Going back to work after a miscarriage

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Miscarriage affects 1 in 4 people. Most miscarriages happen in the first trimester. While it is common to have a miscarriage, how it affects you looks different for each person. A miscarriage can take a toll on your wellbeing. Many women struggle with how and when to return to work after having a miscarriage. Below are some considerations for deciding when to go back to work and some coping tips that may be useful at work.

Considerations to make before returning to work:

1. Is your body physically able to return to work?

Having a miscarriage can be a painful experience. It can drain you not only emotionally but physically. It is common that your hormones may be out of whack and is common that you will still have pregnancy symptoms and you may still feel pregnant. The miscarriage may take a few weeks to complete. You may need to take time away to schedule a D & C. You may need to consider what your job asks of you physically. Do you have to do any heavy lifting or be on your feet all day?

2. Are you emotionally ready to return to work?

Do you feel well enough emotionally ready to return to work? You might be having a hard time concentrating. You also may find that your emotions are consuming you. It is common to feel like your emotions are on a roller coaster often feeling more than one emotion at a time. It is common to feel sadness, anxiety, depression, loss of interest in things, isolated, and feeling disconnected from your body.

3. Will you tell anyone?

If you took some time off after/during your miscarriage your boss may wonder while you are out. Will you tell your boss? Have you thought about how you want to tell them? If you decide not to talk about it at work have you thought about what you might tell your coworkers if they ask where you were. Do you have anyone at work that you can trust or that your feel like you want to tell?

4. What can you do if you are feeling upset at work?

When you have a miscarriage it can affect you at different times. You might be feeling okay but then something may trigger thoughts of the miscarriage and feelings of sadness, frustration, isolation ect. Do you have coping skills at work when these feelings come on? Is their someone that you can talk to? Would you like some alone time? Where can you go? Your office, a bathroom, outside for a walk? Does deep breathing help you? A simple method is called four square breathing. Breathe in to the count of four, hold it to the count of four, exhale to the count of four, hold it and repeat. Can you do a grounding exercise? An exercise that is easy to remember is to just feel your feet. Put your feet flat on the floor and bring awareness to any sensations that you feel in your feet for the next minute.

5. When do you have to be back at work?

Do you know your work policies about how much time you can take off? Have you contacted the correct departments if you need more time off of work. Most companies have a human resources department that can help to guide you through this process. Can you work from home?

If you do not feel ready to return to work it is important to speak with your doctor. If you are feeling depressed or anxious most days it is also important to talk to your doctor or identify a psychotherapist that you can talk to.

For tips on returning to work and early pregnancy loss contact Kull Counseling, LLC at 608.239.4807.

Unplug and Hug to reduce Anxiety

I was honored to be a guest blogger for unplug and hug. This is a repost of the article.

Electronics can be great. We love having our gadgets connected to us and we love having what our gadgets connect us to.  The amount of information available at the touch of a finger (thanks to the internet) is life changing.  FaceTime with family has changed the way we interact and stay close to distant relatives. Social media connects us with friends and family that we don’t get to see often. There are wonderful mental health and meditation apps on phones and computers these days.  Connectivity anywhere, anytime allows flexibility at work to check and manage email when out-of-office.

 

As a psychotherapist that focuses on helping those with anxiety, I see a lot of college and graduate students in my office.  Many of these young adults use their phones and social media in a way that increases their anxiety.  Being active on social media can attribute to the fear of missing out. It can also lead to constantly comparing your lives to others. It can also provide a false sense of social support. It can reinforce those negative thoughts in our head that we are not good enough or that others are better than us.

 

While not all use of social media is negative it is important to unplug once in a while. Instead of grabbing for your phone in a moment of anxiety make time for mindfulness and bring yourself into the present. Focus on your breath, notice your discomfort, observe and let is go. When you are using social media be aware of how you feel. If you notice your anxiety symptoms arising or getting worse it is time to set a boundary and put your device down.

 

Besides practicing mindfulness when you are feeling anxious it can also be helpful to take a walk, spend time in nature, connect with a friend, exercise, read a book or practice another form of self-care.

 

Best practices for helping women after a miscarriage.

