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| Version | User | Scope of changes |
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| Oct 22 2006, 12:30 PM EDT (current) | annika | |
| Oct 22 2006, 12:29 PM EDT | annika |
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Not everyone is going to understand how you feel. To outsiders, it was "just a miscarriage." To you it was your baby, with all the hopes and dreams that come with babies. It does not matter whether you had a positive pregnancy test yesterday or if you were full-term -- this was YOUR CHILD. You were the mother (or father) and you deserve the time and freedom to grieve this loss.
Accept that there are many opinions. Let me tell you a bit about why. Doctors are trained to recognize that a woman needs emotional healing, but not really to help them or explain it to them, since it goes beyond their "bones and tissues" type of practice. Three months is considered the average amount of time a women will grieve hard over a loss, and will have a difficult time (and be a difficult patient) if she gets pregnant prior to that. While there are a few doctors who believe that your uterine lining must take three cycles to get back to rebuilding itself fully each time (especially after a D&C, where it gets scraped pretty thin), most doctors know that it doesn't really matter in about 80% of the cases, and getting pregnant again right away does not carry any increased physical risk or miscarriage risk. So even among doctors, some will say the standard "wait three cycles" and might even scare you into thinking you'll have another miscarriage if you don't wait, and others will say go ahead and try again now.
As for my opinion, I have talked to about 2,000 women who have had miscarriages. From what I've seen, you really should wait for one cycle to complete, because if you do not, you will experience one of two situations, both of which will cause you much unnecessary grief and pain:
On the other extreme, not getting pregnant that first cycle, or for the next few, when you are fervently trying, will actually push your grief further down the line, month by month, and it can really be detrimental to healing, your life, and your relationship. Often your life will completely revolve around trying again and you will feel even more a failure, more unable to cope. This may also happen if you wait, but is more likely to pull you into a clinical depression if you are not yet dealing with your loss and are still having some hormonal upheaval. Even if you feel like you are fine, the grief is really out there, and you need to work directly through it. I don't worry about the women who come to the bulletin board crying and saying they can't go on. They are working through their pain and grief. I worry about the woman who just wants to try again, and doesn't mention or think about the pain of losing a baby. In the end, this is your life and your body, your baby, your future, and your decision. Make your choices well, and try not to look back.
I think it is reasonable, if you have had only one loss, to still request an early blood test and a sonogram at 7 weeks to see the heartbeat. This will reassure you. If you have had more than one loss and no healthy babies yet, then you should be able to request more frequent monitoring of your hCG and progesterone levels, just to see where the pregnancies are failing. This could help give you a clue as to a cause.
Recovering from a miscarriage
Physical Recovery
D&C or D&E
You will recover completely from a Dilation and Curretage or Dilation and Extraction in about two weeks. The bleeding should subside, your cycle will start up again, and the hormone-induced mood swings will even out. It will still take four to seven weeks to start a totally new cycle, and you should wait at least that long before trying again.Birth
A birth takes considerably longer to recover from. You may have shaved areas that will grow out and itch or burn. You may have stitches that will be sore for a few weeks. This recovery is like any other post-partum. Check with your doctor in how long you must wait to try again. A general rule of thumb is that you must wait a cycle for every two months you were pregnant.Miscarriage
A natural miscarriage can take considerably longer. You may have to wait days or even a couple of weeks before the bleeding and cramping begin. (Don't go more than two weeks without talking to your doctor about possibly getting a D&C. Studies show the longer you carry a lost pregnancy, the more likely you are to get seriously depressed, and the more likely you may have physical complications.) The actual miscarriage may only take a few days, or may drag out over several weeks.
Emotional recovery
The emotional recovery is another story altogether. One thing I will point out immediately is that your level of sadness is not at all tied to how far along you were. Everyone will be surprised by their emotions. Some will be near absolute despair and wish to join their baby. Some will be unpleasantly numb and feel nothing at all. Most will swing somewhere in the middle, seemingly okay one minute, then sobbing as if it were only yesterday.
All the stages of grief will almost always be visited. Shock, numbness, denial, anger, guilt, depression, and finally resolution are all emotions you will experience. They do not come in order; some stages may go on for many weeks and others only a few hours. No two people grieve the same, as you will quickly see when your partner does not react the same way as you do. Don't expect that you will "get over it" in a few weeks or even months. Don't assume that getting pregnant again will turn everything around. Don't give yourself a timetable. Just let the emotions come and go and try to keep your life going.
