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The Interdisciplinary Work of Lyss Warmland.

Posts tagged miscarriage

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Photo by Jeannette Breward

Content warning: birth, change in birth plan, failed induction, caesarean section, surgery, previous miscarriage, placenta (including picture of my placenta at the end)

 

I’d planned for a totally natural water-birth at home with my team of midwives, a doula, and my partner with our gentle shepherd dog looking onward. I had read about orgasmic births on Ina May’s farm and which essential oils were best for birth and the benefits of salt lamps and yoga balls. I arranged my birth pool rental and for my placenta to be encapsulated and wrote things like seeding and delayed cord clamping into my birth plan, which I printed out and secured in the binder the midwives gave me to keep at home with my charts and information for after the baby was born along with instructions on how to contact the woman who was to encapsulate my placenta and a phone tree with the phone numbers of family and close friends and who was responsible for each call. In the weeks leading up to my due date, I ate spicy food, had lots of sex, walked my dog for hours up and down steep hills, walked the stairs in my building repeatedly (note: these aren’t easy things to do with a 70+ pound weight gain…), took evening primrose oil, drank a ton of raspberry leaf tea, made art, and wrote affirmations about trusting my body and welcoming my baby.

Then, my due date came and went. I wasn’t too stressed initially, two of my close friends who had given birth within the past year had both gone 10 days over their due dates and I knew that, statistically, something like 60% of first time birthing people went over their estimated due dates. But once I was officially 41 weeks, with my induction scheduled, I started to feel stressed out. I knew I didn’t want an induction and I resented the fact that my baby was already being forced to adhere to some schedule without a medically relevant reason. Sure, there is an increase in some risk factors (including stillbirth) associated with going past 41 or 42 weeks, but my ultrasound and nonstress test showed a happy, healthy baby who we expected to be a bit on the larger side. As the threat of medical induction loomed, I drank two doses of midwife’s brew, a concoction containing apricot juice, castor oil, almond butter, and a strong infusion of lemon verbena. Although I had multiple friends tell me to prepare to go into labour shortly after taking the drink, as they had, it did absolutely nothing to help bring on my labour.

After a long conversation with my doula and an even longer one with my partner about options and how to navigate balancing advocating for my dream home birth with my midwives and their concerns, I decided to go into the hospital, as instructed, at 41+5, to receive a medication that would make my cervix more favourable (I’d been stuck at 1cm dilated for a couple weeks already with no forward motion) in hope that when I went home, I’d be able to relax a bit more and dilate my way into having my home birth after all. I was technically scheduled to continue the induction process (with the midwife breaking my water and starting me on Pitocin) the next day, but I was hoping I’d be able to avoid that part.

When I got to the hospital, I had a long conversation with the patient OB who had followed me throughout my first trimester (due to a history of recurrent miscarriage) and he explained his concerns with me not giving birth within the next few days. He pulled up a chair and took time to answer all of my questions and heard me out about about my concerns. By the end of the conversation, I honestly believe that he was committed to supporting me and my team in achieving as much of my birth plan as possible and that a bit of medical assistance was warranted in this situation. The first step remained what I had already decided I felt okay about doing- the medication in my cervix to increase its favourability. I also opted to stay in the hospital for the night and to reconsider my home birth. The extra couple of days increased the risks for my baby and, at this point, that was my only real priority. I also knew by that point, although I didn’t say it out loud, that the medication was unlikely to work. Something was causing my cervix not to dilate and I just felt, like, SO deeply, that it wasn’t going to budge.

 

The medication was super uncomfortable. I started cramping, and by the time my partner my doula, and I went out for dinner, I was feeling pretty awful. I hoped this meant that I was wrong and that it was working. The next morning, when they checked my cervix, it hadn’t changed at all since the day before. As per my discussion with the OB, he agreed to administer a second type of medication meant to achieve the same result- one that my midwife said tended to work better in her experience. Six hours later, my midwife attempted to check me and, this time the check was so painful I screamed. My cervix still hadn’t changed, it was still so far back she could barely reach it and now so irritated, the extreme discomfort I normally experienced during cervical checks had become a searing pain that terrified me far more than the idea of labour itself. My midwife decided to check in with the OB to discuss possible next steps and came back within a few minutes to explain that neither of them felt comfortable moving forward with the induction as we had planned it, but that at 41 weeks and 6 days pregnant, my pregnancy was too high risk for them to feel comfortable with it continuing. I was presented with two options:

  1. Get an epidural and go through with the induction plan otherwise, in spite of my unfavourable cervix and hope it worked
  2. Elect to get a cesarean section

