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.

The 6th stage of grief: finding meaning

David Kessler recently identified the sixth stage of grief as finding meaning in your loss. Kessler states, “meaning comes through finding a way to sustain your love for the person after their death while you’re moving forward with your life. Loss is simply what happens to you in life. Meaning is what you make happen.”

This concept of finding meaning in grief has been around for much longer. In the 1980’s Miles Model for Parental Grief describes the search for meaning as part of the reorganization phase of grief.

If you have experienced a pregnancy loss meaning making can be an important part of your grief process. In this article you will learn what meaning making is and ways to make meaning of your loss.

The concept of meaning making simply put is finding meaning around why this loss happened to you. No one wishes for a loss or is glad that it has happened but many of you may find some peace in finding purpose.

Here are 3 ways to make meaning in your grief:

1. Volunteer- some parents of loss have started non profits, other parents volunteer at organizations that support bereaved parents. Some of you may donate time or money.

   Local organizations: Mikayla’s Grace and Bereaved Parents of Madison both accept volunteers at different times of the year.

2. Advocate- some bereaved parents find meaning in advocating for policies that impact bereaved parents and infant and pregnancy loss.

3. Education/reducing stigma- Some of you may also find meaning making in educating others or reducing stigma by talking or writing about your loss. This may be in your social circles, on a social media platform, speaking at public events or writing news articles or blog posts.

If you have experienced a loss has meaning making been an important part of your grief? How have you found ways to make meaning of your loss? To learn more about stages of grief and pregnancy loss or to sign up for a free 15 minute phone consultation you can contact me here to work with a therapist Madison.

Pictured above, dropping off donations from Mikayla’s Grace to a local Nicu.

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!

Postpartum PT Care, Interview with a therapist in Madison

I had the honor of interviewing a therapist in Madison, Jessica Dufault from Mindful Motion Physical Therapy to learn more about how she helps postpartum care in Madison. She specializes in pelvic floor and women’s wellness. She is an excellent resource for women in the pre/postnatal stage and also works with women that have experienced a pregnancy loss.

Julie: Hello Jessica,

Thank you so much for agreeing to speak with me. Would you start by introducing yourself?

Jessica: Hello,

I'm excited to be talking with you about pelvic health today and thanks for inviting me!

I'm a mom, partner, business owner and Pelvic PT in a small private practice. I support people throughout their lifespan (18+ years old, my wisest client was 94!)

Julie: Who can benefit from PT for the pelvic floor?

Jessica: Anyone with a pelvis! But specifically if you've gone through life transitions such as pregnancy, postpartum and perimenopause. During these times, your health and pelvis can undergo transitions that can be challenging to navigate alone and may sometimes require additional TLC.

Julie: I work with a lot of pre/postpartum moms. What are some symptoms that they may notice if they need physical therapy?

Jessica: Great question! If you are pre/postpartum, here are some things to look out for

Peeing when you don't want to

Prolapse which is a shift in position of pelvic organs (feeling of pressure, heaviness or a "falling out" feeling)

Difficulty with internal menstrual product use

Pain with penetration, including sex, exams, menstrual products

Scar tissue restrictions or pain (perineal or cesarean)

Diastasis Recti (separation of abdominal tissue) which can lead to feeling weak or even LBP

Pain in areas like the low back, sacroiliac joint, hip. As well as sciatica and pubic symphysis dysfunction

You may also be looking for guidance on exercise or fitness

You may want support for prepping your body for demands of pregnancy and birth

Julie: If someone has a cesarean birth is PT still helpful?

Jessica: Yes! I had an unplanned cesarean and I had NO idea how difficult the recovery would be and didn't have the support I needed (which is one factor that pushed me from an orthopedic PT to a pelvic PT!).

Taking care of the scar tissue, assessing the position and movement of pelvic organs and regaining abdominal strength are all very important to ensure good long term pelvic health.

Julie: I also work a lot with bereaved moms. I think a lot of times they don't always think about being postpartum because they are not given the same attention as a mom that is lucky enough to bring a baby home. Do you have experience working with bereaved moms? How might your work look different? What might be important for them to know?

Jessica: I don't have a lot of experience here but over the years I have supported a few people who've experienced loss in pregnancy, during birth or a few weeks after birth. And maybe my experience is limited because of what you've already mentioned, that they aren't given the same attention, resources and discussion on all aspects of physical postpartum support. And yet they have the right and deserve the same access to physical pregnancy/post-pregnancy care.

