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

guilt.jpg

 

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

reconnect after miscarriage.PNG

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.

Honoring your due date

IMG-7634.PNG

 

Your "due date". 

If you have experienced an early pregnancy loss, you might be overwhelmed with emotions when thinking about these two words.  It might feel like a deadline for you or a last hurdle you are waiting for to move from depression to acceptance. You might even feel that your due date will be the time that you start letting yourself grieve. If you have experienced an early pregnancy loss an upcoming due date might be weighing heavily on your mind. According to clinical psychologist Kirstin Bouse, via www.essentialbaby.com, "Commemorating your baby's due date isn't just a way to reflect on how important your baby was to you, it's also a vital step in the grieving process."

While everyone must find the best way to grieve and honor their baby on their due date, here are some ideas that have helped others:

1. Find something that memorializes your baby.  You may find that it is healing to have something that memorializes your baby. You may find that a piece of jewelry that you can wear is meaningful- an initial, name, date or symbol can be printed on necklaces, rings or bracelets to help you remember your baby. You might find that getting a tattoo would help you to honor your baby. Other ideas include a statue, stuffed animal, plaque, or plant are ways that you might honor your baby. You might find it to be healing to create a memory box adding any pictures, poems, toys, outfits, or other momentos that help you to remember your baby.

2. Donate. Whether this is your time or money, you may find comfort in making a donation to a charity in honor of your baby on his/her due date. Donating can be a wonderful way to not only memorialize your baby but to also help others.

3. Surround yourself with family and loved ones. You may fine it helpful to surround yourself with loved ones on this day. Those who know and will help you to honor your baby. It may be helpful for you to talk about it with others, to have a celebration in your baby's honor or simply to just be surrounded by love.

4. Spend time alone. You may find it comforting to be alone.  You may want time to process what this day means to you by yourself. You may not want to talk about the day. You may find it comforting to write about your baby or use art to process your feelings about the day.

5. Take a vacation or a staycation.  You and your partner may enjoy taking time off from work to go out of town or to have a mini vacation in town. It might help you to celebrate the day by making some happy memories or it just might be a good distraction to get through the day.

These are a few suggestions that have helped others. Everyone grieves differently and you have to find what is right for you. If you are having a hard time processing your grief or are feeling stuck there is help.

For more information about grieving after a pregnancy loss please contact Kull Counseling, LLC at 608.239.4807 or julie@kullcounselingmadison.com

 

Surviving the holidays after early pregnancy loss/miscarriage

grass-2563424_640.jpg

In 1963, Andy Williams sang, "It's the most wonderful time of the year."

If you have experienced an early pregnancy loss you may feel differently. The holidays can be a difficult time of the year for many, but can be especially difficult if you have experienced a  miscarriage.

You may be dreading parties because people do know and are uncomfortable about what to say or  people do not know and are asking when you are planning on starting or growing your family. Or maybe you are dreading opening holiday cards of pictures of friends and family with their children or you may be dreading sending out your own without your child. 

You might be celebrating the anniversary of your loss, a due date or your child's first holiday. Perhaps you were waiting for Christmas to announce your upcoming birth. You might have already made plans for what this holiday would look like with a new baby.  It is easy to feel triggered around the holidays when much of it is centered around family and children.

Wherever you are in your journey, and whatever stage you are at in your grief, here are a few ideas to help through the holiday season.

Tips for getting through the holiday season after an early pregnancy loss:

1. Get extra support - You need additional support during this time. Whether this is doubling up on support groups,  additional therapy sessions or just making plans with those that support you and your loss. If you are  religious, this may include attending services or seeking support through other church members. 

Support groups for miscarriage in the Madison, WI area:

https://www.kullcounselingmadison.com/miscarriage-support-group/

http://www.bereavedparentsofmadison.com

2. Say No - You do not have to do everything. It is okay to say no, whether this is to a party, a family gathering or sending out holiday cards. You especially do not need to do anything that triggers you or that is not a good space for you right now.

3. Practice kindness - During the holidays you tend to practice gratitude and kindness towards each other. Practice kindness and gratitude towards yourself. You may feel like you should be over your grief by now or that you were doing so well and that you took a step backwards-be patient with yourself. Do extra self care during this season: cooking, going for a walk, yoga, practicing mindfulness, reading a book, talking to a friend, or going on a date with your partner are just a few ideas.

4. Honor your baby - you may find it comforting to start a tradition to remember your baby during the holidays. This may look like buying an ornament that honors them or lighting a candle on your holiday to honor their presence. It could be volunteering or buying a gift for someone in need. Whatever this may look like for you, if you want your baby to be part of your holidays you can do it and let the important people in your life know what you need to honor your baby so they can support you.

Please remember if you are grieving a miscarriage you are not alone. If you need help during the holidays, Kull Counseling can help. Please contact  608.239.4807 or julie@kullcounselingmadison.com for more information.