I was scared. All I wanted was my baby safely in my arms and I didn’t feel that continuing to put my body through an extended course of failed intervention was particularly respectful to it. There’s also something incredibly emotionally exhausting about your body repeatedly reacting poorly to failed methods of induction, both natural and medical. I started to cry and asked the midwife if my partner and I could have a few minutes to discuss what we were going to do. We talked about the options, and my partner brought up that his main concern was me feeling sad or disappointed in straying so far from my original birth plan, and I explained to him that, at this point, the game had changed and I felt good about adjusting my expectations. I explained my feelings about something going on with my cervix that we didn’t understand and not wanting anything else to be stuck in it and also that I felt that, for this reason, this birth was going to end up in cesarean whether I continued to put my body through the induction process or not. I tearfully phoned my doula and talked through the situation with her and she, along with my partner, supported my decision to do what I needed to do to emotionally process the change in plans and to shift my mindset around how my baby was going to enter this world.

We told the midwife that I was going to opt in for the cesarean section, and within an hour I was being taken through paperwork, given information by my midwife, by the OB, by the amazing nurse, and by the anesthesiologist, who told me he would be putting a spinal block in so I wouldn’t feel the procedure at all but would be fully awake. I signed the papers, and got to hug my doula before I was taken to the OR and the spinal block was administered.

Everyone in the OR was amazing, casually talking about their weekend while checking in and communicating with me every single step of the way. At some point, I started to cry…not because I was sad as much as because I was a crazy mix of scared for both my body and my baby’s body and also because I was just so physically and emotionally exhausted from the past few days- no- from the past week since my pregnancy had changed to increase in risk each day. My midwife checked in and asked if I was okay, and I said “yes” unable in that moment to explain to her exactly what was going on for me. My partner came into the room (I learned later that when the anesthesiologist had gone to get him, he had warned him that I was pretty emotional) and didn’t need to ask me any questions- he knew exactly where I was at emotionally. He was confused about how violently my body was shaking though, until the anesthesiologist explained that it was from adrenaline. My partner stood right by my head and the procedure began. The midwife and anesthesiologist talked me through the whole thing, though I remember very little of what they actually said.

When they cut me open, they were surprised at how much I bled and I remember the midwife warning me there was a lot of fluid and there was going to be a lot of the sound of suctioning going on. My blood pressure got very high (unusual for me, whose baseline blood pressure is barely that of a conscious person) and also dropped very low at certain points, so the anesthesiologist kept having to give me medications to alter it. The team asked my partner if he wanted to see our baby come out of my body, and he asked me if that was okay with me. I said, “of course”, and he excitedly peaked over the curtain to see our baby be taken out of my body, head and one arm first, and then the rest of him. I heard him cry, and thought with relief, “that’s the most beautiful sound I’ve ever heard”. Someone held him up above the curtain and I saw his screaming, bunched up, red face and thought, “there you are” and “who ARE you” and “holy shit, there WAS a human in there”! This abstract thought that was my “rainbow baby”, who I was almost afraid to believe, even until the end, would ever be here, was real after all. He was here. After almost two years of pregnancies, three miscarriages, and a day short of 42 weeks with this being growing inside my body, I could barely believe it. Wilhelm Erik Warmland was born at 6:27pm on March 2, 2020, weighing 7lbs 15.6 oz at 20.5 inches long.

The midwife placed him on my chest and I held this being who I knew so intimately and it was completely surreal. After a few minutes, the midwife asked if my partner wanted to do some skin-to-skin as well while they finished closing me up. My partner asked if I was okay with that and I said, “of course”. I just wanted one of us to be with him. They went back to my hospital room and I joined them shortly after. I held my baby and didn’t let him go for hours. My dad and brother came to meet him and eventually my partner did more skin to skin and my brother went out to get us food and then he did skin to skin with his long-awaited nephew while we ate. My friend came and took gorgeous photographs of our first hours together.

The woman who was encapsulating my placenta was on route, so my doula reminded me that I could ask my midwife for a “placenta tour”, which I had mentioned being interested in. When she did this, she noticed that my placenta contained an extra lobe with veins. This can happen when the pregnancy started out as a twin pregnancy, though I also wonder if it could be related to my previous miscarriages, including an early miscarriage I had the cycle before conceiving Wilhelm. It turns out this can cause issues with bleeding if it’s ruptured during the process of water breaking and often results in cesarean section, which validates my decision to stray from my birth plan. This wasn’t the only extraordinary thing about Wilhelm’s birth though. In spite of being almost 2 full weeks “late”, he had vernix on him and there was tons of clear, meconium-free amniotic fluid. There was also no calcification of my uterus at all. My body knew. I kept saying I knew I could trust my body, and it turns out I was right. It just didn’t look the way I expected it would.

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Photo by Jeannette Breward

My grief has looked a lot like
taking the long way home,
ugly sing-screaming to a band all
my friends hate

“I don’t care about anything as much as I used to”

the words another grad school reject
wrote feeling like the ones
I wish i’d written
instead of words with no consistent pattern
no structure
no plan.