Because if you have experienced a miscarriage in early or mid pregnancy prior to 20 weeks, or a stillbirth (whether vaginal or cesarean) at anytime past 20 weeks, your body has been impacted by hormones and all the accompanying physical changes to the body that pregnancy and birth can bring on. Which deserves attention and support!

We can start early education and support depending on each person's readiness however we wouldn't do a full pelvic assessment until 6 weeks post birth.

All of my clients are screened for mental and emotional health and this helps me to understand where they are in the (potential) grieving process as well as what support they've been able to access and then I can fill in referral gaps as necessary.

And with all clients, I follow their lead in how we approach the plan of care and meet them where they are and with what they (and their bodies) seem ready for. This is especially important for clients with a history of trauma or loss.

Julie: This is so helpful. Thank you! It is a great to know that you are aware and sensitive to the trauma and grief that all these moms are going through and ways to support them.

Julie: What are the benefits that PT can offer?

Jessica: Navigating changes in our bodies can be a lot and accessing a pelvic PT can help people feel well supported physically, emotionally & mentally. Knowing you don't have to "go at it alone" or "suffer in silence" can have a profound impact.

Also it's not just about the pelvic floor! My training and education allow me to support people with all aspects of their health and wellness as it relates to menstruation, fertility, pregnancy, postpartum, perimenopause & menopause.

Julie: If someone is interested in working with you, how do they initiate that?

Jessica: Our website is a great place to start. Lots of info there on who we support and all the options- like using insurance, choosing our ​self-pay programs or even our online programs. We also offer online scheduling through our website.

We do have a free and private Facebook group that everyone is welcome to join if they are looking for more community, support and general pelvic health education.

Julie: Thank you so much Jessica for taking the time to meet with me today. Is there any other information that would be important to know?

Jessica: I often get feedback that our space feels very warm and inviting and that talking with me is way easier than they anticipated (and they say "I wish I had come sooner!") We work hard to make the experience feel supportive and easy. If anyone has reservations, I'm also open to chatting via email or phone call as necessary to make sure it's the right fit overall.

Julie: Jessica you are a valuable resource to the community. Thank you so much for talking with me today and all that you do for the postpartum moms. One of the reasons I asked Jessica to speak today is because of all the great content I see her putting on instagram for free. If you haven’t found her on there yet she is

that_ pelvic _lady.

For more resources on pregnancy or postpartum mental health contact julie@kullcounselingmadison.com.

The emotional toll of a Missed Miscarriage

Having a miscarriage can be devastating. You may know signs and symptoms to look for  when your body may be starting the process of miscarriage and look for those throughout the first trimester. However, you may not know  that you can suffer a loss, but the body may not show signs of a miscarriage. This is referred to as a missed miscarriage.

Having a missed miscarriage can add an extra layer to the grief and trauma around early pregnancy loss. According to www.progny.com, “A missed miscarriage, also known as a missed abortion or a silent miscarriage, occurs when a fetus is no longer alive, but the body does not recognize the pregnancy loss or expel the pregnancy tissue. As a result, the placenta may continue to release hormones, so you may continue to experience signs of pregnancy.” A missed miscarriage can be devastating when there has not been any symptoms, and often, these symptoms may be typical of a healthy pregnancy - i.e., fatigue, nausea, etc. For most of you, you will find out about missed miscarriages when you go into your doctor’s office for your first appointment. One of the happiest days of your life (when you get to see your baby for the first time) can quickly turn to one of your saddest (finding out your baby is no longer alive).

For many carrying partners this can feel like your body has failed you, twice. Once, that your body was not able to carry a baby to term, and twice, because if your pregnancy was to end in a miscarriage why did your body not do this naturally? This can lead to a strong mistrust in your body that may lead to abuse or neglect of yourself. This also can present in a subsequent pregnancy causing anxiety and depression or ptsd. It can feel like your body is not a safe place for a healthy pregnancy after a missed miscarriage.

Having a missed miscarriage also leads you to what can be a difficult and painful decision of deciding how to manage the miscarriage process. While some people will wait to see if their body can complete the miscarriage on its own, most doctors will encourage you to schedule an intervention to manage the miscarriage process for health concerns.

