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.

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.

Setting an intention for 2020

Last year I wrote this article and it has been updated for 2020. This year I set not only an intention for the year but also looking forward to a new decade.

Last year’s intention was growth. I pushed myself personally and professionally to do things that made me really uncomfortable and that helped me grow. Setting an intention can help you to focus not only on what you want out of the year but also help to hold you accountable. I challenge you to post your intention somewhere that you can see it this year or maybe even somewhere that others can see it too!

Only a few more days and 2019 will be at a close. For many people this is a welcome change. The start of a new year signals beginnings, and provides an opportunity for change and growth. What do we want from this new year? How will it be different than last year? What do we wish was different in our life? What needs to change this year for us? While I am not big on New Year’s resolutions, I do like setting intentions and working to achieve goals.

According to Mind Body Green, “Intentions are the fuel to manifesting your goals and visions.” There are many different ways to set an intention, but this year I challenge you to set a one-word intention. Think of one word that will help guide you in the next year to get you closer to your goals or visions. When we create a long list of goals or resolutions, it can be difficult to stick with. Focusing on one word can provide focus on your intention and more obtainable goals.

My intention this year is to live intentionally.

This means paying attention to what I give and take from my environment.

Paying attention to how I am giving and taking energy from others.

Focusing on the present.

Ways to use Intentions:

• Create a mantra around it that you can repeat to yourself or just say the word.

• Post the word somewhere you can see it - on your bathroom mirror, your daily planner or set your phone screen with a picture of your intention.

• Journal about how your intention is being incorporated into your life.

• Meditate on this word.

• Share your word, ask friends close to you to set an intention and discuss how this word is showing up in your life.

• Create a collage with your intention in the middle and see what develops.

What will your intention be this year?

To learn more about setting intentions and growth check out www.kullcounselingmadison.com

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.

#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.

The importance of self care

Self care. Do you feel like you are hearing those two words everywhere? Have you ever wondered what self care is and how to do it? Self care is defined as any activity that we do deliberately in order to take care of our mental, emotional, and physical health according to  Psychology Today.

Self care is not just exercise or meditation but it certainly does include these things. Self care includes all the different areas in your life: Physical, Spiritual, Social, Cognitive/Mental. 

Physical- How can we physically take care of our bodies? One way is through movement. Exercise is a great form of self care. Examples include: Running, Walking, yoga, pilates, tai chi, stretching, dance, cleaning, hiking, kayaking, swimming, bicycling, getting a massage, and gardening are a few examples. The second physical way that we take care of our body is how we nourish it. What food are you putting into your body? Are you eating a balanced diet? How are you eating? Do you rush through your meals? Do you rely heavily on meal replacements? Are you cooking your meals? Or if you cook often can you take a break to eat at a restaurant? Self care and nutrition can look different depending on your dietary needs.

Spiritual- Are you nourishing your spiritual side? For some that may mean organized religion, for others that may be more spiritual or even philosophical. Examples include: going to church, volunteering within your religious community, taking time to be in nature, connecting to your spiritual side, taking a day of rest, prayer, meditation, or devotions.

Social- Self care for our social side can include social activities and social support. Social activities can include taking a class with others, going to a movie, going out to dinner, playing a sport together, going for a walk or joining a club, volunteering, joining a board, and hanging out with friends to name a few. Social support can include: friends, family, neighbors, religious community, colleagues, 

Cognitive/Mental- Cognitive self care involves stimulating your mind. This can include: reading, learning a new skill, taking a class, learning about something new. This also includes getting enough sleep. Mental self care is nourishing our emotional health. Examples of this include: mindfulness, meditation, journaling, painting, drawing, listening to music, playing an instrument, seeing a psychotherapist, and practicing relaxation exercises.

There are many ways to care for your self and self care will look different for each person. Many of these examples cross over to other categories. It is important to care for yourself in many different aspects of your life. Self care is important to your overall wellbeing. It does not need to take long but even incorporating a few minutes a day or trying one or two examples from above can make a big difference. 

For more ideas on adding self care into your life contact Kull Counseling at 608.239.4807 or julie@kullcounselingmadison.com.

