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.