So, you ask, when WILL I feel better? In some ways, you never will. The complete innocence and pure joy of pregnancy will not come back. But you will feel better than you do right now. Your life will go on, you will try again, and you will survive. There is much more to happen in your life. You have to keep going to see what it is. Only when you look back on where you were will you see that you do indeed feel a little bit betterHow to Cope
The emotional recovery from a miscarriage is not easy. Few people may even know about your loss, and others may brush it aside, even your partner. You are not alone, and you may be surprised to see in these topics that what you are feeling is normal and expected.Feelings you may have
Despair and Suicidal thoughts
It is natural to feel despair and incredible, debilitating sadness. You may not want to get out of bed, talk to anyone, eat, or even breathe. You may think about killing yourself to be with your baby or just lying in bed until everyone gets the point and leaves you alone. I felt all these things. You have every right to feel this way. Let it go for a day or two, even as much as a week. By then, it should start to ease a bit. Your emotions may shift to anger or defeat. But when you cry, you do eventually stop. Your mind will drift to other things occasionally. And you will start getting better. If in a week you are not feeling somewhat better, if you are still feeling like being with your baby would be better than being here, reach out to someone, anyone, call someone you know, find a miscarriage support group, go to a church, do something. Fight to get back to the surface and out of deep despair that you feel. Remember that you still have things to live for, things out there in a future you can't see right now--children you will eventually have, either yourself or through adoption, love you will feel, friends you will make. Don't give up yet. When is despair dangerous? When you stop thinking about committing suicide and start planning it. If you have taken any steps toward really doing it, or sorted out in your mind what would be the easiest way, please, please, get help immediately. What is happening to you isn't just the loss of your baby, it is a hormone imbalance that is affecting your thinking. It is very possible to get out of your despair with just a little bit of help from a professional. You must do this. You have a future.Anger
You are perfectly justified. It's hard to know where exactly to direct your anger, though. God? Fate? Your doctor? Your husband? Yourself? You wonder why in hell you had to get pregnant if this was going to happen. Why did you have to carry the baby so long? Why did it have to happen to you? Anger is one of the natural parts of the grieving process. It is a healthy emotion right now and will get you feeling stronger. But it will probably not last. Anger usually gives way very quickly to sadness and despair. Sometimes you will feel flushed with anger, and just as quickly you will be sobbing. You may feel like you are out of control. Maybe you want to smash things. I actually did smash some things. It helped for a moment or two. Then I just had to sweep it up. All these things are real and valid feelings. And we all experienced them. You are part of a large sorority of sad and angry mothers of angels. We all understand. And we're angry too.Going Crazy/ Feeling Neurotic
Remember to give yourself time to handle your grief. IT IS REAL AND VALID. You may want to read some of the other women's miscarriage stories here or on other web sites to help you see that the crazy things you feel are normal. I did and thought many things after my miscarriage that I thought were really unhealthy or insane, including:
- Wanting to die to be with my baby
- Cuddling the sonogram pictures like a baby
- Hugging the tree we planted in Casey's memory (in full view of neighbors)
- Getting angry with myself for laughing or having a good time
- Picking fights with my husband for no reason
- Telling perfect strangers about my baby
It may not get much better for a long time. There will probably be a time, about 3-4 months later, that it will actually get worse. Getting pregnant again may not give you the release from grief you seek. Just give yourself time and surround yourself with people who care and understand. Forget the rest of them, for now.Guilt
I can't tell you how many women have explained to me what they did to cause their miscarriage, or to ask if their stressful job or glasses of wine were what did it. For a long time, I blamed myself too. All that guilt was for nothing. Let me be the one to tell you: YOU DID NOT CAUSE THIS MISCARRIAGE. I don't care if you were smoking crack--those babies are born all the time. Stand up on the job all day? Doesn't matter. On bed rest but got up a couple of times to raid the refrigerator or use the bathroom (or even to go out to dinner)? Insignificant. Nature is not perfect. Our genetic code sometimes doesn't work just right. It's terrible; it's sad. I hate it. But it has nothing to do with your sins, your stress, your mistakes, your nutrition, or your relationship. There was nothing you could have done. I know. Some of you still feel a nagging guilt. But try to put it out of your mind. It really, truly was not your fault. And most likely, it will not happen again.No one understands
You are right. Unless they have had a miscarriage (and fairly recently at that), people you talk to will not understand what you are going through. The average person will expect you to completely "get over" the miscarriage in about two weeks. This is about the point that things may actually get worse for you, when reality has set in, and you are failing to cope. Women suffer alone with miscarriage, and even the baby's father, your own mother, your best friend, or others you thought you could rely upon will fail you. The best course is to surround yourself for a while with people who DO understand, who are going through it right with you.My partner isn't supportive or grieving like me
This is the number one complaint of women on the bulletin board. They feel sad, overwhelmed, and grief-stricken, and their partners are still watching football, going to work just fine, or even telling them to "get over it."
