I’m often asked by clients, “How can I reduce miscarriage anxiety?” “I’m worried about getting pregnant” “what if I have another miscarriage, and can I prevent it”.
These are huge questions and I wanted to start to unpick some of the emotional aspects that face us after a miscarriage and what you can perhaps do.
Its a long post and it accompanies the podcast episode Number 28.
I want to talk specifically about the emotional effects after miscarriage and how this might impact you when moving forward to trying again, and perhaps what factors might be implicating your success and how to reduce miscarriage anxiety or worry.
My Miscarriage Story
I wanted to start by sharing first of all my own experience of miscarriage. I had a miscarriage when I was 37 and It was my first pregnancy.
I had a missed miscarriage, so my body had stopped developing the pregnancy, but I wasn’t aware of that yet. I hadn’t lost the pregnancy physically, if that makes sense, not visibly lost it.
I remember I was working away from home for the day in Oxford, and I live in Nottingham. I was about to deliver a training course.
I started with some tummy cramps and I went to the toilet, I was bleeding, and my first thought was, I’m having a miscarriage. I was away from home, didn’t quite know what to do. One of my very, very good friends from my student nursing days actually worked at the hospital in Oxford, so I called her and said, “I think I’m having a miscarriage”, and don’t know what to do, should I go into the John Radcliffe (the hospital in Oxford), I really didn’t want to go to A and E, and as her mind processed that, obviously the first news she heard was ” I think I’m having a miscarriage”, which of course meant I’m pregnant. So as her mind processed that she reacted to that, and for a brief moment, she was a little excited about fact that I was pregnant and then “Oh dear, well, I’m sure it’s okay. I’m sure it’s okay”, bleeds happen. But I knew, I felt it.
We went to the hospital, they did a scan saw the yolk sac, as it was no bigger than a five week growth. So I had only physically been pregnant for a week. But I was nine weeks into my pregnancy, in terms of time.
What I did first of all, was drive back to Nottingham and I referred myself to the early pregnancy unit, which apparently isn’t the norm. Apparently you should go to your GP for it, but I had been a nurse previously. I knew it was there and I referred myself and they scanned me again. They said they couldn’t give me anything, due to the size, and it being too soon to see the heart beat. They said, I may have got my dates wrong. We had to let nature take its course.
Three Weeks later
Well, three weeks later, numerous visits, scans and reassurance that it was “coming away’ nature had still not taken its course.
I had to then go in and have a surgical intervention, a D & C, so it was a very long and protracted experience three weeks waiting for my body to kind of give in really. The resilience of my body was hanging on emotionally it was all manner of things because I just really wanted it over so I could get on and try again. But, I wanted to know how I can prevent another miscarriage?
That’s kind of where my mind was at that time. It became inconvenient and that became the focus of my attention, but this affects people in so many different ways, and we all cope differently and we’re all affected differently.
Can knowing the cause prevent another miscarriage?
One of the things that we often look for is a cause. We want to know what caused it because of course, if we know what caused it, then we can look at ways to prevent another miscarriage, which can result in miscarriage anxiety or worry.
When you look at causes of miscarriage, you’ll most likely see that the cause can be most commonly ‘unknown’ which can in itself cause miscarriage anxiety. There are many, and often we will never know. But, some are:
- Chromosomal: an issue with the chromosomes within the embryo that has formed and that could be from the chromosomes in the egg. The chromosomes in the sperm or it can be the combination of the two
- Hormone imbalance: see podcast ‘how progesterone affects fertility’ and blog progesterone, miscarriage and fertility.
- Clotting disorder: this will need to be tested for and diagnosed after recurrent miscarriage (3 or more)
Is it something I did?
But generally, what you’re asking yourself is, what did I do? Was it something I did? And really the answer is NO.
At the time I had got pregnant, I ran, well I say run, I partook of a 45 minute gentle jog 3 times a week, I’d been doing this for some years. And so I thought that perhaps running had something to do with it, because it’s the only thing that I could think. So I stopped running and I didn’t run again, probably for another. I don’t know, five years!!
Or perhaps I had eaten something I shouldn’t have done before the positive pregnancy test, I had had some alcohol, just a little, or perhaps, or perhaps…
A key thing here is that it takes two to make a baby and the same factors apply here too. I discussed how male factors affect fertility with Barbara Scott in episode 14 of the podcast and this applies to miscarriage too.
“Its really common” isn’t helpful
The other thing to explore a little are people’s reaction’s and how that can possibly trigger you. When you tell people you have had a miscarriage, you’ll hear things like :
it’s really common.
