How therapy can help after a miscarriage

It is estimated that 1 in 4 women will have a miscarriage. You may be feeling like if it is so common that you “should” be able to deal with it on your own or that it will not impact you or maybe even that it isn’t a big deal. For most people it is a big deal and it can be pretty hard to cope with.

Statistics suggest that 30-50% of women experience anxiety and 10-15 percent experience depression up to 4 months following a loss according to FIGO.

NIHR discusses a study that found 1 in 3 women show signs of PTSD after a miscarriage.

So why is this important? We know that the mental health of the mother can greatly impact the child even in pregnancy. Their are many studies that discuss the impact of the mental well being of the mom in pregnancy and the long term impact it may have on the child’s physical, emotional and cognitive development. Many women will become pregnant again soon after a miscarriage but long before anxiety and/or depression symptoms have subsided. While it is common to think getting pregnant again after a loss will decrease anxiety it often does not. Seeking therapy after a miscarriage can impact your ability to cope and decrease anxiety/depression in subsequent pregnancy.

How can therapy help?

Normalize- Many of the feelings you may be feeling are common for those that have had a miscarriage. Knowing that your feelings are okay and that there are ways to cope. Knowing that it is hard to have a miscarriage, that women do seek therapy and sometimes medication after a loss and that most people do not just “get over it”, even if it is common.

Validate- I am just going to say it- people are sooo uncomfortable with grief. You may be finding it really hard to express your feelings with family and friends. This can be even harder with a pregnancy loss that it can be when losing a friend or a grandparent. Often the people in your life may have not had an attachment or even known about the pregnancy before. It can be hard for people to relate to what we call an ambiguous loss. It can be really healing to have your feelings acknowledged and validated.

Help you to identify healthy ways to cope with grief- Unfortunately trying again or gods willing it or at least you know you can get pregnant are not the kind of healthy ways you need to deal with grief. But, acknowledging your feelings, finding support, creating a container for your grief, nurturing yourself, honoring your loss, making meaning and acceptance can be.

Set boundaries and ask for what you need in relationship- If you are in a relationship you probably are already starting to realize that you are your partner are grieving this differently. This also applies to family members that may need a gentle reminder on what you need to feel supported or the acknowledgement that this person in your life might not have the ability to support you through this for whatever reason and ouch can that really hurt.

Understand the grief and trauma around pregnancy loss- Understanding a framework for grief and what you have or might experience can help. Looking at your loss and understanding the trauma that can be experienced can also be really helpful in understanding how it has impacted you and what makes it difficult to process. Working with those triggers, increasing your window of tolerance and helping you to feel more regulated can make a difference.

If you still aren’t sure..find out more or schedule a free 15 minute consult here with a therapist Madison.

Pregnancy after infertility

You have been trying for days, months, maybe even years. Part of you felt that it was never going to happen, maybe you even started to prepare yourself for that and then it does. And maybe you feel some joy, but you might also feel shock, denial or numb. It might not feel real even after you take pregnancy test after pregnancy test. Everyone has advice to give when it comes to getting pregnant when diagnosed with infertility but what happens when you get pregnant after infertility?

Does the infertility diagnosis go away?

No! You are not suddenly cured because you now are pregnant. It doesn’t take away the stress, the longing, the anger, the resentment, how its impacted your mental health or your finances or the impact it had on relationships.

Why do I feel like an imposter?

You may feel like an imposter after getting pregnant. You have wanted to be in this group of pregnant people for so long and now that you are here it doesn’t feel right. You feel like you don’t fit in. Infertility has changed you and changed this narrative you have had about becoming a parent.

Why do I fell guilty?

You may even feel guilty after becoming pregnant. It is common to feel guilty about leaving behind those that are still struggling with infertility. This can be isolating and feel very lonely. If you are feeling like an imposter in the pregnancy group, but also no longer feel like you fit in the infertility groups it can be hard to feel supported.

I am pregnant so I can’t complain.