After a decision has been made it can still be weeks to months to complete the process and symptoms of pregnancy may linger for months after that.

It is common to feel many different things, some common ones being shock, anger, denial, grief, shame, jealousy. You may feel a loss of control. It can be helpful to get connected to support during a missed miscarriage whether that is a support group, or a therapist that can help you talk through your decision, feelings and support you through the process and after a loss. Having a miscarriage can be isolating, finding support can make a huge difference.

Finding ways to be present in your body can be an important part of your process. Whether this is through grounding, centering, breathe work or exercise, movement or dance, it is important to be in your body and find healthy ways to reconnect with your body.

For more resources on miscarriage and to learn about the miscarriage support group with a therapist Madison, sign up for my monthly newsletter here. https://www.kullcounselingmadison.com/

October is pregnancy and infant loss awareness month 2020

October is pregnancy and infant loss awareness month. For me it is the time of year that I think about the baby that I lost through miscarriage. October is the month that I found out I was pregnant. I told my husband by buying pumpkins. One for him, one for our daughter, one for me and a tiny pumpkin to let him know we had a new pumpkin on the way. It was such a happy moment and I remember it so vividly even though it was 6 years ago now. Even though I know it is coming every year I am still surprised by it every year. This year it came early. My rainbow baby pointed to a small pumpkin the other day on our walk and said, “oh mom, look how cute this baby pumpkin” is.

Do you have moments like this? A memory or object that bring up thoughts of your baby?

This month is pregnancy and infant loss awareness month. This year is Covid-19. Usually it is a month filled of events that help you by bringing together a community of families that hold their babies in their hearts instead of their hands. This year that will look different. I have included a list of some virtual events in the Madison area. I know this year may be difficult for you because community can be such an important part of your healing journey. Please know that even though we are not able to gather in person, there is still a community here to support you.

OCTOBER:

1st: Miscarriage support group - The free monthly miscarriage support group will meeting virtually on October 1st from 5 - 6:15 p.m. Please email julie@kullcounselingmadison.com to register.

3rd: 10 a.m. CST: Now I Lay Me Down to Sleep virtual walk

The Virtual Walk includes an online presentation with readings, music, and speakers to honor your baby. During the presentation, each baby is honored by having his or her name read aloud.

Also the 3rd: Harley’s Hustle virtual 5k Set your course, set your pace, and just run. Share your pictures by tagging @HarleysHustle on social media.

8th: 6:30 p.m. GPS Hope Janesville (2nd Thursday)

12th: 5:30 - 7 p.m. Bo's Heavenly Clubhouse Support Meetings at Higher Grounds Coffee Shop in Beaver Dam (2nd Monday)

15th - 18th: Forever In Our Hearts Remembrance Day: Join by creating a sense of community and support found at in-person walks. There are many ways to join this event - purchase a yard sign, walk in your community, watch a video of the names of babies being remembered this year, and so on.

26th: 5:30 - 7 p.m. Bo's Heavenly Clubhouse Support Meetings at Higher Grounds Coffee Shop in Beaver Dam (4th Monday)

For more information on miscarriage or the above events email julie@kullcounselingmadison.com or 608.239.4807.

Pregnancy after a loss meditation script

Being pregnant after a loss can come with an increase of anxiety. Meditation can be a great way to get in your body, become aware of how you feel, and to stay present. Recently I recorded a meditation which can be found on the pregnancy after loss page on my website.

Here is the script:

Pregnancy after loss meditation-

I invite you to get into a comfortable position either with your feet on the floor or lying down. Rest your hands by your side or in your lap and begin to close your eyes.

Today we are going to be talking about pregnancy after a loss. There are many thoughts that can come up for those pregnant after a loss.

I invite you today to acknowledge your thoughts and just notice them, without judgment.  Our thoughts are not facts.

There is no wrong way to meditate. Meditation takes practice and it is okay if your mind wanders, if you notice your thoughts wandering simply let them go and bring your awareness back to your breath.

We will begin by bringing awareness into the breath. Inhale to the count of 3 and exhale to the count of 4. If at any moment today something feels uncomfortable in your body please skip it. We will continue to breath in to the count of 3 and out to the count of 4 bringing attention to our breath.