But I guess when it comes to grief,
I’ve learned that no plan I make
no work I do
is going to change the simple fact that
I lost them
I might lose this one-
but maybe I won’t.

So when I ugly sing along with
someone who doesn’t know I exist
about beings I’ve lost who never existed
I feel the spark carried by my voice
her words
my meaning
I let it light the candle that
holds some space for hope.

(quote from “Overbite” by Sincere Engineer.)

Check out my interview with Maureen Pollard!

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Maureen has worked in the field of social work since 1991. In private practice since 2011, Maureen is a specialist in traumatic bereavement, helping individuals, families and groups navigate life after losses, including pregnancy and infant loss, child death, suicide loss, homicide loss and sudden or accidental death. Maureen is a certified Compassionate Bereavement Care provider, and she is trained in RTS Bereavement Care (Resolve Through Sharing). In June 2019, she published The Twentieth Year: A Memoir of Miscarriage, a book that tells the story of her journey through multiple miscarriages to parenthood, and how her personal grief experiences influences her work.

 

Social work website: maureenpollardmsw.com 

Author website: maureenmwrites.com

Facebook page: https://www.facebook.com/MaureenPollardMSW/

Twitter and Instagram handle: @rhythmsinlife 

We talk about:

  • What inspired her to get into social work and specialize in the things she does
  • What kind of training she draws from in her professional practice
  • Her book, “The Twentieth Year: Memoirs of Miscarriage”
  • The process of writing and publishing her book
  • Being public about recurrent miscarriage and early pregnancy
  • Pregnancy after recurrent miscarriage
  • Grief and peoples’ reactions to it
  • How to maintain professional boundaries as someone working with people who have also experienced recurrent pregnancy loss (and other types of traumatic loss)
  • What Maureen wants people to know about recurrent pregnancy loss
  • What Maureen wants youth and parents of youth to know about mental health and suicide
  • How Maureen’s work has contributed to her being well

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Featured Music by:

Sincere Engineer
David Newland
Ellen Torrie
Cale Crowe

 

LISTEN TO THE EPISODE HERE!

 

When I was a little girl,
I lived in a house with a big garden
that gently sloped into a ravine.
Across the water, lived a willow tree
and when my brother and I
followed the stream against the current,
it lead to an open field full of
huge rocks- islands to our childminds
and we swore the water there was magic.

When mom got sick,
I used to walk up stream to
sit, skinny legs folded up against my chest,
smoke cigarettes, let the stream that
has held me my entire life
hold me then

I questioned a lot then, but never that the water
was magic.

And when she died,
I planted a tree beside her grave
one with purple flowers
like the ones in her garden
like the ones on the kitchen table
passed down from her mother to her
the ones that died when she did

because I’ve never been great with houseplants
but I know a few things about putting down roots.

When I grew up to experience
the first bookend loss,
I drove to Lake Ontario
just like she would have done
and scoured the shore
for a jar full of lake glass
and with my own hope for comfort,
the kind I’ve always felt
rooted in water,
I almost forgot to listen
to the messages she sent through the lake-

Something about collecting and purging
what fills her without any control of her own.

So when the second bookend loss came,
it was waterless winter ice
and it’s taken until spring to thaw
and I can’t help but think that maybe

if I stop

listen

connect

my body

I
motherless child
I
childless mother

might find that I can
simultaneously be
mother-child
to the elements that have held me my whole life
and maybe by feeling held,
I can hold her too.

Check out my conversation with Maggie Robbins!

maggienduck

Can’t wait to have a friend I love very much back on tonight to follow up on our conversation (about things like radical inclusivity and rape culture in gynaecology) from episode 46.

At 8pm on Northumberland 89.7 FM Small Town Radio tonight, tune in to join Maggie Robbins and I while we talk about:
– the response from our previous episode (we got stories!)
– an update on Maggie’s battle with cancer
– Trauma as a means of individual and community healing
– parenting through trauma
– leaving space for reaction
– balancing reaction and response
– cannabis as part of a wholistic wellness plan

Featured Tunes:
Let’s Fall in Love by Tiny Stills
Baby I by Amy Millan
Done by Frazey Ford
Dancing in the Dark by The Ruth Moody Band

Content- This essay contains my miscarriage stories and suggestions about what to say to people in your life when they’re miscarrying. This advice is based on my own experiences, but you know your friends best. This is meant to be a starting point and also to generally start more conversations about miscarriage in general, because it’s more common than we think…
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Almost a year ago, my partner and I decided we were ready to have a baby. We’d always talked about wanting a family, and we were at a place where we felt that financially and emotionally we were ready to start it. After 6 months, I took a test and found that it was faint, but positive. I tested religiously the next few mornings and watched the line darken- just a bit. Within another week and a half I was bleeding and a visit to the doctor confirmed that my HCG levels had fallen to 4. They called it a chemical pregnancy.