It is so common for women to feel like if pregnancy is hard or not what they expected that they are allowed to feel this way. You may be telling yourself well this is what I wanted so I can’t complain or you may also be hearing this from others or well you got pregnant what did you expect. Even if you have a very wanted pregnancy that you tried very hard to get, pregnancy is still hard, uncomfortable at times, and not what you expected. Your feelings are VALID!

I don’t feel attached to my pregnancy.

It is common after infertility or a loss to not feel attached right away. This is your protective part telling you this isn’t safe, we need to protect you. For most of you this will grow and develop naturally. If it doesn’t feel like you are slowly starting to develop or that it is feeling more and more real- therapy can help.

I am feeling anxious.

It is common to notice some anxiety or sadness about being pregnant. If you are noticing these frequently or noticing that they are increasing it is important to get help. If you are noticing intrusive thoughts, nightmares or flashbacks there is help.

To learn more about infertility counseling in Madison or anywhere in Wisconsin or to set up your free 15 minute consultation you can reach me here for a therapist Madison.

Meditation for miscarriage, pregnancy after loss and new moms

I remember trying to meditate for the first time. I made every excuse in the book to avoid it. I convinced myself that I did not have time, convinced myself that it wasn’t a good use of my time, that I wasn’t doing it right so what was the point. It took YEARS until I developed a regular practice and it is still a work in progress.

Meditation has so many unbelievable benefits. According to Positive Psychology.com , meditation can reduce physical, mental and emotional disturbances. This can include anxiety, depression, pain, blood pressure, stress, migraines, IBS, ect. Meditation can be so effective.

So if it is so great, why isn’t everyone doing it? What I hear often is that it is hard, you may think you are doing it wrong and if you are doing it wrong what is the point? Other reasons can include you may feel uncomfortable, overwhelmed or don’t want to feel anything.

All of the reasons are valid. I like to invite my clients to start small. Try to take one minute everyday where you just try to tune into your body and breath and go from there. Many of you may find it is easier to do when you have someone guiding you. I certainly do! There are meditations everywhere it seems but finding one that resonates with you is important.

Recently I have created some meditations with you in mind. My library is building slowly but I currently have meditations for miscarriage, pregnancy after loss and motherhood. I will be adding more soon. If you are looking for a specific meditation that is a fit for you please- DM me, reply to this newsletter and let me know what you are looking for and I will do my best to make that available to you.

Interested in learning more about the meditations from a therapist Madison? Click here.

Happy Meditating!

Resources for Pregnancy after a Loss in Madison, Wisconsin - Doula

For this month’s blog post I wanted to take this opportunity to talk to you about how a doula can help with the birth process. It is common when you’re pregnant after a loss to feel an increased amount of anxiety about giving birth. A doula can help with the emotional and physical side of labor.

For this article I interviewed Alli Ryan from Lumos

Julie: So Alli what is a doula?

Alli: A doula provides physical, emotional and informational support. Most folks think that is just to a pregnant person thats giving birth but a doula can extend into birth and postpartum. At a birth we may help you with coping strategies, with positions, we’re going to help you with if your planning a hospital birth so we can navigate some of the hospital systems stuff and know what are your choices, but we can do those same things in pregnancy. We are not medical care providers we don’t give medical advice. We are not midwives- midwives are medical and emotional. As our doula our role is just informational, physical and emotional support.

Julie: How can you help support someone that pregnant after a loss?

Alli: Leaning into that emotional support peace. All people come into birth with a story and sometimes you know what your story is because you have had early pregnancy loss or loss at any point so those emotions are really big. It is finding a safe space. The hormone in labor is oxytocin and oxytocin is the hormone of feeling safe and supported. The way our brain is structured the fear hormones actually compete with our labor hormones. To be able to have someone to set you up to feel safe in not only pregnancy but labor really does allow those hormones to flow a little bit better. It is someone that understands you. We can help you move the staff through so you don’t have to tell your story over and over again. We help you to know what your options are. There can be options available specific to pregnancy after loss such as labor positions that might bring up a lot of feelings for you. We find their are stages along the way like oh I did not realize I had put a lot of energy into getting past 20 weeks or in that ultrasound in our last pregnancy is when things got hard. It is helping you move through some of those milestones. Usually folks that want doula support want all of their feelings honored. They also want information, support and facts.

