Ritualizing Loss (Part 1): My Story of Miscarriage
WARNING: If you are pregnant or sensitive to loss, know that this is a detailed story of my experience of miscarriage. I was pregnant when I wrote this, but this is my story. It may or may not be for you at this time.
Part 1 is my story and some resources and stories.
Part 2 is my reflections on “would haves” for my own story as well as my thoughts on rituals and ceremonies that would aid and normalize the grieving and healing process.
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I lost my child…….
Not the daughter I birthed at home almost two years ago, or the one I’m carrying now. I lost the first baby….
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I read a post my friend shared with me called “After Miscarriage: Missing the Luxury of Grieving.” I was impressed because this man is an NPR commentator and this was on the NPR website. That is impressive to me because people will read what he says, though most people never talk about miscarriage and/or stillbirth. Yet, pregnancy loss is far more common than many think. If there’s a handful of women around, one of them has probably lost a baby. “Studies reveal that anywhere from 10-25% of all clinically recognized pregnancies will end in miscarriage, and most miscarriages occur during the first 13 weeks of pregnancy.” (American Pregnancy Association) That means many of the women we see and interact with as we move through our lives have experienced loss, not to mention the families of those women. As the post above mentions, life doesn’t stop after loss. You may even have spoken to someone who just lost their child recently as they try to “get back to normal.” Who would know?
Who is there to normalize this experience of loss that is common to so many? Where are the rituals and ceremonies to support these families and their communities? This is exactly the thinking that the NPR article proposes. We have funerals for other losses; why do we not think to support families in having a moment of recognition, a gesture of respect and an honoring of the experience. This could allow for the grieving process and foster healing.
Somewhere right now there is a grieving woman watching another woman pregnant with child or playing with a baby, her heart filled with hurt. She, and her family, are in need of support and space to grieve fully and begin the healing process. Having an open, accepting space in the public sphere of relationship would allow families all along the timeline of the grieving process to connect and heal each other. When one person tells their story, it invites others to do the same. Storytelling is key to embracing and normalizing the full spectrum of birth.
In the spirit of making a space for others who have need of it, I tell my story of loss.
[Apologies in advance if the telling isn’t chronological; remembering isn’t a linear process. Also this is a LONG STORY because … well because it’s my story and the annoying details are how I ended up the childbirth advocate, mother, and “hardcore homebirther” (BBHpost) and I am today.]Resources and Stories at the end…..
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I grew up a tomboy, playing in the dirt. When hormones started striking down my friends and I one by one, I dug in my heels and protested loudly that I did not, would not become a “girl” — wearing bras and makeup and talking about clothes and boys. No, I was the one who was standing there dumbstruck: What was happening to us all? Why couldn’t we just keep going on as normal friends?
I say all this because it illustrates the type of late bloomer I have always been. I did grow up in Kansas, so I’m guessing that the average age for folks I knew to experience marriage and children was probably lower than folks who grew up in the city. At 20, however, I was questioning whether marriage would ever be in my future. At 23, having met my future husband, I did not see children clearly in my future. At 31 at the start of the New Year, I still had only gotten to the point where I could imagine being pregnant, and admittedly was a bit intrigued, but I still had years to an actual child in my arms. However, by 32, only a few months later, I was weeks pregnant, nearing the second trimester. This had happened soon after one day when all of a sudden I woke up ready to start “trying” to get pregnant. [This really just meant not mentally inhibiting the intention of pregnancy more than “trying.”]
At this point in life I was fully engrossed in my teaching. I wasn’t sure where this baby would take me in life. Physically, I was feeling a little nauseous but not too much (compared to this pregnancy!). Still, I was annoyed with the little aches and pains and inconveniences of pregnancy. I felt emotionally disconnected and foggy. I thought I would be talking to the baby all the time, but I didn’t feel inspired to do that much at all. Tired and nauseous were the feelings that came up most often.
The pregnancy wasn’t really affecting my work, I would say, but I wanted to tell my colleagues because we worked as a team. I wanted them to have time to find a replacement and figure things out, so I told them when I thought I was going on 13 weeks because I had my first midwife appointment. We were mostly open about the pregnancy early on with family and friends. It didn’t feel like something to hide.
Soon after telling people, I was feeling like things were really starting to get settled. I had my first midwife appointment on May 6 in which we tried to listen for a heartbeat despite learning I was only at 10 weeks. We heard nothing. I wanted to hear it, but it seemed normal not to and there would be other appointments to hear it. I left my midwife knowing she was leaving in a few days to get married and then go on her honeymoon.
