Miscarriage hurts, and is often misunderstood. Síle Seoige’s groundbreaking TG4 documentary ‘Deireadh Tochta’ follows her journey, shares stories, explores research, finds help. I’m delighted to have been part of her healing to a rainbow pregnancy.
I was a ‘rainbow’ baby, born after my mother’s fourth miscarriage. She felt each of her pregnancy losses all her life. Not surprisingly I became an NHS midwife. Caring for pregnant women at and in hospital – very like ‘Call the Midwife’ with a car instead of a bicycle. You really get to know people well when you have time to spend with them. I had an understanding of the utter devastation that death loss brings – miscarriage, ectopic pregnancy, fatal fetal abnormality, stillbirth, death of a newborn, cot death. I wasn’t afraid of talking about it – listening and hearing about pregnancy loss, helping women ( mostly women still) heal and continue to grow their family. Death and loss are bitter parts of our brief lives. Kindness and compassion help us live, and flourish. I learned how to help women heal after pregnancy and baby loss. And men too.
No one expects to have a miscarriage – as soon as you get a positive pregnancy test you’re ready for your baby. The sense of loss is excruciating. Healing involves learning to take back some control, finding balance within your narrative. Healing IS possible…
Miscarriage – healing after pregnancy loss
Here are some things I’d like to share with you…
- It’s not uncommon for your identity to take a big hit after the tragedy and trauma of miscarriage loss. Feeling very insecure, overwhelmed, life is turned upside-down. I help women remember it’s not their fault, something very bad has happened to them. It’s blinding and all-consuming. Blame, guilt and shame create extra layers and add on a massive burden.
- Grief is utterly exhausting. Overwhelming. You’ve got to realise that sometimes it takes what seems an age to begin to begin to feel normal. That’s normal in this weird new norma spacel you’re learning to live. So be gentle with yourself, nourish your body, your mind and soul and take the comfort you need. In a healthy way.
- Please don’t go it alone. Grief and loss are the loneliest experiences in life. Get a great trauma therapist specialised in miscarriage and perinatal work. Build your support system however small, a strong network of people who add value. Steer clear and avoid anyone dishing out unsolicited advice, judging, telling you their story or pressuring you in any way. Be honest with yourself about your needs, and highly selective about who makes the cut. It’s not forever.
- Learn to say NO! You and your healing are the main focus for now. Loads of things are unhelpful or exhausting when you’re grieving. Resist the easy temptation to bow to social pressure. You know what you’re able for, what events or people you’ve got enough energy for on a given day or week. Check in if it’s worth the effort to you right now.
- Your horizon shifts a lot closer after a traumatic loss. Meaning and planning are out the window. You are still you inside. Gradually you can begin pick up the pieces of your life and your interests again. Even if you don’t feel like it noe.
- This grieving time honours the little one who was with you and is part of your healing. EMDR is a gamechanger for helping people process and integrate their loss more gently and quickly. Very different to lengthy and ongoing counselling sessions, it often only takes 6-10 sessions.
- Grief after miscarriage is often devastating. Not always. It’s usual to feel numb for a while, or an overwhelming cascade of emotions. You may be withdrawn or find emotions are intense. There is no right way to feel or to grieve. Everyone is different.It’s shocking to feel out of control. Partners help in this transition by validating feelings, being positive about the future, reminding you of your strengths and capabilities while letting you talk and grieve. Family, friends and professionals can say the most hurtful things, usually inadvertently.Clichés wound – ‘You’ll have another in no time’ diminishes the impact of your loss. Find people who listen supportively. Our grief experience may outlast other’s sympathies. Most women do find a point of resolution about 12 weeks after a miscarriage. You recover in your own time and in your own way, regaining your self-confidence. Some couples focus on getting pregnant as soon as possible, others need to wait til they are good and ready.
- Don’t let anyone rush you. You’re not ‘getting over’ a cold. Grief is different. Be gentle with each other. Each of you is grieving the loss of your expected baby – the hopes and dreams that accompany pregnancy. It sometimes takes longer than you wish to get used to living with pregnancy loss.
- If the good parts of a day don’t outweigh the the bad after the 12-week mark, it may be time to consider getting some professional help. Miscarriage is a traumatic event that changes your fertility narrative.