Breath in and out

In and out

We will begin by bringing awareness into our body. Starting by bringing awareness into our head, notice how your forehead, your eyes, your mouth, your cheeks your ears are feeling, notice any sensations without judgment.

Now bring your awareness down your head to your neck and shoulders, simply noticing how you are feeling.

Now draw your attention to your chest and back and simply notice. Continue to breath into the count of 3 out to the count of 4.

Bring your awareness into your arms and then your hands. Notice if they feel heavy, light, warm or cold. Simply notice how they are feeling at this very moment.

Continue down your body now into your lower back, stomach and hips noticing any sensations. Continue traveling down into your legs and toes continuing to breath and notice any sensations.

Take a deep breath in through you head and breath out through your toes.

We will now return to our heart and our stomach. If it feels okay to you bring one hand to your heart and another to your belly.

Continue to breath in to the count of 3 and out to the count of 4.

Bring breath and awareness to your heart and your belly. Your body is strong. Your body can grow a healthy baby. You can hold love in your heart for both your loss and for the new baby growing inside of you.

Whatever emotions you are feeling inside or okay. Emotions are not good or bad, they just simply are. Notice your emotions without judgment and bring your awareness back to your breath.

Continue to breath. If you have an intention for your pregnancy you can say it silently now.

As we start to return now to the room know that your baby is loved, that your body is strong and capable of caring for this baby.

Know that meditation is available whenever you need it. You can return to these feelings of calm whenever you need to.

I will count back from 5 and then we will return to the room.

5, 4, 3 begin to bring movement back to your body, 2 bring awareness back to the room 1 open your eyes.

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

October is pregnancy and infant loss awareness month

In 1988 Ronald Reagan declared October as Pregnancy and Infant loss awareness month http://nationalshare.org/october-awareness/

“When a child loses a parent, they are called orphans.

When a spouse loses a partner, they are called a widow or widower.

When a parent loses a child, their is not a word to describe them.” -Ronald Reagan

Every October we take a moment to honor babies gone too soon. For many this may be a very difficult time of year, but can also be a time of year for healing.

Here in Madison we are fortunate to have some great resources for those who have suffered pregnancy or infant loss.

October 2- Lunch and Learn about Pregnancy after a loss at Madison Area Parents Support

11:30-12:30 p.m.

Psychotherapist Julie C Kull, LCSW will lead a lunch and learn discussing education and coping skills for pregnancy after loss.

https://www.madisonareaparentsupport.org/calendar

402 E Washington Avenue at MAPS Base Camp

October 3- Kull Counseling Miscarriage Support Group

5:30-6:45 p.m.

This support group is run by psychotherapist Julie C Kull, LCSW. The purpose of this group is to provide a safe place to share your loss and connect with others in the early loss community. We will be painting rocks to honor your babies in October.

720 Hill Street, Madison, WI

To register contact Julie at 608.239.4807 or julie@kullcounselingmadison.com

October 17- Bereaved Parents of Madison Support Group

7:30pm (Doors open at 7:20pm)
St Mary's Hospital in Conference Bay 4
700 South Park Street 
Madison, WI

October 19- Remembrance Day hosted by Mikayla’s Grace

“This Remembrance Day is to honor families who have lost babies through pregnancy, stillbirth, or in early infancy. This 9th Annual Forever in Our Hearts Remembrance Day is being planned by local bereaved parents and Madison area non-profit Mikayla's Grace.”

BTC Events in Fitchburg, WI

#miscarriage matters...my story

October is pregnancy and infant loss awareness month. I hope that sharing my story may help someone else find comfort and strength.

This Thanksgiving will mark 4 years since I said goodbye to one of the men that I respected most in this world, my grandfather. As the priest mentioned later at his funeral, it was so fitting that he died on Thanksgiving because he was the most thankful and giving man despite facing many challenges in his life. It was difficult to say goodbye to him, and bittersweet, as I had a secret that only my sisters knew, I was pregnant with my second child.

Fast forward 5 days later and I was sitting at the doctor’s office with my husband and one year old waiting for our 8 week ultrasound. I remember thinking how lucky I felt and how it almost did not feel real. I could not wait to show our daughter that she had a sibling on the way.