It’s nature’s way
you’ll get pregnant again,
It happened to me, my friend, my sister
You should try soon. It’s easier to get pregnant straight away, especially if you’ve had a D and ,C that was something I was told.
It’s really, really difficult because you know yourself, when somebody tells you something sad, we want to make it better. We want to give helpful, reassuring advice. As humans in situations where somebody tells us something very sad or troubling. We don’t know what to say. So we reach for something we’ve heard we reach for something positive. But actually, sometimes you just want someone to say, Oh, I am sorry, that shitty. And you just want them to be with you.
Being seen as a victim
Sometimes, you don’t want to be seen as a victim. And so you may take the approach of “Oh, it’s okay” because you just want them to stop. You just want them to stop focusing on what you’ve just told them. Sometimes you maybe do want the attention and feel that its not forthcoming, because people say it is so very common.
We deal with things in such different ways, and we are not mind reader’s. So we don’t know how to react with someone because we don’t know what they’re feeling, but we tend to second guess it.
Sometimes you just want to let it out. You want to have someone there, you want to be honest, but it’s not always possible. You perhaps don’t want it to define you, you might want to just get on and move on.
Loss of the future
Like I said, I had this experience, but also as with me, you might not have told anyone because it was before 12 weeks. So then you’re experiencing this grief, and this horrible situation, you cant just turn up somewhere ad cry, if you didn’t tell people you were pregnant in the first place, they will ask so many questions. So to them as with my friend, it’s a double whammy of information. And all of that is so incredibly hard.
What I would say to you is this is grief and yes, you can be sad its the loss of a baby, of hope, of the future.
Another thing you hear is “Oh well, it was only six weeks or it was only eight weeks or you might be saying that to yourself.
But where were your thoughts in your pregnancy? Where were you at? Because it’s a loss of the future. That you could, within a four week window between 38 and 42 weeks, you would be expecting welcoming a baby into your world. You saw yourself as a mum and let me say you were, you are. You saw your partner as a dad and he was or he is.. We don’t have to talk in past we can be in present IF that’s is comfortable to you.
Maybe you had an image of what the baby looked like, perhaps you’d thought of names, you knew that your baby maybe would be a similar age to some friends, children and family members who would be born around the same time
You had been looking into your future. It’s hard not to of course you would. It was a baby.
What the Brain is doing
If we look at how the brain deals and stores memories, it associates them with feelings. And we can start to look at that in terms of the methods to support us moving forward.
I’ve talked about this before in the fertility rewire programme based around:
So survival can lead to fear based future activities, and it’s what is there to keep us alive. If you touched a wood burner and burn your hands then you would know for future that would burners are hot, and your learned behaviour is not to touch. We know about tigers and keeping ourselves safe our ancestral self, say from tigers.
The brain parts at play here are the limbic system and the prefrontal cortex. So something traumatic is happening or something dangerous or the currents that rise is the adrenaline through the body.
That memory becomes imprinted in the amygdala which is part of the limbic system. And it holds emotional significance to that event. When we think back to sad or scary events, the emotions rise again. So the amygdala stores images in sensory fragment so it’s not like a story. but in the experience of the five senses of sight, sound, taste and Touch, all at play and stored in these fragments. This is the same for non traumatic events too in terms of sensory and emotional imprint.
How memories are triggered
It’s how memories are stored. So it might be that, a certain smell takes you back to a happy place, or a certain smell. So the brain is triggered by the sensory input.
An example of this is the smell of a hospital for me. Now hospitals years ago used to smell very much of hospitals. I don’t seem to smell the hospital smell anymore. perhaps its a change in disinfectant, or I became immune while working as a nurse, but other people say that they can still smell a distinctive hospital smell.
So, yes hospitals, many people hate the smell of hospitals and that’s is because it’s linked to a memory, not a good memory and often a childhood one.
I’m quite sad that hospitals don’t have that smell to me anymore, maybe it was an old fashioned disinfectant? My mum was a nurse and that smell reminded me of her. It reminded me of her coming back from work. And, what’s interesting is, My mum passed away when I was 22, but it doesn’t make me think of the sad time in hospital. It still is that very strong, comforting memory, clearly imprinted in that as it reminded me of her when she came home. And that’s really fascinating about memories and how this works and how we can reimprint through mind based therapies.
Survival instinct not logic
When your body is in fight or flight, say with a fear response, the prefrontal cortex, the human part of the brain for logic, reason and decision making actually shuts down.