- There are still the pregnancy milestones to consider, the due date, watching others pregnancies progress, the birth of babies around your due date. You can choose to step back until you feel stronger around women with new babies. Why wouldn’t you feel more sadness as the milestones pass? You were prepared to know and love this little one.
- A farewell ceremony may be helpful for you. My clients often find it easier to be in contact with the helpful folk, taking time away for a while to heal before connecting in with more challenging people or situations. Let them all be guided by your needs. Go back to work when you feel ready to. The same goes for those social gatherings (even online) like gender reveals, christenings, baby birthdays or communions.
Ready to conceive again?
When it comes to loss and trauma it’s not ‘What’s the worst thing that could happen to you?’ It’s actually that the worst thing did happen. Initially the sheer shock of it brings acute vulnerability, insecurity and hypersensitivity and emotional reactivity. It’s natural to believe if something bad happened once, something bad can happen again. The world feels unsafe, cruel and threatening. ‘How can I feel safe being pregnant again?’ is something I hear a lot. And hypnotherapy really helps with this, and to ease early pregnancy anxiety. Professional trauma care helps prevent it. Simply telling your story validates your experience. Brushing it under the carpet may seem useful in the short-term but it shores up pre- and post-natal depression risks.
Professional care addresses all the strange things that can blindside you after traumatic loss and gives you coping strategies. Shock, numbness, disbelief, insomnia, nightmares, anxiety, panic attacks, intrusive thoughts, detachment, confusion, hopelessness/helplessness, withdrawal and more. Therapy changes thought patterns, eases anxiety, improves feelings, self-esteem and restores confidence and hope.
You ay need to acknowledge the fact that a huge loss has happened. We tend to minimise, avoid or deny painful things – “I’m grand”. In fact therapy helps finding your way to accept and integrate the full truth of the situation that was outside your remit to predict, prevent or alter.
Continue to mind yourself – even if it feels like your body has let you down. A healthy nourished body provides a strong base to handle the emotional challenges. Sleep often goes after trauma and hypnotherapy helps you regain it quickly. That makes a huge difference to your energy and wellbeing.
This next piece may be very triggering for some. It’s about the physical side of miscarriage. I’ve included it because I believe everyone should know about it in order to be able to help themselves or another woman.
What is Miscarriage?
The loss of a pregnancy before the 20th week of pregnancy, or before survival outside the womb is possible, is described as miscarriage. About 20% or 1 in 20 pregnancies end in miscarriage. The correct medical term is ‘spontaneous abortion.’ I hate both of these terms, and prefer pregnancy loss. Most miscarriages occur during the first 14 weeks of pregnancy. About half of those ending in the first 8 weeks involve chromosomal abnormalities, unlikely to recur in future pregnancies. Pregnancy loss includes ectopic pregnancy.
A whopping 50% of all fertilized eggs do not continue on to pregnancy. A woman may not even miss a period or know she was pregnant. A chemical pregnancy describes a very early pregnancy loss. The fertilised egg, now called a blastocyst or morula, fails to implant and develop a placenta. This about week 4 or 5 of the menstrual cycle.
When a pregnancy just stops growing, this is called a ‘blighted ovum.’ In about 20% of cases a hormonal imbalance hinders development, and for 10% of women the womb may have a faulty design that doesn’t support a pregnancy. Sometimes the cause is not found. Miscarriage is easily thought of as a women’s problem. Until recent years the scant research there was, into the causes and prevention of pregnancy loss, concentrated on women’s bodies, neglecting men’s 50% contribution. That’s beginning to change…
In a 2019 study of recurrent miscarriage at Imperial College, London, lead author Dr Channa Jayasena, explains: at Imperial College explain “This growing body of evidence that suggests sperm health dictates the health of a pregnancy. Previous research suggests sperm has an important role in the formation of the placenta, which is crucial for oxygen and nutrient supply to the fetus.”
When a pregnancy ends suddenly by miscarriage, physical recovery is often much quicker than the emotional healing. Many women describe it as an emotional roller coaster. It’s difficult for a couple. There is no set formula to help you through. Some couples bond closely in sharing the loss, others find a distance opens up between them.
