It took me four losses to realize that miscarriage, ectopic pregnancy, stillbirth and other pregnancy loss are always traumatic. There is always some sort of trauma involved and yet nobody ever said it out loud.
My grandma’s death, when I was 14, was the first close death I had experienced before I lost a baby in utero over a decade later. When I was 14, I avoided the grief and distanced myself from her sickness and death so I could pretend it wasn’t happening. When I lost a baby, however, this wasn’t a death that I could pretend wasn’t happening. This time it hit me to the core and there was no way out. I had a dead, fully-formed baby inside me, one whose first kicks were felt just a week or so earlier, who now needed to be born. Birth after death seemed such an unnatural, cruel, upside-down sequence of events.
I chose to have an induction, where labor was induced and the baby delivered ‘naturally’, rather than a D&C because I wanted the baby to come out in one piece and to see the body and find out if we had been expecting a little boy or a little girl. The day the delivery happened was traumatic. It wasn’t because of the induction – I had resigned myself to that since the news at a scan two days earlier – it was because of the doctor. I was in Lima, Peru, (where I live), and the doctor was insensitive, abusive and severely lacking compassion and I felt trapped and powerless. There were also many humiliating and unnecessary preparations for the procedure that I was made to undergo, like being shaved and clearing out my intestines into a bedpan in front of a nurse when a bathroom was just three meters away!
The second, third and fourth babies that I lost, all ectopic pregnancies, all involved bleeding, slight to extremely-horrendous pain and subsequent surgeries, each with their necessary recovery times post-operation.
It wasn’t until the fourth loss that I thought about miscarriage and pregnancy loss and realized that there is always some sort of trauma involved.
What is trauma?
Trauma is a stressful situation, you find yourself stuck in, with no way out. Your body’s natural response to stress is either to fight or flight. (Think of a lion chasing down its prey or the fight response a scared animal will give you if back it into a corner). When your body can fight or flight, then it responds to the stressor, and then calms down ‘when the danger is over’. But when there is blood flowing you can’t run from and a hospital stay you can’t avoid, then trauma is naturally present in pregnancy loss. When we are subject to painful, shocking and unexpected experiences which are out of our control which we can’t fight or flight from, they can leave physical traces of trauma: stressful and painful neural pathways in our brain and on our memories. Whether it be facing blood loss, the passing of our baby’s physical body or undergoing unwanted medical procedures and care, trauma is unavoidable for women facing pregnancy loss.
And yet I had never heard anyone talk about the trauma of pregnancy loss before. I had heard whispered acknowledgments of grief, and conversations about how terrible it is to lose a child, but I had never heard someone say out loud that the process of miscarriage and pregnancy loss has trauma involved (beyond the obvious pain of losing a child).
The shock of miscarriage and pregnancy loss:
Miscarriage and pregnancy loss is not simply the transfer of the baby from the womb to heaven. A physical process has to happen that is similar to full labor – either contractions and the delivery of the baby’s physical body, or a medical process, which often involves being under anesthetic. And this labor and delivery all happen much sooner than we are prepared for. When a woman delivers a baby full term, she has time to prepare mentally for the physical delivery, but pregnancy loss and miscarriage often mean that there is no time to prepare. And women are usually unaware that having a miscarriage can be a process which involves painful contractions and labor.
Because women are often unprepared, they may feel like they have no say or choice in the process and default to the suggestions of the medical personnel (who they may or may not trust) or simply feel swept up in the whirlwind of the loss. It can feel like the world and your own body has turned against you and you are trapped. And that is traumatic.
Call it what it is: traumatic.
Rarely does society acknowledge the trauma involved in losing a baby or recognize that it is unavoidable. Women are often left feeling overwhelmed by the trauma but led to believe that they should be over their grief quickly and that it doesn’t leave any physical impact on your body. Society fails to recognize that part of the healing and grief process, for a woman who has experienced miscarriage or pregnancy loss, is dealing with the strong emotions, visual memories and the memories of our senses from a traumatic event. Society fails to recognize the way trauma has changed our brains and neural pathways and how it makes life in general much more difficult for a season.
But there is also hope!
When we recognize that what we have undergone is traumatic, we can take the effects of trauma on our bodies and minds seriously and give them the attention and time they need to heal.
What are the effects of trauma on the body and mind?
