Content Warning: Miscarriage and Pregnancy Loss mentioned in this content
For my first miscarriage, I didn’t even know I was pregnant until I was already miscarrying. I wasn’t even sure what the experience was until a year later, after my second miscarriage, a few questions of my ob confirmed my suspicions. When I got pregnant a few months after that first miscarriage, I was two years into trying to conceive our second child. A matter of weeks before, I had received a diagnosis to explain our infertility, and a harsh statistical warning that, as a woman with PCOS, I had a fifty-fifty shot of carrying this baby to term. Fifty-fifty. That seemed like pretty lousy odds. I was offered no support, no information, no education about what to expect or what to look for in the event that my body miscarried. When an ultrasound at 15 weeks detected no heartbeat, my care provider was sympathetic, but simply sent me home. To wait. Again; no information, no support, no education about what to expect. I literally had no idea what was about to happen to me. I had a basic concept that a miscarriage meant lots of bleeding and no baby, but no real context or concrete expectation.
I went home. For ten more days, nothing happened other than occasional light spotting and mild cramping. I got no follow-up call from my care provider. I still had no idea what to expect. And then one morning, all hell broke loose. Soaking a pad every ten minutes for an hour, I was freaking out that I might bleed to death, alone at home with my five year old daughter. I called my husband home from work and he rushed me to the emergency room. We sat there for SIX HOURS, but never did see any care provider from my PCP group. The on-call doctor, obviously unconcerned, but still unwilling to explain ANYTHING to me, sent me for a multitude of tests, and finally an ultrasound. The moment that broke me was realizing that the ultrasound tech had no idea what was going on either, and hadn’t been told we were there for a miscarriage. She was obviously concerned about the scan, but refused to tell us anything, so we waited another hour for the on-call doc to come and tell us: “It looks like you are probably having a miscarriage.” No shit, Sherlock. The whole experience was wildly traumatic and it has taken years for me to be able to share some of the details (not included here)– even with my husband. Suffice to say, I was not aware that I ‘could’ claim the tiny body of my child, name her publicly, and have a burial ceremony. The shame I felt when I later realized this could have been an option is difficult to express.
Those first miscarriages occurred in 2005 and 2006. In the past fifteen years, not a lot has changed. A study of women who experienced miscarriage, conducted in Australia in 2019, set out to, “explore the psychological distress experienced by women as a result of miscarriage, as well as the perceived support provided by healthcare professionals.” The study found that “the levels of distress, grief, and loss associated with their miscarriages were significant”. The developing analysis of the results of the study are also showing that partners’ experience of grief and loss is often undervalued by health providers and the broader society, as well as by the miscarrying partner– often because each are too plagued by their own grief to provide support for the other. The study shows a distinct need for change in societal norms surrounding several items. 1) the taboo around sharing pregnancy news “too early”. 2) the societal taboo of talking about miscarriage in general. 3) general societal lack of knowledge about how to respond to the grief of miscarriage. The personal stories shared in this article from Today’s Parent give a personal face to the statistics in this study.
Another study, with participants from emergency departments around the country, looked specifically at the impact of “…beliefs, attitudes, and practices regarding women and families experiencing miscarriage and barriers to care.” The study found that dehumanizing terminology, such as referring to a miscarried embryo as “a blighted ovum” increased distress and mental anguish for the patient. The results of the study showed that, “Availability and awareness of specific services by professionals and health system issues were identified as barriers to care.” Another problem revealed by this study: “Nurses who work in emergency departments … encounter women and families who miscarry the most often and are the least likely of all professionals to mobilize support and provide information to mothers.”
The one thing that has changed is that women like me, who’ve experienced the trauma of miscarriage and infant loss are starting to speak out. Those voices; on blogs, in Mommy Forums, on Infertility Facebook Pages, and in studies like these, are finally starting to have some impact. Slowly, societal norms are starting to shift and it’s becoming more acceptable to ask for and receive help and support in the midst of miscarriage. The voice of women all over the internet, advocating for themselves and their sisters is beginning to change public expectations.
Because of this slow, but steady shift, I was fortunate (if you can use such a word in this context) to have a very different experience in 2021. This time, better informed, more experienced, and more determined to advocate for ourselves, my husband and I went to a homebirth midwife at 10 weeks gestation. In the first interview I laid out the distinct possibility that this pregnancy would end in miscarriage. I needed to be sure that once contracted as my support person, she would be there no matter the circumstances. She assured me that she was willing to provide support for a miscarriage at home, just as readily as for an at-term home birth. Sadly, the tell-tale cramping and spotting began while I was at work on a Wednesday evening. The miscarriage was complete before the end of the day on Thursday. Because I knew what to expect, because I was prepared and had support from my husband and a midwife, I was able to catch the caul-wrapped embryo, and tiny placenta– just the size of my hand– and save the remains of our much-grieved little one for a backyard burial.
While the ordeal of actual labor surges and parturition were much briefer this second time around, the postpartum period was much harder. Yes. Even after a miscarriage, there IS a postpartum period. And just like during the postpartum period after an at-term birth, you need support! Friends brought us meals and groceries, family members took our older kids to give us some privacy and peace. And best of all, our midwife provided us with the professional care required in the comfort of our own home; with no need to run to the emergency room and wait for hours to be seen.
I’m telling this story for two reasons. First, taking something tragic that has broken you, forming it into a story, and telling the world serves as an important part of healing and finding meaning in tragedy. Second, it has always been a priority of mine to use my experiences to advocate and educate. I want everyone woman facing the heartbreak of miscarriage or infant loss to have the support they need. You don’t have to walk this road alone. One in ten women will face the reality of losing a much-desired pregnancy, and they deserve the dignity of the same support given to women who carry their pregnancies to term. If you are facing the possibility of miscarriage, due to a hormonal or other diagnosis that increases your risk, please know that it is absolutely appropriate to find maternal care that is willing to provide you with the same support given to any pregnant or laboring woman. Miscarriage at any point past about the first week or two carries the possibility of being a very physically draining, as well as emotionally turbulent experience. This is trauma. It often is unavoidable, but you can, and should ask for help to get through it. Please don’t let the still lingering social mores and taboos surrounding honest acknowledgment of the trauma of miscarriage discourage you from acknowledging the depth of what you are facing, or experiencing.
By: Guest Blogger Elisa Forshey
Elisa Forshey is a freelance writer, former-doula/midwifery apprentice, and friend of the Birthing Community. She lives, writes, reads, and buys and sells books and toys in Southside Virginia. She blogs at theforsheyfour.blogspot.com
Bellhouse, Clare, et al. “‘It’s Just One of Those Things People Don’t Seem to Talk about…” Women’s Experiences of Social Support Following Miscarriage: A Qualitative Study.” BMC Women’s Health, BioMed Central, 29 Oct. 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206670/.
Kristen Thompson October 11, 2018. “Why Is There Hardly Any Support for Moms after a Miscarriage?” Today’s Parent, 10 May 2019, https://www.todaysparent.com/getting-pregnant/infertility/why-is-there-hardly-any-support-for-moms-after-a-miscarriage/.
L;, Engel J;Rempel. “Health Professionals’ Practices and Attitudes about Miscarriage.” MCN. The American Journal of Maternal Child Nursing, U.S. National Library of Medicine, https://pubmed.ncbi.nlm.nih.gov/26658536/.