Julie: Are their commonalities that you see in the labor and delivery room for people pregnant after a loss?

Alli: Moving through pregnancy their are these milestones that you have to get through like I knew I was going to have a hard time getting through that. We can help you think about those things ahead of time, move through those things and coming up with a plan. Sometimes I will find early labor can feel like some of those sensations of an early pregnancy loss and so having a person you can call and say I am having really hard feelings, we aren’t necessarily going to be there to fix them and this is where mental health providers can help with tools but we can be those safe people to help remind you of what your tools are when all of that kind of goes out the window. We can help you bring in your past losses so if you named your babies or put some sort of energy or labels or icons or symbols or teddy bears we can normalize that. That is very normal. It is very normal to help you feel connection in those experiences.

I also think most folks don’t understand how hard the postpartum is.

There can be a big huge wave of grief that comes in waves because you start to realize what you lost in a way that is like in your arms. Their can be a lot of complicated feelings. To lean into the support team that you have created, those are all really important things to do.

Julie: That’s such a good point. I also feel that people are hesitant to have a doula in the room because they are very private and it can be hard enough to be in front of your medical team. Can you speak to that?

Alli: We hear that from a lot from all folks not just from people pregnant after a loss. What we hear now is that a doula actually hear that a doula helps keep things private. We aren’t a stranger thats a weirdo in the room. We’ve also been to a lot of births. If you guys need us to disappear for a while because you need a moment we are going to know that without you even saying it and we are going to kind of blend into the background. We’re also going to in particular in a hospital environment we are going to help that hospital feel more private. We may be able to communicate to stay hey they are just going to have a little time together and can we keep folks out and help you ask for that as a patient. Advocate for what you need. Helping that environment feel like your nest, this is your experience and not a sterile hospital room. There are simple things we can do like turning down the lights and bringing twinkle lights and having is smell different and thinking about your music. But there is also a lot that just comes with our presence a doula in and of itself is a communication tool that we want this labor to take into account our emotions. We want it to feel like an individual experience. We want to understand what is happening around us and we want support. Just having a doula present makes that experience a little more private.

Julie: Do you want to speak why you are interested in working with pregnancy after loss?

Alli: I had been a doula for a couple of years, my husband and I hadn’t had any complications getting pregnant. We seemed to get pregnant very easily but we weren’t able to stay pregnant very easily. My big rainbow, we use the terminology rainbow at our house, pregnancy after loss, was born and then got pregnant again and then almost term we had our daughter who was born via stillbirth. She is a huge part of our life, her name is Vivian and pretty quickly realized that was going to transform the birth work and postpartum work that I was already doing. So I come to doula work in a way that is believing and trusting that people can figure out there way through it but that we need support to figure our own way through. I don’t come with this perspective of this is how I did it, I come with the perspective that is more I understand how hard this is to do this, there are a lot of great professionals in our community that can understand that whether or not they have had loss, I can understand it in a way that is a little bit different. So, right it transformed my work as a doula and then really did. We also went onto to have another brother, so another rainbow and my work was transformed.

Julie: Thank you for sharing that and willing to be vulnerable. If someone is interested in working with you how can they get in contact with you?

Alli: So I own a business called Lumos you can go to our website at welcometolumos.com. We work with other doulas all who have some level of experience working with all different sorts of families of shapes and sizes. Those that have experienced loss as well.

Anxiety and Infertility

1 in 8 couples struggle with infertility. Infertility is a disease that carries a lot of stigma. If you are going through infertility, it is common that you may be feeling: shame, loss of control, detached from your body, sad, angry, emotional, depressed, and even anxious.

Anxiety is common when going through infertility.

In Rewiring your Anxious Brain, by Catherine M. Pittman, PHD and Elizabeth M. Karle, MILS, you learn that anxiety can come from the cortex or the amygdala. The anxiety that develops in the cortex, is the anxiety that you interpret; the “what ifs”. What if you never get pregnant? What if you never become a parent? What if you do get pregnant and lose the baby? What if infertility ruins your relationship?

