Taking care of yourself through miscarriage

Miscarriage is the hardest thing I have gone through and am still going through. Your whole life shifts 180 degrees from one day to the next. This change is all encompassing. It is deeply physical and overwhelmingly emotional. It is a recalculation of the future, a letting go of expectations and plans and a grief for what could have been.

When confronted with it, I was both baffled and hungry for information. Being new in this experience, I had no idea what would help. I wanted to know what to expect, what may have caused the miscarriage, how other women survived this, how they recovered from it, how long recovery took, and where I might seek and find help.

The experience itself is difficult and complex enough on its own, but this difficulty is amplified by the stigma and culture around the miscarriage. Somehow, the topic is still somehow taboo and women are set up to handle this experience in silence. The culture of silence around miscarriage makes it even harder to know what to expect, and to find resources and strategies that might help.

This is why I have put together a list of what has helped me move through these difficult days, hours and minutes and to move forward (one small step at a time). This isn’t a list full of what you should do. It is what helped me and I hope that you take from it what you need and find the things that help you (and ignore what is not for you).

• Getting outside. I went for many long walks alone. Even though my partner was very supportive, I also needed a lot of alone time to process. I would go for long walks and listen to the podcast Life After Miscarriage. This was a form of therapy hour.
• Crying. I cried a lot. In fact I cried most part of every day for a few weeks. My emotions were so raw; I felt like this experience cracked me open. I can’t say if crying itself helped but I think it’s much healthier for healing to let it out than to bottle it in.
• Talking openly about how I was feeling. I told friends and colleagues about what I was going through. I didn’t announce it openly until months after but I was honest about what happened when people asked. I even told people about the miscarriage who didn’t know about the pregnancy. I think this helped in some ways because it provided context for where I was at emotionally and it made it so that I didn’t have to pretend I was okay when I wasn’t. Though it was difficult to talk about and I always cried when I wrote or talked with people, I think this is in some ways part of the healing process. For me, it was cathartic and important to express those feelings and not hide behind a mask.
• Reading and hearing about other women’s experiences. I am so grateful for other women who share their experience. There is so little medical information out there about recovery after miscarriage. The most important source of information were personal experiences, miscarriage and post-miscarriage cycle charts, podcasts and articles from other women. I used the App Kindara often to look for other miscarriage charts to see how other women recovered. It helped because it gave me some concrete examples and gave me milestones to look towards.
• Writing. I did not write regularly but every now and then I felt a need to download all of the thoughts that were circling in my mind. I regularly feel a need to write down my stream of consciousness, otherwise I get stuck in these thoughts. I write to understand how I am feeling. To free myself from the gravity of some thoughts. To give myself advice, like I would a good friend.
• Monitoring changes in my body. I continued to track how my body was doing by monitoring my temperature, HCG levels and spotting, amongst other symptoms. This was painful in some ways (e.g. still seeing positive pregnancy tests after the miscarriage) but it also helped me to see some of the ways my body was healing (e.g. temperature slowly dropping back down, or the positive line on pregnancy tests getting fainter gave me feedback that my body was at least physically recovering).
• Acknowledging that my body is postpartum. There are many things you don’t think of when you think of pregnancy loss until you experience it. One of them is that it takes time for your body to break down all of the hormones it built up. One day I noticed a rash on my stomach, only to have it diagnosed as postpartum hives (caused by stress and hormones, usually after delivering a baby). Reading the word postpartum was hard. I knew that I had experienced a miscarriage but I didn’t think of my body as being postpartum until that moment. Being confronted with that word helped put things into perspective. It made me realize that my body is going through big changes and I need to be patient with it. That patience is still a struggle but I remind myself that my body is doing a lot of hard things, bouncing back from pregnancy. Just like all of the hormones do not build up overnight, nor do they disappear overnight either. Just like my stomach didn’t stretch overnight, nor does it tighten up overnight. Understanding that my body is postpartum helped me appreciate the big changes it is undergoing.
• Continuing to care for my body. At first I felt betrayed by my body and did not want to care for it. Why should I? It had let me down. But slowly, I started exercising again. I started taking vitamins again. Giving myself a small massage. Step by step, I started feeling more connected with my body again.
• Having a next milestone to look towards. A friend helped me focus on making sure I had a next milestone to reach. These are small stepping stones towards recovering. It can be anything from stopping spotting after a miscarriage, a negative pregnancy test indicating HCG levels went down, the next doctor’s appointment, the start of the next cycle, or anything else that gives you something small to move towards. The whole experience is overwhelming and all consuming and it is helpful to break it down into small moments that are within reach.
• Going to a naturopath. I searched for what helped other women and I came across acupuncture. I had never had acupuncture before but I though: “What’s the harm in trying it out?” I researched and reached out to several naturopaths. My first appointment was largely a therapy hour filled with crying, and then the naturopath put in a few acupuncture needles, gave me a short massage and recommended an herbal tea that could support my liver in breaking down hormones. This experience calmed me down. It gave me time to reflect. It helped me connect with my body and it made me feel like there was actively something I could do to support my body other than wish time away. I ended up taking out additional insurance to cover future naturopath visits.
• Pushing for blood tests with my doctor. Most miscarriages happen because of genetic issues. But some miscarriages happen because of thyroid or blood clotting problems — both things that can be easily tested for and treated. Usually though, most doctors do not run any sort of testing until a woman has experienced three miscarriages in a row. My nightmare was that I would have another miscarriage only to find out it was caused by a thyroid abnormality that I could have easily controlled. Even though it was not part of regular testing, I insisted on thyroid and blood clotting tests even when some doctors told me they were over the top. Other doctors were sympathetic and said that the recommendations should change; that these tests should be offered right away to any woman who has suffered pregnancy loss. For me, getting these tests done gave me some peace of mind and confidence moving forward.
