Holly Cave wants to know why her pregnancy ended at nine weeks. There are no easy answers, but talking about miscarriage could help us change the way we think about it
“Don’t worry, pregnancy isn’t an illness,” said my midwife, smiling affectionately as I worried about my lack of morning sickness.
She must have been well acquainted with the limbo of early pregnancy, the constant fluttering between hope and fear.Two days later, doubled over on the toilet and clutching a hot water bottle as I watched dark clots of blood drip into the pan, it felt very much like an illness. I knew something was desperately wrong.
The largest lump of tissue – what I believe to be the yolk sac – was smaller than it felt in my heart. I searched for the embryo inside it until my clothes were stained with blood. I couldn’t flush the toilet for an hour because I was sure that my baby was in there. Rationality had ceased to register through the distress.
The list of things I don’t understand about my miscarriage seems never-ending. I don’t know how old the embryo was when it stopped living. I don’t know why it stopped living. I will never know.
“Why?” I asked myself. Again and again and again, as if it was a mantra that would take me back in time and stop it happening. Why? If someone could answer that, then at least I’d be able to grapple with another looming question: Will it happen to me again?
Good journalism matters – because the world isn’t all bad.
“Miscarriages are so common – one in five pregnancies end up in a miscarriage,” says Arri Coomarasamy, a professor of gynaecology at the University of Birmingham. Empathy is soothingly evident in his voice as I come to the end of my story.
The one in five figure is often quoted. Sometimes it creeps up to one in four. This is because it’s difficult to determine how many miscarriages take place. In the UK, miscarriage means the loss of a pregnancy during the first 23 weeks (any later and it is called stillbirth). But it often occurs before a woman even realises she’s pregnant, and most of the time – 85 per cent – it is in the first 12 weeks of pregnancy.
That has given us clear social guidelines. The ’12-week rule’ warns against telling anyone you’re pregnant until the end of the third month. It anticipates the risk of loss, even sets us up to tentatively expect miscarriage during the early stages of pregnancy, but this silence doesn’t make it any easier if it does happen.
A survey of more than 6,000 women who had had a miscarriage, conducted by the charity Tommy’s, found that around two-thirds found it hard to talk about. The same number felt that they couldn’t discuss their miscarriage with their best friend. A third didn’t feel that they could even talk to the father about it.
Finding support remains a challenge for women experiencing miscarriage. Sharing was important for me – although saddening, I took comfort from the fact that friends of mine had also been through it. Like them, I would get through it. But we never talked about the experience itself, the physical process and the effects of miscarriage. Saying “I had one, too” seemed to be as far as it went.
So here goes. I was nine weeks pregnant when I started bleeding in the middle of a late night shift at work. The sight of that fresh, bright red blood was a sudden, vicious smack in the face. I pressed my hand over my mouth until I could feel the outline of each tooth, as if to prevent anything else leaving my body. I bled; I cramped; I googled. The lady who answered the phone at the community midwife centre directed me to A&E. Later, my GP assured me that I was right not to go. “I can’t think of a worse place to have a miscarriage,” he said, his head in his hands.
The pain was bearable and the bleeding stopped after a week or so. My miscarriage was natural and complete, meaning that when I had a scan at the end of it, there was barely any evidence that I’d been pregnant at all. Nothing was left. Unlike many women, I didn’t need medical management to complete the process. The staff who dealt with me were polite, straightforward and quietly sympathetic.
Other women are not so lucky.
Lizzie Lowrie has had six miscarriages, all in the first trimester. The care she has received has been patchy. She’s met people who’ve been “amazing”, but she’s also had to beg and cry down the phone to be admitted to hospital, and has turned up only to be congratulated on her pregnancy.
When she tells me about her most recent miscarriage, at ten weeks, I am shocked. She opted for a medically managed miscarriage, in which you take tablets that open the cervix to let the remaining tissue leave the body. “It was horrendous,” she says. “It was so painful. And I was in this ward with other people doing the same thing. It was terrible.”
Around one per cent of couples are affected by recurrent miscarriage, which in the UK is defined as the loss of three or more consecutive pregnancies.
Emma Benjamin has had several miscarriages, too, but still remembers the terror of the first. “They just sent me home and they didn’t tell me anything,” she says. “I came home bleeding – having the most awful period pains, I suppose – and not really knowing what to do or what was going to happen or how long I was going to bleed for. I knew nothing, literally nothing. I wasn’t given a leaflet or anything. So it was horrible, it was really awful, because I suppose I didn’t really know what was going on.”
It’s another side of the silence that surrounds miscarriage. But Benjamin and Lowrie both talk clearly and calmly about their experiences, and have become more open with each successive miscarriage. Lowrie tells me that for her husband and her the 12-week rule has “gone out the window”.
“At first, very few people knew that I was pregnant,” she says, “but then as the miscarriages went on we just made sure there were certain people close to us that knew; they tried to keep me sane when I was going through the pregnancy. It’s just so hard breaking those two bits of news: I was pregnant and I’m not now. It’s really hard to bring it into conversation.
“It is still quite a silent thing,” she adds, “and I think part of it is that no one knows what to say.”
Coomarasamy agrees that lack of support is a serious problem and that women who have an early miscarriage, and their partners, may need just as much help as those who have lost an older baby to stillbirth. “Whether it was this size baby or that size baby is irrelevant, and the psychological impact is not much different,” he explains. “So I think there is a real need to understand how couples experience miscarriages. There’s a real need to identify better ways of supporting the couples.”
Lowrie and her husband now run a blog about childlessness called Saltwater and Honey. Of course, no one should ever feel they have to share their experiences – I have friends who wanted to keep their miscarriage private. But it does seem that it’s becoming increasingly acceptable to speak out about miscarriage.
Breaking the silence is crucial. Research has shown that one-third of women attending specialist clinics as a result of their miscarriage are clinically depressed. As well as depression and grief, it’s been reported…
The post Making sense of a miscarriage appeared first on FeedBox.