How to cope with having a miscarriage

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When one suffers from miscarriage it can be devastating experience . A major loss has taken place and with that loss one must allow the proper space and grieving time for what could have been . There is no limit or time for how long one needs to grieve , it is all ones personal journey.

In my practice I help my girls by sharing my spiritual beliefs , planting seeds of positivity, hope and faith and help them clear from their body on an emotional and energetic level; but When someone is suffering deeply from loss that is beyond my scope of expertise I always refer them out to someone who is a specialist in the field . Dr. Ivy Margulies is a clinical Psychologist and My go to girl .

We were having lunch a few weeks back and the topic of miscarriage came up . She shared with me such  great and much needed advise that I asked her if she would do a Q&A with me for my blog on this topic . Here is our Q&A :

What is a miscarriage?

A miscarriage is defined as the loss of a pregnancy during the first 23 weeks. It is believed that possibly 50% or more of all conceptions end in a very early miscarriage. The most common sign of a miscarriage is vaginal bleeding which may or may not include cramping. The bleeding may come and go over several days and may vary from light spotting, brownish discharge, to heavy bleeding and bright red blood. However, light vaginal bleeding is relatively common during the first trimester of pregnancy (the first 12 weeks) and does not necessarily mean you are having a miscarriage.

On extremely rare occasions an ectopic pregnancy may occur. This is when a pregnancy develops outside the womb. These pregnancies are potentially serious because there is a risk of internal bleeding. Symptoms generally appear between week 5 and 14 of the pregnancy.

What are the physical symptoms?

As stated above there will be bleeding and physical symptoms may also include: cramping and pain in your lower abdomen, possible discharge of fluid, possible discharge of tissue, and you may no longer be experiencing the symptoms of pregnancy (i.e. breast tenderness, feeling nauseas, and extreme fatigue).

What percentage of women experience having a miscarriage ?

The percentage of women experiencing a miscarriage is influenced by her age. Women 30 years of age and younger, the statistics state 1 in 10 pregnancies will end in miscarriage. In women aged 35-39, the statistics state 2 in 10 pregnancies will end in a miscarriage. In women aged 45 and older, more than half of all pregnancies will end in a miscarriage.

While we may not know specifically why miscarriage happens during the first trimester of pregnancy, it is generally believed it is due to chromosome problems of the fetus. Chromosomes are blocks of DNA that contain a detailed set of instructions that control the development of the fetus. It is estimated that up to two thirds of first trimester miscarriages are associated with chromosomal abnormalities

There are other factors that can increase your chance of a miscarriage, such as, obesity, smoking during pregnancy, drinking more than 2 glasses of wine a week or 25ml of hard alcohol, as well as drug abuse and misuse. There are several prescribed medications that if taken during pregnancy can also increase your chances of a miscarriage. These include, but are not limited to, medicine for rheumatoid arthritis, retinoids used for eczema and acne, methotrexate also used for rheumatoid arthritis, and non-steroidal anti-inflammatory drugs used for pain and inflammation. Certain antidepressants are not compatible with pregnancy while others are considered safe to take during pregnancy. Only you and your doctor can weigh the benefits verses the risks of taking an antidepressant during pregnancy.

Second trimester miscarriages are generally due to chronic (long-term) health conditions that can increase your risk of having a miscarriage. Such as, diabetes (if poorly controlled), severe high blood pressure, lupus (a chronic inflammatory disease that attacks healthy organs and tissue), kidney disease, an over-active thyroid gland, an under-active thyroid gland, and celiac disease.

Additionally the following infections may also increase your risk of a miscarriage: Influenza (a recent study found that pregnant women who contracted the flu were twice as likely to miscarry or have a stillbirth), rubella or German measles, HIV, chlamydia, gonorrhea, syphilis, toxoplasmosis, cytomegalovirus (a type of herpes virus), and malaria.