• Finally reaching out to friends and asking about how they are doing. How is their new job? That new apartment? Turning the focus around helped me not think about my own experience all of the time. It helped to have new input and information, to connect with friends and to focus on someone other than myself. As much as I wanted to talk about the experience I was going through, there were also times when I desperately wanted to talk about other things.
• Acts of service. Small acts to take care of others fill me with joy and energy. For example, I took muffins to an elderly neighbor. I sent a friend a care package after he lost someone important to him. I am not sharing this to toot my own horn, but rather to say that helping others is also a way of helping ourselves. These are small acts that helped feed my soul in a very important way during this time and they sparked a positive energy that kept me going.
• Eating (or doing) things I couldn’t indulge in during pregnancy. This was also hard at first because I didn’t want to be able to eat those things. But I now try to fit in as much sushi as the week allows and focus on enjoying this while I can. I know, official recommendations indicate you should align your diet with pregnancy even before you are pregnant, but you can’t do all of the right things all of the time. Sometimes you also have to take care of your soul. I would have liked to also be able to go on trips that I might not be able to go on while pregnant or taking advantage of other activities but in my case it was difficult with the lockdown.
• Voicing my guilt and shame. Against all reason, some irrational thoughts enter your brain. These are filled with all of the ways you may be responsible for what happened. I shouldn’t have eaten that slice of prosciutto or cheese. What if that alcohol-free beer had too much alcohol? Did I make the hot water bottle too hot? Was it that bumpy bike ride? At first I was ashamed to speak these thoughts aloud. I was afraid that if I do so, someone might tell me that there is truth in them. But slowly, I started voicing some of these worries. I mentioned these thoughts with my midwife, who reassured me. I bring up these fears when talking to friends. Speaking these thoughts aloud helped take away their power. It’s not that I can speak up once and have these thoughts be gone. I have to chip away at them and regularly remind myself that I couldn’t have prevented this.
• Seeking out (professional) emotional support. I did not end up going to a psychiatrist because I did not feel like my thoughts were spiraling out of control. I felt that, for the most part, what I was thinking and feeling was within the bounds of a normal emotional reaction to grief, with all of its unexpected triggers. And to be honest, I felt pretty talked out at times. I spent so much time talking through my thoughts and feelings with my support network that I wasn’t sure I needed to talk about it more. Even though I did not actually see a therapist, I did get a referral from my doctor to have this option ready in case I, at any point, felt that I needed it. This alone helped me because I knew I had this resource at my fingertips if I ever needed it. I made sure that there was no barrier between me and professional help. What I did do is reach out to my midwife. I mentioned a lot of my concerns and she was also able to put some of them to rest. She told me that no hot water bottle could kill a baby. Her words and experience helped calm me.
• Creating the boundaries I needed. It seems like all of my friends and acquaintances are pregnant and due around the same time of my expected due date. I truly am happy for you but I am also sad for myself. Seeing your beautiful, healthy pregnancies is overwhelming for me and in some cases I have had to create some distance, both physically and online. I have had to mute some friends on social media, or delay seeing pregnant friends because I knew it would be overwhelming for me. I really do wish you all of the best but I also need to take care of myself right now.
• Thinking of it as more of a delay than a loss. Sometimes it helps me to reframe it as a delay rather than a full on loss. Maybe this is a coping strategy to avoid really fully dealing with it but sometimes that’s okay too. Whatever it is, thinking of this experience as a delay sometimes helps mediate the heaviness that comes with loss.
• Finding lessons and learnings, but only when I felt ready. It feels wrong to call them silver linings, but there are important learnings that are to be found in dark experiences like this. I was very grateful for my support system who made me feel caught when I was free falling (more on that here). You think having a miscarriage as an end and it is. But it’s also a beginning. It’s the beginning of a new way of being in the world. The experience has changed me, both mentally and physically and has pushed me to grow. The past few months I have practiced advocating for myself. I have set boundaries to take care of myself. I have shared my miscarriage story, even when it felt uncomfortable. I have really grown in the way I see the world and how I can empathize with other people’s pain. I have connected with so many friends and strangers who have also had to go through this experience. I think there are learnings and moments of light in difficult times, but only when you are ready to look for them and take them in.
• Sharing my experience to change how we think and talk about pregnancy loss. Aside from all of the painful emotions that come with pregnancy loss, I also felt a lot of anger. I felt (and still feel) anger about how our society treats miscarriage as taboo — as if it’s something we’re not supposed to talk about. No wonder women feel shame and guilt around it. Everything in our culture surrounding early pregnancy sets women up to grieve alone. The whole conversation around early pregnancy and miscarriage is infuriating. But this anger can also be fuel. For me, it’s been important to share and to talk about my experience, with the knowledge that each one of us who does so helps another woman or partner or friend and slowly changes the culture around early pregnancy and pregnancy loss to be more open and supportive.

There is a balance between letting the feelings come up as they do and feeling hopeful looking forward. Sadness and hope are not feelings that come one after the other; they are feelings that can exist in parallel. Give yourself permission to feel both on your own terms. Explore some of the activities and approaches that worked for me, but also take the time to discover what else may work for you. Learn from and lean on other women and find ways to be there for others when the time comes. This experience is impossibly difficult but it is also a big push to grow. You likely will never get over it but you will get through it.

For ideas on how to support friends and family going through miscarriage, read my reflections here. www.carriedtogether.com