What to Say (Or Not Say) When Someone Miscarries

Let me start this by saying nothing has gone wrong with this pregnancy, the baby and I are healthy and fine.

I've thought about writing this post for a long time, but have always felt like everyone is so different in how they grieve that my one opinion would be helpful.  But  a few months ago a friend, who has never had trouble getting pregnant, asked for some advice on what to say to someone she knew who'd lost a baby.  She said she knew she didn't understand and didn't want to pretend to, but that left her at a loss as to what to say.

I hope I do not hurt anyone's feelings with this post.  I know many of the people who said these things to me/us after we miscarried were trying to be helpful and love us a lot.  But I also think it's important to explain how I saw things.  And I am fully acknowledging that this is how I dealt with my grief and it may be totally different for someone else.

I'll start with the things that were not useful to hear.

1.  Something must have been wrong with the baby
              While this is entirely accurate medically, I did not want to hear about how the perfect baby I had imagined must have been genetically abnormal or deformed.  The image I have of him/her is and always will be perfect.  It was insinuated to me that we were better off losing the baby than having him/her deformed, which just made me mad and hurt more.

2.  It wasn't God's will.
               As someone who believes in God and believes He has a plan for my life, I know that this is also true.  Even when I was at my darkest moment, I still believed God was with me and could feel His presence with me.  But I was also mad at God for letting it happen and questioned the fairness of it all quite a bit.  Saying that the death of a baby we had tried for for 2 years was God's will only made me more upset at God.

3.  When it's God's timing, you'll get pregnant.
                  This one is very similar to number 2.  Death is part of life and I believe God walks, or carries, us through it, but that doesn't make this a comforting statement.  Also, there is no one on Earth who can claim to know that I would get pregnant again.  There is always a possibility that I wouldn't.  So trying to reassure me that I could have another baby (as if that could replace the one I was grieving for) was just a reminder that I might never get pregnant again.  We would have and still might adopt, so I knew I would be a mom, but I had no guarantees that I would ever be pregnant again.

4. At least you weren't farther along.
                   This one still makes me clench my fist.  You cannot compare someone's grief to another.  And trying to mitigate the grief and sadness just invalidates the feelings that were going on inside of me.  Could it have been worse?  Yes.  Did that make me feel any better?  No.

5.  20% of all pregnancies end in miscarriage.
                  A true statistic that I have heard many many times.  But just because a lot of other people have gone through the pain does not mean that I will feel better when you tell me that.  It also felt like a very dismissive statement most of the time.  Like losing our baby was "bound to happen."  Definitely not something that helped.

6.  You'll get pregnant again.
                  This one is similar to #3.  You don't know that I will ever get pregnant again, no one can know that.  Is there a good possibility?  Yes.  But you can't promise that or offer it as a reassurance when the person knows it might not be true.

7.  Nothing at all.
                   Miscarriage is a strange grief because it's different.  There's no body, no funeral, and life just goes on as usual.  I remember driving in the car, sobbing, and wishing I could be as oblivious as the people in the car next to me who were laughing and talking about something.  A lot of people didn't know what to say, so didn't say anything at all.  I understand why, but I felt very alone at times.  And I did have people who talked to me, so I wasn't alone.  Had I not had those people, I can't imagine what the silence would have done to me.
           
As you can see, many of these things I intellectually know to be true.  But they either made me mad, more sad, or just didn't help.  So what did help?  Here's what helped me:

1.  People acknowledging the grief
             A simple "I'm so sorry" and a hug was an acknowledgement that my grief was real, legitimate, and that the person was there for me.  Don't ask "how are you doing" with the slight head tilt and pursed lips, though.  "Crappy, that's how I'm doing" was the answer I wanted to say.  I didn't really want pity, but I did want people to acknowledge my sadness.

2.  Offers of help
              But this has to be specific.  Saying "let me know if there's anything I can do" was never going to get a request from me.  Saying "can I bring you dinner in the next couple of days" is helpful and doesn't require me reaching out to you.  I know I have a hard time asking for help, so the only people who did bring us food or other stuff were people who offered very specific things.  Or just came.  Flowers and a card left on the front porch the day after we found out let me know that our friends were thinking of us.  Dinner so I didn't have to worry about what we were going to eat (which I could have cared less about the first couple of days).  A gift to remind us of the baby.  All of these things helped me.
              On the flip side, some people may not want the same kind of thing.  I did want a reminder of this baby, but others may not.  But if you are going to offer help with something, be specific about it so the only required response is "yes."

