Long Reads

“Having a miscarriage is traumatic, so why don’t we talk about the loss?”

One third of women will suffer from post-traumatic stress following a miscarriage, according to the largest ever study into the impact of early pregnancy loss. Here, one writer explains why it’s so important that the trauma of miscarriages starts to be taken seriously. 

My first article on pregnancy loss tumbled out so quickly I couldn’t type fast enough. Detailing the three miscarriages my partner and I had experienced during the year prior was both the easiest and hardest thing I’d ever written; it took nothing to get the words out because they’d been banging around in my head for 12 months already, drowning out the rest of our lives.

But sending those words out into the world? I was physically shaking at the thought. I was shaking as I sent the piece to a friend to proofread, still shaking as I emailed an editor and terrified when she said yes, she’d like to publish it. We could count on one hand the number of people we’d told about our losses, and yet here I was, laying bare the graphic physical and emotional details on a very public forum. 

But I did it because I needed to, I needed to desperately.

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Miscarriage: what to say to a friend who is going through loss

The largest ever study into the psychological effects of early pregnancy loss – ectopic pregnancy and miscarriage before 12 weeks – has this week revealed just how severely it can impact women who experience it. For many, including me, it’s confirmation of what we already knew: the toll can be traumatic, brutal and long-lasting.

Questioned a month after their loss, nearly a third of women reported suffering post-traumatic stress while one in four (24%) experienced moderate to severe anxiety, and one in 10 had moderate to severe depression. Nine months later, 18% of women still had post-traumatic stress, 17% moderate to severe anxiety, and 6% moderate to severe depression.

sad woman
Having a miscarriage: "I could no longer tell how I was coming across to others: did they realise I was acting, that I was numb?"

In my experience, ‘traumatic’ is right. After keeping three to ourselves, it was no exaggeration when I said in my piece that I was “losing it”. I felt like I was living two lives – totally miserable but pretending everything was the same. I could no longer tell how I was coming across to others: did they realise I was acting, that I was numb? When I was socialising I felt like my head was in bubble wrap, and I was smiling, glassy-eyed, completely unable to focus or connect. 

I’d cry the moment I left work, on every form of public transport, nearly every night at home. Seeing anything connected to New York – where our second loss had happened while on holiday – was a jolt of electricity through my body, making me feel physically sick. Vivid flashbacks of the bloody, intrusive, scary parts of the losses would pop up unbidden, taking me right back to the surgery, the bleeding, the ‘tissue’ clumping into the toilet bowl.

And I was tired. Constantly, energy-sappingly tired.

A year of silence and pain has repercussions. We never sought professional help, nor was it offered, so I was not diagnosed with anything official. But when I read about the initial study by Imperial College London describing symptoms of post-traumatic stress disorder, I cried with relief. Here, in black and white, was what I had been going through for more than a year. It wasn’t in my head, or overblown, I wasn’t imagining or wallowing: other people felt this way, too.

I felt the same sense of relief when my first piece was published, and all the pieces after that (we went on to have two more miscarriages), thanks to the people who contacted me, who still contact me, to discuss their own experiences. Because they’re often telling me the same thing: thank god you feel the same. Thank god I’m not going mad.

miscarriage
Having a miscarriage: "The physicality of pregnancy loss is rarely spoken about openly."

In my case, and in that of many who contacted me, some of the main sources of trauma are easily pinpointed in hindsight: there’s the shock of the physicality of pregnancy loss because it’s so rarely spoken about openly, and the spin-off issue of feeling it’s wrong to be so affected – because the lack of open discussion means others don’t take the loss seriously. They simply don’t know what’s involved and therefore often don’t know how to best support someone.

This is why it feels so important to me to discuss the physical and emotional impact of early pregnancy loss. In New York, I was blindsided by the process – having had a very early loss with no intervention required for my first miscarriage, I was completely unprepared for the second. In the two days I had to wait before an operation to remove the pregnancy, I was suddenly seized by near-hysterical panic – this baby, this embryo, this ‘product of conception’, it couldn’t… come out before, could it? I frantically googled, devastated to learn that of course it could and just a few hours later, it did.

I didn’t know that, and I didn’t know that I’d be having general anaesthetic for the first time in my adult life, or that other times I’d wait days for the bleeding to stop, or that you might be asked to take used sanitary pads to the hospital. I didn’t know some people are given medication to induce contractions they’d have to suffer through at home. I didn’t even know that early scans are rarely over the stomach, but carried out via lubed-up vaginal wands.

You’re pushed and poked and prodded, which can be disassociating and disconcerting at a time when you’re trying to process loss, especially if medical staff don’t have the tools to recognise or deal with the associated psychological pain.

This is why research such as this is so important. Not only does it call for better treatment, care and understanding from medical teams, but it lays bare the ramifications of miscarriage, paving the way for people in general to start taking it seriously, and for further research on related issues such as anxiety in subsequent pregnancies and the effect incongruent grief can have on relationships.

couple
Having a miscarriage: "As long as pregnancy loss remains little spoken about, the isolation, secrecy, shame and guilt of those who experience it will not ease."

Being a questionnaire rather than a clinical diagnosis means the research is of course not perfect, but the more we talk, the more likely it is that mental health assessments post-loss become standard, for both women and their partners, and appropriate support is routinely offered.

My husband and I have been talking and writing about it for four years now, and sometimes I’ll still shake a little as I press send on an article. I didn’t think it would become my specialist subject and I almost feel I should include a disclaimer about being such a bore.

But I’m not sure I should apologise for discussing our losses and the effect they had on us. As long as pregnancy loss remains little spoken about, the isolation, secrecy, shame and guilt of those who experience it will not ease, and people who badly need help will continue to worry that the words post-traumatic stress are not for them.

For support and information on pregnancy loss, please visit Miscarriage Association 

Images: Getty, Unsplash