In addition, these thoughts are usually accompanied by physiological symptoms. This is anxiety that comes from the amygdala. Anxiety that comes from the amygdala is the physical sensations and anxiety of past experiences. This type of anxiety contains the triggers and associations. Examples include feeling anxious every time you see a pregnancy test because it was negative before and that caused anxiety. Also, anxiety about going to the doctors office because the last time you were there you got bad news.

Anxiety symptoms can include, but are not limited to, racing thoughts, rapid heartbeat, sweaty or clammy hands, upset stomach or butterflies, tight muscles, inability to focus, feeling lightheaded, and dizziness. Everyone experiences anxiety, as it is our body’s coping mechanism for danger. It is when there is no danger and our body still goes into the fight/flight/freeze mode that it starts impacting our functioning in life and becomes an anxiety disorder.

Stress is a common trigger for anxiety. If you are going through infertility this can be a stressful time in your life. Infertility treatments can also be emotionally and physically stressful. If you are feeling anxious you do not have to let it control you.

Here are some ways to deal with your anxiety:

1. Exercise - When you exercise you can lower the baseline for your anxiety so that it doesn’t peak every time you start to notice your symptoms of anxiety. Exercise is also great when you are feeling anxious. When your body goes into fight, flight or freeze mode your body sends energy to the parts of the body that you need to either fight or flee, when you exercise you can use up that excess energy allowing your body to get the message that you are no longer in danger.

2. Breath - If you are feeling anxious one of the best things that you can do is start to take some deep breaths and start to notice your breath. When your body is in the fight or flight mode our breathing becomes quicker to get more oxygen into the parts of our body preparing to fight or flee. When you start to slow down your breath your body gets the message that you are no longer in danger.

3. Take charge of what you are in control of - If you are going through infertility, it can be easy to feel out of control. Write down your anxious thoughts. In one column, put those thoughts that you have control over. In the other column, put those thoughts that you do not have control over. Take the list that you have control over and work on those things. Rip up the other list.

4. Say no - It can be very difficult some days to be facing infertility. You do not have to go to every baby shower or every kid’s birthday party. You do not have to join in on every holiday. You get to decide what you can handle that day. You do not have to listen to people’s advice or tips on how they got pregnant. It is okay to say no and to set boundaries.

5. Be kind to yourself - Going through infertility is not easy. It is very important that you treat yourself kindly through the process-self affirmations, self care, mediation, support groups, counseling. These are all great ways to show yourself kindness through this difficult journey.

   If you are struggling with infertility and anxiety you are not alone. Please contact Kull Counseling, LLC to learn more about coping with anxiety during infertility. 608.239.4807 or julie@kullcounselingmadison.com

The Grief of Infertility

The Mayo Clinic describes grief as: an emotion, sorrow, numbness, a natural reaction to a loss, a universal and a personal experience. When going through infertility, you may not realize you are experiencing grief. You may identify with feeling sad, worried, hopeless, or angry. Many of these emotions are part of your grief. Infertility has so many losses that are not acknowledged. Grief is a huge part of what you are going through if you are struggling with infertility.

Types of loss when going through infertility:

1. Loss of dreams and expectations. You may have grown up playing with dolls, being told that you are a good mommy, or that someday you will make a good mommy. You might have been told that when you meet someone that you love and decide to get married then that is the right time to have children. You also might have been told to put your career or school first, and that after you accomplish your goals then you can have children. You may have the age planned out of when you would like to have children. You probably were never told you might get to be a mother or that you can decide when you want to start trying to conceive but that might not be when you get pregnant. You probably were not told when you were a little girl playing with dolls that it may take months, if not years to conceive, and that you might have to use assisted reproductive technology in order to do it. With infertility there is grief over your dreams and the realization that they may not be what you thought they would be.

