I have a long history of processing things in life by figuring out what lessons come from painful experiences. Fell in love with a high school friend who is dating someone else; what lesson can I learn from this? Took 26 credit hours and when making a study schedule couldn't schedule sleep until Thursday; what lesson can I learn from this? The friends with benefits situation suddenly and dramatically fall through; what lesson can I learn from this? Find out there is "Not a place for you," at your place of work which is actively trying to hire people; what lesson can I learn from this?
So as I'm going through this new journey of miscarriage I'm looking for the lessons. Here are some that I've found, but I'm sure there will be more.
This is a different kind of grief. - I've had a lot of loss in my life. I lost Papa Shegog, my paternal grandfather, when I was 4. I lost Grandma Shegog when I was 6. I remember being sent out to the car to get something and screaming at the sky when my grandmother died. Since then I've lost family friends, Uncles, Aunts, Cousins, and most recently powerful my Aunt Rose and my Father. I've grieved a lot, and been trained to help people through it. I know that this is a process. There is no drug that can make it go faster and no short cut around it. One has to just go through grief. It never really goes away.
But this grief is different in many ways. It is physical in a way that no other grief is. There are so many hormonal changes that my body is going through in addition to the literal loss through bleeding and passing tissue. The physical pain in someways mirrors the emotional pain. I literally lost something that was apart of me.
The grief of miscarriage is also different in the fact that it is lost potential. In other losses I have been able to celebrate the lives that my friends and family lived. Take solace in the lessons my loved ones have taught me. This loss is the loss of what could have been. It is also feels like the loss of time, money, effort and energy put into getting to that point (see TTC ). There is literally nothing good that I can see in this loss other than that I found out at 9 weeks and not later.
Because I didn't find out until after the pregnancy was over I still can't quite process the fact that this was a loss of twins. But it does make the loss literally and emotionally greater.
Grief or Depression or Anxiety is not a fun new game. -- Since I already have anxiety and history of depression, when I let myself think about my emotions, there is a constant wondering which element is contributing most to how I feel right now. I've always treated my anxiety by figuring out the worse possible situation and trying to prepare myself for it. My depression I've treated with counseling and medication. Grief has always amplified these, but, as I mentioned in the beginning, this is a different kind of grief. There is some time in each day that I try to figure out if I'm back into a major depressive episode or just grieving. This does not help my baseline anxiety, but it does make me feel like I have a little control.
You can never hear "It's not your fault" too much. - As far as I have read about other's experiences formally in blogs and informally in online support groups, all people who are pregnant wonder if there is something we did to cause it. I was working a hospital shift when it happened, was it because I was working too hard? I had caffeine two days this week, was it that? I started spotting after orgasm once, did that cause it? Am I just too darn old?
For the first two weeks one of my fellow family medicine docs, who had a similar experience, texted me "It's not your fault," about every other day. Every time she text it I needed to hear it. It is easy for me to fall into feeling like I need to punish myself; the constant reminders that it is not my fault help.
There are triggers everywhere. - I was looking forward to going the farmers market. We haven't gotten a chance to go since we moved here. It was almost 3 weeks since I found out and two weeks since my last cytotec. I've been seeing patients; therefore, I can go out in a social situation. What I was not prepared for was all the people walking around with their babies: in arms, in strollers, in carriers. Each one dripping a little bit of salt water into my wound. You never realize how many pregnant people there are in the world until you are suddenly and unexpectedly not. You can be watching your previous favorite TV show then, BAM, one of the main characters is pregnant, delivering and making your wound bleed a little brighter.
It's pretty easy to start to feel resentful of anyone who has not gone through this. Even more frustrating are those mothers who are "accidentally pregnant," on their 4-6+ child, or on any kind of substance from tobacco to meth and heroin. I want to yell at them - DO YOU KNOW HOW HARD I WORKED FOR THIS TO HAVE IT END LIKE THIS?!?!
I really want anyone lucky enough to have their G's (pregnancies) and P's (live deliveries) match to know how lucky they are. I pretty much only want to surround myself with other people who have experienced a pregnancy loss, because they are the only ones that get it. It's an exclusive club that no one wants to be in. Annoyingly this is not completely possible.
Bleeding like grief can pop up at the most random of moments. - I chose to use Cytotec/Misoprostol, a medication to help cause uterine contractions and opening of the cervix, instead of an procedure to help complete my miscarriage. There was cramping and bleeding for about 8 days and then just spotting for 2 weeks. Then out of the blue more cramping, bleeding and clots again pretty heavily for about 45 minutes. I was worried until my husband, after lots of searching, found that this can be common.
