Opening Up on Miscarriage, Isolation & Grief
Our very own Katherine Patterson opens up about her pregnancy loss and why we should never give up hope.
There’s an uncomfortable reaction around the word ‘miscarriage.’ For those hearing the news, and for those who bear it, communication can feel awkward and superficial. Unlike a death of a friend, a parent or a grandparent, there seems to still be a resounding taboo around knowing what to say or do in response to the loss of a baby that hasn’t yet been introduced to us.
This taboo extends to women’s bodies, especially women’s bleeding, whether it be menstruation or miscarriage.
It seems to make people feel very uncomfortable, perhaps because the subject either gets politely avoided or swept under the rug.
“People don’t want to know,” said Julia Bueno, a London-based psychotherapist and author of On the Brink of Being: Talking About Miscarriage.
“It has taken a woefully long time for miscarriage to be taken seriously by the medical profession.” In the absence of knowledge and data, Bueno noted, women in their desperation for an explanation will find reasons to blame themselves. “They’ll say, ‘Oh, I shouldn’t have had that cup of coffee.’ The void creates a strong pull to blame oneself.”
British musician and TV host Myleene Klass told The Sun’s Fabulous magazine how her own experience of miscarriage awakened her sensitivity to how she talks to others.
“It’s really made me think about how I speak. I don’t ever ask anybody if they’re planning a family, ever. You just don’t know if the woman you’re speaking to is pregnant or trying or whether she miscarried last night.” Wise words.
Here at British American Household Staffing we take pride in celebrating and supporting families and their journeys through the home, the workplace, parenthood, and all that’s in-between. It’s those in-between moments and milestones that measure our understanding and empathy. As we learn and grow, we invite our incredible clients and readers to join us.
We sat down with our wonderful, multilingual Childcare and Senior Placement Specialist, Katherine Patterson.
Katherine, 38, ex-Governess and a lover of all things health, fitness and outdoors, was born and raised in the South West of England. Having impressively worked all over the world, from Paris to Cape Town, it seems fitting that her love of travel and sense of adventure would eventually bring her to San Francisco where she now lives with her husband, Ed, and 2 rescue dogs.
She bravely opened up with us to share about her own personal experience and the stigma surrounding miscarriage that can create feelings of shame and guilt:
I was 36 and this was my first stab at childbearing. I had nothing to compare it to. My pregnancy was intensely physically, emotionally, and psychologically challenging (oh hi there, Estrogen and Progesterone), but I was acutely mindful of how lucky we were to have conceived naturally as quickly as we did, especially given that I was over 35 (otherwise known as high risk and “Advanced Maternal Age” in the medical field).
I, therefore, scolded myself for feeling anything other than gratitude, even though I was crippled by nausea, and seemed to be constantly, irrationally, and inconsolably sad and hopeless. I remember thinking this felt like far more than "the blues". I was starting to feel duped by the slew of blissful early pregnancy images on social media - manicured hands cupping nascent bumps, curated backdrops, DIY placards, ultrasound scans and blithe, sunny hashtags. I couldn’t relate to any of it - most of the time I could barely peel myself out of bed. Instead, I found solace in what few authentic accounts of not-so-instagrammable pregnancy experiences I could find online. There weren’t many, but there were some, and they sustained me. I thank those women every day for keeping it so very real.
Like millions of women, I am 1 in 4. I’m inadvertently part of a secret club that nobody wants to join, even though members include the likes of Lily Allen, Jools Oliver, Michelle Obama, Chrissy Teigen and Meghan Markle, to name a few. It’s not a new phenomenon and it’s as unexceptional as it is indiscriminate, brazenly disregarding age, social status, religion, race, ethnicity, creed or other. In spite of this, the subject remains taboo, and the prevailing expectation is that women will endure the experience quietly, stoically…behind closed doors.
Though my story is one of so very many, my hope is that by sharing it, and transparently contributing to the dialogue, other women might feel less alone and more empowered on their own fertility journey, whatever this looks like, and wherever miscarriage features along the way.
Of course, we all grieve differently. Publicly unpacking emotional trauma can be anything but a means of catharsis for some, especially as it pertains to miscarriage, which seems to be one of the most ubiquitous elephants in the room. But doing so becomes every woman’s prerogative if we normalize the narrative and do away with the abominable associated connotations of shame, failure, and guilt.
Perhaps we can eventually even address the term itself - “miscarriage” - a veritable misnomer with a prefix (mis) that implies blame. As if women have even a modicum of control over the outcome. Language matters - we deserve more respectful, more accurate terminology.
Pregnancy is a funny, compartmentalized journey. The unwritten rule of thumb is to keep the news to ourselves until we reach the end of the First Trimester, and then society has standardized the notion that it’s only appropriate to share that news if it’s good news. This amounts to a very lonely 12 or so weeks, where the physical, emotional, and psychological changes are typically most acute, especially for those women who’ve never experienced pregnancy before.
Those early weeks are a paradox - your pregnancy isn’t yet medically deemed “viable”, but you’re no longer who you once were pre-pregnancy either, which is only accentuated by the myriad of do’s and don’ts that shape your new normal - your diet, exercise regime, and general habits all look very different now. It can feel like you’re trapped in-between two worlds for what seems like an eternity. And if you’ve not shared your pregnancy with anyone, you’re inevitably more isolated in the event that things to do not pan out. Too many women have to muddle through a kind of solitary bereavement that is difficult to rationalize to the outside world, because there’s often nothing “tangible” to show for it.
Physical and emotional relief didn’t come, but my 12-week scan finally did. It only took a matter of seconds for me to read the situation - the expression on our OB-GYN’s face and her desperate attempts to pick up a heartbeat that we’d never come to hear. As her efforts to encourage movement from the tiny, lifeless bubble on the screen grew ever more frantic, a calm and resigned knowing filled my veins.
