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.

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.

What to expect at the miscarriage support group

I often get asked about the free monthly miscarriage support group so I thought I would take the opportunity to share a little Q & A about what you can expect if you are thinking about attending.

When and where does the group meet?

The group meets the first Thursday of every month from 5:30 p.m. to 6:45 p.m. at 720 Hill Street.

Why do I need to register and how do I register?

I do ask that everyone registers in advance. This lets me know how many I can expect so that we will have enough people to make a group. I know how hard it can be to get the courage to come in for a group and if we do not have more than one participant than we cannot hold a group that month. I also ask that you register so that I can send you a few questions to make sure that the group would be a good fit for you. You can register by emailing julie@kullcounselingmadison.com or calling 608.239.4807.

What is the purpose of the group?

The purpose of the group is to find support and connect with others that have been through a miscarriage.

What can I expect at the group?

You can expect a relaxed atmosphere and an inviting space. I usually start the discussion with a few reminders, an introduction and sometimes a quote or intention. I invite everyone to talk when they are ready to. It is not a requirement that you participate but I find that most people are ready to share when they come. I keep the group small so that is not overwhelming. You may not be in the exact same place as others but more than likely you will find that you have some things in common with the other participants. If the group happens to fall near a holiday or a due date we often discuss these and ideas on how to cope.

Is the group religion based?

No. Everyone is welcome. Everyone is also welcome to share their beliefs as it pertains to their loss. We respect that people have different beliefs.

How much does the group cost?

Nothing! This group is free of charge. I want everyone to be able to access it.

Who is appropriate for this group?

Anyone who has had a loss before the 20th week of pregnancy.

Can my partner come?

Yes partners are welcome.

What can I do if I have more questions?

If you have questions or would like to register please contact Julie at julie@kullcounselingmadison.com or 608-239-4807.

The guilt of miscarriage

It is estimated that 1 in 4 women will experience a miscarriage.  For many, having a miscarriage is a devastating loss that leads to a roller coaster of emotions. One common emotion many women hesitate to talk about is guilt. When you have a miscarriage there is a large amount of guilt associated with it because you feel like you did something wrong.  

Different types of guilt with a miscarriage:

1. The Guilt of It was my job. You may feel that that having a baby is part of your role as a woman and a wife. You might feel guilty that this is your job and since this is your job and you did not give birth to a healthy baby you have failed your job. You might have been taught that pregnancy and motherhood come naturally (and easily might I add) so when you are not able to maintain a healthy pregnancy there are strong feelings of guilt.

2. The Guilt of I did something wrong. If you believe #1, that it was your job to get pregnant and have a baby, than this is usually where the second layer of guilt sets in. If you could not do "your job" than you must have done something wrong. Did I drink too much caffeine? Was I exercising too much or not enough? Was it that glass of wine I had before I knew I was pregnant? You probably have come up with a dozen things that might have caused your miscarriage and concluded that is was your fault. 

3. The Guilt of what if I can't get pregnant again. If it was your job and you did something wrong than you might be feeling it is quite possible that you cannot get pregnant again. You may fear that you have already lost a baby and now you feel the guilt of what if I already lost one baby and I will never be able to have another. You might feel that this was your only chance and you did something wrong to cause this. You might feel that this is punishment for something else that happened in your life.

Guilt is an intense emotion and a very real part of the healing process of losing a baby in early pregnancy. There is help working to challenge these negative thoughts and normalize these feelings. If you have experienced early pregnancy loss it is not your fault, and  you are not alone. To learn more about guilt and other common feelings after a miscarriage or more information about the free monthly miscarriage support group please contact Julie at 608.239.4807 or julie@kullcounselingmadison.com

How to reconnect with your partner after pregnancy loss

Pregnancy loss can have a profound effect on your relationship. For some, it can be a life altering event bringing you closer, and for others, it can lead to the end of your relationship.

When you lose a baby it can be difficult to cope. There is no handbook that gives you instructions on how to grieve. You may feel like you and your partner created this baby together, so grieving should be a joint process.  However, for many couples this is not the case. People grieve differently; how you process grief, when you process grief, and when you get to the acceptance stage of grief. You most likely felt different the minute you realized you were pregnant, connecting with your baby early on in your pregnancy. Research shows that for many first time fathers, a man does not consider a pregnancy a baby and himself a father until he holds that baby in his arms. www.webmd.com

You may feel emotionally disconnected from your partner when you are processing pregnancy loss, and you may also feel physically disconnected from your partner. It is common that you may also feel physically disconnected from your own body. You may find it difficult to be physically comforted by your partner or may have difficulty being intimate. This is common after you experience pregnancy loss. 

Reconnecting with your partner can be difficult, but it is not impossible. Here are a few things that can help you reconnect with your partner after pregnancy loss.

1. Reconnect with yourself - Before you will be able to reconnect physically with your partner, you need to reconnect with yourself. This can be done using mind-body techniques to reconnect you to your body. Two mind-body techniques that I use in my work include progressive muscle relaxation and the body scan. These exercises are both helpful to identify where in the body we hold pain, grief and stress from the trauma of a pregnancy loss and where we are disconnected. 

2. Communicate - This may not sound difficult in theory, but in practice can be difficult. Discuss your feelings about the loss with your partner and accept that they might not understand and that they may feel different about the loss of your baby. Tell your partner if it is difficult to connect physically. Explore feelings about being intimate and what that means for each of you. You may feel like being intimate again will lead to a subsequent pregnancy that you are not ready for. Your partner may just be trying to comfort  you and connect physically. Identify triggers that lead to feeling disconnected. Continue to check in about how you are both feeling.

