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Serena: Hey Everyone, I’m Serena.
Tina: And I’m Tina and we are the Mental Health Mamas.
Serena: Welcome to No Need to Explain, we are so glad you’re here.
Tina: First, as always, a quick disclaimer.
Serena: We come to you NOT as mental health professionals or experts in the field, but rather as the parents of kids who struggle with their emotional health.
Tina: If you or someone you love is experiencing a mental health crisis, please seek professional support. You’ll find a variety of resources in our show notes and on our website, NoNeedToExplainPodcast.com.
Serena: Today we are going to be talking about pregnancy loss and I’ve asked Tina to sort of interview me about this topic because I so happen to be an Expert by Experience. We ask that you please take extra good care of yourself as you listen.
Tina: So Serena, let’s start with why you wanted to bring this topic to the podcast.
Serena: One of the goals of our podcast from the beginning has been pushing back on stigma of all kinds. Over the course of our lifetimes I can think of quite a few topics that have become less stigmatized and more likely to be talked about. So Tina, can you think of any examples of this?
Tina: Yeah for sure. In my life certainly cancer is something that comes to mind first. And for certain the conversation, thinking back to my childhood, and about the LGBTQ+ community, and also around sexual assault around the Me Too movement.
Serena: Yeah, right. There are a lot of things that have become more easily talked about and yet, the topic of pregnancy loss is still so deeply stigmatized that women often wait until their second trimester to tell others that they’re pregnant “just in case”. And this is a topic that very few people are comfortable talking about and what we know is one of the best ways to destigmatize something is just to talk about it. October is Pregnancy and Infant Loss Awareness Month, so this felt like the right time to share some of my story. And what I know statistically is that many of you out there listening have also experienced pregnancy loss.
Tina: So let’s talk about those statistics for a moment. How common is miscarriage?
Serena: It’s very common. And yet, again, because of the stigma attached many people feel very alone if they lose a pregnancy. The actual statistics are a little tricky to figure out because many losses happen before a woman knows that she is pregnant. According to the March of Dimes, for women who know they’re pregnant about 10-15 percent of pregnancies end in miscarriage, so that’s about 10 to 15 pregnancies out of every 100. And overall, if we include the women who did not know that they were pregnant, the estimates are around half of all pregnancies will end in miscarriage.
Tina: That’s a lot, a lot of people!
Serena: That’s a lot of people. And that’s why we need to talk about it. No one should have to feel alone in this.
Tina: So my brave friend, are you willing to share some of your story?
Serena: Yeah, I would like to do that. So, I will note that what I’m about to share was so influenced by the stigma surrounding pregnancy loss that there are very few people who actually know my whole story.
I will start by saying that my first pregnancy resulted in my oldest daughter. I was very young and while I suffered from hyperemesis gravidarum for my entire pregnancy (which I will spare you the details but you can look it up if you are interested).
Tina: You and Kate Middleton!
Serena: Exactly! Yes I suppose lots of people know now, right. I didn’t really think a lot about miscarriage, um, it was not really on my mind because I was so sick that I could hardly think of anything else.
So because of the difficulty of that pregnancy, it took me a long time to even consider having another baby. I got pregnant again in the fall of 2006 and have to be honest that something felt off from the beginning but that didn’t stop me from imagining a second baby the moment I saw a positive pregnancy test. I’ve always been an all or nothing kind of person and I was so excited to be having another baby. There was no way I could not envision that new little life ahead and all it might bring with it. I remember my husband was out of town and I started experiencing some bleeding a few weeks in. I ended up taking my daughter with me, who was 4 at the time, to the emergency room where a doctor proceeded to tell me that I was totally fine and that I’d be back in a year to see him with a baby with an ear infection. And I just remember thinking, how does he know? How can he promise me that? And yeah, he was wrong. So, I lost that baby. And we hadn’t told anyone about the pregnancy because that is the advice they give you, right? Don’t tell anyone until the second trimester. But in many ways that made the experience, the loss harder because I felt like I had to suffer in silence. And we say that neither me or my husband handled the loss well and it actually hurt our relationship in many ways and we were both suffering in silence and nowhere to put the pain.
Tina: But then you did have another.
Serena: I did. I had my second daughter in 2008. And it was scary, it was terrifying to let go and trust and try again but we did, we made it through.
So, A few years later we decided we wanted another baby and really had no reason to think it would be a problem. We had two babies and one loss, so the odds seemed on our side. I got pregnant again in early 2013 and I lost that pregnancy in March. And then it was all a blur because I got pregnant again a few months later and had another miscarriage in June.
Tina: Serena…That’s a lot.