The very next day, it happened: the dreaded spotting.
Anyone who’s been pregnant and had any bleeding knows how unsettling that can be. Just doesn’t seem good. Well, I went off the deep end researching bleeding and miscarriage while working hard in my heart to ward off the thought. [I don’t suggest this strategy, by the way. Better to stay off the internet, talk to your midwife/doctor and do some reflecting and resting and praying, affirmations or whatever positive thinking technique possessed.] I emailed my midwife about the spotting and who told me about some supports for the pregnancy. [Welcome Womb Tincture from Wishgarden Herbs and vitamins E and C to support the placental bed] In a subtle way, I think reproductive things were kind of mechanical in my mind, and I just needed to fix the machine.
[I looked back at emails from that time and read some things I had forgotten. Like the fact I had a dream the night before in which I suddenly realized was bleeding (profusely). This strikes me, given another dream I had two days later which I clearly interpreted as me being somewhat reluctant and unwilling to embrace motherhood. Pregnancy dreams are powerful.]The spotting wasn’t slowing in frequency or lessening, despite efforts. I got in touch with the other midwife, but nothing had changed, or if it had it was just worse. My heart was faltering. My mind was exhausted. It hadn’t even been a week.
What was I feeling?
Guilt. Why would I feel guilty? Why should I? That dream said it all. Filling my heart and mind was the realization, that I had squandered away weeks of connection with this little being living with me. All the energy and love I could have given inward to help grow and support my baby, I withheld. And why? Because I had the slightest nausea? Because I was tired? …. Because my whole life as a woman and a person was shifting in unforeseen and unknown ways to accommodate for new life? Could I blame those crazy pregnancy hormones that make your feelings all wonky for making me feel disconnected from everything and everyone, including my baby? Whatever the reasons, the guilt I felt was an ever present wave I could only sometimes hold back.
What did I do during this time when nothing was working?
I talked to the baby. I searched my spirit, my heart and my mind. I let that baby know everything. I couldn’t be honest about my fault and lacks with anyone else, but I was going to be honest with this baby. I apologized. I expressed my true hopes and intentions. As the days of spotting verged on a week, I sent all the love I could find and sent it to this other spirit I could now imagine tangibly in my belly. I let my baby know that if she wanted to come back to me again I was ready to accept her this time.
I wanted to be a mother.
I could feel that want through my whole being. This was nothing I felt before. This was what had been missing through the whole pregnancy, what was off. My spirit was not in motherhood. I could not be the mother I wanted to be, truly, with a resentful spirit. I opened myself to the hours and days of motherhood I had left. Who knew how many I had, or if I would be blessed with any more?
The spotting took a turn to light bleeding. Cramps came. Tiny clots came. I felt a need to get an ultrasound.
I don’t know why. I really don’t understand the decision, looking back. I knew what was happening, but I didn’t want to know. I think the ultrasound was me trying to make real the struggle that had been going on inside me, proof that there was life in my womb…while the rest of the world turned, not knowing a part of me was passing on. I believe this turned out to be a final instance of trusting the authority outside myself, putting greater faith in things beyond my intuition and my body-knowing.
I asked my midwife her opinion, but it was clear that this ultrasound thing was my idea and my decision. So I went with my husband all the way downtown to my doctor’s office (who hadn’t seen me for 2 years) to ask for an ultrasound or get a referral or whatever that procedure would entail. [Consequently, I called the insurance people and the lady on the phone, Thomasina, was the sweetest ever and a big support. Who would have thought?] I didn’t know when the insurance lady and the doctor’s receptionist had been so helpful that I should have just stayed home because my support was running out.
The doctor’s office sent me with a slip of paper across the street to the giant hospital where I found the ultrasound place. It’s fuzzy now, but I waited there for some reason before finding out that they don’t do what I needed them to do. Pregnancy ultrasounds were through somewhere else. Some other floor on some other wing. Trekked over there to hear that they don’t do ultrasounds without appointments. (Then why did my doctor send me over here???) Go to the emergency room and get an ultrasound that way. …. Just another chance to go home.
If you have ever been in an ER waiting room and through that process, you know that you do not get the feeling what is happening to you is important. There I sat hours with truly ill and injured folks, waiting to see this baby on that screen like all those people who post their photos on Facebook. Finally, they called my name. Unfortunately, all it meant was that I was to sit with this lady and answer a gazillion questions, many of which I didn’t have the answer to.