Sometimes our bodies have structural challenges maintaining a pregnancy, such as our womb structure, or a weakened cervix or polycystic ovary syndrome (PCOS). These issues tend to increase the chances of having a second trimester miscarriage. The problems and abnormalities of the womb can include fibroids (non-cancerous growths in the womb). Or, an abnormally shaped uterus. Approximately one woman in 100 has an uterine abnormality. Generally, uterine abnormalities do not interfere with your ability to become pregnant, the challenge becomes in carrying the pregnancy the complete 9 months of gestation.

What are the emotional symptoms ?

There will be myriad emotions after you have experienced a miscarriage. There is no right or wrong way to grieve. Miscarriage is often a lonely, confusing and sad experience. Initially you may feel shocked and angry. You may think “how could this happen to me” or “why me”? Your initial reaction will also be based on your unique pregnancy story. For example. this may be your third miscarriage in a row, or your first – you may have gotten pregnant easily, or your pregnancy was the result of an IVF treatment. The universal feeling at this time will most likely be grief, sadness and disbelief. The sudden and unexpected loss can shatter your hopes and dreams for having children, or having another child.

Sometimes the impact of the finality of your pregnancy is felt immediately after the miscarriage, or it can take several weeks for you to feel the enormity of the loss. There can be a sense of distorted reality, as if this is all a bad dream and you will wake up and still be pregnant. As the shock and numbness subside you may find yourself feeling like a failure, you may believe your body has betrayed you. I assure you these are all normal angry reactions to feeling out of control and realizing there is nothing you could have done to save the pregnancy.

Guilt and blame are common feelings associated with bereavement. It is not unusual for parents to feel a sense of guilt or a need to blame when a trauma occurs. Mothers may be asking themselves what they could have done differently, how could they have prevented this from happening. The previous days events, and even hours before the miscarriage, may be playing over and over in your minds. You may wonder if you are going crazy. Grief often feels ‘crazy’ and like ‘losing one’s mind.’ We become forgetful, can’t form complete sentences, we lose things, we cry uncontrollably…all of these are common grief symptoms. Grief is like riding a wave, one day you could be feeling better and find yourself laughing, while the next day you find you can’t get out of bed.

Often times our feelings of anger can linger and become destructive and cruel, not only to yourself but to others around you. Our anger can express itself in obvious and not so obvious ways…such as, irritability, continual tearfulness, impatience, apathy, poor hygiene, trouble sleeping and restlessness. You may feel you are not yourself. This is when you need to seek professional guidance and support.

Additionally, the hormones your body began to produce can wreck havoc on your emotions. Prior to menstruation post-miscarriage, there is a physical component to the sadness where it almost feels the sadness owns you. As your hormones return to your non-pregnant state, you will begin to feel more like yourself again. Though you are still grieving, there is a sense that you own the sadness.

Disenfranchised Grief

Disenfranchised grief is a term to describe grief that is not fully acknowledged by society and where there are few supports systems, traditions, or institutions to help the grieving process. Many people do not consider a miscarriage as the death of a baby, but rather a fairly common occurrence and the end of a pregnancy, although studies show that about 75% of parents who have a miscarriage thought of it as a baby. These mothers-to-be and fathers-to-be are suddenly faced with a shocking loss that is not fully acknowledged by society. Many believe that because they did not meet their baby that they had no relationship with the baby, therefore it didn’t exist. Nothing could be father from this belief. Miscarriages continue to be considered a private and lonely event. Increasing the feelings of shame, stigma, and loneliness in the woman, and the man, because their loss is not validated by society.

Research has failed to find a correlation between length of gestation and intensity of grief, anxiety or depression. A woman who has lost her child at 8 weeks may be just as distraught as a woman who lost her pregnancy at 20 weeks. In a paper published by the British Journal of Psychiatry in 2011, the researchers found that women who had experienced a miscarriage were more likely to suffer clinically significant depression and/or anxiety during and after their pregnancies for up to three years postpartum. It is also now known that women who have a miscarriage are statistically at an increased vulnerability to develop a postpartum mood or anxiety disorder. Understandably, disenfranchised grief, or miscarriage, can complicate a woman’s ability to grieve and to grieve with others close to her.

