TALKING ABOUT MISCARRIAGE
Photo credit: Vitaly Gariev, Unsplash
“For those who are pregnant or have had a baby, there is at least a recognised care pathway, albeit not always perfect.
But for those who ‘almost’ had a baby, the system often does not know what to do, leaving people to be told to ‘come back when you’re pregnant again’, and to navigate the aftermath of this loss alone.”
Photo credit: Vitaly Gariev, Unsplash
In Child Zero, my protagonist, Ayla, suffers a miscarriage. It is her third loss, and she and her partner are devastated. It is estimated that one in four pregnancies in the UK end in miscarriage. That’s around 500 miscarriages every day. For those couples and individuals involved, it is highly distressing and incredibly painful. Some miscarriages require surgical intervention at maternity hospitals where other pregnant mothers are being treated, and they have to wait to be seen whilstAnd yet we rarely discuss it.
For some couples, this will not be an isolated event. Five percent of women experience two miscarriages. One percent experience three or more. This is known as recurrent miscarriage. Currently, doctors are only required to provide follow up investigations to women who have recurrent miscarriage. Women and partners who experience one or two miscarriages are often left to grieve their loss alone, and then expected to try again, hoping that next time they will carry their baby to term. For many, who have struggled to get pregnant in the first place, this can be deeply traumatising.
Photo credit: Kristina Flour, Unsplash
The Miscarriage Association carried out a survey which reveals that 65% of women said they did not receive adequate follow-up care after their miscarriage for both physical and emotional effects. This compounded their feelings of isolation, distress and uncertainty.
Many spoke of feeling dismissed by medical professionals, and that it was a ‘dehumanising’ experience.
More than 68% experienced mental health problems related to their loss, including grief, depression, PTSD and suicidal thoughts.
A third of women talked about their miscarriage to family and friends, a third to a few selected individuals, but there was still a lot of stigma around the subject, with women worried about discussing it with people, especially at work, and fearful of the consequences of taking time off to recover or for follow-up medical appointments.
Miscarriage can profoundly affect emotional wellbeing, mental health, personal relationships, working life and social identity. And yet the research shows that responses from medical professionals, employers and wider communities is inconsistent, inadequate and not joined up.
“Knowing there were things that could make a difference. That gives you some hope to hang on to. It takes away the guilt and shame that you feel.”
Photo credit: Vitaly Gariev, Unsplash
The good news is that a pilot project at Birmingham Women and Children's Hospital has been launched, which experts believe will prevent thousands of miscarriages every year by offering earlier checks and advice. It will also save the NHS money by preventing future hospital admissions, even accounting for the extra staff and training.
Under this scheme, women who experience one or more miscarriages are seen by a specialist nurse who can offer emotional support as well as specific tests to see if there are reasons for the loss. Appropriate treatment options are then discussed, including hormone supplements which may increase their chances of success next time.
After two miscarriages, women are offered an early scan.
These early checks and scans are currently only offered to women who have recurrent miscarriage: i.e. after the loss of three babies.
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“The three miscarriage wait is an unacceptable anomaly. We don’t do that with any other medical condition. If somebody has a heart attack, we don’t say have your third heart attack and then we will see if there is anything we can do.”