Serena: It is, yeah. And now the odds weren’t in our favor anymore, right and even though it felt even more important to have another baby. There was clearly no way we could replace all of our losses yet it felt like, I couldn’t help but feel like there was another child out there for us. So, I got pregnant again in January of 2014, this time with twins. And this may sound strange, but it felt sort of like it was a reward for our suffering. And um, with these two babies, it felt like I could be happy and that our family would be complete. And I was terrified. I was a lot older than when I had my first baby which put my pregnancy at higher risk along with like all of the risks associated with twins. But, I felt strong and excited to figure out how to care for and frankly find space for two babies in our small home. I had a really amazing ultrasound. We were able to see both babies clearly and each had a very strong heartbeat. I was exhausted and sick, which is totally normal for me during pregnancy so those were all good things. And because I was pregnant with twins they were monitoring me a bit more closely and doing extra ultrasounds. I had started my second trimester and I was thrilled that we would soon have two more babies. The next ultrasound I had revealed not two babies, but one. And, um yeah, we were devastated. I felt cheated. You know, there were two strong heartbeats before and none of it made sense. And the response from the doctor was, hopefully the other baby will be ok. We just have to wait and see. And I thought, wait and see?? I was frozen with anxiety and caught between two worlds. I knew that I needed to grieve for the baby I had lost yet I needed so desperately for the baby I was still carrying to be ok so I needed to not, kind of, go there. And I wanted answers that no one could give me, you know. Why did it happen? What can we do? How do I protect the baby inside me? But all I got was wait and see.
Tina: mmmmm, wow….that is a lot. That is a lot. And that is not, I know you my friend and I know that wait and see is not your style, right?
Serena: It is my least favorite thing.
Tina: And I would say, uh, you know that kind of stress and anxiety on anyone, from what we to be true on a fetus is not healthy and on the mama it is not healthy, right.
Serena: Yeah, so I spent the rest of my pregnancy feeling paralyzed and I didn’t know how I would survive if I lost the other baby. I was barely functioning. I somehow managed to go to work each day but that was about it. And I can’t imagine that I was a very good mother to my two kids during that time. I was so numb to everything and as we know, when we are protecting ourselves and feeling numb from the bad feelings, we also numb the good feelings too so it was not a good time in my life. And we made it through eventually and I gave birth to my third daughter in October of 2014. And in one of those strange moments, we brought her home on the day of pregnancy loss awareness and there was a beautiful rainbow over our house. I am not making that up.
Tina: You don’t make things up so I totally believe you. Yeah absolutely, so wow…that is….I have goosebumps for sure. And knowing your Amazing Grace, not surprising for sure. Yeah. So we know from experience that when someone is struggling, the people around them who are trying to offer support in very kind ways actually say things that are quite hurtful. Can you share some of those things that you know of that other people have said to you or others so that people listening can understand what might not be helpful to say?
Serena: Yeah, so I will start by saying that everyone’s experience is unique and we know that losses are experienced differently by every single person. I personally struggled a lot with my losses. Some people are less affected and some may even feel a sense of relief depending on their personal circumstances. So I would say first and foremost, never assume you know what the person is feeling; you can always ask, right, check in with them and stay away from anything that is like a platitude and a cliche. And this is something we talked about in one of our previous episodes from last April about showing up for your people; sometimes people say things that seem like a good idea but don’t feel very good to the people hearing them so, some of the things that I’ve heard include any kind of statement about everything happening for a reason. People have said, you know, “At least you know you can get pregnant and you can try again”, This one may be the worst one, maybe there was something wrong with the baby and you didn’t want that baby, which is not true and it is not a big deal, which it is for some people. So I would say basically anything that minimizes or invalidates the person’s individual experience. And I am just going to say that no matter how or what you’re feeling after a loss, it’s totally valid.
And then there’s this other category of comments that I do want to mention as well. And these, again, are said in perhaps curiosity and are not meant to be mean but sometimes can be triggering and these fall into the “Everyone has a story you know nothing about” category. And so any kind of personal question about your kids or you like: Are you planning on having more kids? Wow, your kids are really far apart in age! That’s one I get a lot and that can be triggering or you have all girls...do you want a boy? Yeah so just don't say those things please.
Tina: And you happen to specialize in girls which is what I say about you all… so….yeah so tell us Serena, what does help? Are there things that helped you get through?
Serena: So at the time, particularly at the time of my very first loss all those years ago, I had a much smaller circle of support, but I would say that connections and support from others is huge. If you know someone that has had a miscarriage, check in on them and just a simple, “I’m so sorry” and asking for what they need. You know, just showing them that you’re willing to talk about this hard thing that is hard to talk about, but even harder for the person who is dealing with the loss, it helps. You can help them hold the pain of the loss. It’s huge. And it will be different for everybody again, You have to ask people what they need.