Stark reality
Not every hospital has a special miscarriage clinic. Sitting in a waiting room full of happily pregnant women is really upsetting. Staff focus on the physical side of treatment, keeping you safe and protecting your reproductive health. Some of the medical terms used sound old-fashioned, cold and clinical. “Incompetant cervix” doesn’t have a corresponding male soubriquet like ‘ ineffective epidymis.’ Hearing the words ‘spontaneous abortion’ to describe the loss of your baby seems unnecessarily harsh, but it is a medical term. Long ago doctors and nurses used uniforms and technical terms to help them stay detached in professional mode and not get overwhelmed by the sadness of their work.
Recurrent miscarriage is investigated after 3 consecutive losses. It’s hard to believe it takes that long. Your gp or consultant should check your bloods for anaemia and things like thyroid issues.
How soon can we try to conceive again?
The risk of miscarrying again after a pregnancy loss are the same as before.
Periods tend to resume 4-6 weeks after a miscarriage. It depends on things like whether is was a spontaneous or medically assisted miscariage, or if a D & C was done. Blood loss and infection weigh in on recovery times. Your doctor should advise you when it is physically safe to try to conceive again.
Emotionally the toll of pregnancy loss is often far, far greater than you’d expect. Grief in whatever degree you and your other half feel it is natural and normal.
It’s a different experience for everyone going through it. Whatever you feel, or don’t feel is valid. There’s no timeframe. or linear progression.
Overwhelm, anxiety and depression, along with PTSD can develop, and there’s a greater risk of post natal depression after subsequent pregnancies.
Consider getting help, outside of family, friends and support groups. It may only take four sessions with a specific trauma treatment like EMDR to process the emotions and ease anxiety.
You’ll know when you, and your partner feel ready to try to conceive again.
Risk factors
Obesity
Diabetes
Age of both parents
Smoking
IVF
Multiple pregnancy
Previous miscarriage
Chemical toxins arsenic, benzene lead, formaldehyde, ethylene oxide
Signs & Symptoms of Miscarriage
Bleeding
Pain … cramps
Smelly discharge
Fever … ‘flu-like symptoms
Feeling weak, dizzy or light-headed
Vaginal bleeding is often a first sign of miscarriage. Any combination of symptoms may be present. About 25% of women get a light ‘spotting’ of blood in early pregnancy as the embryo implants. This is normal but if it persists, or increases, a checkup will put your mind at ease. Pain may be felt as the womb spasms, and not everyone feels pain. From period-type cramps that come and go, to sharp, severe and constant it may be felt in the abdomen, pelvis, lower back or up into the shoulders. There may be fever, chills, aches and pains, like a dose of ‘flu.
Ectopic pregnancy
An ectopic pregnancy occurs when an embryo implants outside the womb, where it cannot survive and thrive. It often happens in a tiny Fallopian Tube, attaches to the gut or around an ovary. Early detection is vital. Rupture of ectopic pregnancy is life-threatening. Many women may not realize they are pregnant. Any sudden, severe pain in a woman of child-bearing age needs to be fully checked in the emergency room. There may not be any noticeable blood loss. This is an emergency, which can cause fatal haemorrhage. Surgery to remove the pregnancy, may conserve the Fallopian tube. Recovery after this double trauma of pregnancy loss, and life-saving surgery needs to include a ‘convalescence’. Body, mind and heart need care, and time to heal.
What to Do
If you notice any combination of these symptoms or just feel that something is wrong, trust your instincts.
- Call your doctor, midwife or hospital, Get an ambulance or head directly to the ER. An ultrasound will check your baby’s health.
- Get someone to stay with you and to drive you to hospital or clinic. You shouldn’t drive yourself.
- Keep count of the number of pads used. Soaking a pad in an hour means urgent care is needed.
- Rest in bed if you’re not advised to go to hospital.
Advice to avoid baths, tampons and sex may sound obvious but make sense.
What next?
Treatment involves pain medications and antibiotics and to help prevent infection. Sometimes doctors prefer to let nature take it’s course and send women home to miscarry.
A small operation under anaesthetic, called a D & C is sometimes done to empty the womb, stop the pain and prevent infection. This is called a D & C. A hospital stay is rarely required. It’s usual to feel sore and continue to bleed for up to 10 days afterwards. Pain meds and rest help. You are still full of pregnancy hormones and may continue to feel pregnant. And that’s so harrowing.
