We Need To Talk About Miscarriage

To mark Babyloss Awareness Week (October 9th-15th), Belle About Town writer Emily Cleary recalls the trauma of her own miscarriage experience and questions why such a common experience is still so avoided in everyday dialogue….

“Kiss the baby”, I said to my son. At one year old he couldn’t walk, or talk, but he leant over from my husband’s lap and placed his lips on my swollen belly. The three of us giggled as we thought of the baby growing inside that would complete our family. I glanced at a poster on the wall which screamed ‘ONE IN FOUR PREGNANCIES END IN MISCARRIAGE’ at me. How insensitive to put that there, I thought. Coming for your 12 week scan should be a happy occasion. If I’d had a miscarriage I wouldn’t be here.

Not for one second did it cross my mind that the baby inside of me, causing me to be so large I was in maternity wear already, might not be alive.

As I lay on the hospital bed, ready to see a wriggling foetus appear on the screen, it was quickly evident something was wrong. Dates were checked, I was asked to undress, ready for an internal examination. Then looks were exchanged between sonographers and we were hastily told “I’m afraid there’s no baby. Well, there was, but it stopped growing. It’s what’s known as a missed miscarriage.”

The next few minutes were a blur. I was wailing, my tiny son was shocked and confused, and my husband wore an expression I’d never seen before and have never seen since. We were ushered into a side room where it was explained that although my uterus continued to grow, the embryo (not baby, they explained) had not. “It’s what we call a blighted ovum” said the matter-of-fact doctor. Just one of the stark, heartless phrases I was to hear over the next few days.

It is estimated that a miscarriage occurs in 15-20% of recognised pregnancies, where a health professional or pharmacist has done the testing. The true figure, taking positive home pregnancy test results into account, is likely to be nearer 25%.

In the UK, early pregnancy loss accounts for over 50,000 hospital admissions each year. Every day, women endure these at home in their bathroom, in a shop toilet, or on a tube, train or bus, often before even realising what is going on. Frequently there’s no warning, just a huge, instant attack. So if this is happening up and down the country on a daily basis, why are people still not talking about it? Every now and then we might read about a celebrity losing a baby, but never once consider it could happen to us, and has probably already happened to our mother, sister, best friend or the woman sitting next to us at work.

Once we knew I was no longer pregnant, we were faced with the decision of what to do. In cases like ours, discovery at around 12 weeks, you can choose to wait to miscarry naturally, accept medical management – a tablet or pessary – to induce the miscarriage, or undergo a procedure known as an ERPC – that’s an Evacuation of Retained Products of Conception. Catchy, eh? Sensitive, eh? Those pesky retained products of conception, or, to us, our second child.

Having decided to get it all out the way and undergo the procedure we went home to absorb the news and for me -a huge glass of wine and a packet of fags. It seemed the only thing to do – stick two fingers up at my blighted ovum and chain smoke while drinking myself into a drunken rage. Arrangements were made for our son to be looked after, and my husband and I were left looking at each other, wondering why this had happened to us. What had we done wrong? How could it be true? We knew alcohol couldn’t be a factor, I hadn’t smoked for years, and I was fit and healthy. We felt so alone and there was no information available, no support offered or explanation to find. “I don’t think I’ve ever felt this sad,” he said, simply. And I knew how he felt. But I had the added elements of guilt – guilt that somehow I had caused this – and failure – I’d let everyone down. I couldn’t even carry a child, the one thing women were put on this earth to do.

The poster I had seen in the hospital was one created by the Miscarriage Association – to raise awareness of their existence and offer help and support for sufferers. But apart from seeing the notice on the hospital wall, I had no idea what they were, what they did, or how they could help. Nobody at the hospital wanted to talk about miscarriage, they just wanted a medical problem resolved.

Ruth Bender Atik, director of the Miscarriage Association, wants things to change. The charity offers information and support for women struggling to cope with their experience – and for their partners too. They also work with health professionals to promote more sensitive care. She says: “When you’re looking after someone with miscarriage, kindness, compassion and clear information can really help them through the most difficult of times.” The language and terminology used is crucial too and the charity is working with The Association of Early Pregnancy Units and the Royal College of Obstetricians and Gynaecologists to get hospitals to use the term “surgical management of miscarriage”, as opposed to the stomach-churning Evacuation of Retained Products of Conception.

On the day of my planned evacuation procedure I awoke with stomach cramps, and started bleeding. Luckily I knew what was happening, a strange blessing of having had my three month scan two days before. For many women the cramps or bleeding are the first sign that they are losing the baby they have been carrying for the past three, four, even five months. As I bent down to kiss my son goodbye before heading to A&E I felt a pain. It was the strongest, hardest, scariest pain I have ever had. It felt like I was being ripped apart from inside to out. Within seconds there was a rush of blood, clots, God I don’t know what, all falling from me. It was like the worst case of diarrhoea you can imagine, but all from the front, and all at once. The fear I felt is something I will never, ever forget. Fluid was just falling, it wouldn’t stop falling. I screamed to get my baby away and crawled to the toilet, but it was all beneath me. There for me to see. There was my pregnancy. Ten seconds of torrential outpouring and it was over. I felt like my world had fallen out through my vagina.

It wasn’t over, of course, I was rushed to A&E, losing litres of blood and spent the next 12 hours inhaling gas and air, just waiting for the next contraction to push out another torrent of waste. There’s no control to be found, no dignity to retain. Just lying on a hospital bed while blood and mucus pour out of you. Occasionally wondering whether that lump you felt was the remains of your unborn child.

What happened to me happens to dozens of women every day. It causes physical pain and emotional trauma. But until I had my miscarriage I had no idea how many people I knew had been through the same thing. I didn’t discuss it with anyone apart from those closest to me for months. Miscarriage is still the M word, a word left unspoken and an experience left undiscussed. One of the last remaining taboos.

A miscarriage is the loss of a baby at any point up to 23 weeks and six days of pregnancy. That’s about five months. While we had only (only?) had three months of planning for a new arrival – browsing double buggies, working out maternity leave dates, training our son to ‘kiss the baby’ – many women have spent almost half a year carrying a new life inside them. Subconsciously touching their stomach dozens of times a day, thinking of names, wondering what features he or she will inherit, even feeling those first, fluttery, butterfly movements.

We need to talk about miscarriage. We need to discuss what happens, how it feels, and what support is there for sufferers. Technical terms and medical descriptions have their place, but when your world has collapsed around you, and all you’ve been building towards has gone, you need sympathy, kindness, and support.

The physical scars from miscarriage can take months to heal, the emotional ones years. While my husband admits he rarely thinks about our ordeal, every time I have a period I’m reminded of what happened. Looking down and seeing blood brings it all back. The fear of what was happening, the heartache of rewriting our future. To him, to doctors, it may just be a blighted ovum. But to me it was my second child.

• For more information on the symptoms of miscarriage, Babyloss Awareness Week, and where to get support and advice, see www.miscarriageassociation.org.uk.