The doctor’s office confirmed my pregnancy with a blood test, so it was on to the ultrasound. As the tech started to move the wand around she was silent. I looked at the screen and knew immediately that something was wrong. I had seen what a 8 week ultrasound looked like with my first child and I knew this baby did not have a heartbeat. What happened next is a blur of talking with the doctor, crying, and feeling so empty. I will never forget the nurse that sat me down to go over my options with me telling me how sorry she was and that she had had 4 miscarriages. In that moment, hearing her story gave me strength to get through that day.

I decided to wait hoping that the baby would come out naturally on its own. I spent the next few weeks trying to heal and also let go. I went to my grandfather’s funeral, showing little emotion, fearing that any emotion would lead to a breakdown or trigger the miscarriage.

The baby did not come out on its own. The miscarriage took an entire month to complete. It was a month filled with pain, bleeding, and doctor’s appointments.

After the physical symptoms had subsided, the emotional ones had kicked in. Every person that has had a miscarriage is different and everyone reacts differently. I was embarrassed, ashamed and heart broken. I felt like my body had one job in life and it failed. I told a few people in my support circle. Some people were great, some people had a hard time relating. Support came from surprising places. Even with this support I felt really lonely. I looked for resources in the community and nothing was the right fit. Based on the challenges I had finding help in the community, I made a promise to myself that when I was at a place to help others with pregnancy loss that I would. In 2016 I started taking trainings and doing research on psychotherapy and pregnancy loss. In October of 2017 I started offering a support group for miscarriage.

Having a miscarriage can make someone feel so alone. If you or someone that you love has had an early pregnancy loss please share this resource with them. No one should have to go through this alone.

For more information on pregnancy loss or to sign up for the free monthly support group please contact julie@kullcounselingmadison.com or 608.239.4807.

Going back to work after a miscarriage

Miscarriage affects 1 in 4 people. Most miscarriages happen in the first trimester. While it is common to have a miscarriage, how it affects you looks different for each person. A miscarriage can take a toll on your wellbeing. Many women struggle with how and when to return to work after having a miscarriage. Below are some considerations for deciding when to go back to work and some coping tips that may be useful at work.

Considerations to make before returning to work:

1. Is your body physically able to return to work?

Having a miscarriage can be a painful experience. It can drain you not only emotionally but physically. It is common that your hormones may be out of whack and is common that you will still have pregnancy symptoms and you may still feel pregnant. The miscarriage may take a few weeks to complete. You may need to take time away to schedule a D & C. You may need to consider what your job asks of you physically. Do you have to do any heavy lifting or be on your feet all day?

2. Are you emotionally ready to return to work?

Do you feel well enough emotionally ready to return to work? You might be having a hard time concentrating. You also may find that your emotions are consuming you. It is common to feel like your emotions are on a roller coaster often feeling more than one emotion at a time. It is common to feel sadness, anxiety, depression, loss of interest in things, isolated, and feeling disconnected from your body.

3. Will you tell anyone?

If you took some time off after/during your miscarriage your boss may wonder while you are out. Will you tell your boss? Have you thought about how you want to tell them? If you decide not to talk about it at work have you thought about what you might tell your coworkers if they ask where you were. Do you have anyone at work that you can trust or that your feel like you want to tell?

4. What can you do if you are feeling upset at work?

When you have a miscarriage it can affect you at different times. You might be feeling okay but then something may trigger thoughts of the miscarriage and feelings of sadness, frustration, isolation ect. Do you have coping skills at work when these feelings come on? Is their someone that you can talk to? Would you like some alone time? Where can you go? Your office, a bathroom, outside for a walk? Does deep breathing help you? A simple method is called four square breathing. Breathe in to the count of four, hold it to the count of four, exhale to the count of four, hold it and repeat. Can you do a grounding exercise? An exercise that is easy to remember is to just feel your feet. Put your feet flat on the floor and bring awareness to any sensations that you feel in your feet for the next minute.

5. When do you have to be back at work?

Do you know your work policies about how much time you can take off this may include bereavement leave or your company may even have a policy around pregnancy loss? Have you contacted the correct departments if you need more time off of work. Most companies have a human resources department that can help to guide you through this process. Can you work from home?

If you do not feel ready to return to work it is important to speak with your doctor. If you are feeling depressed or anxious most days it is also important to talk to your doctor or identify a psychotherapist that you can talk to.

For tips on returning to work and early pregnancy loss contact Kull Counseling, LLC at 608.239.4807.