Welcome back Chaise Lounge readers! This week we have the third and final installment of our series on miscarriage. If you missed the first two installments, you can find them here and here. This week we will explore the psychological effects that a miscarriage brings to the pregnant person and their partner. To learn more, I spoke with a licensed clinical social worker who specializes in working with this population to find out more about how to best understand and support those who have miscarried. But first, let’s take a peek at global and national news.
Sara Rogel, a woman in El Salvador, is to be released from prison after serving 8 years of a 30-year sentence for the questionable death of her unborn child. In 2012, Rogel arrived at the hospital bleeding telling the staff there that she was injured while doing chores at home. Her release is on hold because the prosecution has 5 days to file an appeal. Her case is an example of what could happen in the United States if any of the proposed anti-abortion laws are passed at the state level.
In South Korea, disenchantment with gender equity advances are pitting men and women against one another. With the election of Moon Jae-in, a period of attention to gender equity arrived. But now, many younger men feel that they are now the target of criticism and discrimination. In a Reuters article, Park Jun-young, a 27-year old engineering graduate school student, says, "Feminism in South Korea started with gender equality, allowing women the same access and to break the glass ceiling, but it's turned into something where the nowadays young men - who aren't better off than women the same age - have become a target of criticism.”
While all eyes were on Helio Castraneves winning his fourth time at Sunday’s Indianapolis 500, another milestone was being set by the Paretta team. Four of the seven team-members were women. The driver, Simona De Silvestro, is also a woman. Beth Paretta, the team’s owner, has been working toward this day for several years. According to Paretta, "My hope is that in five years, us being a team of mostly women is the least interesting thing about us."
Dr. Erica Kaye recently tweeted about this #Manel that was to take place at the Pediatric Academic Society’s meeting bringing much attention to the fact that 75% of pediatricians are female, but they were only featuring male doctors on the panel. PAS responded by thanking “Erica”, not Dr. Kaye, and canceling the session. Many were upset that they canceled a session for an important topic rather than try to find female doctors who could join the session.
Varsha Jain, an academic space gynecologist, is studying the effects of space travel on women’s reproductive systems. We know that men lose sperm while in space, but it is replenished when they return to Earth. What happens to a woman’s eggs which cannot be replaced? What is the effect on her menstrual cycle? The lack of information is due to the lack of women going to space. But in 2013 things changed with NASA having an equal number of men and women in their class.
You Are Not Alone in Miscarriage
People who have miscarriages often blame themselves. The psychological tricks that we can play on ourselves can wreak emotional havoc on our lives and fray relationships. Although miscarriages usually happen for natural reasons when there are chromosomal abnormalities, the emotional pain can be hard to heal. I interviewed Kat Quinn, LCSW, who specializes in treating people who have miscarried to learn more about the psychology of miscarriage and how those who experience it can obtain support and heal.
Chaise Lounge(CL): Thank you so much for agreeing to speak with me about miscarriage and support. When you are working with people who come to you after they've had a miscarriage, what are the main things that they want to discuss? What are the issues?
Kat Quinn: It can vary greatly. For a lot of folks, it's really similar to what the broader population understands is the grief process. Some people are coming because they're feeling really sad, and they haven't been able to get through that, and maybe it's only been a short time. And for other folks, it's been months, and they're just not feeling any better, and they're not sure why. Other people arrive at my door, and they're feeling angry, or they're in denial, or they're not sure how to accept difficult news. Some have already worked through the grief process and have started to accept it and feel better, but are feeling traumatized around moving forward. And so they're feeling really anxious or nervous around, potentially trying to get pregnant again if that's something that they or their family are interested in.
So it can be kind of a wide range, which I think is good for people to know. There's no right way to go through this. There's no right way to heal from it, there's no right way to process it. It's all individual. And yet at the same time, it's a real shared experience, and a lot of people can relate to the different feelings and the different timelines.
CL: Do you feel that the silence and stigma around miscarriage contribute to the issues that bring someone to you for support?