There are a few critical points I want to bring up about this:
- Almost every single woman feels this way (only a very small number mention partners that are sensitive and helpful)
- 100% of dads I've talked to or who have gotten on the board either want to know how to be strong for their wives or confess that they are grieving deeply and don't want their wives to know.
- Men (and many women) really do believe that if you stop thinking about something, the problem goes away. Thus, they say comments like "Stop thinking about it" or "You're getting obsessed about this" or "I don't want to talk about it anymore." Truly, nothing could be further from the truth. Talking about your problems is a catharsis and will help you heal faster.
- A very natural dynamic in every couple, particularly if you live together or are married, is that only one person can fall apart at a time. If you both fall apart, no one will be making dinner, keeping the clothes washed, or manage other children, if you have them. This is an important function of the partnership, and is very rarely breached. Whoever is less sad at the moment will swallow their grief and deal with it later. The other person will feel abandoned and alone, and the partner may recognize it, but feel helpless to really get involved due to the pressure of keeping everyday life going. This time will pass, and the acute phase is usually a month or less.
Jealousy of other pregnant woman
This is perfectly natural, and is reported by 100% of women who have lost babies. Why you and not them? Why does your teenage niece get to have a baby when you don't? Or that woman who is still smoking? Or the five friends of yours who are pregnant right now? You will feel surrounded by babies and pregnant women. You will see reminders of your loss everywhere. This is something you are going to have to tough out. Here are some things that might help:
- Buy something for your baby. Or better yet, make a little memory box.
- Don't feel obligated to go to baby showers. Don't bother with excuses, or to explain yourself. Just send a lovely note with a gift certificate to the mall, or Target, or an online baby store, and say, "Wish I could have made it. Best wishes." Will some people be upset? If it is your best friend, or your sister-in-law, maybe. But that's okay. One of the two of you were going to get bent out of shape with this situation, so let it be the one who is about to have a joyful moment and will forget all about it in a few weeks.
- Don't bottle it up. If pregnant co-workers or friends talk incessantly about babies, just say, "I am so happy you all have so much to look forward to. I can't wait until it is one day my turn." Then walk away! There is no need to stand around and endure the conversation. Even if they say something negative about your sensitivity, they are just projecting how guilty they feel for upsetting you. They know it's their fault. And they have no idea how hard this is for you. Often you'll find out who has had a miscarriage before, because they will seek you out with a sympathetic, understanding ear.
- Remember that this is a joyful time for them. You too will want to shout to the rooftops when your healthy baby is born. They are having a happy moment, and in the momentum of their anticipation, they don't always remember that you are grieving that very thing that they have. When women are pregnant, and blissfully ignorant that anything could ever go wrong, they don't always put others' feelings first. Forgive them, and don't seek their company if you cannot handle it. Joining in their joy will be one of the last things you will be able to do as you heal from your loss. Laughing at a baby shower will be a sign that you are moving through your healing stages and looking forward to a happier future. This is going to be a long way down the road, and may not happen until your own little one is safely delivered. It's okay, and don't beat yourself up about it. You're a survivor, and sometimes survivors can't always act the way everyone else does.
