Miscarriage Care Needs to Change  

Miscarriage Care Needs to Change

When I was in my early 20s, I woke up one morning bleeding heavily. I was on birth control and didn’t have regular periods anymore, so this was somewhat shocking and concerning. I made a same-day appointment to see an OBGYN. In the hours that I waited for my appointment, my mind spiraled to thoughts of cancer or infection or some other terrible thing. It never crossed my mind that I could be pregnant.

So, when the provider I had never met before told me I had been pregnant but was now miscarrying, I could barely string two words together. She explained the warning signs and what to look out for as I sat naked from the waist down covered only with a paper drape in a puddle of my own blood. She assured me that “probably everything will pass normally in a week or so” and then she walked out. The whole encounter lasted about 10 minutes and I had barely said a word. 

I cleaned myself up the best I could and got dressed. No one said another word to me as I was leaving, and I walked out into the street utterly stunned. It was true that I didn’t want to be pregnant, and I don’t know what I would have done if I had found out I was pregnant while I was still pregnant. Nevertheless, the next few days brought a rollercoaster of emotions. There was relief, and guilt around that relief, and a sense of longing for this little being who could have been. There was worry about my physical body – were any of the scary things the doctor had warned me about lurking in the moments ahead of me? All the while I had no one to talk to. I confided what had happened to my best friend and her partner, but they were far away and could only do so much. The whole experience left me feeling too embarrassed to talk about it with anyone else.

The days passed, the bleeding stopped, and I was back to ‘normal’ again. The emotional rollercoaster eventually ran its course, and those outsized feelings shrank until they were easily tucked away in the recesses of my mind with the other memories of trauma and sadness. Life moved on.

Reflecting on this event years later as a midwife, I know my story was objectively straightforward. I was fine. I lost a pregnancy I never wanted. The authority I had sought care from was so unimpressed by my circumstances that she didn’t even think to offer a simple condolence. And yet, those moments surrounding that experience were sad and lonely and frightening. When I imagine layering on the emotional burden of those experiencing pregnancy loss of a highly desired pregnancy or a termination due to a seriously ill baby or a pregnancy loss that was medically complicated, I just want to wrap these parents in a warm blanket and tend to them as they heal.

The truth is that the providers in the medical system as it is currently conceived cannot give the kind of care most parents need after a miscarriage, even if they want to. A fifteen-minute office visit can do nothing to address the complex emotions surrounding pregnancy loss. Emergency rooms can help to manage serious complications of pregnancy loss but are often ill-equipped to help with follow-up care of the person experiencing the loss. Community midwives are wonderful options for helping to heal from miscarriage, but many people don’t even know how to seek out our care.

It is estimated that 25% of pregnancies or more end in miscarriage. While many miscarriages happen so early that they may go unnoticed, many more are known, desired, and grieved in silence. At Hatch Midwifery, I am committed to making miscarriage care a routine part of community midwifery care.

Miscarriage care is what the person experiencing the miscarriage needs it to be. If this is one of many pregnancy losses, we can discuss and explore potential reasons why with a careful medical history and labs as needed. If this was a medically traumatic event, we can process that experience and plan our visit around healing therapies, including abdominal massage, moxibustion, acupressure, castor oil packs, and other modalities. If there is a desire to become pregnant again quickly, we can talk about nutrition and supplementary support to prepare the body for that journey. There is room for any and all of these approaches. My goal is that you feel heard and supported.

Some people may read this and say to themselves “I had a miscarriage, and I felt fine with it.” I am genuinely happy for you. I am glad that the experience went smoothly and that you had the resilience to emerge from it feeling whole. The goal of personalized miscarriage care is that everyone can walk away from their experience feeling that way. 

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