Kat Quinn: It just seems like people don't realize how common it (miscarriage) is, which makes it so difficult for people to talk about. Sometimes people internalize it as their own failings or their own issue. And since they might have never told anybody about the pregnancy in the first place, it can be even harder to get the support that you're looking for. Certainly the stigmas around it being something that you're not supposed to talk about and that you're not supposed to tell people don't make any announcements until you're 12 weeks, all of those expectations contribute to women and families feeling like it's something they have to go through alone. That makes people have a harder time reaching out and getting the support that is out there.
CL: I was going to ask you about that whole practice of not telling about your pregnancy until you know you’re “safe.” But then of course, if a miscarriage does happen, you are all alone in that space.
Kat Quinn: Right, of course, it's super individual. For some people, they just feel better waiting because they might feel uncertain or uncomfortable about making an announcement and then having to tell people bad news. Telling people that you've lost a pregnancy, that you previously announced to them happily, is also traumatic. So there's no right way to do it.
I think the key here is recognizing that people who lose a pregnancy through miscarriages or even later through pregnancy loss down the line deserve to be able to talk to people about it. They deserve to know that their friends will be there for them. Therapists are out there, support groups are out there. And same with their partners, you know, their partners might be going through really difficult times too, and not know how to get the support they need as well.
CL: I interviewed a personal friend after she revealed on Facebook on Mother's Day that she’d had two miscarriages before having a successful pregnancy. She wrote this beautiful post on Facebook telling women who had miscarried how she understood their pain on that day since she had experienced it and gave them love and some solace. We had a good discussion the other day, and she brought up a lot of what you mentioned.
Kat Quinn: I think it's becoming more normalized, at least in some people's social circles to talk about miscarriage or to even send a note sent to friends to say, you know, this was something we were looking forward to and something went awry. There's even a hashtag, #1in4, that women use to try to make people understand just how common it is and to spread awareness, to be open about their experiences. Almost always on those types of posts, there are many comments by people saying that they went through the same thing. Even if people haven't gone through it themselves, we know somebody who has. When people are able to be open, they almost always realize that they're not the only ones they know, who have had hard mother's days, who has had a hard time seeing other people's announcements and babies, and all the feelings that come with it.
CL: Her experience was that she found out all these women that she knew had had miscarriages, but she had not known that before because nobody talked to her about it.
I think you touched on this a little bit earlier, but can you discuss if shame is a part of the psychology of miscarriage?
Kat Quinn: When things happen to us, a human tendency at times is to look for a place to blame or a reason for why it happened. For some people, they end up looking at their doctor and think, “Why didn't you tell me? What did you do wrong? What should have happened sooner? Why didn't I have my appointment sooner?” Things like that can come up a lot.
And other times, it's another source of stress, like it's my job or other things, but most often, people feel that it must have been something they did. Or if they don't feel like they did it on purpose, which of course they didn’t, it's this feeling of shame around your own body. Why didn't my body take care of this? People use different terms, but you know, this child that I was hoping to bring into the world, “Why didn't my body help me move forward with this and create a safe space for it?”
Sometimes there are answers. Sometimes you can run tests and find things out and figure out why it happened. But a lot of the time, we never get any answers. And that can be so hard for people to then move into a space of understanding and reducing that self-shame. I think it's part of what makes it hard for people to talk about too, because everybody else wants to know, why did it happen? Everyone's like, “Oh, well, like do you have a secret condition? Or did you smoke or something?” When so often, it’s just that a lot of pregnancies actually don't make it past the first trimester.
CL: One of the things my friend said was that she felt was really helpful for her to accept, is to understand that there was a reason she had very early miscarriages, and that baby wasn't gonna make it and right, it's better than to have a baby that wasn’t going to live beyond birth.
Kat Quinn: But it can still be harder than to accept, “Why is my body creating that? What's wrong with me? What can I do now?” It can just be so confusing, especially when there aren't easy answers. Some of the answers end up being like working with fertility specialists, which can be expensive and its own difficult process for people in their own way, and it's not always accessible.
CL: You mentioned partners, and I did want to hear specifically about the kind of issues that partners bring to this discussion. What are their needs?
