Thank goodness that second trimester miscarriage is so rare. I wouldn’t wish it on my worst enemy. But if first trimester miscarriage is taboo and misunderstood, second trimester miscarriage is even more so. Today I’d like to write about some of the well-intentioned but in fact very painful things that people said to me, that might not have been as painful for someone who had experienced a first trimester miscarriage.
I’ve read a lot about how people recovering from a miscarriage were both shocked and comforted by the huge numbers of people (mostly women) who came out of the woodwork with stories of their own miscarriage experiences and (generally) subsequent healthy births. My experience was exactly the opposite. I wasn’t shocked, since I’m both the daughter of a women’s health nurse practitioner and an obsessive statistics reader, so I knew that anyone with a 2- or 3-kid family had about coin-toss odds of having experienced a miscarriage. And I was not comforted, because I felt that the physical (if not emotional) experience of my miscarriage was very different from theirs, and I know that my prognosis is different as well. So while “Oh, honey, I had a miscarriage between kids 2 and 3 and I recovered quickly and went on to have more beautiful children” might be comforting to someone miscarrying at 9 weeks, who has every science-backed reason to believe that they *will* recover quickly and go on to bear future beautiful living children, it was not to me. Nor was “Oh, the same thing happened to me!” (bet you ten bucks it didn’t) or “I know just what you’re going through!” (no, you really don’t). Instead, these types of statements left me with feelings of being misunderstood and alienated, even from other people who had experienced miscarriage!
Some context: Instead of the surgical or home medical management that is typical for first trimester miscarriage, I had no choice but to have labor induced and deliver in the Labor and Delivery ward of the local hospital, which involved holding my dead baby while listening to the cries of newly-born live babies from down the hall. I’ve been told I have a 30% risk of placenta-related complications in future pregnancies, and all my future pregnancies will be high risk; that’s not something that happens when you have a first-trimester miscarriage. I’ve found studies (albeit with small sample sizes) that show that women with a history of second trimester miscarriage and Factor V Leiden have miscarriage rates as much as 2-3 times higher than the general population (particularly in the second trimester!); my perinatologist has offered prophylactic blood thinners for future pregnancies, which means that throughout any future pregnancy I’ll be giving myself daily injections (twice daily in the last month). And I experienced complications after my miscarriage that are ongoing and may have further serious implications for my future fertility. Most of these things are outside the experience of someone who has had a first trimester miscarriage — and naturally they have no idea that that’s the case.
So those are the stickiest ones, because they really are so well meaning but ultimately hurtful. Here are a couple others that were said to me — again, I’m skipping the obviously terrible ones, and focusing on the ones that were meant with nothing but kindness yet wound up hurting bitterly.
“It’s so nice that you got to take a couple of days off!” – On Thursday afternoon I found out at a routine prenatal appointment that my baby was dead. Friday I was in labor. Saturday I was discharged from the hospital. Sunday my milk came in and I was so dizzy that when I tried to walk the dog with my husband I couldn’t make it home and he had to come pick me up in the car. Monday I was sitting at home dizzy and bleeding and icing my chest (not to mention weeping uncontrollably), and there’s no way I could have lectured for 1.5 hours. You bet I took a couple of days off (Friday and Monday, to be precise), but it wasn’t “nice,” it was necessary, and in fact insufficient! Frankly it was phenomenally stupid to think I could teach again by Wednesday, and a few comments on my teaching evaluations reflected my careless preparation in the middle of the semester when my job (which I normally love) was approximately the last thing I cared about. With 20/20 hindsight, I really should have taken the week off, at least.
“You look great!” – Really? Because I feel the worst that I have ever felt in my life. I lost 12lbs literally overnight, and a few more in the week after that when my appetite completely disappeared, and the burgeoning belly that I LOVED with every fiber of my being was gone, also overnight. I was one of the lucky girls who skated through teenagerdom without significant body image issues, possibly related to the fact that I have a disabled father and was always able to appreciate what my body could DO rather than what it looked like. But for the first time in my life, my body has failed me, utterly and completely, in its most essential biological function. I may look great (although I doubt it), but I am still gushing blood, feeling dizzy and sick, and for the first time in my life I hate my body. Would you tell a cancer patient who lost 15lbs in a week that she looks great? Thought not…
OK, moving on, what SHOULD you say to a woman (or a man) who has experienced second trimester miscarriage? I can’t pretend to speak for everyone, but the most helpful people kept it simple, asked open-ended questions, weren’t pushy but left the door open for as much or as little as I wanted to talk (in reality, I was dying to talk about things, because it has been the biggest/only thing on my mind for the past four months), were kind, and didn’t make the interaction about them or their experiences. Ideal interactions for me went something like this: “I am so sorry for your loss; can I give you a hug?” “How are you doing? Really, I want to know.” “If you want to talk about it I’m here, but if not that’s fine too. What do you need?” “We made/sent you some dinner/chocolate.” “Would you like to go for a walk and catch up?” Crucially, the people who were most helpful kept checking in. One of my closest friends (whose wife was due with their second within a week of my due date) called nearly every day — while the circumstances could easily have devastated our friendship, we are closer than ever because he was so thoroughly THERE for me, and didn’t back off even though I spent hours sobbing into his ear from across the continent. And other friends were lower-key, but weeks or months later I’d see an email that said “Hey, I just wanted to let you know that I’m thinking of you and I know you might be having a tough time with the holidays. I’m here if you want to talk.”
I mean, seriously, that last one… grief is always awkward to talk about, and it often feels like everyone else moves on faster than you do. I haven’t been able to move on, since I’ve had so many ongoing complications, so it’s still a very current part of my life… but hardly anyone brings it up anymore, and I feel bad raising the issue because I don’t want to give people TMI. But any other medical issue that landed me in the hospital twice in two weeks and required corrective surgery months later… people would be talking to me about it, asking how I’m doing… or would they? Maybe it’s not just because it’s a squicky women’s issue; maybe everybody is this bad about grief and loss. Maybe I’ve been this bad about it in the past when other people have experienced loss. One of the ways I’ve been working to mold this into a constructive experience is to think about how I can be more empathetic to others who have experienced loss or other difficult times.