What are some things someone who has experienced a miscarriage do to get through the grieving process ?

Some of the things you can do to help yourself through the tough days are:

1.Involving friend(s) and/or family who can listen and hold you. It is important to ask and receive support from others during this time. Don’t be afraid to ask for help with the shopping, cooking, driving, childcare, etc.

2.Good nutrition is very important to nourish your body and your mind. Drinking lots of water helps to cleanse your body of any built up toxins and build up your strength on every level.

3.Get active. Choose an activity that gets your circulation moving. Your body needs to feel the sunshine, this also helps to decrease feelings of depression, sadness and anger.

4.Write your feelings down in a journal.

Is there any advice for when trying again or newly pregnant after having a miscarriage in the past to help with the fear of it happening again ?

Understandably you may feel anxious, unsure, and ambivalent to try again for a baby. Miscarriage is usually a one-time occurrence. Most women who miscarry go on to have a healthy pregnancy after miscarriage. Less than 5 percent of women have two consecutive miscarriages, and only 1 percent have three or more consecutive miscarriages. Though you may be physically ready to get pregnant again, you may not feel ready emotionally. Take time to examine your feelings and think about what it would be like to be pregnant again. Some women are ready to go for it as soon as possible, others may need some more time to reduce their fear of the unknown.

If you are pregnant again it may be impossible not to have some trepidation about bonding with the baby in-utero, you may be hyper vigilant for any sign that something feels wrong. You can drive yourself crazy and increase you

feelings of stress during the pregnancy which is not good for the growing baby. Studies have shown a correlation between stress and the increased hormone called cortisol. Cortisol bathes the baby in this stress hormone which may increase the chances of colic, can affect the infant’s ability to regulate stress and increases the chance of preterm delivery. Please take the time to talk about your fears with others, and take a prenatal yoga class to reduce your feelings of stress. Using lavender spray on your pillow at night has a nice calming effect and will help you relax.

Whether you are trying again or pregnant again, you are feeling very vulnerable. Pregnancy is a vulnerable time, it is important that you surround yourself with all the support you can.

What are some ways that loved ones , family and friends can be supportive ?

Grieving a significant loss increases the risk of complicated depression. Complicated depression is when someone’s grief doesn’t seem to be fading or softening within 3-6 months time. In fact the depression getting worse, such as, the person is having difficulty functioning in daily living, there is an extreme focus on death, inability to enjoy the things she used to, withdrawing from others, drinking alcohol, abusing drugs, neglecting personal hygiene, excessive irritability, anger or guilt and any talk of suicide. You can help by looking out for any chronic behaviors that deviate from the person you know. The symptoms I have described above can become life threatening and she may be in eminent danger to herself and others. Please seek out professional help immediately, it is better to be safe than sorry.

Some things family and loved ones can do to be supportive would be to simply listen to what is shared. As painful as it is to hear your loved one’s pain, it is important that you don’t try to fix her pain, or offer hallow cliches, such as, “You are healthy and young. You can always have another baby.” Or, “There really wasn’t a baby, why are you so upset?” Or, “I know how you feel.” These statements are not helpful. Remember there is no timeline to bereavement.

Other things would be to offer her hands on help by cooking, cleaning, driving, and if there are other children it would be helpful to offer her a break. Perhaps taking her out to a movie or offer to walk with her to get some fresh air.

Remember to reach out often and offer support, typically the grieving person does not have the energy or motivation to call you when she needs something.

for more info on Ivy  :

Ivy Margulies, Psy.D.

Clinical Psychologist
Ivy & Osborn
310-828-7500
direct cell and email : (310)850-1330 Drivylove@gmail.com
Fertility, Pregnancy, and Postpartum Mental Health
2730 Wilshire Blvd.
Suite 550
Santa Monica, CA 90403

 

http://www.rootedforlife.com

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