Tina: So Brene Brown has an excellent animated video online about empathy vs sympathy and I would say that the piece that I will mention here is when you don’t know what to say, sometimes what is important is to say nothing or maybe even to say, gosh, I don’t even know what to say right now but I am right here with ya.
Serena; Yeah, yeah. So I want to talk now to anybody experiencing the loss or who has experienced a loss and say how very important it is to be kind to yourself. I felt so much shame and a feeling that my body had betrayed me, and the idea that I couldn’t do the thing that women do all the time, all around the world. So being kind to yourself about that. Treating yourself gently, if you are able to take time off from work. And you know, keep in mind the piece about the sort of physiological piece and I had someone who was kind enough to say this to me when I had my first loss it comes with a drop in hormone levels you know a hormonal kind of crash you have after having a baby so you are not only grieving a loss but also dealing with that as well so being kind to yourself about that. And there is no timeline, right, for “getting over” a miscarriage or for how you deal with the loss. I would say that it can be helpful to memorialize the loss in some way, something that’s meaningful to you and your family. And I am not even going to give suggestions because this is such a personal kind of thing,but it can be helpful to think of a way to remember.
On another note, I also want to mention the fathers as well. Men are also affected by pregnancy loss but they are even less likely to talk about it. So if you happen to know somebody who has experienced, check in on the father too. We know that men need support as well.
Tina: Absolutely, Absolutely. So let’s break down some of the misconceptions. There’s a 2018 article on NPR entitled, People Have Misconceptions About Miscarriage, And That Can Hurt. It discusses some of these misconceptions. One of them that stand out to me is the idea that we are in control of this situation. Or that we did something wrong. We parents often go to that place right? What did we do to cause….fill in the blank and in this case the blank is miscarriage. What did we do to cause that?
Serena: Right. So they actually surveyed 1084 adults to ask them what they believe the causes of miscarriage were. The article states that Chromosomal abnormalities in the fetus cause 60 percent of miscarriages. A handful of other medical conditions that are also known to cause miscarriage. But, the survey respondents had some interesting ideas. They believed that there were a lot of different factors that could trigger a miscarriage such as a stressful event (76 percent thought that); 64 percent thought lifting something heavy could cause it; previous use of contraception like an IUD (28 percent) or birth control pills (22 percent); and 21 percent even believed that having an argument could cause a miscarriage.
They also included several quotes from people who had experienced miscarriage theselves. One woman stated, "I wish people understood that miscarriages are the flip side of the coin," "If you've had a healthy pregnancy that went full term — you won a lottery. Short of obvious substance abuse and bull riding,” which makes me laugh—”your healthy baby is not the result of anything you did or didn't do. As much as you want to think you are in control — you aren't. And the same goes when I lost each pregnancy — as much as I wish I could have been — it was not in my control."
Tina: So the survey Serena’s talking about that is in this article came about after Dr. Zev Williams realized that many of his patients had misconceptions about miscarriage. He says in the article, "I'd tell them how common a miscarriage was, and they seemed shocked," he is an OB-GYN who directs the Program for Early and Recurrent Pregnancy Loss at Einstein College of Medicine of Yeshiva University and Montefiore Medical Center in New York. Miscarriage is actually, and I quote, "by far the most common complication of pregnancy." So Serena, can you reflect on that a bit?
Serena: Yeah, I think this quote really backs up everything we’ve been talking about and aligns with my own personal experience as well. I was shocked too to learn that they were so common. So again, I really want to reiterate to everyone out there listening that if you have experienced pregnancy loss you are not alone. Please, please talk about it so that we can all talk about it more and we can move closer to normalizing this conversation. If you , you know, if you are so compelled, you can certainly email your stories and we will hold those confidentially and help you hold some of the hard stuff.
Tina: Yup it is really hard and that is what we do best. We help you hold the hard stuff. So, we Mental Health Mamas, when we are around you are never, ever alone! I want to thank Serena again, my brave friend for sharing this. I admire your ability to continue to pay it forward by sharing and you know making some of those painful losses, you know making some purpose out of that. So thank you.
And so podcast friends, we are, as always, grateful for all of you listening and supporting us. You can help us out by visiting Apple podcasts, leave us a review, subscribe and please share with others. You will find more content on our website, NoNeedtoExplainPodcast.com. And, as Serena said, we would love to hear you and we assure you anything we help you hold, some of that hard stuff, we will never share with others.
Serena: And this is your gentle reminder to take good care of yourself while you are also taking care of your people.
Tina: Thanks for listening!