2. Loss of identity. Many of you grew up wanting to be a mother and probably felt it was always part of your narrative. For many of you it is part of your identity even before you ever start trying to conceive, knowing that one day you will be a mother. You may wonder if I am not a mother than who am I?

3. Loss of relationships. When you are going through infertility it can be extremely difficult to watch friends or family get pregnant when you are also trying to conceive. You may feel disconnected, such that if someone invites you to a party you may not want to go because everyone will be there with their children or will be talking about their children. If you are not invited because you do not have children it is equally as painful. If you are going through infertility your relationships may be changing, weakening, dissolving and even ending. Even if your relationship with someone does not completely end you may feel a loss of what your relationship had been with the person.

4. Loss of body function. When you are suffering from infertility it can be because one of your reproductive organs is not working. There is a loss when you feel like a part of your body does not work or is broken.

5. Loss of youth. If you are going through infertility you might have heard the term, “advanced maternal age”. You also might have been told that you are too old to go through assisted reproductive technology, which may leave you grieving for your youth.

6. Loss of control. You may be feeling a loss of control. This can look a like a loss of control of emotions. You may feel like you are on a rollercoaster of emotions, one day feeling hopeful, to the next day feeling like you cannot get out of bed. You may also feel a loss of control over your body. Even if you are timing everything perfectly, following your medical advice on how to conceive it still might not be working for you. You may also be feeling a loss of control over the fact that you do not have as much control as you thought. You might have thought that when the time is right that you would get pregnant, that you could decide when you were ready to be a mother and coming to terms that you do not have that kind of control can be a loss and need to be grieved.

7. Loss of not being pregnant. For most of you every time you only see one line on a pregnancy test or get your period every month there is a loss of not conceiving. You may need to process your grief every month after this happens.

   Grief is an emotion that many of you are feeling during the infertility process but may not have acknowledged was there. Acknowledge it, name it, feel it, observe it. There are ways to process this grief.

   For more information on grief during infertility contact Julie@kullcounselingmadison.com or 608.239.4807.

How to love your body through infertility

Infertility is the inability to conceive or sustain a pregnancy after 1 year (for women less than 35 years of age) or after 6 months (for women over 35 years old).

If you are struggling with infertility you may feel anger, guilt, shame, depressed, or broken. It is common for women going through infertility to struggle with anxiety or depression. But one of the things that I rarely see addressed is how women feel about their body while going through infertility. You may be feeling like your body is broken, like it let you down and is not doing its job to reproduce. If you are a woman, odds are you may have a history of a body dissatisfaction. Infertility may be bringing up some new feelings about your body or triggering ones from your past.

You may hate your body.

You may want to punish your body by saying mean things to/about it. You may want to punish your body by dieting, restricting or bingeing food. You might even want to hurt your body. You may have a hard time connecting with your body, struggling to remain intimate with your partner, or even feeling numb in certain areas.

If you are going through infertility, you are not broken.

Here are some ways to love your body through infertility;

1. Challenge your negative thoughts about your body - When you are having negative thoughts about your body it is easy to see your body as broken or bad. It is easy to want to punish your body or even to hate your body. By challenging these negative thoughts we can examine where they have come from, what proof we have to support them, and how to reframe them.

2. Praise your body - Even if you do not believe what you are saying, even if you cringe while you are saying it, say it. Start by focusing on the part of your body that you do love or that you feel is strong. Focus on the functions of your body and what it truly does for you. If you have other children this is a great activity to do together. This is also something you can do while doing a physical activity. Examples of this are, “I love my feet because they allow me to run many miles” and “I love my hands because they are steady and stable allowing me to create a painting or piece of pottery.”

3. Positive affirmations - When thinking of negative statements (i.e. “my body is broken”) try to mentally or verbally replace that statement with a positive statement about your body. For example, “I love my body” or “My body is strong” or “My body is amazing” or “My body can do so many things.” Start each day by looking in the mirror and saying one positive thing about your body.

4. Give your body the proper nourishment - Fill your body with foods that give you energy and make you feel good. Feed it until it is full. Nourish it when it shows signs of hunger.

