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3/10/16

Sometimes there aren't words to speak, so here I am... writing. It has nothing to do with my specialty, but maybe it will still help someone.

I snapped photos of the vulnerable tears so many of us have shed, to document this hurt; to later reflect, in gratitude, when the light has healed these new cracks. 

I realized, deciding to have a child means a conscious decision to accept the possibility of loss; of utter heartbreak. You're creating something uniquely precious that could be gone in a second.  

Your heart is forever external. And today mine hurts a little extra. 

Waking up to a reminder for my 13 week midwife appointment when I miscarried 2 weeks ago... still bleeding, skin flaring, hormones resetting. 

Raw. Shitty. It happens. I know. Statistics. Blah blah. 

Normal? I guess. Painful? Hell yes. 

#IWokeUpLikeThis photos for the first time in my life... because it will be ok, but it's not ok yet. And that’s ok. 

P.S. After miscarrying again (4 times total), my healthy son was born in April 2017.

You may feel eager to conceive again, or you may feel like you’ll never be ready. I urge you to allow space for whatever healing needs to occur.

Your nutritional status has a big impact on how fast you heal and when your body is ready to conceive again (if you so choose). It’s certainly not the only factor, but it is an important one.

After passing a miscarriage naturally (expectant management) the general medical recommendation is to wait at least 1 cycle before conceiving again. However, there’s little agreement in research to back up this reasoning, except that it makes it easier to date the next pregnancy. There is also a general recommendation to wait 3 cycles to allow the uterus to fully heal at the implantation site; but again, little research.

A lot depends on how far along you were at the time of the miscarriage as well as how depleted your body is. Rebuilding is so important! Whenever you feel strong and ready to try again, have at it.

For more detailed information, download our eGuide:
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Womb Tea

1 cup red raspberry leaf
1 cup nettle leaf
¼ cup rose hips
¼ cup chamomile
⅛ cup spearmint leaf

Mix all herbs together in 1 quart glass jar with lid. To make, place ¼ cup to herb mix in a separate quart jar. Fill jar with boiling water and let steep 30 minutes to 1 hour. This mix is tasty hot or cold, especially with some fresh squeezed lemon. Drink 1-3 cups daily.

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It can be emotional and jarring to read “cold” medical information and jargon during this time, so please be kind to yourself. You do not have to read this part; especially right now. I’ve softened up my language somewhat, but it is still a medically heavy section.

Please remember the statistics/”facts”/information about miscarriage are sorely lacking, so this is what research knows right now. (i.e. take it with a grain of salt and listen to your body!)

Miscarriage: The spontaneous loss of a fetus before the period of viability.  

Incomplete miscarriage: Some of the products of conception have been passed but some remain in utero.  

Complete miscarriage: All the products of conception have been expelled

Inevitable miscarriage: The cervix has already dilated open, but the fetus has yet to be expelled

Missed miscarriage: Nonviable intrauterine pregnancy has been retained within the uterus without spontaneous abortion

Miscarriage is a common event in women of reproductive age and the incidence of clinically recognized miscarriage remains around 10-20%. Many miscarriages are not clinically recognized, for example, if it happened early or the woman did not know she was pregnant, so the real percentage is much higher. This is just the reported percentage- many many miscarriages happen early before the woman realizes, or are early and unreported.

The majority of miscarriages occur early, before 12 weeks of pregnancy.  Second trimester pregnancy loss contributes to less than 4% of pregnancy losses.

Traditionally, surgical curettage was the gold standard for the management of miscarriage because of the fear of uterine infection and bleeding. However, we now know the risk of infection or hemorrhage is low with spontaneous miscarriage, even if no treatment is given.

The introduction of medical and expectant management of miscarriage has increased options for women and clinicians alike for the management of this unfortunately common occurrence.

Surgery is the method of choice for excessive bleeding, if vital signs are unstable or the woman has either suspected infection or gestational trophoblastic disease.

Where suitable, patients choice (your choice!) should be taken into consideration for how to manage the miscarriage.

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The sensations could range from a crampy period to strong wavelike contractions. It will likely last a few hours of being more intense. It could be very painful. Just keep relaxing into it and breathe. I know this will be difficult and not what you want to do, but it it helpful. You can do it. Have someone there with you making sure you are ok. Keep an eye out that you are not bleeding excessively. ​

Miscarriage symptoms include:

• Vaginal bleeding- heavy bleeding or light spotting (often pinkish white), constant or irregular. Bleeding is often the first sign of miscarriage, however, bleeding in the first trimester can also be normal with a healthy pregnancy.  Note that bleeding with pain increases the likelihood that it's a miscarriage. 
• Pain- abdominal cramps, pelvic cramps, stomach pain, or a persistent, dull ache in your low back. Pain may start before or after bleeding.
• Passing blood clots or gray colored tissue
• Sudden loss of pregnancy symptoms; not feeling pregnant anymore

Determining a miscarriage from a healthy pregnancy can be tricky just based on symptoms. Many miscarriage signs and symptoms can be normal in a healthy pregnancy. Please contact your healthcare provider for help on the next steps. One woman's physical experience of a miscarriage can be very different from another woman's experience. If you need more detailed information about miscarriage, download our free eGuide.

Seek medical help at the first signs of miscarriage.

Miscarriage can feel like an unsutured wound, open ended, or even like a bad dream. This is in part because there are not any rituals around it. Saying goodbye is imperative to your healing; physically, mentally, and emotionally. I highly recommend beginning or continuing a mindfulness practice, but also choosing a way to create closure.

Personally I found lighting candles and thanking the little soul, as well as my body, brought healing even though it was the last thing I wanted to do in that moment. This doesn’t take away the super shitty feelings, but it cultivates healing, gratitude, and forgiveness.

Here are some ideas:

Light a candle and say a prayer
Write a letter to yourself, your future self, or the baby
Write a list of what you are feeling
Create a death certificate (ok, I know this may sound morbid, but it really helps some people, especially the partner)
Buy an ornament for your holiday tree as a little reminder
Anything else that feels right!

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When you need to go to the emergency room:
If you feel disoriented, lose consciousness, develop a fever, begin hemorrhaging, or if you feel you want medical attention.
    
Warning signs: feeling spacey, very sleepy, incoherent, unusually anxious, becoming pale, soaking a pad in 30 minutes, bleeding steadily for more than 2 hours without passing the tissue, or developing a fever.
​Seek immediate medical attention for any of these concerns.

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1-4 weeks is all within the realm of normal- as long as you are not having heavy bleeding, large clots or fever, possibly pointing to retained products of conception. Contact your health care provider if any of this applies. ​

1) Take care of yourself
2) Talk to your partner
3) Set expectations

Take care of yourself — First & foremost, you need to take care of yourself before diverting your attention to your partner. Going through the miscarriage process has many feelings you need to be prepared for.

Talk to your partner — Your partner is sad & confused about what to do. Realize that your partner has a different perspective; they’re sad about the miscarriage but also now worried about your wellbeing. When you are ready, take some time to talk with your partner about their emotions and how you two can best work together to recover.

Set expectations — This can apply to your partner, family, friends, & workplace. People do not know how to react in this situation. Setting expectations for those you share this event with will help them understand how to proceed. With your partner, it might be asking them to not constantly talk about the miscarriage. At work, it might be creating time and space to return to work when you are ready. With your family, it might be boundaries for communication or a respectful ask for time and space before reconnecting.

We each go through this process in a different way; letting the people in your life know how they can best help goes a long way. For people you do not want to share personal information with, feel empowered to respectfully tell them you are dealing with a personal issue. This is your path, do not worry about their perception of it.

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