Two months later, I was pregnant again. I hoped that this was the time, but I was secretly waiting for blood. I started to feel sick, I monitored my HCG levels, and then started to see them rise more slowly than they should. I went to the the hospital for an unrelated reason, and when I told them I was 7 weeks pregnant, they offered to do an ultrasound for me to confirm that my organs were all in decent shape, related to my reason for being there. They weren’t looking for  heartbeat, but they also didn’t find one. I was referred to an OB who sent me for a more in depth ultrasound. It was confirmed that there was no heartbeat. I opted to wait to miscarry naturally, hoping for some miracle baby that was just hiding. A few weeks later, after a visit with my midwife, who I was planning to get my care from, where she answered all my questions, I got my final confirmation. My next choice was to take a medication to help pass the pregnancy or to do a D&C. I was still hoping not to have a D&C, so I tried the pills.  

They caused some bleeding, but nothing like what I was expecting. A scan a few days later proved me right, I was still pregnant, but there was no baby. I tried another version of the medication and I had a day of pure hell where I thought it was all over with, but my next follow up showed that there was still tissue inside of me. They told me they would do a D&C that day and I texted my partner asking him to come to the hospital. When he had to go to work, my dad showed up to drive me home and make me soup and walk my dog. When my partner got home, he sat with me and we talked for a while and then went to bed early.

**Important side note: the “abortion pill” became approved and available in Canada over the last few years and is only covered by six provinces. Without OHIP, each round of drugs would have cost me $337.25.

All in all, it’s been one hell of an experience trying to expand our family. My partner and I had been of the mindset that is was something to be open about with the people close to us, since it was something that was a huge deal in our life and support (or at least understanding) would be nice in the case of a loss. What we found when we told people about our losses, was that most women we knew had their own miscarriage stories. We also found that, like with any loss, people rarely know what the “right” thing to say is.

The short answer is that there’s no right thing to say because there’s nothing that can be said to change that your friend/family member/whatever has experienced a loss. That’s not always the most practical (or sensitive) thing to say in the moment though. The only thing I heard more than people’s own miscarriage stories was “people really need to talk about it more”. And we do, and I gotta tell you, it felt good to hear that my story wasn’t unusual. because grief is lonely enough without acknowledging that miscarriage is such a common reason for so many people’s grief.

Here are some ideas for things to say when someone in your life has had a miscarriage:

1. I’m sorry you’re going through this.

As someone who has experienced a decent amount of significant deaths around me, I feel pretty confident saying that this is solid way to respond in any situation where someone is grieving for any kind of loss. You acknowledge that they’re going through something and it’s appropriate, regardless of your relationship with the person or how close you are to them.

2. Do you want to talk about it?

If you’re fairly close with this person, it’s worth asking if they want to talk about it if you have the emotional capacity and physical time to take that on. If you don’t have that emotional capacity or physical time, just don’t offer.

This shows that you’re able to hold that space for your person and encourages them to process what they’re experiencing. Even early loss can feel like crap (to say the least) when you’ve been trying to get pregnant and found out that you were. Some people don’t process through talking about it, or they may just not  want to in that moment. By asking, you’ve given them the option to talk about it or not with you.

3. Do you want some company? I’m available at [time, days].

This is another way of identifying a way you feel capable of being supportive. Sometimes it can be lonely when you’re grieving and it helps to have people around physically. Sometimes it’s nice to have a distraction from feeling bad to talk about completely unrelated things.

Miscarriage can be an intense experience, both physically and emotionally, at times, but it’s important to consider that even grieving people are whole humans and their grief isn’t all that’s going on for them. It can be a really helpful way of supporting your person.

4. I get that you’re going through a lot right now. Take whatever time you need.

We live in a society where we put a lot of pressure on women to carry on with their lives during their pregnancy, especially early pregnancy, which people are typically expected to hide. My experience of early pregnancy was that it can be pretty challenging to carry on with everything in your life when you’re exhausted and nauseous. Miscarriage can be painful, physically and emotionally.

Sometimes, knowing that people realize you need a little more gentleness or time or space or care can be really helpful, whether that’s an extra day off work or understanding around missing a meeting.

5. What kind of soup do you like?

Bringing people food is rarely a bad idea, especially if they’re sad or not feeling well. Soup is warm, comforting, and most people like at least one kind. Be a friend. Bring soup.

The sky turned grey the day after
To match my head the day after
I lay on the table and
allowed myself to be at the mercy of
doctors and this body
The one that just seems to
Keep failing me
Betraying me
When all I want is to
do this thing I feel called to do
I-
Motherless child
I-
Childless mother
Felt grey the day after
Cervix still open
Another lifeless love
Lifted from my body.