In March 2023, I had a miscarriage when I was 10.5 weeks pregnant. I am blessed to have a wonderful husband and loving family, two healthy sons, and supportive friends, though I still grieve at times. I share what is helping us below, in the hope of helping others:
1. Early pregnancy assessment clinic (EPAC) and caring providers at my OB office. My obstetric office has an EPAC (also called Pregnancy Early Assessment Center or PEACE) with OB/GYN physicians and registered nurses who specialize in miscarriage care. They gently guided my husband and me through what to expect through the miscarriage and the expected side effects of the misoprostol I took. They had multiple in-person and video visits with me and phone calls to check in. They sympathetically informed us that this happens in 1 in 4 pregnancies and that we didn’t cause this (more workup would be done if I had a second miscarriage in future). An ultrasound tech also briefly told me about her miscarriage. I valued her disclosure and her validation of the pain of this loss. The nurse offered for me to call her directly to schedule an early ultrasound, if my husband and I are blessed with another pregnancy. The team’s competent and coordinated care supported us tremendously. Besides the qualitative benefits, one study showed that patients were (not surprisingly) seen much faster and at lower cost in EPAC versus ED for early pregnancy bleeding/other concerns.
2. Mindful self-compassion. My psychologist recommended the Mindful Self-Compassion Workbook to me. This listed techniques such as putting your hand on your heart and saying to yourself, “May you be at peace,” among other exercises for coping. This physical and emotional way to intentionally accept all my varied thoughts and feelings soothes me. Writing this piece and journaling about my experiences (both in a physical journal and Notes app on my phone) are helping me to process also. Those looking for more intensive support (which helped me too) can start at Betterhelp, Psychology Today, or through discussion with a primary care or OB provider.
3. Disposable underwear. My dad had fortunately left some Depends at my house, and these got me through a couple of (literally and figuratively) heavy bleeding days when the biggest pads alone didn’t cut it. I plan to keep at least a few in my home/in my bags in future.
4. Support from my Catholic faith community as well as online support. The prayers, hugs, texts, cards, and gifts we received lifted our spirits. I also appreciated when others shared if they had a miscarriage also. I had no idea the number of couples in my life who had gone through this. This online resource had many helpful articles for those looking from a Catholic perspective. Quick online searches yielded other websites from nondenominational Christian, Jewish, and Muslim perspectives (as well as this comprehensive site with no religious affiliation). Children’s Hospital of Philadelphia lists resources for those experiencing loss of pregnancy or loss of a child.
5. Fertility awareness. My husband and I have practiced the sympto-thermal method (monitoring my basal body temperature and cervical mucus) to both postpone and achieve pregnancy in our nearly nine years of marriage. Seeing the return of fertility signs gives us hope after this loss. I admittedly have slacked off a bit (now just tracking cervical mucus on a free app called Clue), but if we have trouble getting pregnant again or have another miscarriage I could restart collection of temperature data to help in diagnosis of luteal phase deficiency or other contributing condition. There are physicians and other professionals trained in national procreative technology (also known as Napro Technology) who can help diagnose and treat fertility issues based on these signs.
My thoughts and prayers are with all who have suffered a pregnancy loss at any stage. I thank those helping my family and me on this journey, especially those who cared for us in clinic. Their compassion reminded me in my work as a primary care NP how important it is to pause, look into someone’s eyes, and give the gift of presence.
Maria Petty is a nurse practitioner.