-- Why isn't miscarriage more studied? This data was surprisingly really hard to find. There are some, but they often stop after 2 weeks. (example 1 and 2) This may be another example of women being ignored in health care research. But, I digress. --
Because of the physicality and pretty much ignoring how I actually felt all week. It brought all the feelings from the background to directly in front of my face.
Ignoring your feelings can help temporarily but only temporarily. -- See above lessons.
What not to say when people have a miscarriage. -- Here is a list of things that have been said to me that are not useful
- "Everything happens for a reason" - Technically yes, it was probably a genetic abnormality. But this is not helpful in anyway.
- "I know what you are going through, I had a abortion/spotting in my successful pregnancy/lost a family member/pet." - Unless you have had a miscarriage of a wanted pregnancy, You Don't.
- "At least you know you can get pregnant." - Again, Technically true. But that excitement sailed around week 6. Two-thirds toward the end of first trimester it's just painful: so close to the end of the first trimester when miscarriage is less likely, almost done with the fatigue and nausea, and the point when I already had to start buying new clothing to accommodate my physical changes (34 G Bras are impossible to find).
- "I'm sorry for your loss." - This might be specific to me, because I have gone thorough so much loss, but I hate this phrase. I'd rather people say "I'm so sorry," rather than qualify it. It seems more empty and trite. For me it is similar to when people say "I'm sorry if you were offended," instead of "Sorry for offending you."
There are some more things not to say in this article.
Here are some useful things people have said to me.
- "It's not your fault."
- "I can't imagine what you are going through."
- "I also had a loss, here's what happened to me..."
- "Sending Hugs/Love/Warm Fuzzies."
- "Can I give you a hug?"
- "I'm here for you for whatever you need."
The best thing was how many people opened up about their own experience. We don't talk about pregnancy loss enough, but finding a community of my friends and family who understand is a refuge.
Music still helps. -- I often have a soundtrack of my life and what things are happening right now. Music has always helped me express emotions that are hard for me. When I realized I was in love with one of my friends in college, and my roommate was gone for the night, I would put on a playlist and cry under my blankets. This strategy can still be very cathartic. Here's my current play list
I'm In a Sexy French Depression - Crazy Ex Girlfriend Cast (I still have a bit of sense of humor, plus the end french monologue is pretty spot on)
Tears of a Clown - Smokey Robinson (this is work mostly)
It's constantly updating so I'm sure there will be more. --- Yes I know in theory I could do this with some Spotify type thing, but that takes way more effort than I'm willing to put into it right now. -- Watching movies and shows about people with a loss is also helpful. I've watched "Frida," and may watch "Pan's Labyrinth" next.
Trust your body, or try to. -- With PCOS (PolyCystic Ovarian Syndrome) I often feel like my body has betrayed me or that it just doesn't work. Although my body doesn't work like normal. It makes extra ovarian cysts for no reason. It is resistant to insulin and doesn't process sugar making it unreasonably hard to lose and maintain weight. It doesn't ovulate monthly without a lot of effort and medications on my part. In the early part of my pregnancy I was surprised to that my body was acting like normal: nausea, some breast tenderness, increased urination, and fatigue. There was so much fatigue I wasn't able to exercise as I usually did. With the miscarriage I feel like this is one more example of my body betraying me. However, with the cytotec it did what it was supposed to do. My beta HCG levels are dropping appropriately, and my basal temperature is back to normal. Working out again feels wonderful.
If I get lucky enough to be pregnant again I will try to be a little active in spite of the fatigue.
If you are able to be pregnant again, this miscarriage will color that pregnancy. -- Even with this loss we are still TTC (at least for the next 11 months or so). So the first cycle after a miscarriage tends to be more fertile. I was reading up on how miscarriage can affect your next pregnancy. But so many of the things I was already doing because I know everything that can go wrong. I was already checking for spotting obsessively, anxious about all the visits, and not super excited for a positive pregnancy test. All of this knowledge did not make the loss hurt less. I'm not sure if I'm going to want to get an ultrasound earlier or later than 6 weeks. I'm not sure if I want to just wait until 12 weeks before having my first prenatal appointment or want to be seen super early. I had already kept my pregnancy a secret with a select few; maybe I really won't tell anyone else until third trimester or tell everyone at 20 weeks. I'm not sure what changes this will have if I get pregnant again, but I know it will change my next pregnancy as it has changed my life.