3. Honor your loss - Find a way that feels comfortable to grieve your loss. Create a ritual that you can do with your partner to honor your loss together. It is important to find at least one way that you can honor your baby and sharing this with your partner is a great way to reconnect.

 4. Seek help - If the above ideas do not work and you are still finding it hard to reconnect there is help. Psychotherapy can help you reconnect to your partner after a loss. Remember to be kind to yourself. Pregnancy loss is a complicated loss and there is no one way to navigate it. 

For more resources on reconnecting with your partner please contact Kull Counseling, LLC at 608.239.4807 or julie@kullcounselingmadison.com.

Honoring your due date

Your "due date". 

If you have experienced an early pregnancy loss, you might be overwhelmed with emotions when thinking about these two words.  It might feel like a deadline for you or a last hurdle you are waiting for to move from depression to acceptance. You might even feel that your due date will be the time that you start letting yourself grieve. If you have experienced an early pregnancy loss an upcoming due date might be weighing heavily on your mind. According to clinical psychologist Kirstin Bouse, via www.essentialbaby.com, "Commemorating your baby's due date isn't just a way to reflect on how important your baby was to you, it's also a vital step in the grieving process."

While everyone must find the best way to grieve and honor their baby on their due date, here are some ideas that have helped others:

1. Find something that memorializes your baby.  You may find that it is healing to have something that memorializes your baby. You may find that a piece of jewelry that you can wear is meaningful- an initial, name, date or symbol can be printed on necklaces, rings or bracelets to help you remember your baby. You might find that getting a tattoo would help you to honor your baby. Other ideas include a statue, stuffed animal, plaque, or plant are ways that you might honor your baby. You might find it to be healing to create a memory box adding any pictures, poems, toys, outfits, or other momentos that help you to remember your baby.

2. Donate. Whether this is your time or money, you may find comfort in making a donation to a charity in honor of your baby on his/her due date. Donating can be a wonderful way to not only memorialize your baby but to also help others.

3. Surround yourself with family and loved ones. You may fine it helpful to surround yourself with loved ones on this day. Those who know and will help you to honor your baby. It may be helpful for you to talk about it with others, to have a celebration in your baby's honor or simply to just be surrounded by love.

4. Spend time alone. You may find it comforting to be alone.  You may want time to process what this day means to you by yourself. You may not want to talk about the day. You may find it comforting to write about your baby or use art to process your feelings about the day.

5. Take a vacation or a staycation.  You and your partner may enjoy taking time off from work to go out of town or to have a mini vacation in town. It might help you to celebrate the day by making some happy memories or it just might be a good distraction to get through the day.

These are a few suggestions that have helped others. Everyone grieves differently and you have to find what is right for you. If you are having a hard time processing your grief or are feeling stuck there is help.

For more information about grieving after a pregnancy loss please contact Kull Counseling, LLC at 608.239.4807 or julie@kullcounselingmadison.com

Surviving the holidays after early pregnancy loss/miscarriage

In 1963, Andy Williams sang, "It's the most wonderful time of the year."

If you have experienced an early pregnancy loss you may feel differently. The holidays can be a difficult time of the year for many, but can be especially difficult if you have experienced a  miscarriage.

You may be dreading parties because people do know and are uncomfortable about what to say or  people do not know and are asking when you are planning on starting or growing your family. Or maybe you are dreading opening holiday cards of pictures of friends and family with their children or you may be dreading sending out your own without your child. 

You might be celebrating the anniversary of your loss, a due date or your child's first holiday. Perhaps you were waiting for Christmas to announce your upcoming birth. You might have already made plans for what this holiday would look like with a new baby.  It is easy to feel triggered around the holidays when much of it is centered around family and children.

Wherever you are in your journey, and whatever stage you are at in your grief, here are a few ideas to help through the holiday season.

Update 2021: This is an article that I wrote a few years ago but I have found is still helpful for navigating the holidays today. That being said for most of you, the holidays will look much different this year in the midst of Covid-19. I think more than ever this year support is especially needed. Whether it is virtual, or socially distanced I encourage you to find your support people. If you are not getting the support you need, it is important to ask for it. You may find going through a pregnancy loss can be isolating.

Tips for getting through the holiday season after an early pregnancy loss:

1. Get extra support - You need additional support during this time. Whether this is doubling up on support groups,  additional therapy sessions or just making plans with those that support you and your loss. If you are  religious, this may include attending services or seeking support through other church members. 

Support groups for miscarriage in the Madison, WI area:

https://www.kullcounselingmadison.com/miscarriage-support-group/

http://www.bereavedparentsofmadison.com

2. Say No - You do not have to do everything. It is okay to say no, whether this is to a party, a family gathering or sending out holiday cards. You especially do not need to do anything that triggers you or that is not a good space for you right now.

3. Practice kindness - During the holidays you tend to practice gratitude and kindness towards each other. Practice kindness and gratitude towards yourself. You may feel like you should be over your grief by now or that you were doing so well and that you took a step backwards-be patient with yourself. Do extra self care during this season: cooking, going for a walk, yoga, practicing mindfulness, reading a book, talking to a friend, or going on a date with your partner are just a few ideas.

4. Honor your baby - you may find it comforting to start a tradition to remember your baby during the holidays. This may look like buying an ornament that honors them or lighting a candle on your holiday to honor their presence. It could be volunteering or buying a gift for someone in need. Whatever this may look like for you, if you want your baby to be part of your holidays you can do it and let the important people in your life know what you need to honor your baby so they can support you.

Please remember if you are grieving a miscarriage you are not alone. If you need help during the holidays, Kull Counseling can help. Please contact  608.239.4807 or julie@kullcounselingmadison.com for more information.