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.

Best practices for helping women after a miscarriage.

A miscarriage is pregnancy loss before twenty weeks. Early pregnancy loss is estimated to occur in 1 out of 4 women. Most miscarriages happen between 6-12 weeks gestation. Early pregnancy loss is considered a loss but also a trauma. I recently was asked by Kat Schuknecht to give a presentation to the Madison Postpartum collective on best practices in helping people through early pregnancy loss. Here is a summary of my presentation.

Miscarriage is an invisible loss. It is the loss of your baby but also the loss of your dreams to come. Many people wait until the second trimester to share pregnancy news. When pregnancy is unknown by others it can feel invisible to the couple that is grieving. There is no one asking how you are doing or checking in with you. It can be difficult to share your news with others because of the sense of shame and guilt that surrounds the stigma of miscarriage. Many women blame themselves even though it is not their fault. In most cultures there are no rituals or ceremonies to help people grieve. It is normal to grieve with others, you may grieve miscarriage alone or with only a few people and you may feel very isolated.  It can also feel very abstract. If you do decide to share the news of a miscarriage it can feel abstract to the people you are sharing it with. It can even feel this way for your partner. Women tend to connect with their pregnancy and baby early on while partners often connect later in the pregnancy or once the baby is born. This type of loss can feel very uncomfortable for people and you may find them shying away or not knowing what to say.

If you have had a miscarriage you have experienced a major loss. An earlier loss does not equal less grief. Grief does not go away, it becomes part of a new normal that you carry with you. Grief is not linear it is actually quite messy and make look different every day. Grief is different for each person. You have a right to your grief. Your partner's grief will be different from your own.

Miscarriage can lead to feelings of shame, guilt, anxiety, depression, isolation, emptiness, failure, feeling disconnected from your body and sadness. No two people feel the same way. We cannot assume that we know how someone is feeling.

Miscarriage can lead to women feeling disconnected from their bodies. It may lead to difficulties with intimacy. Because women may be feeling disconnected they can be unaware that they are holding trauma in there body. It is important if you do bodywork with people that you are taking a trauma informed approach.

A miscarriage is a loss but also a trauma. Having a miscarriage can trigger post traumatic stress disorder. Symptoms of PTSD to look for our: fatigue, trouble sleeping, hyperarousal, nightmares, lack of concentration, anxiety, depression, loss of appetite and frequent crying. Pregnancy after a loss can be triggering for people.

Women who experience a miscarriage can have postpartum depression or anxiety. Anytime a woman goes from pregnant to not pregnant there is a shift in hormones that can affect brain chemistry.  It can be difficult to identify what is grief and what is anxiety or depression.

How Can Professionals Help

Holding Space - Professionals can help by holding space for clients. Holding space is being present with clients. Starting where a client is and remaining non judgmental. It is providing an environment that honors your clients needs.

Communication - How we communicate with people about early pregnancy loss can greatly impact our work. By opening dialogue about early pregnancy loss we can normalize and help reduce stigma. Ask. Include questions about early pregnancy loss in your assessment.  Take cues from clients when addressing early pregnancy loss. Refer to it as your client does. Whether they call it a pregnancy, a baby or even a name. If you meet with couples acknowledging a partner's grief.

Advocacy - Advocate for your client's needs on different level. At a micro level address their needs within your office. Are there pictures you may want to take down in your office or waiting room? Does this client have to wait in a room full of pregnant women? Is it possible for them to wait in the office? If you have someone that needs support validating and normalizing that it is okay to need support. Connect them to resources in the community. Therapy and Support groups are a few sources of support.

What do clients want us to know? I surveyed a group of women that had experienced early pregnancy loss and this is what they wanted providers to know.  They wanted providers to:

• Be present with the client and loss

• To listen

• To validate

• To understand that grief is a lifelong process

• To be told they are a mom

If you are a provider or someone that has experienced miscarriage and our looking for resources Kull Counseling provides therapy and a free monthly miscarriage support group. Contact Julie at 608.239.4807 for a free 15-minute consultation.