There's a lot being said these days about natural childbirth. I really have little to add to the conversation beyond my hearty approval. Much less is being said about natural miscarriage. Truthfully, little is said about miscarriage at all...until you have one.
At the time I became pregnant with my first child, I knew about a dozen other women who were also pregnant. I wondered idly which of us would be the 1 in 4 that miscarry. In my 13th week, with no outward signs of trouble, I certainly didn't think it would be me. As no heartbeat could be found by Doppler in my midwife's office, I was sent to the hospital for an ultrasound. There it was confirmed that my baby had died several weeks prior, but the amniotic sac had continued to grow.
I asked for a picture of my baby from the ultrasound for my scrapbook. The technician didn't want to give me one, but the doctor in charge granted my request. There is little enough to hold on to in memory of a miscarried child. Some women are barely allowed to grieve the loss. For me the photographic evidence gave me something tangible to justify my grief, if only to myself, and to share with later children as I tell the story of our family.
Back in my midwife's office, I was given an option most women today are not. Most women, especially those who miscarry so far along, are promptly sent back to the hospital for a surgical procedure called a dilation and curettage or d&c. This is the same procedure used to remove the fetus in a first trimester abortion. Since I was involved with a program presenting a high school sex ed curriculum that explained the risks of these procedures, I knew that it wasn't just an easy fix without side effects. My midwife explained the reason for this procedure—fear of bits of the pregnancy being left behind and causing infection—but I asked if there were any other options.
A veteran of thousands of births, she shared my faith in my body to do what women's bodies have evolved to do over thousands of years. I tend to trust these natural processes over medical interventions that have only been around a few hundred years at the most. Especially pertaining to natural physical processes like reproduction that should not be considered illnesses or medical events in the first place. Because of that, she explained that I could just go home and wait for my body to birth this preterm, already deceased baby naturally.
Sound terrifying? I will admit that it would have been comforting to go through this process in a more typical prepared birth environment. It is just like childbirth only more painful and over more quickly. Unfortunately, the medical establishment highly disapproved of natural miscarriage at that time. In order to send me home my midwife had to delay reporting it and scheduling the d&c and hope that I delivered naturally before anyone caught on. Home I went, with a better than average understanding of birth thanks to my sex ed instructor history and Doula mom, and instructions to call if we needed any help.
A few days later I gave my husband the scare of his life. It was two in the morning when I started having contractions and, thinking it would be a while, I decided not to wake him. I was aching in my lower back and beginning to bleed so I climbed in the shower. The pain, worse than anything I had ever experienced or imagined, escalated quickly. He awoke in a panic to the sound of my agonizing vocalizations. He called the midwife who sympathized and explained that it should be over in about an hour and reminded him to either look to be sure everything had come out, or save it to bring to her to do so. In the meantime, the shower was probably the best place for me. Then, he paced helplessly in the hall, just being there for me.
In that hour I experienced gut wrenching pain compounded by soul rending grief. I saw the fear in my husband's face and understood the desire of doctors, husbands, and even women to try and avoid this agonizing scene. I also was able to release everything that hurt inside me at the loss of my first child.
Near the end of the hour I felt I couldn't sit on the floor anymore so I stepped out and sat on the toilet. I felt the urge to push and quickly delivered an intact amniotic sac the size of a large baking potato. Clearly everything was there, and the pain abruptly ceased. My mind and body were spent. My husband helped me get cleaned up and climb into bed. I slept for two days straight waking only briefly to eat and use the toilet.
And then I woke up. I woke up with renewed hope and renewed health. The process of natural miscarriage allowed me to grieve deeply and completely and I was done. I remember my baby's birthday every year but feel no compulsion to commemorate it, and I am comfortable talking about my loss with others. Through my experience I can better understand how some cultures incorporate forms of self flagellation in their grieving practices. There was something about experiencing physical pain in tandem with my emotional pain that helped me process it and let it go. Perhaps this is part of the appeal of running marathons in memory of loved ones lost to various diseases. It's not a guarantee of closure, but it is a more active path toward it.
Having had no medical procedures, I had no complication or recovery issues. A few months later I was pregnant for the second time with a healthy baby girl. Nine months later I gave birth to her naturally in a free standing birth center with no complications.
In the wake of my miscarriage I was astounded by the number of women who opened up to me about their own miscarriages. Given the odds, most women who have three or more children have had one. Many of these women carry their grief for years if not a lifetime. In later years, as I became a practicing Doula, I saw the damage carried by women who had undergone d&c procedures for miscarriage. Not only did it leave scar tissue on the cervix that prolonged labor in future childbirth, but it seemed to have complicated the grieving process. The disconnect between the physical loss and the emotional loss seemed to leave something undone. Something that needed to be exorcised during labor before the mother could progress and deliver her healthy child.
As a result of my experience, I strongly believe that natural miscarriage should be permitted in a medical environment to reduce the risk/fear of complications. I also strongly believe that it should be encouraged by the medical profession whenever possible for the emotional health of the women who must experience this loss. I understand that further study would be required before such a recommendation could become established policy, but a study is warranted. While I would never suggest natural miscarriage be mandated (no woman should be forced to deal with this process if she is not ready for it), nor that it is a cure all for grief, I believe that in our efforts to avoid pain, we often overlook the higher goal of complete physical and emotional healing. We would rather schedule a procedure than give our bodies time to do what they can to heal themselves. We don't like to acknowledge that some types of pain are good for us.
