Four Tools For Navigating Life After Pregnancy Loss
October is Pregnancy and Infant Loss Awareness Month and the October 15th is Pregnancy and Infant Loss Awareness Day. This month always takes me down memory lane. When I had my first miscarriage my first thoughts were, there must be a mistake, what did I do wrong? Why me? While intellectually as an OBGYN, who at that time was in fellowship to become a fertility doctor, I knew that it was not my fault. I couldn’t help feeling a strong sense of failure, inadequacy and shame. These emotions were very isolating and made it hard for me to reach out for the support I needed.
Navigating pregnancy loss and life afterwards is hard and unlike some may expect, the next pregnancy does not always come with a sense of relief. Yes, there is relief that you were able to conceive, but there is also an underlying fear that everything is about to go wrong again and the knowledge that there may be little to nothing that you can do about it. There are many tools to help with the grief of pregnancy loss for both you and your spouse. I am writing this blog to share some tools that have worked for me in the past and continue to work for me today. I say continue to work because grieving pregnancy loss is not a one and done process, it is a lifelong journey, a deep ache that is like a causeway; hidden in high tides when your cup is full, but exposed and bare when your cup is low.
1. Acknowledge Your Loss and Grief - Feel All The Feelings
In our society, there is a lot silence around pregnancy loss. There is a failure to acknowledge pregnancy loss as a true loss, and as a result, a failure to validate the need to mourn that loss. Pregnancy loss comes in so many forms, from the biochemical pregnancy before an ultrasound is even done, to the ectopic pregnancy, to the miscarriage before 20 weeks of pregnancy and the stillbirth after 20 weeks of pregnancy. Each of these leaves an indelible mark.
Too often, we are expected to return to work and the normal cadence of our lives, as if nothing happened. This forced return to “normalcy” reinforces a sense of shame, guilt, weakness or failure if you don’t feel normal right away following your loss. But in reality you and your grief are what’s normal, and it the forced return to normalcy that is the lie.
While we cannot always control when we return to work, we can allow ourselves grieve. It is important to create space and time in your day to sit in your grief and engage in activities that validate your pain and/or give your comfort. It is okay to cry, scream, pray, take time to be alone, eat the ice cream, do the yoga video, read the beach reads and binge watch k-dramas (yes that oddly specific k-drama reference is personal 😉).
Lean into your support system
Following both of my miscarriages, the overwhelming sense of shame and failure made me want to keep my experience to just me and my husband. Especially with the second, I didn’t want people to know that I had once again failed to hold on to my pregnancy. It made me feel like a failure as a woman, a doctor and especially as a reproductive endocrinologist. However, I remember when I chose to tell my family, I was met with support.
The nature of this support is that no one is you and so even though they love you, they will sometimes stumble in their attempt to comfort or encourage you, but when their overall intent is love, allowing them in and forgiving the stumbles will allow them to show up for you in ways that you may not even know you need them to.
Remember It Is NOT Your Fault
Even though as an OBGYN and fertility doctor I knew that I did not cause my miscarriages, I couldn’t help combing through my actions leading up to the miscarriage to try to identify how I had brought this upon myself, how I had failed my pregnancy and my body. So I had to become very intentional about reminding myself, that my miscarriages were not my fault. Up to 1 in 4 pregnancies end in a miscarriage and the vast majority of losses are due to sporadic abnormalities in the amount of DNA in the pregnancy’s cells (i.e chromosomal abnormalities). The remainder are vastly due to factors outside of your control. So, as many times as you need, remind yourself that it is not your fault.
Seek Professional Help
While the steps above were very helpful, speaking with a therapist was a pivotal part of my journey. I was lucky enough to find someone with expertise in women’s health and pregnancy loss. I acknowledge that not everyone may need to speak with a therapist, but I recommend having at least one consultation. Therapy provided a deep validation of my experience and dislodged my deep rooted sense of guilt. It also equipped me with a tool-kit of skills to navigate the waves of grief when they came and the complex emotions of joy and apprehension that came with my subsequent pregnancies. It was at times painful or tearful, but always empowering.
Like I wrote at the beginning, grieving pregnancy loss is not one and done, but the tools above will help decrease the duration and intensity of the pain over time. If you have experienced 2 or more pregnancy losses, I recommend seeing a reproductive endocrinologist and/or a perinatologist (high risk OBGYN) for a complete evaluation. Keep in mind, that although the evaluation for recurrent pregnancy loss is negative in 50 of women, most will go on to deliver healthy babies. As always, sending you love.