Kat Quinn: Well, sometimes they're still going through a similar grief process around disappointment, especially if they've had multiple miscarriages within the family. But a lot of it is just often not knowing how to support their partner, and how that can impact a relationship. You know, if you don't know what to do or say, it can be confusing. Even if you know that your person that you love is hurting, and they're scared to try again, or maybe you're ready, or maybe you're scared and they're ready, there can be a lot that goes into figuring out those next steps along with just the healing piece.
But I think wanting to protect your partner from another miscarriage, but not being able to or not necessarily knowing you know what to do differently because there's not always something to do differently is, can just be so hard. I see a lot of it coming from a place of care like that.
Sometimes there's also denial and anger. And, again, everybody who's trying to build a family can be really impacted by a miscarriage. But the typical questions are “What should I do? Am I saying the wrong things?, or Am I doing the right things?” And that tends to be a lot of our work. So you can just keep trying to support your partner, but you have to let them grieve on their own and be ready on their own.
CL: And there are the hormonal changes that are part of the equation as well, right?
Kat Quinn: Definitely, definitely hormonal changes and they can be ongoing because sometimes people miscarry, and it still is weeks until they end up having a procedure to totally clear everything out or until they start to feel better. And then it can be a while until they get a normal period again, which is sort of the sign that your uterus is healed. So there can just be a lot of waiting with a lot of triggers within that. That can put couples on edge because of just not knowing how to get through it because it's not just like a one-day one-time tragic event. It's usually kind of ongoing for a little while.
CL: If somebody does confide in you that they've had a miscarriage, what are best practices for supporting friends?
Kat Quinn: Well, there's definitely a lot of do nots out there. Don't say, “you'll just try again, soon.” I think can really minimize the experience for people even though there's some truth to it. People mean, well, by it, but saying, “It just wasn't meant to be or the timing must have not been right for you. Everything happens for a reason.” Those types of statements are hard, and may not be something that resonates with your friend, even if it was a phrase that helped you get through it.
I think a lot of it is just validating wherever they're at, letting them know that you're there for them and that you're hearing how they feel. I think that can go a long way. People who are going through something hard, just want to know that it's okay for them to feel this way and that their friends aren't judging them for it. So anything that we can say along those lines of “Wow, this must be really hard for you” or “How are you feeling today?” even just to check in and letting them get things off their chest if they're up for it can be really helpful, and help people feel cared about is most important. A lot of empathy and just a lot of “this is hard, and you didn't deserve this, and it's not your fault. And I'm here for you.” is, in some ways, the only things we can say.
CL: What resources can you point people to?
Kat Quinn: I always encourage people to talk to their doctor. Doctors, whether it's their OB/GYN or just a general practitioner will have resources for that. They'll have ideas for organizations or therapists who take their insurance.
The other thing is that social media actually can be incredible for these types of experiences. There are probably hundreds of Facebook groups geared around this exact experience, whether it's women in their 30s, who have chronic miscarriages, or it's men whose partners keep miscarrying. There's good stuff out there, and they have hundreds and sometimes 1000s of people. I point them out because, for many of my clients, they've actually been a huge source of comfort in remembering that they're not alone.
But this access through Facebook, anyone can post and people can comment and share is so easy. It can be at any time of day that you're feeling a certain way. There will be other people there who feel the same way can be incredibly helpful. Because there are so many groups out there like Christian moms trying to understand God's plan, or queer couples going through a miscarriage, there's going to be such a wide variety.
Of course, finding a support group can go a long way to help. You can Google in your area or ask around.
Sometimes I'll give books or podcast recommendations. And it really just depends on where people are at. Are they trying to heal and start again? Or are they trying to just grieve? So it is person-specific. There are podcasts specifically about miscarriages too, and how to to help yourself keep moving forward. There's so much available, people just have to know where to look and remember it's out there.
CL: Thank you so much for all of the information. I am sure that many of our readers will have learned something new and have new tools for supporting their friends.
Lisa Hanasono experienced a miscarriage and decided to break the stigma of talking about it at a TEDX Talk. Click her name for the link to the video
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