It’s an instinctive response, the body is basically saying react, react, react, there is a tiger and you react, you run, or you stay in fight. Right now, in this traumatic event, the prefrontal cortex is shut down. So after the traumatic event, when you are safe, the prefrontal cortex steps back in and says okay, does a bit of analysis and can rationalise it. But for some, that doesn’t work, the memories don’t get analysed and stored, they stay attached to the trauma emotional response
It’s why some people have phobias and it’s how PTSD works, and don’t forget this can happen when you imagine an outcome or situation or outcome too. So when you are thinking about the what ifs? What if it happens again? What if I get pregnant and it happens again?, you’re into this element of in the podcast episode future tripping.
So if you think about your emotions, now the emotions that you experience after during a miscarriage can include sadness, anger, grief, there maybe some guilt, sadness, unfairness or you might experience jealousy in other people.
You may take away a positive from it and experience a sense of hope that actually you did get pregnant. So now as you move forward, you are positive. It can make some people step back and look at their lifestyle and nutrition.
You may start the research scroll, what is suggested, what did others do and when you see lifestyle suggestion, this may trigger emotions that will drive your response.
I’ve talked before about how there’s always a situation, a fact that cannot be denied. We then develop a thought about the situation, that thought leads to an emotion and that emotion leads to a chemical response so a physical reaction and a behaviour and action, which leads to a result. So it’s really important to work towards being able to see the emotion and acknowledge the emotion. Then we can start to see where it comes from and what thought led to it. This is a huge part of what I do with clients when we are working to develop and implement their action plan.
Grief and Release
I mentioned grief earlier, so for many the first thing is to grieve, sometimes is what’s needed. That could be a thought process and mentally working through and acknowledging your feelings. It could be a ceremony, some people have planted plants or trees in memory, or have some sort of saying goodbye. When you look into all cultures, a really important part of us as humans is that we have this process of saying goodbye. And also a sense a of letting go, not of the memory of the loss, not at the loss itself, but almost a sense of letting go of the emotions.
I do a release visualisation with my clients, which is always so incredibly powerful and it’s something that I did myself during my fertility therapy training. It was about five or seven years after my miscarriage. And I really didn’t think that I was affected by that miscarriage. I was very much, compartmentalising things and said right come on, let’s just get on with it. There’s no point in dwelling and that is what I was taught as a child. Get up, and get on. But perhaps that child ‘part’ of me was doing as she was told.
I think looking back the grief of the miscarriage was pushed down, not pushed away, but down. There is increasing evidence that trauma is held in the body and manifests itself as many things physically later. So, I did this release, and my response was huge. I sobbed and sobbed sobbed and felt such a release, a lift almost as if Id created space.
Whenever I do this release, with clients who have experienced miscarriage, it is really, really powerful. And they really do feel that shift. So if you want to know anything more about that, then just drop me a line and let me know.
I may also undertake some trauma work with some clients, which helps them to reprogram the memory, not remove the memory, but change the emotional imprint. So you still remember everything that’s happened, but the emotional response changes. I use this for birth trauma, that maybe you experienced if you’ve had a child previously or what you have heard or witnessed.
Taming your tigers
I also work with clients within my programme, which is where we look at taming your tigers. And you’ve heard me talk about Tigers before. And when we are in that innate survival instinct and that fear based response we are reacting to on modern day tigers,
It’s not an actual tiger, but the chemicals released during our fear based, worry based thinking are telling the body that it’s not safe and reduces or shut downs body systems and functions, including fertility.
I said earlier that emotions comes from a thought. So one of the things that you can either work towards doing or perhaps have a go now:
Start to distance the thought by saying
“Here is the thought that..” “Here is the thought that I will miscarry again, here is the thought that I did something wrong.
What you are doing is distancing it. and bringing in that pre frontal cortex with its logic and reasoning.
Going a step further is to say “I notice I am having the thought that…” This distances it twice.
I would also encourage you to write down the thoughts you are having and recognising them as thoughts, that’s something really powerful. And I do get people to do that in the programme when naming the Tigers, your fears and worries are your tigers.
What would you say to a friend?
Another thing that you can do is conversational journaling. Now, I don’t know if you journal and if you don’t, I would suggest you give it a go because it’s incredibly powerful.
In conversational journaling you kind of have a conversation with yourself. So you can start to think, what would you say to your Best Friend, if they had just said that to you what you are thinking, what would you say to them? Or another way is what would you want someone to say to you? Its so incredibly powerful, because it makes you step out of that momentum of that thought building and growing and whirring away. You step out, you step back, you come in with logic and reason
You don’t feel in control when your thoughts are fear based “what if it happens again” and we know the effect of fear based thinking on health and therefore reproductive health.
Developing an action plan can give you a sense of control and this is something that’s part of the Fertility Rewire Programme. The podcast episode It takes 12 months to grow a baby, will tell about the importance of that three month pre conception plan and why that is key.
The focus is often on getting pregnant, but these factors all affect staying pregnant.