“When was the start of your last period?”
[Silence.]“How many weeks are you?”
“Uh…11, I think?”
“What? You don’t know how many weeks you are? Who is your OB?”
“I have a midwife, not an OB.”
“Oh. Well, didn’t she tell you how many weeks you are?” [How was I going to tell this one?]
“Well, I thought I was 13 weeks but my midwife just said last week I was about 10 weeks.” [Silence.]
“Well when was your last period?”
“I’m not sure.” [Now I feel like I should give her something that seems reasonable.] Feb. 11 maybe?”
[Gets out wheel.] “14 weeks.”
I didn’t know then, but these questions and more would be asked of me over and over and over by every person I saw, so in some ways she helped me find some quick answers to give people.
After leaving the not so warm lady and waiting more hours in that same room, I saw the first of 13 people, none of whom could stop what was already happening to me. [I’ll spare telling you about all of them.] A lady came in with my IV, and I told her I’m not getting one of those. “Oh,” she said, looking at me puzzled. “Yeah, they said I don’t have to have one.” “Oh, ok,” she said and left. Whew! I don’t know who “they” was, but I was glad I already was showing the strength to advocate for myself. What did I need an IV for? She clearly had no idea who I was or why I was there. This was the system.
A man came in, after almost two hours, who gave me an ultrasound. He was polite enough, despite asking all the same questions he could read, but he said it was hard to see because the ultrasound on that floor was weaker than the one upstairs. He was going to send me upstairs to get an internal ultrasound which is more powerful.
When he left I waited there, sitting in the weird chair thing having stronger cramps than I had been having throughout all this. I looked at my husband and told him something was happening. These cramps were painful, but I imagined they were like the powerful cramps some women have during menstruation. I remember thinking about contractions during birth and wondering if these were similar in any way. I tried to breathe and embrace all the sensations. My pregnancy was ending, my baby leaving me.
I felt a sudden hot gush and realized there was way more blood than the chux pad I’d been in for hours could handle. I hobbled to the bathroom where I tried to clean myself up. Instead, another gush in which I happened to reach down and catch an enormous piece of tissue that was my baby. What a surreal moment. I kept my baby in case someone needed to see it, and also just to hold it and study it for a few moments.
I could feel things subsiding somewhat, leveling down from where I’d been. I cleaned myself as best I could with those rough, not-big-enough paper towels. I had to make a makeshift pad out of those darn things because no one was coming around to ask for another one. I sat there, for once grateful that we had wait time to allow some moments to cry together and comfort each other. We were beginning the grieving process in earnest.
When someone did come, they could not have been more jarring and disruptive to that process. Two loud, laughing young guys come in joking in that stereotypical young jock way. They stopped their conversation and cheerily said hello, explaining that they were there to draw blood. I was not in the state of mind I was previously with the IV lady, ready to ward off interference. I sat there dumbfounded that this was real, that these two guys were here joking and smiling at me completely unaware I had just lost my child and was trying to grieve. I shut off my grief for a time and became polite, listening to their nonsensical chatter…or pretending to. They finished and left as boisterously and oblivious as they had come in. I remained stunned and found it hard to get back to my private hurt.
I sat there and waited until a woman came who was going to do something with me. Thank goodness it was her at that moment and not any of the others. I liked her the best of all the people I saw. She was the only one who looked me in the eye, put her hand on my shoulder, said “I’m sorry” in more than a routine way, and gave me a moment of silence. This woman, in her three minutes with me managed to encourage my healing by inciting my grief and allowing me to cry. As soon as our brief moments of connection were settling into comfort, in rushed someone else who said I had to go with them upstairs right then. I said goodbye to my only medical moral support. The woman put me in a wheelchair and left me in the hall outside a closed door in a freezing, empty hall. [Of course, my backside is bare because of that stupid gown, and I’m still bleeding from losing the baby and still in need of chux.]
The ultrasound technician let me in and said nothing. Not. A. Thing. Not anything besides her usual talk about “this is what this is and what I’m going to do.” She did a regular ultrasound and then a transvaginal ultrasound, pushing on my uterus from the outside and pinching me (unknowingly). It was uncomfortable, and I wanted it out. When my heart and spirit wanted to begin grieving, here I was embarrassed that I was bleeding all over everything and wondering how I could ask this cold woman for another chux pad for the wheelchair. She left the ultrasound device in and left me there for 15 minutes while she asked the doctor if he wants any more pictures. When she came back and said she was done I did ask, and she ended up actually speaking and giving me net underwear with thick pads to wear. I went back to sitting in the hall outside the door while I waited for someone to take me back downstairs to my husband where my ordeal would reach it’s peak.