I am interested in the thoughts of other women who have experienced a miscarriage, natural or with d&c. Please feel free to share them in the comments.
At the time I became pregnant with my first child, I knew about a dozen other women who were also pregnant. I wondered idly which of us would be the 1 in 4 that miscarry. In my 13th week, with no outward signs of trouble, I certainly didn't think it would be me. As no heartbeat could be found by Doppler in my midwife's office, I was sent to the hospital for an ultrasound. There it was confirmed that my baby had died several weeks prior, but the amniotic sac had continued to grow.
I asked for a picture of my baby from the ultrasound for my scrapbook. The technician didn't want to give me one, but the doctor in charge granted my request. There is little enough to hold on to in memory of a miscarried child. Some women are barely allowed to grieve the loss. For me the photographic evidence gave me something tangible to justify my grief, if only to myself, and to share with later children as I tell the story of our family.
Back in my midwife's office, I was given an option most women today are not. Most women, especially those who miscarry so far along, are promptly sent back to the hospital for a surgical procedure called a dilation and curettage or d&c. This is the same procedure used to remove the fetus in a first trimester abortion. Since I was involved with a program presenting a high school sex ed curriculum that explained the risks of these procedures, I knew that it wasn't just an easy fix without side effects. My midwife explained the reason for this procedure—fear of bits of the pregnancy being left behind and causing infection—but I asked if there were any other options.
A veteran of thousands of births, she shared my faith in my body to do what women's bodies have evolved to do over thousands of years. I tend to trust these natural processes over medical interventions that have only been around a few hundred years at the most. Especially pertaining to natural physical processes like reproduction that should not be considered illnesses or medical events in the first place. Because of that, she explained that I could just go home and wait for my body to birth this preterm, already deceased baby naturally.
Sound terrifying? I will admit that it would have been comforting to go through this process in a more typical prepared birth environment. It is just like childbirth only more painful and over more quickly. Unfortunately, the medical establishment highly disapproved of natural miscarriage at that time. In order to send me home my midwife had to delay reporting it and scheduling the d&c and hope that I delivered naturally before anyone caught on. Home I went, with a better than average understanding of birth thanks to my sex ed instructor history and Doula mom, and instructions to call if we needed any help.
A few days later I gave my husband the scare of his life. It was two in the morning when I started having contractions and, thinking it would be a while, I decided not to wake him. I was aching in my lower back and beginning to bleed so I climbed in the shower. The pain, worse than anything I had ever experienced or imagined, escalated quickly. He awoke in a panic to the sound of my agonizing vocalizations. He called the midwife who sympathized and explained that it should be over in about an hour and reminded him to either look to be sure everything had come out, or save it to bring to her to do so. In the meantime, the shower was probably the best place for me. Then, he paced helplessly in the hall, just being there for me.
In that hour I experienced gut wrenching pain compounded by soul rending grief. I saw the fear in my husband's face and understood the desire of doctors, husbands, and even women to try and avoid this agonizing scene. I also was able to release everything that hurt inside me at the loss of my first child.
Near the end of the hour I felt I couldn't sit on the floor anymore so I stepped out and sat on the toilet. I felt the urge to push and quickly delivered an intact amniotic sac the size of a large baking potato. Clearly everything was there, and the pain abruptly ceased. My mind and body were spent. My husband helped me get cleaned up and climb into bed. I slept for two days straight waking only briefly to eat and use the toilet.
And then I woke up. I woke up with renewed hope and renewed health. The process of natural miscarriage allowed me to grieve deeply and completely and I was done. I remember my baby's birthday every year but feel no compulsion to commemorate it, and I am comfortable talking about my loss with others. Through my experience I can better understand how some cultures incorporate forms of self flagellation in their grieving practices. There was something about experiencing physical pain in tandem with my emotional pain that helped me process it and let it go. Perhaps this is part of the appeal of running marathons in memory of loved ones lost to various diseases. It's not a guarantee of closure, but it is a more active path toward it.
Having had no medical procedures, I had no complication or recovery issues. A few months later I was pregnant for the second time with a healthy baby girl. Nine months later I gave birth to her naturally in a free standing birth center with no complications.
In the wake of my miscarriage I was astounded by the number of women who opened up to me about their own miscarriages. Given the odds, most women who have three or more children have had one. Many of these women carry their grief for years if not a lifetime. In later years, as I became a practicing Doula, I saw the damage carried by women who had undergone d&c procedures for miscarriage. Not only did it leave scar tissue on the cervix that prolonged labor in future childbirth, but it seemed to have complicated the grieving process. The disconnect between the physical loss and the emotional loss seemed to leave something undone. Something that needed to be exorcised during labor before the mother could progress and deliver her healthy child.
As a result of my experience, I strongly believe that natural miscarriage should be permitted in a medical environment to reduce the risk/fear of complications. I also strongly believe that it should be encouraged by the medical profession whenever possible for the emotional health of the women who must experience this loss. I understand that further study would be required before such a recommendation could become established policy, but a study is warranted. While I would never suggest natural miscarriage be mandated (no woman should be forced to deal with this process if she is not ready for it), nor that it is a cure all for grief, I believe that in our efforts to avoid pain, we often overlook the higher goal of complete physical and emotional healing. We would rather schedule a procedure than give our bodies time to do what they can to heal themselves. We don't like to acknowledge that some types of pain are good for us.
I am interested in the thoughts of other women who have experienced a miscarriage, natural or with d&c. Please feel free to share them in the comments.
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