During the healing process after a miscarriage it is normal for women to feel:
– heightened levels stress
– under constant attack even after the trauma has passed
– vulnerable, like the universe and your own body has turned against you and everything is out of your control
– Anger and irritability
– Fearfulness and anxiety
– memories being re-lived through flashbacks and dreams
– desire to avoid any reminders of the event
– Feelings of panic/fear if reminders of the event are brought up unexpectedly
– a need to find someone to blame
All these feelings are the body’s way of recognizing the stress that has been put on the body and either fighting (anger, reliving memories, blame…) or flighting (depression, numbness, avoidance) the stress. They are often emotional and physical reactions to the effects of stress from the trauma on the body.
All of these feelings have been part of my recovery after pregnancy loss each time and I found them so disorientating because I wasn’t expecting them. Society had led me to believe that the only acceptable emotion was sadness, perhaps followed by depression (which I didn’t want to accept!) but there is a failure to educate women about the normal process and helpful ways to address those emotions after pregnancy loss.
So what can be done? What ways can women process their trauma and work towards healing?
1) Find a way to acknowledge and process the traumatic events you have faced.
When you face a trauma, your brain tells your nervous system that you are under attack and your body gets ready to fight or flight. When it can’t do either of those things then the stress builds up in the body and get locked there. To release it, our bodies need to feel safe again – we need to feel seen, loved and valued. Chatting with your partner, a friend or counselor, or by writing down your experiences and sharing them with someone who understands, can all be ways of bringing release from the negative stressful emotions connected with trauma. The key is talking to someone who you feel safe with, who will value your story. When it comes from someone we feel safe with and trust, physical touch such as a hug or a hand placed on a shoulder can be healing because it tells your physical body you are now safe as you share the pain you underwent, and your nervous system can now relax. Even without physical touch, studies have shown that when others empathize with us, our brains physically read cues from others which tell our brains that the trauma has now passed and we are safe, so we can relax.
You may find that drawing your trauma or expressing your emotions through art is another helpful to help you identify and respond to traumatic events and strong emotions.
2) Recognize that trauma takes time to process
Be kind to yourself and give yourself time to heal. Emotional healing can often take longer than physical healing after pregnancy loss. Everybody’s healing journey is different and will depend on how resilient your body was to stress before your loss. Getting a runner and a non-runner to participate in a half-marathon race would most likely see the runner win and the non-runner stop before the end because the runner has trained for the event and is stronger and better prepared. In the same way, some people have had more experience in dealing with loss in life and have learned good coping strategies. But if the race was just after the runner had participated in another run, the non-runner would perhaps get further because the runner would have been worn out. Equally, if pregnancy loss happens to us when we are already running on empty with the stresses of work or family life, then it can take a larger toll on us than if we have had plenty of space to rest, and things are going well in life. Don’t compare your pregnancy loss healing with someone else’s.
3) Practice self-care.
Trauma puts a strain on our emotional, physical, and at times spiritual strength, and we need to find ways to strengthen ourselves daily. Strength building is about embracing resistance and providing ample time to rest. Self-care is about embracing the rest we need for our souls to breathe. (Life after loss and people’s unhelpful responses give us plenty of time to practice the resistance-building side!) Self-care is a way to show yourself compassion and kindness and to deal with the trauma step-by-step. I have put together a free guide with 10 ideas for self-care after pregnancy loss which you can pick up by clicking here, but the important thing to find an activity which relaxes and calms you personally and where you feel able to be yourself. For an extrovert that might mean joining a group class, whereas for an introvert that might mean curling up in a quiet room to read or have a bath.
4) Practice spiritual care
Many women find that prayer and spiritual rituals are helpful in coming to terms with pregnancy loss trauma. You can find some prayers you may find helpful by clicking here. It is normal to feel like God or the universe is against you after a loss and it is normal to have many questions. Try and find someone who can listen and encourage you, not necessarily try to answer all your questions.
Although miscarriage, stillbirth and pregnancy loss always have elements of trauma in them, there is hope! For most women, as they process the events surrounding their loss with others who value their stories and see their pain, healing comes slowly but surely. For a small percentage of women, physical reactions to triggers continue or appear in the months following loss and PTSD (Post-traumatic stress disorder) can be diagnosed. I personally was diagnosed with PTSD in the months following my fourth loss and have written about my story in the first issue of Healing After Pregnancy Loss magazine. Much of what I have learned about trauma was by reading The Body Keeps the Score: Brain, Body and Mind in the Healing of Trauma by Bessel Van del Kolk, which I highly recommend for those who want to explore the science behind trauma and different strategies towards healing.
Did you or anybody else ever acknowledge the trauma you faced during your loss?
What might you find helpful today?
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