A miscarriage is pregnancy loss before twenty weeks. Early pregnancy loss is estimated to occur in 1 out of 4 women. Most miscarriages happen between 6-12 weeks gestation. Early pregnancy loss is considered a loss but also a trauma. I recently was asked by Kat Schuknecht to give a presentation to the Madison Postpartum collective on best practices in helping people through early pregnancy loss. Here is a summary of my presentation.

Miscarriage is an invisible loss. It is the loss of your baby but also the loss of your dreams to come. Many people wait until the second trimester to share pregnancy news. When pregnancy is unknown by others it can feel invisible to the couple that is grieving. There is no one asking how you are doing or checking in with you. It can be difficult to share your news with others because of the sense of shame and guilt that surrounds the stigma of miscarriage. Many women blame themselves even though it is not their fault. In most cultures there are no rituals or ceremonies to help people grieve. It is normal to grieve with others, you may grieve miscarriage alone or with only a few people and you may feel very isolated.  It can also feel very abstract. If you do decide to share the news of a miscarriage it can feel abstract to the people you are sharing it with. It can even feel this way for your partner. Women tend to connect with their pregnancy and baby early on while partners often connect later in the pregnancy or once the baby is born. This type of loss can feel very uncomfortable for people and you may find them shying away or not knowing what to say.

If you have had a miscarriage you have experienced a major loss. An earlier loss does not equal less grief. Grief does not go away, it becomes part of a new normal that you carry with you. Grief is not linear it is actually quite messy and make look different every day. Grief is different for each person. You have a right to your grief. Your partner's grief will be different from your own.

Miscarriage can lead to feelings of shame, guilt, anxiety, depression, isolation, emptiness, failure, feeling disconnected from your body and sadness. No two people feel the same way. We cannot assume that we know how someone is feeling.

Miscarriage can lead to women feeling disconnected from their bodies. It may lead to difficulties with intimacy. Because women may be feeling disconnected they can be unaware that they are holding trauma in there body. It is important if you do bodywork with people that you are taking a trauma informed approach.

A miscarriage is a loss but also a trauma. Having a miscarriage can trigger post traumatic stress disorder. Symptoms of PTSD to look for our: fatigue, trouble sleeping, hyperarousal, nightmares, lack of concentration, anxiety, depression, loss of appetite and frequent crying. Pregnancy after a loss can be triggering for people.

Women who experience a miscarriage can have postpartum depression or anxiety. Anytime a woman goes from pregnant to not pregnant there is a shift in hormones that can affect brain chemistry.  It can be difficult to identify what is grief and what is anxiety or depression.

How Can Professionals Help

Holding Space - Professionals can help by holding space for clients. Holding space is being present with clients. Starting where a client is and remaining non judgmental. It is providing an environment that honors your clients needs.

Communication - How we communicate with people about early pregnancy loss can greatly impact our work. By opening dialogue about early pregnancy loss we can normalize and help reduce stigma. Ask. Include questions about early pregnancy loss in your assessment.  Take cues from clients when addressing early pregnancy loss. Refer to it as your client does. Whether they call it a pregnancy, a baby or even a name. If you meet with couples acknowledging a partner's grief.

Advocacy - Advocate for your client's needs on different level. At a micro level address their needs within your office. Are there pictures you may want to take down in your office or waiting room? Does this client have to wait in a room full of pregnant women? Is it possible for them to wait in the office? If you have someone that needs support validating and normalizing that it is okay to need support. Connect them to resources in the community. Therapy and Support groups are a few sources of support.

What do clients want us to know? I surveyed a group of women that had experienced early pregnancy loss and this is what they wanted providers to know.  They wanted providers to:

  • Be present with the client and loss
  • To listen
  • To validate
  • To understand that grief is a lifelong process
  • To be told they are a mom

If you are a provider or someone that has experienced miscarriage and our looking for resources Kull Counseling provides therapy and a free monthly miscarriage support group. Contact Julie at 608.239.4807 for a free 15-minute consultation.

 

The guilt of miscarriage

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It is estimated that 1 in 4 women will experience a miscarriage.  For many, having a miscarriage is a devastating loss that leads to a roller coaster of emotions. One common emotion many women hesitate to talk about is guilt. When you have a miscarriage there is a large amount of guilt associated with it because you feel like you did something wrong.  