Visualisation/ Self hypnosis
There is increasing evidence through research to support the effectiveness of hypnosis with Fertility/ Infertility.
I have recorded a set of 4 Fertility Rewire Self Hypnosis tracks
The control room is really powerful for this but also the library exercise where you’re removing and replacing fears. Aside from this I also provide a track to my clients when they do get pregnant an early pregnancy visualisation which again gives this element of control.
Facts and reframing
“10% of a situation is what happens 90% is our reaction to it”
We can engage that pre frontal cortex with some facts, as you read these, take a moment to see how they sit with you. If they make you anxious, don’t use them but see if they can help you to move forward.
You may have seen been told, read or heard that one in five pregnancies end in miscarriage, that’s 20% of pregnancies. This is early miscarriage (pre 12 weeks) There are some stats that suggests one in four pregnancies because there are pregnancies that perhaps people hadn’t recorded or didn’t know about. So, if it’s that then we’re looking at 25% of pregnancies end in miscarriage.
1% of pregnancies end in recurrent miscarriage, three or more miscarriages in a row.
A US figure shows that 2% of pregnancies end in a second miscarriage in a row.
As you read this, do you see that rationally? What it shows is that it is very unlikely that you would have another miscarriage? Of course it can happen and it does happen and if you have had more than 1, 2, 3 or more,please know I am not saying it doesn’t happen.
Recurrent miscarriage is investigated, so if you have had 3 miscarriages, this will be investigated further. More detailed tests are undertaken, and we can start to see if there are chromosomal issues, clotting disorders and so on.
Perhaps it works better to see the stats from a different view point.
Lets revisit the stats above, if 2% of pregnancies end in a second miscarriage in a row, that means that 98% of pregnancies after miscarriage are successful
If you were drawn into thinking that you could be in the 2% there’s more to dig into emotionally there and some thing we can have a chat about.
Resilience and planning
Some of us are great at dealing with stressful situations, but many of us although good when it hits the fan are not so focused when we image the situation, when we catastrophise. I talk about my “Little Miss Catastrophe” in the episode on Future Tripping
You’ve come through all sorts of situations in your life. And you may have come through your miscarriage or you are still working through it.
An exercise I do with some clients and especially if they are future tripping, is to get them to dig a little deeper, if it’s safe to do so. I ask them to write down the likelihood of this fear happening based on fact, then you score it between 1 and 10, where 1 is improbable and 10 is it will definitely happen.
Then you write down your action plan of what you would do if it did happen. The prefrontal cortex is being engaged here and its important that it is.
When you have a plan of what your action plan would be, but step out of fight or flight and engage the frontal cortex.
Can you Enjoy being Pregnant?
Do you have a tendency to try not get your hopes up?
Where does that come from, were you taught it? Many of us tend to say we are prepared for the worst, but really you’re just just fearing the worst?
People you have a tendency to try to not get your hopes up. And this is the question I asked all of my clients who get pregnant, when they say things like it’s early days, anything could happen.
My questions is:
If you don’t get your hopes up, if you carry on saying what you’re saying to me now, will it feel less painful? If you have a miscarriage? Does it protect you? Because you’re not allowing to get your hopes up?
So what I would suggest is be present, when you are pregnant again, be present, and experience the joy being pregnant in that moment, without future tripping.
You can stop yourself running forward to the future. You are four weeks pregnant, and that’s great. You’re five weeks pregnant, you’re six weeks pregnant, and so on, and so on. The pregnancy books that tell you day by day, week by week, what the embryo development is, that show you how it is right there in that moment can be a useful tool that some people use.
How can I help?
I hope you’ve been able to take some useful advice away from this. It’s more a kind of a thought provoking discussion really, I hope you have some answers to the question, “How can I prevent another miscarriage?” and I hope you can see that it may be within you, your thoughts and emotions. And perhaps rather than looking to prevent or avoid another miscarriage, you can look towards getting and staying pregnant.
I’ve mentioned some resources available. I’ve mentioned a few podcast episodes. And the hypnosis tracks that are available on the website.
You can of course, always reach out to me if you wanted to work with me on this moving forward or find out perhaps how we could work together on this. Then you can always call for a 20 minute chat, which is free.
There are different associations you can gain information from in the UK, we have the Miscarriage Association.
There is support, there is information but as ever with information can have too much information or the wrong information, it can lead to overwhelm and it can lead to more fear based thoughts and emotions or it can arm you with a sense of control.
That’s why I’ve created the FREE course – FERTILITY 101-AN OWNERS MANUAL
I’m passionate about this information. But I’m passionate about sharing it with you and it being useful for you to be able to use tools to move forward.