3.  Offering an understanding shoulder
              I had a lot of people tell me or email me about their own experience with miscarriage.  The ones who did it with sympathy and who answered questions for me helped me get through the roughest days.  There were some whose stories felt almost like they were "one upping" me, which was not helpful.  But for the most part, people shared their stories and offered a shoulder to remind me that I was not alone.  Everyone's story is different, so know one can understand exactly how I felt, but there is a certain camaraderie in grief.

4.  Help tell other people
             We'd had a hard time keeping the pregnancy a secret, even though we were still in the first trimester.  We were so excited that we told a lot of people, even knowing that we were at a higher than normal risk for miscarriage.  The most difficult thing we had to do was type out the texts telling everyone that we had lost the baby.  I forwarded the same one to most people, but having to think of everyone that we had told was hard.  If there's any way you can help the person tell other people about the miscarriage, that will take a weight off their shoulders.  And having to answer the same questions over and over makes it hard to just be sad and start to grieve.  Most of my responses became automated, and I didn't even have that many people to tell.  I was lucky enough to tell a few and let them handle the rest.

5.  Acknowledge the due date
             Our due date was engrained in my mind and there was no way it was going to pass without me remembering it.  You can read about that week here.  I thought I could handle it, but I ended up having my emotions bubble over.  I thought no one else had remembered, which made me even more sad.  It turns out that because I hadn't said anything, those who were closest to me had hoped I hadn't remembered.  I think it would have been better to do something to acknowledge the day and deal with the grief head on instead of trying to bury it.

Those are all the things I can think of at the moment.  And remember, this is just what I felt.  The best thing you can do is ask the person.  Do they want to talk about it?  Do they want to stay busy?  Do they want to have a lot of people around?  Do they want to be alone or just one or two close friends/family?

As Mother's Day approaches, I feel for the many friends that I know are still dealing with infertility and loss.  It's one of the most difficult days of the year and unfortunately a lot of well-meaning people trying to acknowledge mothers don't realize how much it hurts to not be considered one of them.  For those of you in that situation, I am praying for you.

Hopefully this helps with some difficult conversations, or at least makes someone stop and think.

The Storm Begins to Clear

So I figured it would be good to write a blog post before school officially starts and things get even more busy.  Since I haven't written anything since before the D&C, I figured it was time for an update.

I actually don't really remember the D&C itself.  It was in Roseville and we had to be there really early (7 I think), so the drive was uneventful.  We were among the first people into Kaiser, I think, because it was very empty.  We even beat the receptionist by about 5 minutes.  They checked us in and Stephen got to stay with me the whole time.  (While they put in the IV, checked all my vital signs, etc).  We were the only ones back there, so it was pretty fast.  The doctor came and talked to us and then they wheeled me back.

I remember them talking to me a little bit, and talking about the patient that was coming after me.  The doctor patted my feet every once in a while, which I found strangely comforting.  It was like I "I know you're here, you'll be fine" kind of pat.  After they gave me the "cocktail" I don't really remember anything.  I wasn't actually unconscious, but the drugs have an amnesiac effect and pretty much knock you out.  Just not completely.  The one thing I do remember is tears running into my ears because I was laying flat on my back.  The nurse must've noticed because she wiped away some of them.  But I think they were either done or almost done because I don't remember anything else about that moment.

The next thing I remember I was back out in the recovery area and Stephen was there.  I guess the doctor came out to get him right away because I was crying.  I slept for a while, but the machine I was hooked up to kept beeping because my heart rate was dropping too low.  I guess I just have a very slow resting heart rate, especially with the drugs in my system.  The nurse said it was okay because my blood pressure is very low, too, so it's not a bad thing.

We left there around 10:30, so the whole process went very quick.  We got Arby's on the way home and had to wait for the drive through to open.  :-)  I laid around for a couple of days, but I think overall I did okay.  My family and a couple of good friends checked in a lot, which was a nice reminder that I wasn't alone.

