just past 37 weeks and says her pregnancy had been “very normal” up until that point. “I had no signs of being high-risk,” Gould tells Yahoo Life. “I’m under 35, I’m healthy, Caucasian” — referring to the fact that Black women have a significantly higher risk of miscarriage than white women. “I don’t meet any of the risk factors.”
Over Mother’s Day weekend in 2021, however, Gould noticed that she hadn’t felt her baby — a boy she and her husband had named Ari — move. “I didn’t really understand that was an issue,” she says. She remembers having lemonade at lunch; the sugar would normally elicit a reaction from her unborn baby, but she didn’t feel him moving. She later ate a doughnut, and still nothing. “This is so weird,” she thought.
After calling her doctor, she headed to the hospital for an ultrasound. “We walked in and they couldn’t find his heartbeat,” she says. “They only found my heartbeat.” She adds, “You hear the words as a mother you never want to hear. I still play it through my head and it feels like a movie: ‘Sorry, there’s no heartbeat. He’s gone.’ And you’re just like, ‘What is happening?’”
She adds, “I didn’t know what stillbirth was or what it meant. I was a nervous pregnant person anyway, but once I hit 37 weeks I thought, ‘I’m good. Nothing can happen now.’”
Yet here she was, being asked to choose to deliver her stillborn baby vaginally or through a C-section. Gould was told that sometimes doing a vaginal birth can help with postpartum depression, so she chose that. “The umbilical cord was wrapped around his neck, cutting off his oxygen,” she shares. “There were no genetic issues they could see.”
Gould and her husband held their son for about five or six hours. Nurses took photos on their behalf. And then it was time to leave. “The hardest thing we had to do was walk away from our child’s body forever,” she says.
After Gould and her husband lost Ari, “I had so much love that I didn’t have anywhere to place because physically he wasn’t here,” she says. People cope with a deep loss like this in different ways. For Gould, she has always been someone who can’t sit still. So she dove into researching “everything I could” about stillbirths and why they happen. (The most common causes include problems with the placenta, including not enough blood flow, fetal genetic problems and birth defects, and umbilical cord problems that cut off oxygen to the fetus.) “I was told it was a fluke accident,” she says.
She volunteered for Push for Empowered Pregnancy, an organization whose mission is to end preventable stillbirths, and participated in a fundraiser to establish the first Rainbow Clinic at Mount Sinai Hospital in New York, an ob-gyn practice specializing in helping women who become pregnant after having a miscarriage or stillbirth. “Rainbow baby” is the name given to a baby born after such a loss.
In the meantime, Dr. Steve Rad, a maternal fetal medicine specialist and high-risk pregnancy specialist in private practice in Los Angeles, had been caring for lots of pregnant women who had experienced miscarriages and stillbirth. The Push organization heard about Rad’s work, and he shared that he’d like to have his own Rainbow Clinic by establishing the second one in the U.S. He met Gould through the organization and when she became pregnant with her own rainbow baby, she became Rad’s patient.
Gould gave birth to a baby girl, Eden, in November 2022. In April 2023, the second clinic — and first one on the West Coast — was certified in L.A. With permission, Rad named it after Gould’s son: the Ari Rubin Rainbow Clinic at the Los Angeles Center for Maternal Fetal Health and High Risk Pregnancies.
What makes Rainbow Clinics different from other ob-gyn practices?
Pregnancy after a loss requires specialized care. At Rainbow Clinics, “we try to figure out the cause of the previous stillbirth ... to prevent another pregnancy loss,” Rad tells Yahoo Life. “That’s our job as our specialty. There are very few, if any, clinics that have a section or center dedicated to pregnancy losses.”
For example, “one of the causes of stillbirth is small placenta size,” Rad says. He explains that Dr. Harvey Kliman, director of Yale University’s Reproductive and Placental Research Unit, “created his own measurement of placenta size,” which could indicate the risk of stillbirth and signal the need for more monitoring and possibly early delivery. “We check the placenta volume, which is not routinely done by maternal fetal medicine specialists,” says Rad.
Pregnant patients are also monitored much more closely, which helps alleviate anxiety. “Even if you went to a maternal fetal medicine specialist in general they will still monitor you [frequently], but not this much,” Rad says. “The protocol of seeing people weekly to three times per week is even more than someone with a previous stillbirth would get from your average ob-gyn or high-risk center.”
Why Rainbow Clinics are needed
Rad says that Rainbow Clinics are important not only to care for and monitor patients who have previously suffered a pregnancy loss, but also to help prevent stillbirths in the first place. “Besides the obvious fact that pregnancy loss and stillbirths are devastating, stillbirths can be prevented,” he says. “At least 25% to 50% of stillbirths are preventable. That’s a huge number.”
Rainbow Clinics also provide mental health support and have staff that have been trained in how to communicate with patients who have experienced pregnancy loss in the past. That’s important given that being pregnant after a miscarriage or stillbirth brings up a mix of emotions. Gould, who shares that she was on “pins and needles” during her second pregnancy, says that while everyone is excited that “your rainbow baby is here and of course it’s a blessing ... even afterwards there is a lot of grief and pain.”
Women’s health expert Dr. Jennifer Wider tells Yahoo Life that women experience “a range of emotions after a miscarriage, from shock [and] confusion to anger, fear, anxiety, depression and grief.” She notes that “a significant number of women who have experienced a miscarriage express fear and anxiety in subsequent pregnancies.”
But Rainbow Clinics can help. “Having a dedicated ob-gyn practice that specializes in the emotional and physical needs of women who get pregnant after miscarriage would be incredibly helpful,” Wider says. “So many women feel overwhelmed with emotions, and having medical professionals to address those needs on top of providing obstetrical care would be a gift to the women who suffer in silence, not knowing where to turn.”