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Miscarriage – for the 1 in 3 women who have been here, and for the 2 others who will know someone who has, even if they never told you.

I have tried to sit down and write this article so many times. As a woman who has had one, and as a practitioner who supports so many other women who have, I still couldn’t figure out the right words to make sure I did this topic justice. So, I may adapt and change this article as time goes on, but for now, here is my overview of miscarriage, and hopefully some words that may help someone who has been or is going through this.

If you have never experienced a miscarriage or struggles of infertility, then please take some time to read how you can support those around you who have. It is hard to understand the gravity of emotion or pain that occurs when someone loses a pregnancy. And that’s okay by the way, however there are some things to avoid saying that will help your friend if you’re the one they share their devastation with.

Despite the walls that women try and build up, especially before that 12-week mark, the immense grief that hits them no matter how early or far through, is hard to imagine.

If it took a long time, medication, repeated negative tests, late periods that did eventually come or huge financial, physical and emotional sacrifices before this moment of joy then there will be a whole other level of grief. Add to that the fear it will take all of that to do it again.

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I have focused this article and the information on first trimester miscarriages, as although the term stillborn isn’t used until 20 weeks medically, I think it’s important that beyond the first trimester, we make space for the enormity of that and I simply don’t think I’ll do that justice by including it here. If you have a friend who lost a child after that 12-week mark, then the section on how to support them will still be useful.

If you kept your loss silent, and felt completely and utterly alone, I hope you know that while your loss can never be minimised, there are so many other women who stand with you. We know that the next pregnancy is often robbed of the joy you had with the first, and instead you’re scared. We know that baby showers, birth announcements, seeing prams in shopping malls, and being reminded of baby sales can be re-triggering and traumatic. Please make sure you take time and space for yourself here.

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The science stuff.

What is a miscarriage?

A miscarriage or spontaneous abortion is where a positive pregnancy test and confirmed pregnancy ends, usually before the 12 week mark, more commonly, before 9 weeks.

What causes miscarriages?

The sad reality is that for most cases, we simply cannot know what has caused your miscarriage. The complicated dance of cells and hormones required to create a viable pregnancy are nothing short of a miracle, and often, the cells simply do not divide in a way that would end in a viable baby. A miscarriage can be the result of your body knowing this and evacuating early. There are genetic risk factors that can cause this in some cases, and hormone levels, nutrient levels and embryo health can all play a role, so can sperm health and male factors but know that YOU did NOT cause your miscarriage.

How do you lower your risk of a miscarriage?

While we simply do not have control over so many risk factors, there are a few steps we can take to lower our overall risk. Ensuring you take some time for preconception health is one way to be certain you’re doing everything you can. Ensuring you take the right supplement for you, (usually this means avoiding folic acid and using activated folate instead alongside a good prenatal), working on stress, ensuring a healthy endometrium lining, boosting nutrient levels focused on sperm health and egg health, and limiting environmental hormone disruptors. There is emerging evidence that men’s health plays a hugely important and far greater role in miscarriage than we once thought so looking at the health of your partner or donor is a part of the puzzle.

How do you recover from one and when to start trying again?

From a health perspective, I want my clients waiting until they’ve had 3 healthy menstrual periods before they start trying again. Not only does this give the next egg a full 3 months to develop, it offers time to rebuild blood and iron stores, allows hormones to resettle and balance and hopefully gives you some time to grieve, move through it, and be mentally ready to start again. The joy of an early pregnancy test is likely going to be robbed and replaced with nerves and fear next time so it’s important you don’t rush the decision and do what feels right for you and your partner. 3 months might not be long enough for you, and it’s important to listen to your body.

What do medical professionals not mention?

They don’t mention how rough it can be for so long and that your experience isn’t necessarily going to be textbook. They fail to mention that your first period can not only come with emotion, but physical pain that can be worse than the miscarriage itself for some women. They don’t mention the shame for some, the judgement from others at times, and the disconnect you may feel from your partner. It’s not always like this for everyone, there are times when it’s easier, understood and you feel listened to and supported but if this wasn’t you then know you were not the anomaly, sadly you were the norm.

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What not to say to a woman or couple who have lost their pregnancy.

We know it’s not always easy to say the right thing, so a little guidance can help. If you’re stuck on what to do or say when a someone shares their story with you, sometimes they’re just after someone to listen. If you find out as it’s happening then food drop offs can be a practical way of supporting their family, picking up their other children and running them to school or daycare, dropping off a coffee, or leaving hand picked flowers on the door step can just let them know you’re thinking of them. Loneliness is the feedback I get from so many women – they just felt so alone, so with this knowledge, hopefully you can help reduce those feelings a little and that’s the best anyone can do.

“At least you know you can get pregnant”

Statistically we know that 85% of healthy women who have a miscarriage with their first pregnancy go onto to have a successful second. That still leaves 15% who will not. 15 women out of 100 is still a lot of women. This fact aside, the joy of an early pregnancy next time is now completely robbed. There will be very little joy, and instead fear and nerves. The idea of getting pregnant again is not going to help move through the loss or the pain despite your best attempt at a silver lining for your friend or family member.

“It must have been for a reason or was meant to be”

Science knows that if there are cell abnormalities in a fetus that early miscarriage is likely, but losing something that may not have survived, is still loss, and saying this only attempts to lessen the validation that a woman or couple needs when they are grieving.

“At least it was early or wasn’t a real baby”

Validating any pregnancy loss is so important. It doesn’t matter when a pregnancy is lost, if it were natural, induced, passed freely or had to be given birth to, there was still pain, grief, and likely loneliness. Instead you could say, loss at any stage is awful. I’m here for you if you need to talk.

“Did you not notice or feel different”

Many women will notice when something isn’t right, but they hold onto every molecule of hope that can and when a scan shows there is no heartbeat or an empty sack, they’re still devastated. Some women don’t feel anything and that is equally as hard with some thinking they failed as a woman. No matter if they feel different or not, it’s not up to you to try question why they didn’t pick up on something that is complicated and often unknown.

Places to go for support

Miscarriage Support NZ – https://www.miscarriagesupport.org.nz/

Sands NZ – http://www.sands.org.nz/

Kiwi Families – https://www.kiwifamilies.co.nz/articles/miscarriage-support/