Trying Again
This can be the most difficult topic of all, because everyone has an opinion, and your doctor and your friend's doctor, and internet sources, and your mother, and your partner will all say different things. You will personally go from wanting to try again RIGHT NOW to never wanting to try again, sometimes in the span of five minutes. You may not agree with your doctor. Your partner may not agree with you. You are already grieving, and upset, and feeling like a failure, and thinking too long about this topic can make you feel so very much worse.Accept that there are many opinions. Let me tell you a bit about why. Doctors are trained to recognize that a woman needs emotional healing, but not really to help them or explain it to them, since it goes beyond their "bones and tissues" type of practice. Three months is considered the average amount of time a women will grieve hard over a loss, and will have a difficult time (and be a difficult patient) if she gets pregnant prior to that. While there are a few doctors who believe that your uterine lining must take three cycles to get back to rebuilding itself fully each time (especially after a D&C, where it gets scraped pretty thin), most doctors know that it doesn't really matter in about 80% of the cases, and getting pregnant again right away does not carry any increased physical risk or miscarriage risk. So even among doctors, some will say the standard "wait three cycles" and might even scare you into thinking you'll have another miscarriage if you don't wait, and others will say go ahead and try again now.
As for my opinion, I have talked to about 2,000 women who have had miscarriages. From what I've seen, you really should wait for one cycle to complete, because if you do not, you will experience one of two situations, both of which will cause you much unnecessary grief and pain:
- If you do get pregnant again before having a period, you will not establish a reliable Last Menstrual Period date (your miscarriage date is of no use). You will run into lots of problems when you go in for your first prenatal sonograms and blood tests, causing you tons of grief (often for nothing) and can wreck your relationship with your doctor (supporting the "difficult patient" theory.) For example, the blood test will say you are six weeks; you will insist you are eight. The sonogram will not show a fetal pole yet, but you have read that you should see a baby by now. You will think your doctor should do something, but he or she will just say your date is wrong and come back in a week. You will spend a week of torture, wondering if the baby is dead, and why do you have to wait for answers. All these things can be avoided by knowing your LMP, or preferably ovulation. Most of the time, the babies are fine, but sometimes you are having another miscarriage. Everything is murky because you don't know for sure when you got pregnant, because you didn't complete a full cycle.
- If you have retained tissue, your period will be "late" (although all post-miscarriage periods take more than four weeks and are late) and you can even have a POSITIVE PREGNANCY TEST, but you are not pregnant. This is hCG left in your system from the miscarriage, which has not completed. You may begin bleeding and cramping and think you are having another miscarriage, but you are just still going through the first one. We have had women on the site grieving over a 2nd lost baby, naming it and everything, when it turned out she only had missed tissue from the previous loss. Having a D&C does not guarantee that all the tissue was taken. About 1/4 of the women on this site with missed tissue had a D&C. If you did not wait for a real period, you will not know if a pregnancy test really means you are pregnant again, or if your loss has become a long drawn-out ordeal.
On the other extreme, not getting pregnant that first cycle, or for the next few, when you are fervently trying, will actually push your grief further down the line, month by month, and it can really be detrimental to healing, your life, and your relationship. Often your life will completely revolve around trying again and you will feel even more a failure, more unable to cope. This may also happen if you wait, but is more likely to pull you into a clinical depression if you are not yet dealing with your loss and are still having some hormonal upheaval. Even if you feel like you are fine, the grief is really out there, and you need to work directly through it. I don't worry about the women who come to the bulletin board crying and saying they can't go on. They are working through their pain and grief. I worry about the woman who just wants to try again, and doesn't mention or think about the pain of losing a baby. In the end, this is your life and your body, your baby, your future, and your decision. Make your choices well, and try not to look back.
Monitoring a New Pregnancy
Some doctors will respond to your worries and bring you in for additional hCG tests and early sonograms to monitor the new baby more closely. Most will not do anything. It can be frustrating and scary to think about waiting until 8 or 9 weeks to see the doctor, when every day brings a new twinge or cramp or cervical discharge that makes you panic.I think it is reasonable, if you have had only one loss, to still request an early blood test and a sonogram at 7 weeks to see the heartbeat. This will reassure you. If you have had more than one loss and no healthy babies yet, then you should be able to request more frequent monitoring of your hCG and progesterone levels, just to see where the pregnancies are failing. This could help give you a clue as to a cause.