 

Different types of guilt with a miscarriage:

1. The Guilt of It was my job. You may feel that that having a baby is part of your role as a woman and a wife. You might feel guilty that this is your job and since this is your job and you did not give birth to a healthy baby you have failed your job. You might have been taught that pregnancy and motherhood come naturally (and easily might I add) so when you are not able to maintain a healthy pregnancy there are strong feelings of guilt.

2. The Guilt of I did something wrong. If you believe #1, that it was your job to get pregnant and have a baby, than this is usually where the second layer of guilt sets in. If you could not do "your job" than you must have done something wrong. Did I drink too much caffeine? Was I exercising too much or not enough? Was it that glass of wine I had before I knew I was pregnant? You probably have come up with a dozen things that might have caused your miscarriage and concluded that is was your fault. 

3. The Guilt of what if I can't get pregnant again. If it was your job and you did something wrong than you might be feeling it is quite possible that you cannot get pregnant again. You may fear that you have already lost a baby and now you feel the guilt of what if I already lost one baby and I will never be able to have another. You might feel that this was your only chance and you did something wrong to cause this. You might feel that this is punishment for something else that happened in your life.

Guilt is an intense emotion and a very real part of the healing process of losing a baby in early pregnancy. There is help working to challenge these negative thoughts and normalize these feelings. If you have experienced early pregnancy loss it is not your fault, and  you are not alone. To learn more about guilt and other common feelings after a miscarriage or more information about the free monthly miscarriage support group please contact Julie at 608.239.4807 or julie@kullcounselingmadison.com

How to reconnect with your partner after pregnancy loss

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Pregnancy loss can have a profound effect on your relationship. For some, it can be a life altering event bringing you closer, and for others, it can lead to the end of your relationship.

When you lose a baby it can be difficult to cope. There is no handbook that gives you instructions on how to grieve. You may feel like you and your partner created this baby together, so grieving should be a joint process.  However, for many couples this is not the case. People grieve differently; how you process grief, when you process grief, and when you get to the acceptance stage of grief. You most likely felt different the minute you realized you were pregnant, connecting with your baby early on in your pregnancy. Research shows that for many first time fathers, a man does not consider a pregnancy a baby and himself a father until he holds that baby in his arms. www.webmd.com

You may feel emotionally disconnected from your partner when you are processing pregnancy loss, and you may also feel physically disconnected from your partner. It is common that you may also feel physically disconnected from your own body. You may find it difficult to be physically comforted by your partner or may have difficulty being intimate. This is common after you experience pregnancy loss. 

Reconnecting with your partner can be difficult, but it is not impossible. Here are a few things that can help you reconnect with your partner after pregnancy loss.

1. Reconnect with yourself - Before you will be able to reconnect physically with your partner, you need to reconnect with yourself. This can be done using mind-body techniques to reconnect you to your body. Two mind-body techniques that I use in my work include progressive muscle relaxation and the body scan. These exercises are both helpful to identify where in the body we hold pain, grief and stress from the trauma of a pregnancy loss and where we are disconnected. 

2. Communicate - This may not sound difficult in theory, but in practice can be difficult. Discuss your feelings about the loss with your partner and accept that they might not understand and that they may feel different about the loss of your baby. Tell your partner if it is difficult to connect physically. Explore feelings about being intimate and what that means for each of you. You may feel like being intimate again will lead to a subsequent pregnancy that you are not ready for. Your partner may just be trying to comfort  you and connect physically. Identify triggers that lead to feeling disconnected. Continue to check in about how you are both feeling.

3. Honor your loss - Find a way that feels comfortable to grieve your loss. Create a ritual that you can do with your partner to honor your loss together. It is important to find at least one way that you can honor your baby and sharing this with your partner is a great way to reconnect.

 4. Seek help - If the above ideas do not work and you are still finding it hard to reconnect there is help. Psychotherapy can help you reconnect to your partner after a loss. Remember to be kind to yourself. Pregnancy loss is a complicated loss and there is no one way to navigate it. 

For more resources on reconnecting with your partner please contact Kull Counseling, LLC at 608.239.4807 or julie@kullcounselingmadison.com.