When she finally communicated what my husband and I already knew, my response was perfunctory and guarded, which took even me by surprise. I was too proud to burden her with my emotions, and I was utterly ashamed that my body, which I had determined was obviously broken, had failed at what it was biologically designed to do. I had failed our unborn child. We were told there’d been no growth beyond 7 weeks - this meant that there had been no heartbeat for over a month. Known as a “Missed Miscarriage” or “Silent Miscarriage”, I wondered how I hadn’t noticed - shame on me for not instinctively sensing something was wrong, as any decent mother surely would have. In truth, there are no symptoms, and women often continue to experience signs of pregnancy – it’s as cruel as it sounds.
The pressure to navigate next steps was swift and transactional. The options (natural/expectant, medical or surgical) were limited, but no less overwhelming. The overriding sentiment was that I should just wrap things up there and then. Being told to move on so quickly after having invested a quarter of a year attempting to nurture a life inside my body was such was a jarring concept. They said it would only take 15 minutes, and I could go about my life again, like a lunchtime beauty treatment.
This silver bullet they were so fervently encouraging (known as a Dilation & Curettage, or a “D & C”) also happened to be the most invasive and most expensive option on the table. It certainly has its place and I have friends who’d prefer to just rip the band aid and curtail the emotional discomfort (totally understandable) but I was extremely lucky that this route was not considered a medical necessity for me. I’m also intrinsically more holistic when it comes to health/wellness or anything medical, so surgery (however speedy) was never going to appeal to me.
May every woman be free to make an informed and safe decision when it comes to miscarriage - in a non-emergency situation, there is absolutely no right or wrong way, and we should all be given appropriate time to weigh up our options – it will never be a “one-size-fits-all” scenario. I did wonder how frequently women are encouraged to expedite this decision-making process when they are at their most vulnerable, as I was, and I’m forever grateful for the little voice inside my head that told me to rain check.
To be one thing one moment (that you so desperately want to be), then the antithesis of said thing just moments later, requires adjustment. And time to grieve. Like all the other women who’ve worn my shoes, I walked in a mother-to-be and walked out nothing more than a statistic, prescription in-hand. The tiny bump I so proudly donned was now an affliction, rather than a miracle. I left the building as quickly as I could, trying to un-see all the burgeoning bellies that peppered the waiting room. I felt like I was in a life-size game of Snakes and Ladders - I’d almost graduated to the Second Trimester, but I landed on a snake, and wound up all the way back at square one. It was a bitter pill to swallow.
Knowledge is power, and I knew no one would advocate for my body better than me, so I dived into the labyrinth of cyberspace. I had not anticipated that this would unearth a systemic failing in the way in which miscarriages are managed in the US, and that I would personally suffer the consequences. In a nutshell, if you decide to manage your miscarriage medically (as I did, at least to start with), then you should be prescribed a combination of 2 drugs – Misoprostol and Mifepristone, as recommended by the American College of Obstetricians and Gynecologists (ACOG).* However, Mifepristone’s association with, and use in the treatment of, medical abortions means its availability is limited and many emergency rooms, primary care or prenatal clinics are not permitted to dispense it. It’s also expensive. This translates to the potential for a less effective outcome, which I experienced first-hand.
After being prescribed Misoprostol alone, twice, and experiencing an “Incomplete Abortion” on both occasions, I decided my body had endured enough. Letting nature take its course (known as “Expectant Management”) felt like the right path from here, so I proceeded to relinquish control and trust in my body’s capacity to take the reins.
It didn’t fail me, and I questioned why I’d ever doubted it might, given that humans have been doing this for thousands of years. Our bodies know what to do, and when to do it. It wasn’t instantaneous, but I was very grateful to be in a position where waiting it out was an option.
I might have expected, rationally, that friends and family would express shock and sadness that I hadn’t confided in them and allowed them to support me. In fact, my confession was met with a shocking number of “me too’s”. Tragically, one friend said she hadn’t wanted to “inconvenience” anyone with her grief, especially since the world was already so preoccupied with the Covid pandemic.
Now, almost 18 months on, it’s clear we’re turning a corner. Social media and society as a whole are finally starting to embrace “real” motherhood. For the first time, a growing number of celebrities (men included – most notably, Mark Zuckerberg and James Van Der Beek) are leveraging their influence online and shedding the filters on their habitually flawless lives. In sharing the harder parts of the reproductive journey and validating both the ups and downs in equal measure, this is empowering mothers and fathers (who are not exempt from the emotional and psychological repercussions) the world over to follow suit. Naturally, it’s still too raw and uncomfortable for some, but the hashtags are gaining traction, and there have never been more resources, support, and honest accounts of pregnancy loss as there are now. It's really a watershed moment.
To whoever needs to read this - wanting to be pregnant and struggling with the associated symptoms of pregnancy are not mutually exclusive. Similarly, not enjoying pregnancy because of said associated symptoms does not mean you’re any less grateful to actually be pregnant in the first place. As the statistics corroborate, if you experience a miscarriage, you are far from alone. Your body is not broken and there is nothing you could have done differently to change the outcome. Finally, however you choose to grieve, know that your grief is valid.
Ultimately, sharing not just the highs, but also the lows, begets relatability, authentic connection, and solidarity. Our shared struggles are the glue that holds us together if we only allow it to.
As I write this, half-way through the Third Trimester of my “Rainbow Pregnancy”, it seems most fitting to close with one of my favorite quotes;
“Everything will be ok in the end. If it’s not ok, it’s not the end.”
For miscarriage and pregnancy loss resources and support, please visit Share Pregnancy and Infant Loss Support