Since then whenever people ask how I am, my answer is usually "good days and bad days."  The majority of days are good now, unless something sets me off.  I hear a sad song on the radio and can't keep it together.  Someone at work is confrontational and I get over emotional.  Sometimes it all happens in one day (two weeks ago) and I just come home and cry.  I get strangely overwhelmed sometimes, like the first big family thing we went to, or the first time we went back to church.  I know I am loved and supported in both places, I wasn't nervous about being there, but I just get really emotional for no reason.  It's happening less often, though.

It feels like the major storm is clearing out.  Not gone completely, but less central and consuming in my life.  I don't know if it will ever be gone completely.  My grandpa died in February, so I believe he got to meet our baby before we did.  But someday we will meet him or her.  Until then, life goes on.

Pre service days start next week and the students come Thursday.  I've actually been at school all week trying to get ready.  But I'm actually glad to be going back.  It will focus me on other things, I have some good leadership students who are excited and happy to be there, and I'm looking forward to my second year as activities director where I feel like I know a little more.  A little.

Also new for us is a couple from Ireland, Daniel and Samantha, are renting from us while they get their feet under them in the U.S.  Daniel is actually originally from Sweden and Samantha is from New Jersey/St. Louis, but they've been living in Ireland for 6 years.  Daniel works for Apple and worked with Stephen.  I met him when we went in March 2011, but only briefly at a large table with a lot of Apple people (I mentioned the dinner here).  Daniel decided to transfer from the Cork Apple to the Elk Grove Apple, and were looking for a place to live.  Hotels are really expensive, and apartments rarely come furnished and are hard to decide on without seeing.  We said they could rent from us since we have a furnished room and extra bathroom.

One of the first things we did was go to IKEA, which is a Swedish company.  You know all those Swedish names they have for every item in IKEA?  Well the really are Swedish, but not all make sense.  Some are no brainers, like the sewing machine name means "sew."  But there was a braided basket whose name meant "snip."  And some of the names are just cities.  We decided someone in Sweden sits behind a desk and just laughs as they decide on names.  It was quite entertaining to walk through IKEA with a native Swedish speaker, who pointed out some of the more interesting names.

And that Swedish market they have after the registers is truly a Swedish market.  Daniel was very excited to find a certain cheese that is not found anywhere else.  Apparently IKEA used to carry actual Swedish brands of things, but now they are making their own.  But it's still good, at least according to Daniel and Samantha.

They flew into Elk Grove around 11:00pm last Saturday, so between that and starting school, life has been busy.  It's a welcome distraction.

So how am I doing?  Good days and bad days, but more good than bad.

  

Confidence Makes All the Difference

So we are feeling much better about the surgery after going to the doctor today.  We met the doctor who's going to do the surgery and he was very nice, very reassuring, and perhaps best of all, very confident.  He did the ultrasound for the sole purpose of helping us be comfortable with our decision.

Right away he said stuff was beginning to happen in my uterus, and even we could see a difference.  At the 6 week ultrasound (when the baby was still alive), there was a dark circle that would eventually have become the placenta.  At the 8 week ultrasound (2 weeks after the baby stopped growing), it was more of an oval.  Today, what should've been 10 weeks, it was misshapen, like a deflating balloon.  He said that was the beginning of the miscarriage.

He also showed us the fetal pole and how it measured 6 weeks and 4 days.  Then he showed us how big it should have been at 7 weeks (twice it's size), 8 weeks, and when I said I should be 10 weeks, he showed us how big it should be.  He said at that point it's a baby, very clear and easy to see.  All we could see was a little stick looking thing (he was pretty sure it was the fetal pole).  It was actually more difficult to see the baby on this ultrasound than the 8 week one, so it is very obvious, even to Stephen and I who cannot read ultrasounds, that there is no chance that this baby could be alive.

He said he couldn't tell for sure if the baby had implanted on the septum.  He said it was in the left half, and it looked like it was on the side, but he couldn't be sure.  He said we should still do the septum surgery, which we were going to do anyway.  I guess some people would say if it wasn't a problem this time, why do another surgery.  But for us, anything we can do to improve our chances is worth it.  It means we have to wait 3 - 4 months before we can start trying again, though.  6 - 8 weeks recovery from the D&C before the septum surgery, then 1 or 2 menstrual cycles recovery before trying again.  This means a late summer, fall, or winter baby, which is definitely not what I had planned, but at this point it doesn't seem as big of a deal.

