Did you know October is Miscarriage and baby loss awareness month?
I didn’t until I saw a post from a fellow doula in my Facebook feed saying:
A miscarriage is natural and common. All told, probably more women have lost a child from this world than haven’t. Most don’t mention it, and they go on from day to day as if it hadn’t happened, so people imagine a woman in this situation never really knew or loved what she had.
But ask her sometime: how old would your child be now? And she’ll know.
It’s a quote from Barbara Kingsolver, a gifted writer and poet. Her statement is powerful in evoking the sentiment of loss that comes with miscarriage, but how she defines that loss isn’t true for me.
I am in the middle of my fourth miscarriage.
My first miscarriage was a couple months before I conceived my first child. My second was a few months before I conceived my second child, and the last two miscarriages were five months apart.
For me, I am grieving a dream created with love and hope.
This dream had a timeline of possibilities and my body is experiencing the physical loss of those possibilities. I am grieving on a soul level. But I don’t carry the grief of any of my miscarriages like the loss of a child.
If those pregnancies had held, I don’t know how old the children would be. I’d have to do the math and I don’t want to. This doesn’t discount the loss or grief I felt during each miscarriage. I didn’t grieve wrong. This is my experience and my process.
As doulas, it’s important to recognize each woman processes the loss of miscarriage in her own way. Don’t assume because it was an unwanted, or unknown pregnancy, that a woman doesn’t experience a deep loss. If a woman is pro choice that doesn’t change the way she carries her grief either. Whether you are religious, atheist or anything in-between, everyone will work through the grief of her miscarriage in their own way. Let’s not tell a woman experiencing a miscarriage how and what to grieve. Instead, let’s show up for them and give them support for this loss that is seldom acknowledged and rarely discussed.
As doulas, we don’t tell a woman how she should view the births of her children. Many of us have attended births that were difficult for us but beautiful for our clients. It’s not our place to put our perspective on their experience. It’s part of our service as doulas to be aware of our own agendas as they develop and approach our clients with an open mind and heart. We know that people are compelled to share birth-horror stories with pregnant women in a misguided attempt to relate to them. People often miss the mark when talking to a woman about miscarriage.
When I experienced my first miscarriage I was in a hatha yoga teacher training program that became a state accredited school shortly after I enrolled. What that meant for me was the flexibility of attending classes at different dates and times to work around my travel schedule disappeared. Attendance was required. The miscarriage began early in the week and by the weekend the worst of the bleeding had past, so I soldiered on and went to class. This class was the prenatal yoga segment. I sat in class grieving with my whole body and deeply aware of the emptiness in my uterus. We moved through a series of postures with bolsters belted around our midsection to replicate how yoga felt to the pregnant body. I said I was sore and injured, so I wouldn’t have to participate. I was nervous about enacting something I may never again do for real.
Later we sat to do a meditation. “Place your right hand on your heart and your left hand on your baby.” It was too much.
I left the room in tears and explained to the director of the school I needed to go home even though I didn’t have anymore absent days available — because I just had a miscarriage. She asked me to sit and offered me tissues and tea. She asked how far along I was in the pregnancy, if the pregnancy was intentional, and how long we’d been trying to conceive. I think her questions were a way of trying to understand what I was going through, but to me it felt like she was calculating the sum of my loss. My experience was being weighed and put into perspective by someone else. I didn’t feel supported. I felt judged. And embarrassed. I felt vulnerable.
When I recovered she asked if I would consider going back into to the class and sharing my experience because it would be a valuable learning opportunity. I felt like I was being asked to put my grief on display. It was disrespectful and inappropriate. I knew she didn’t mean it to be.
In my second miscarriage I found myself having to explain a prolonged absence from a workout commitment to a class trainer who was encouraging me to push past my limits. I kept my workout easy. I was still spotting from the miscarriage, but it had been almost two weeks. So I told him, “I’m having a miscarriage.” My use of the present tense alarmed him.
Most people don’t understand that a miscarriage can take weeks. The woman is then hormonally thrown into the postpartum period. Sometimes women are informed they’re going to miscarry by their care provider because HCG (Human Chorionic Gonadotropin) levels aren’t raising enough, or the fetal heartbeat isn’t detected, and it takes days or weeks for their body to miscarry.
Sometimes a woman’s body doesn’t recognize that the pregnancy isn’t viable, so the uterus keeps growing, pregnancy hormones rise and morning sickness continues, until a surgical procedure called a D and C (Dilation and Curettage) is performed. I’ve listened to a woman struggle to find words to describe that particular situation, but I had the presence of mind to stay quiet and let her find her own words.
After my third miscarriage our housekeeper commented on the state of our home. With two small children and a husband who travels during the week the house was trashed. I told her I’d been sick, but she wanted to know with what. I tried to brush it off, but she asked again. She seemed worried about being exposed to something. She has young children too. When she asked a third time and I couldn’t bear the effort of saying it was allergies, or a cold, while my body was weak and still recovering from borderline anemia. I told her I had a miscarriage and that’s how I learned she had no tools for dealing with loss or grief. Her whole body stiffened, her lips pursed and she didn’t make eye contact with me for the rest of the day.
This time I’m explaining my absences with an explanation of strep throat. There is a grain of truth to it. I was at a Walgreens clinic waiting for a quick strep test when the miscarriage started. I wrestle with tears each time I explain rescheduled appointments with the words, “I was sick.” And still, the lie is easier because so many of us have no idea what to say to someone experiencing loss or grief, and miscarriage is even more unspoken.
If a family member dies it would be understood that a person will need time to process the loss, especially 
if it is someone in the same household, but with miscarriage a woman is expected to shoulder the loss, grieve silently, receive no bereavement from work and offer up socially comfortable explanations for her absence or change in physical health. It’s too much to ask.
From the beginning of this miscarriage I’ve had reoccurring dreams of grizzly bears releasing an earth quaking roar in my face. It’s taken me nearly two weeks to figure out what they mean. In childbirth a woman is asked with each contraction to give more of herself, more than she thought she could, more than she knew she had. For some women the sacrifice comes with a beautiful and fierce roar. Seeing the postings about miscarriage and baby loss awareness, and the mis-interpretations of how that grief is experienced, while experiencing my own loss awakened a roar of my own. In my efforts to grow my family I have given up more than I thought I could. It’s been done in silence with socially acceptable excuses. This is my roar.
If a woman shares her miscarriage with you, it’s okay not to know what to say. Words aren’t going to fix it. “I’m sorry. Thank you for telling me,” are all the words you need. After that, it’s better to hold the space in silence or offer a comforting touch than to ask detailed questions for the benefit of your understanding. Unless you are her doctor or midwife, your understanding may not help her. If she wants to talk, she will. Don’t assume you know how she’s experiencing her grief. If she’s someone close to you, or in your circle, and you want to do something for her, offer to make food. Ask if she would like you stop by for a hug and chocolate. Follow up with a phone call the next day. Send daily texts for a few days so she knows she’s loved and cared for. She may not want company, but if she’s told you about her miscarriage she needs you to hear her roar.
Kisha fell in love with birth in the midst of giving birth. She comes from a background of teaching yoga and meditation and spent years working in the Austin community as an advocate for women who have experienced domestic and sexual violence. She is passionate about working with women to stand in their power and creating community to nourish and support women and their families before during and after birth. You may find more information about Kish at her website www.bhaktifamilybirthing.com
Kisha is a DTI Doula and our Austin Texas DTI Ambassador.