Why Us?
The cause of a miscarriage often remains unknown.
It is thought that more than half of early miscarriages are due to chromosomal abnormalities - a one-off problem with the fetus caused by the way the genetic material from the sperm and egg combine during fertilization. The process of creation is finely balanced and such a problem is more likely to be down to pure chance that to a problem in either parents.
Less common causes include hormonal imbalance, serious infections (like German Measles and listeria), chronic illness (such as diabetes, lupus and kidney disease) and womb abnormalities (especially in later miscarriages).
Other factors that increase the risk of miscarriage are age (the quality of a woman's eggs declines with age), heavy smoking, heavy drinking and the use of recreational drugs.
Was it something I did?
Normal day-to-day things like coughs and colds, exercise, lifting heavy objects, lack of rest, falling over, having sex (or falling over having sex), eating spicy food or being constipated do not cause miscarriage.
In fact, there's not much a healthy woman can do to interfere with a viable pregnancy.
So a miscarriage is usually out of your control and that is, of course, part of the problem: it feels like your body is out of control, doing something you don't want it to and not protecting the baby growing inside. But you body is in control, and knows exactly what it is doing: it is making sure things are right for a healthy pregnancy. And your body has to make a tough call if things aren't right. It's a kind of tough love - being tough now to prevent things being even tougher later. And in that sense you have to trust nature and the body's wisdom to do the right thing, even though your mind and heart are screaming that it's wrong.
Is it normal to feel like this?
Most probably yes. Miscarriage is like bereavement. You go to pieces.
Emotional distress following miscarriage is very very normal. Most women experience a range of emotions: loss, grief, loneliness, confusion, helplessness, anger (why has this happened to me?) and guilt (was it something I did?). Such feelings can be accompanied by sleep problems, loss of appetite and loss of energy.
There is a strong maternal bond between a woman and her developing baby from the very beginning. This special connection grows as the foetus grows and becomes like a companion, a part of almost every waking thought. Meanwhile, on the outside, parenthood is being bestowed: congratulations and special attention are received, plans are made, books are read, scans are taken, dreams are dreamt. The unexpected loss of a baby takes all these things away and more. It's like grief but harder because there are no memories, just the future and a lost dream.
And all these feelings can be exacerbated by the silence surrounding miscarriage. It's hard to talk about. People - even partners - don't know what to say. Or, meaning well, say the wrong thing.
And miscarriage is something that happens to two people. So men will experience distress and grief as well but this is usually shorter-lived and less intense that the mother's. This is because the father doesn't have the special physical connection to the growing baby, so for him it's not so real. And the father's concern and anxiety will often be more focused on his partner and her well-being than on the loss of the pregnancy. These differences can lead to tension and stress in a relationship following miscarriage.
Will it happen again?
This is the biggy. Uncertainty about whether a miscarriage will happen in future can be crippling. The thought of going through it all again, or of "holding on" through a full term pregnancy can seem too much to bear. This is where you really need to understand the numbers and the "normality" of miscarriage. The percentage of women who go on to have normal pregnancies and healthy babies after miscarriage is very high. So take heart. And take medical advice.
Try, above all, to tolerate some uncertainty because, in the end, there is only one way to really answer the question of whether you will miscarry again, and that is to try again. Think carefully before you do this, be patient and give yourselves time to physically and mentally recover.
What to do now
The challenges of a miscarriage are something you have to move through emotionally and physically, so it's important to keep moving. The following things will help you.
Note that If you have been highly distressed for more than two months following a miscarriage then it is recommended that you seek professional psychological help.
Talk
Discussing loss can be uncomfortable. But silence doesn't help - yours or theirs. It's important to understand that the silence of those around you doesn't mean they don't care. Most likely they don't want to upset you or don't know what to say or even if you want to talk about it. Some mothers avoid talking about miscarriage because they feel a sense of guilt or failure. But for those who have been through it, most will tell you that talking about the miscarriage is the best therapy, the fastest way to start to heal. So talk to your partner. Talk to friends and family. Tell your story. Hear their stories (there will be more than you expect). Talking will reconnect you with the world, break the loneliness and give context to your experience. You will find out that you are not alone and, despite how it feels now, that you will recover and survive. Talk, share and heal.
Grieve
It is hard for those who have never experienced miscarriage to understand that it is an event worthy of grief. It is. So allow yourself to grieve. It is something you have to move through. Unfortunately there is no such thing as speed-grieving, but by acknowledging and expressing your grief you will move through it more quickly. Rituals can help enormously in this by making the loss more tangible. Some couples find that naming the baby or viewing the fetal material helps. Others hold ceremonies although this is less common in Western cultures which have no established rituals. In the East however, there is an incarnation of Buddha called Jizo who watches over miscarried fetuses and to whom all kind of offerings are made in gardens of infant statues adorned with clothes, toys and sweets. But if you are not a Japanese Buddhist there are some simple and beautiful rituals you can undertake: lighting a candle and saying a prayer, writing a poem to express you love and sadness, or planting a tree together in a special place.
Learn
Understanding as much as you can about miscarriage - what it means and doesn't mean (it doesn't mean infertility for example) - can help enormously. Get as much information and explanations as you can from your health advisors and from reading about other people's experiences. You will find many supportive forums on the internet and articles about dealing with the emotional challenges of miscarriage.
Keep moving
Physical activity - moderate exercise like walking or swimming - will reconnect you to your body (and to nature) and generate endorphins and serotonin to calm you and lift your mood. And things like yoga, dance, massage and meditation will help strengthen the mind-body connection.
Mentally, give yourself time-out with relaxation and meditation CDs. The best one on the market - in fact, the only one addressing miscarriage - is Mind Body Baby's own Coping with Miscarriage, specially written to sooth you, comfort you and give you the strength to move forward.