The doctor offered us a card for a counselor, went through everything that's going to happen tomorrow, and spent some time just talking to us.  I have felt strangely okay all day.  Maybe this is God's way of showing me this is the right decision.  And the upside of not being pregnant and not being able to try to get pregnant is now I can drink caffeine and eat sushi.  I'm not a huge alcohol fan, but I could drink if I wanted to.  And I can get healthier and more in shape, which will hopefully lead to an easier pregnancy.    

Update on the miscarriage

It seems like most people are afraid to ask for updates, so I figured it would be good to post about it on here.  I know there's a lot of people reading it.  And for those of you who sent emails, whether or not I responded, I appreciate your kind words and prayers.

It's been 10 days since we found out there was no heartbeat, 3 and a half weeks (24 days) since the baby stopped growing.  And I'm still queasy, still tired, and still can't stand the sight, thought, or smell of eggs or ham.  Pretty much exactly the same as when I was pregnant.  No spotting whatsoever.  Some cramping, but I've had that for over 2 weeks.

We did two blood tests last week and while my HCG levels are high, they are decreasing.  And while HCG levels do decrease in the 9-11th week, they should be higher before they decrease.  So that pretty much seals the deal.  Even if the doctor, the ultrasound tech, and the radiologist were all wrong, my hormones don't lie.

We're going to do one more ultrasound tomorrow, just for peace of mind.  And we have the D&C scheduled for Monday morning.  It's with one of the fertility specialist doctors, so I feel confident in his knowledge of my weird uterus.  The other doctor said several times in our conversation that the septate uterus shouldn't be a problem, wouldn't be a problem during the D&C.  I got the feeling she was convincing herself just as much as convincing us.  Granted, our only interactions with her have been negative and being told that this baby we were dreaming about was no longer alive.  So we may be a little biased against her.

I am not feeling overly confident in the decision to do a D&C.  I know there is not really any chance that this baby is still alive, but what if...  The D&C spares me the physical pain of a miscarriage, and the possibly long period of bleeding afterward.  It means we can schedule the surgery to remove the septum sooner.  And it means we can start moving on and really healing emotionally.  We had the initial shock and sadness, but now we're just waiting.  Checking every time I go to the bathroom.  Praying that the cramping gets worse so it can just be over.  But everyday it's just more nausea, exhaustion, and cramping.

I am not getting a clear answer from God, either.  I do know He's with me.  I have one friend who I haven't seen in a while who we happened to run into and tell we were pregnant.  I texted her and told her when we lost the baby.  She is one of the strongest women of God I know; when she says she'll pray for you, things happen.  It the darkest moments, after the radiologist confirmed no heartbeat and after the initial decision to not do the D&C right away, she texted me.  The first was just to say I was on her heart, and the second time that she was later.  Both came within 5 minutes of getting the news.  It was like God using her to remind me that He sees me and I am not alone.

Exodus 14:14, "The Lord will fight for you; you need only to be still" (NIV) and "The Lord Himself will fight for you.  Just stay calm" (NLT) have popped up in my life multiple times.  It was in a "worry" Bible study I started on YouVersion after I found out I was pregnant (I was worried from the beginning).  A friend sent it to me in an email.  And I've seen it on Pinterest of all places.  It's pretty much where I'm at right now.  I don't have the emotional or physical fight in me, my only option is to be still.  I tend to withdraw when I'm upset, or angry, or sad....pretty much all the time.  Given fight or flight I choose flight everyday and twice on Sundays.  All I can do right now is be still, and that's ok for now.

Waiting to Miscarry

So I haven't posted anything in a while because I was hoping my next post would be an "I'm pregnant!!" post.  We found out about 3 weeks ago that I was pregnant.  Did the home pregnancy test, it was positive.  Did the blood test, it was positive.  Did an ultrasound because I was spotting a little, it was positive and the doctor thought she could see a heartbeat but we couldn't hear it.  But that is normal for around 6 weeks (which is what I was).  We did another blood test 2 days later and my HCG hormone more than doubled, which was a good sign.  We told immediate family and a few friends, but were waiting until our 8 week ultrasound to confirm the baby had grown before telling everyone.

I spent the two weeks beyond thrilled that I was queasy and had strong aversions to certain foods.  It's not fun to be queasy, but I so desperately wanted to be pregnant that any sign of pregnancy was exciting and welcomed.  We knew we were high risk, but still hoped.

