Miscarriage isn't talked about a lot - particularly the details. What is it, what should you do when it's happening to you, and how do you cope afterwards? I've spent the past few months working on an article about miscarriage that shares five personal experiences (including the experiences of a dad), plus information from infertility and baby loss counsellor Megan Downer. A huge thank you to The Spinoff for publishing this story today - and to the people who agreed to be interviewed for the article. I hope I've done your stories justice.

Read The Loneliness of Miscarriage on The Spinoff.

In this post I'd like to share a bit more information about miscarriage - Megan's tips on dealing with grief, information about the different types of miscarriage, and links to places where you can get support.

Coping with grief after miscarriage
Tips from infertility and pregnancy loss counsellor Megan Downer.

1. Give yourself permission to grieve and process what has happened. Miscarriage is a significant loss which is often silent and unacknowledged by others, making it difficult to work through.  
2. There is no ‘right way’ to feel following a miscarriage. Each person’s experience of pregnancy loss and the circumstances surrounding it are different, so it is important to not put pressure on yourself to feel a certain way.
3. When you are ready, ceremony or ritual to acknowledge the loss of your baby can be comforting.
4. Many women who miscarry find support from those who have been through miscarriage. Some women find online chat groups helpful during this time, eg facebook.com/groups/miscarriagesupportnz
5. Grief is emotionally and physically exhausting. Find some distractions to help you recover from the waves of grief that come. Mindfulness websites and breathing relaxation can be helpful.
6. The experience of miscarriage for some women can lead to PTSD and depression. Seek professional support from your GP or a qualified counsellor if you or your support people are concerned.
7. Communicate what you need to those around you.
8. Take care of yourself. Sleeping, eating and exercise are disrupted during grief and trauma but these basic things can help you to feel better.    
9. Men and women grieve differently. Listen without judgment to each other’s experience. You do not have to feel the same way to understand each other.
10. Counselling can be enormously helpful to those who have suffered pregnancy loss.  It provides a safe place to actualize their loss and talk about their feelings and find strategies to cope.
11. For those supporting someone who has miscarried, do not minimise the loss. Miscarriage is the loss of a pregnancy and baby and is often devastating.

Types of miscarriage

• First-trimester miscarriage: Within the first 13 weeks.
• Anembyronic pregnancy: Also known as ‘blighted ovum’. A pregnancy in which the gestational sac continues to grow but the foetus doesn’t develop.
• Missed miscarriage: Where the miscarriage is diagnosed based on scans or other evidence, but there has been little or no bleeding or cramping.
• Molar pregnancy: A relatively rare condition caused by a chromosomal abnormality that causes pregnancy tissue to overgrow.
• Second-trimester miscarriage: A miscarriage that occurs between 13 and 20 weeks.
• Chemical pregnancy: a very early miscarriage, often undetected as the pregnancy loss may occur at around the same time as the woman’s period. These pregnancies are generally unconfirmed.   
• While not strictly a miscarriage, ectopic pregnancy (where the embryo grows outside the uterus) is also a cause of early pregnancy loss.
• Recurrent miscarriage: In New Zealand recurrent miscarriage is considered to be three or more consecutive miscarriages, or two late miscarriages, with all pregnancies by the same partner. Recurrent miscarriage is estimated to affect between two and three per cent of women.

Management of miscarriage
If a miscarriage begins unexpectedly, you are advised to seek medical help. You can speak to your GP, your midwife (if you have been formally registered), visit an urgent care or after-hours medical centre, or call Healthline on 0800 611 116. If the bleeding is heavy, you are advised to go to hospital urgently. You may need to call an ambulance.

Miscarriage support
Visit the Miscarriage Support website for more information.
You can also join the private Miscarriage Support Facebook group to chat to other women who have experienced miscarriage.

Alicia Young is pretty much the worst pseudonym I could have chosen. I didn't even google it. I was walking through the fog of infertility treatment and probably not thinking clearly. I wrote a short series about undergoing IVF and having a miscarriage, and it was published on The Spinoff under Alicia's name. 

Alicia came out again recently when our PM revealed that she is expecting and I knew that a certain group of women (and their partners) would be juggling some mixed feelings about the announcement. The piece must have tapped into some kind of zeitgeist as it was picked up by The Herald Online and was printed in The Herald the next day. 

It felt weird and exposing and a bit self-indulgent to share such personal feelings, but the comments I received made me feel as though I did the right thing. 

"It was refreshing piece you wrote and I just wanted to say thanks. You helped me."

"Thank you for putting some of this into words. Know that you are not alone there are many of us feeling as you do, and we are grateful that you have had the courage to write this."

"Oh god, yes it hurts. I think she'll be due around the week as I was."

"Thank you for writing this."

Thank you to everyone who has expressed support for changing Section 69 of The Holidays Act so that those who experience miscarriage are entitled to take bereavement leave. I have talked to a very supportive local MP who may submit this as a Members’ Bill. 

Along with gathering your support, I’ve also reached out to organisations:

• CTU (the Combined Trade Unions), the PSA and TEU, to hear what experiences their members have had in regards to The Holidays Act and to find out if they will lend support
• Sands Bereaved Parents network, who have indicated that they may support this initiative 
• Otago Community Law Office, who Parliament suggested contacting in order to find out whether or not people have made similar submissions in the past

I will wait a few weeks to hear back from these organisations and will keep you in the loop. In the meantime if you would like to lend your support please get in touch or comment at the bottom of this post. 

I have also written a letter for the publishers of The New Zealand Pregnancy Book asking for more information about miscarriage to be included in the upcoming new edition. Sands may also be interested in supporting the letter, which you can read here. 

I’ve been trying to get some action on both of these issues since December. What I’ve learned is that the wheels of bureaucracy turn slowly – and that just when you think you’ve found the right person to talk to, they tell you that the right person to talk to is someone else! 

I listened to a great Freakonomics podcast with Trevor Noah yesterday, in which he said that trying to make change when you're angry is not effective. It was a great reminder to take a deep breath and play the long game. 

I’ve also discovered that even submitting a Members’ Bill is no guarantee that anything will change. The Bill might not ever get heard in Parliament. At the very least though, it may influence further changes to the Holidays Act in the future. Based on the advice I’ve received, submitting a Members’ Bill seems to be the best way to proceed. I think it’s worth a shot!