5. Let your body rest - Trying to get pregnant is tough work. You are challenging your body physically, mentally, and emotionally everyday while trying to get pregnant. Being aware of when your body needs to rest; self-care is necessary. For most people, that is 7-9 hours of sleep and may be even more when undergoing procedures or fertility interventions.

6. Move your body - Physical and mental exercise is helpful.

7. Practice mind/body exercises - Mind/body exercises are those that combine breathe work with mental focus and body movement. This could be yoga or tai chi, as well as grounding exercises or progressive relaxation.

8. Know when to get help - Many women suffer from an eating disorder, disordered eating, and/or body image concerns in their lifetime. If going through infertility is triggering any disordered eating behaviors such as restricting, bingeing, purging, only eating certain foods, feeling detached from your body, or punishing your body in any other way it is time to seek professional help.

For more information on loving your body through infertility contact Julie at julie@kullcounselingmadison.com or 608-239-4807.

The silent suffering of secondary infertility

“Is that your daughter? She's adorable. So you just have the one child?”

I overhear a mom speaking to another mom and cringe. Even before the other mom tells me that she's been trying to get pregnant for years, even before she tells me about her failed attempt at IVF.

According to the Mayo Clinic, Secondary Infertility is the inability to conceive or carry a child to term after already having a child. Secondary infertility, much like infertility can lead to feelings of: isolation, dissatisfaction with your body, anxiety, feelings of sadness, problems with your relationships and grief.

Secondary infertility also presents a new set of challenges:

1. Feeling like a bad mother-There are different reasons why you may feel like a bad mother. You might be feeling this way because you cannot get pregnant again. You might feel this way because infertility may be causing anxiety or depression and may effect your parenting. You may feel like a bad mother because you want to give your child a sibling.

2. Disconnection from your child- You may feel disconnected from your child. It may be hard for you to make sense of parenting a child that is here and grieving the one that you do not have. Infertility can be all consuming. You may have trouble staying present with your child.

3. Feeling split between wanting more kids and wondering why you had them in the first place-It is hard to have a child. Really hard. You may be having opposite feelings of wanting another child and at the same time feeling not cut out for parenting all together. It is really hard to think about having a child when your current child is taking all of your energy and mental space.

4. Feeling shame because you already have a child- You may be feeling shame about wanting another child. It is common to hear comments like “well at least you already have one” or “some people can’t have any”, “appreciate what you have”. You may also have trouble connecting with others that are struggling with infertility because you have a child and they may not.

If you are struggling with these symptoms you are not alone.

Ways to cope with secondary infertility:

1. Find support- Find someone that you can talk to about your feelings. Whether this is a professional, a support group, a family member or a friend, it is important to talk about your feelings and get validation that those feelings are real for you.

2. Make me time- In a culture that prides itself on being “so busy” take some time for yourself to do self care. Self care is not selfish, it is not a luxury, it is necessary. Taking time away from being a mother, partner and trying is important. Finding something for just you is important. This could be exercise, massage, getting your nails done, taking a class, sometimes even just grocery shopping by yourself can feel therapeutic. Make this a habit and set boundaries so that it happens on a regular basis.

3. Make special time to connect with your child- Find some time to spend time with your child in the moment. Whether this is reading a book at night or playing a game time find to be present with your child and connect.

4. Take some time with your partner-Spend time together outside of trying for another child. Go on a date. Have dinner without your child around. Make time to talk to each other.

5. Take a break- You may feel that it is necessary for your mental or physical health to take a break from trying.

6. Sit with the discomfort- know that these feelings will dissipate. Let them wash over you. Name them, acknowledge them, and let them pass. It is common for women going through infertility to feel a lack of control. This can be one of the hardest things for women to process, especially when they are planners and are used to being able to achieve goals. It is hard to sit with feelings of discomfort. Using grounding and mindfulness exercises can help with sitting with these feelings.

If you are struggling with secondary infertility I Can Help.

If you would like to learn more about coping with secondary infertility contact Julie at 608.239.4807 or julie@kullcounselingmadison.com for a free 15 minute phone consultation.