After a (comparatively short) waiting period, a woman walked in who clearly looked new and nervous. She is a Gynecology resident. She said she was “sorry to meet me under the circumstances” (is everyone trained to say this?) and asked me the usual questions minus a few plus a few new ones, now that I had miscarried. Then she tells me she wants to do a vaginal exam to see if my cervix is open. I don’t want this, but I want to go home and letting her do this seems like a final step in their questioning so I can leave. This ends up hurting more than anything so far. She pushes on my abdomen and pushes on my cervix. She pull out pieces of my baby and placenta, tells me my cervix is still open and there’s still a lot of tissue.
[NOTE: The D stands for dilation, which means enlarging. Curettage (the C) means scraping. Together, this procedure involves expanding or enlarging the entrance of a woman’s uterus so that a thin, sharp instrument can scrape or suction away the lining of the uterus and take tissue samples.]“I recommend you get a D & C tonight to clear it all out.”
“Do I have to?”
She looks incredulous. “Well there’s a high risk of infection and hemorrhaging and there’s a lot of blood loss. This way you go in and it’s done. We can’t force you to do it. It’s your choice, but I strongly recommend it.”
[Silence. She sees in my face that I am not going for it.]“Are you completely against it or are you thinking about it?”
[I want to know more details.] “Would I go under?”“Twilight anesthesia in the vein. You won’t remember anything.”
“How long would I wait?”
“Probably a while. It’s whoever is on call.”
I don’t want this, but instead I say, “I’ll think about it” the way I tell my mom I’ll think about the thing she is telling me to do that I will never do.
“I’m going to go check the ultrasound and consult with the GYN Team and bring them back here.”
I can tell at this point she is bringing in the big guns. This means I am close to leaving but have a big battle before doing so. While they are gone, I called my new midwife who comforted me and confirmed that I could trust my instincts and miscarry fully on my own at home, coming back only if there was a problem.
We heard the door turn, saw a foot step in the doorway, a head turned sideways looking back for the head guy. We heard a muffled “Oh, he’s not ready?” before we saw the first resident’s panicked face clearly deciding whether to come in without the big guns or leave in embarrassment. Having been seen, she chose to step through and her colleague with her.
It was the same woman with another woman (the chief resident) who seemed more sure of herself and quicker on her feet (and also says “sorry to meet you under the circumstances.” They have left the big guy on the phone and are trying together without him. The resident has clearly gotten some new language. She starts in again, while the chief resident looks at me.
“You have 3 options. Option 1 is to do nothing. Option 2 is to take a medication we can give you orally to help the body go through the process. Option 3 is to get the D & C and be done with it.”
[The chief resident jumps in here to inform me more before I can answer.] “We get some women choosing options 1 and 2 but we don’t recommend them because those women usually come back anyway.” [She sees my face asking why they come back.] They come back because there is a lot of bleeding and heavy bleeding scares people. With the D & C it’s 10 minutes and it’s over.” [They look at me. Why do they seem to think I want to get this over with? They can tell I’m not going for it, and I can tell they have told me everything that usually works and now they’re waiting for the big guy.] “I want Option 1.”
That’s all I can get out. Not the confident, eloquent answer I hoped to give, but it causes them to switch gears and start asking me about my gynecologist, who they seem to know and respect, as if she would agree with them if she was there. While the resident writes something furiously, the chief resident switched her tone from business to personal. She tells me miscarriage is more common than we think, that it’s the body’s way of fixing something that was wrong, that it’s not because of anything I did or didn’t do. They’re both filling time I can tell because they are looking at the door expectantly now. They say they’re going to wait outside rather than stand there and stare at me.
At this point, my husband was about to explode violently if they didn’t let me out of there. I knew it was taking everything he had to keep quiet so far. I told him that it was important to me that when they bring this guy back in that he keep his mouth shut and let me do all the talking. I wanted them to know for sure that this was my decision and I meant it. [This, I think, is the first true moment of me being an active participant in my birth experiences.]