At the 8 week ultrasound the doctor was quiet for a while, looking for the heartbeat.  Then she told us she couldn't find one.  And the measurement was 6 weeks 3 days, when it should've been 8 weeks and 2 days.  When we'd gone in 2 weeks earlier it had been 6 weeks 1 day.  She said they always confirm by having someone else do another ultrasound, but she'd been doing it for 16 years and didn't want  to give us false hope.  After talking a lot, she kind of sat there waiting like we were supposed to say something.  I don't know if we were supposed to have questions or what, but all I wanted to do was leave.  She left and then came back with some paperwork on dealing with miscarriage and took us out to make an appointment for the next day.

The next day we went to the radiology department to have another ultrasound.  I was already very emotional, and then they wouldn't let Stephen come back with me.  And the tech was pregnant.  And grumpy.  She did the regular external ultrasound, then had me go to the bathroom and did an internal ultrasound.  She had me put the wand thing in, which I found really weird.  Between the uterine abnormality stuff and this pregnancy, I've had 5 or 6 of these internal ones done and had never been told to put it in myself.  When I questioned her, she got really defensive and said she likes to give her patients the option and if they didn't want to that was fine.  Well she hadn't given me the option, I just did it.  But she kept defending herself at which point I lost it and said I really didn't care.  After that she was a little nicer.  She asked if I'd seen my doctor lately, I said yes and she was doing this to confirm.  So I took that as a bad sign.

The doctor called that afternoon and said the radiologist had not found a heartbeat either.  We have three options, either let my body miscarry on its own, take medication to start the miscarriage, or do a D&C.  My doctor seemed to be leaning toward the medication, but after talking to T about it, I didn't want to do that.  T said the medication basically induces labor and can be very painful, and sometimes you still have to have a D&C.  So then I was leaning toward the D&C so I can get it over with and start to move on.  We already have to push the surgery to remove the septate back and I want to start trying again as soon as we can.

Stephen answered the phone when the doctor called.  She started talking about the procedure and actually described a D&E where they use suction instead of scrapers.  She said several times that the septate shouldn't be a problem for her, almost like she was convincing herself.  When she said it was the same procedure as an abortion but not an abortion because there was no heartbeat (I think to reassure us), I lost it.  She just kept talking and talking so Stephen had to cut her off and almost hang up on her.  When her nurse called to schedule to D&C (or E) I told her I'd changed my mind and was just going to let my body do what it's supposed to.

But it's now Sunday (4 days after finding out there was no heartbeat and almost 3 weeks after the baby stopped growing) and I am having no signs of miscarriage.  I'm still queasy, still have strong food aversions, and am still exhausted.  Except now instead of praying there is no blood when I go to the bathroom, I'm praying that there will be.  All the queasiness and other pregnancy symptoms are just a sad reminder that my body can't get with the program and still thinks I'm pregnant.  I'm in this horrible in between time where I can't start to move on because it hasn't happened yet.

Part of me is (irrationally, I know) worried about doing the D&C because people make mistakes.  What if the doctors are wrong?  I also didn't want that particular doctor to do it because I seemed to know more about my septate uterus than she did.  She said several times that it could not have caused the miscarriage, which is exactly opposite of what our fertility specialist said.  And she couldn't tell me where it had implanted, so she couldn't have known that wasn't the cause of the miscarriage.

I'm going to do two more HCG tests this week, and if they're going down, then I know the doctors weren't wrong.  I'm not really holding out hope, I would just always live with the fear that our baby might still be alive and I did a D&C.  It seems like the easy way out for me.  It's over quickly.  I'm not worried about surgery or anesthetic.  I'm terrified of the physical pain that I've read online about natural miscarriages.  And even more terrified of being in this horrible limbo for weeks.

I know God is walking with us through this.  The day after we found out I felt like I was in this protective little bubble.  I was still sad, but I knew we were going to get through it, like there was a light at the end of the tunnel.  It was like coming up for a breath.  Certain days and hours have been worse than others.  Sometimes something triggers the tears, sometimes they just come for no apparent reason.  I know we have a lot of people praying for us and a few good friends who've been checking in.  I know we'll get through this, it just feels like we have so long to go.