It was then that I heard the man who stood between me and my home. He was talking on the phone loudly enough for me to hear everything. I hear him say something about “the problem with midwives and clinics….” His responses told me that there was a scared mama on the other side of the line asking questions about her son’s kidney situation. In a callous and condescending tone, he told her that his “prominent kidney” was not caused by whatever she was saying it was. He gave her a version of “just watch and wait” with heavy overtones of “stop calling me.” Having just lost a child I had just started connecting with, I fully empathized for the first time with a mother’s worry. I could hear that this was not going to be like the other two conversations. I gave my husband another reminder to keep his thoughts to himself. The door swung open (unlike the timid creaks everyone else had done up to this point), and in walked the head honcho with a stereotypically pompous air and walk.
He strolled over to me and said something like let’s cut to the chase. I thought, “yes, lets.”
“These two tell me you don’t want the D & C.”
“I want to go home.”
“You are at high risk for infection. There is heavy bleeding. Most people don’t know when the bleeding is too much.”
[More questions, more description of procedure. He can tell I’m not listening really.]“You understand that you are at high risk for infection.”
“I understand that. I want to go home.”
“You do realize that you are putting yourself at risk for hemorrhaging and bleeding out?”
“Yes.”
“You understand that several things could go wrong? Some could even affect your future pregnancies.”
“Yes.”
He then leaned in and said in a curt, condescending tone with a demanding shake of the head, “And you don’t want this procedure why???”
Pause as I ran through my reasons for going home: my trust in my body and the process and all the rest. How could I express my true reasoning? I calmly said,“There is nothing nothing I can say to answer your question in a way you would understand.”
He starts in about going to the gynecologist and fever and bleeding, and they look at me wishing I would take this last chance, but I know I have won! As if that’s something to be excited about. They leave looking disappointed….or angry?
And so, I waited some more. The worst waiting of all because I was so close to going home. Then the very first guy came back, the one who gave the first ultrasound. His demeanor was sweet and understanding, the first words out of his mouth, “Let’s get you out of here.” He could not have said anything else to make me like him more.
I went home, bled some more, cramped some, cried and slept. Would feel fine, and then guilty for feeling fine, and then break down completely at some unexpected moment. My birthday came and went a week and a half later. I walked around looking at everyone wondering if they could see my grief and feel my loss, but it was as if nothing had happened. And nothing had happened, really, to anyone but me and my baby. That made it hard and isolating.
Back at work a week later, grateful for the time to grieve truly, I started to find out that so many of the women I worked with every day had lost one, two, three children in between having as many. Some had multiple ectopic pregnancies or a still birth (with full labor and delivery) at seven months. All remembered their loss intimately. It was clear to me that I was not alone. I decided that I needed to be an example to other women that pregnancy loss is common and a natural part of the spectrum of birth. I needed to be able to tell my story.
I worked hard to process my loss. It felt certain at the time that I had learned how precious motherhood is and how much I wanted to be a mother. I began to trust more fully and to respect birth and babies and my body. I knew in my heart the time was not right for whatever reason my mind could not know.
My daughter was conceived a year to the cycle, within days of the first conception. It seemed a sign. It turned out that the timing for my daughter’s birth was far closer to ideal than for the baby I lost. I was in a better place physically (different house), emotionally (stronger), and mentally (knew a heck of a lot more about birth and homebirth). My spirit felt sure and solid. I was ready to face my fears and take on the challenges and feel the joys of birthing at home and entering into motherhood.
Her birth came, two weeks early, at dawn with the sun rising on the horizon on one side of the room and the full moon still shining in the sky on the other. It was the most spectacular experience. I know that the power I felt then to let go, to relax into the process, to listen to my baby and my body all came from my initial loss. All of my choices — to have a homebirth, to do the constant work of preparing myself for natural childbirth, to breastfeed till my child weaned themselves and my trust in birth, bodies and children — came from that experience.
I LOST MY CHILD on May 13, 2008. Yet gratitude fills my heart, for the time that I had with that baby, for the mother and person I have become because of that baby, one of my life’s greatest teachers…..
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BLOGS/STORIES
Healing Hearts: Baby loss Comfort
Faces of Loss, Faces of Hope (tons of stories, plus community and resources)
Moments of Pause (one mother’s ongoing blog about life after a stillborn son)
Loving Cora Rei (a mother’s ongoing blog about losing a daughter at 37 weeks — Update: just gave birth to her third child)
Understanding Your Grieving Wife
RESOURCES
Facts about Miscarriage (Information/Healing/Hope)
Lactation after Loss:
- Podcast (Motherlove)
- Brochure (Motherwear‘s Breastfeeding Blog)
Baby Loss Directory (list of blogs and information)
