Last month a fellow birth professional asked a question about whether it was possible to have postpartum depression after miscarriage. My response was as follows:

I think it is crucial to remember that miscarriage is a birth event—sometimes a very, very, very early birth event, but reproductively speaking that is what it is! Since we don’t have a better vocabulary for pregnancy loss in our culture, socioculturally speaking we tend to class it as “something else,” but in most ways it isn’t. A soul (or fertilized egg) touches down in a woman’s womb. Her hormones and all other physiological systems are impacted and feel its presence. The embryo/fetus/baby stays for a time and when it leaves her body, the uterus must contract and the cervix must open and the woman’s body must open to allow its passage. Her body, mind, emotions, and spirit are all affected (to varying degrees). In this way, miscarriage and full-term birth simply exist on a continuum of possible birth outcomes and are all birth events whether the pregnancy lasts five weeks or forty-two weeks.

Miscarriage as a birth event is one of my “pet” subtopics within the wide range of reading about miscarriage and quotes that respect the birth-miscarriage relationship always catch my attention. After the birth-miscarriage of my own third baby three years ago today, I found the following quote in a back issue of Midwifery Today:

“Miscarriages are labor, miscarriages are birth. To consider them less dishonors the woman whose womb has held life, however briefly.” –Kathryn Miller Ridiman

It meant so much to me and I returned to it again and again. I believe I was also responsible for introducing the quote to the internet, because since I first typed it up, I’ve now seen it floating around on many other websites and blog posts. And, in a full circle moment, my own miscarriage-birth story was published in Midwifery Today in 2011. I also latched on to a quote from the book Wild Feminine saying, “though it is not always recognized as such, miscarriage is a birth event.”

Christine Moulder in the book Miscarriage: Women’s Experiences and Needs quoted another mother: “Although I had a miscarriage technically, I don’t feel this. I went through labour. It was incredibly painful but my husband was with me and it was almost a happy occasion.” I agree, with my own birth experience feeling just as “legitimate” as either of my prior labors or my subsequent birth. I And, actually even more so in that Noah’s birth became possibly the most defining moment of my womanhood. I would also describe it as a spiritual experience or “awakening” of sorts in a way that has profoundly influenced me, shaping my future work with women and my life goals. I return to this experience again and again and continue to draw both strength and insight from it.

Returning to Moulder’s book, later in that section, the author says:

“With the exception of women who have a late missed [miscarriage] there will be a baby that has to be born. The baby may or may not have died prior to the miscarriage. As with full-term birth, the waters must break, there will be pains and contractions and the cervix must dilate for the baby to leave the womb. Of course the baby will be smaller, in some cases much smaller, but it is essentially the same process and this comes as a great shock to many women.”

And this is absolutely true, but also not something that is mentioned in very many miscarriage books. This shock of experiencing miscarriage so clearly as a labor and birth rather than as “something else” is what led me to describe my wish for miscarriage doulas on my now-complete miscarriage blog:

On a pregnancy loss message board that I read, a mother posted asking if she was the only one who experience her miscarriage as painful (because no one mentioned it being painful in the stories she had read and she was very shocked by the pain involved). I had a couple of thoughts in response to this question. I also shared my “favorite” miscarriage-birth quote: “Miscarriages are labor, miscarriages are birth. To consider them less dishonors the woman whose womb has held life, however briefly.” (Kathryn Miller Ridiman).

I do think the amount of physical pain probably depends in part on where you are in the pregnancy. Since a lot of women experience very early miscarriages (less than 6 weeks), I think that is perhaps why you don’t hear them talk as much about pain because the baby is still so small. OR, because a lot of women end up having D & C’s and thus do not go through the “natural miscarriage” experience, perhaps that is why pain doesn’t figure heavily into narrative. Or, maybe because there is so much emotional pain involved as well, the physical pain gets overshadowed? That said, my 6-week miscarriage was not physically painful at all (not that it couldn’t be for some women, of course). However, my miscarriage at nearly 15 weeks was indistinguishable from a full-term labor. It was just the same, except with the addition of MASSIVE blood clots following the baby. I value his birth as another birth experience in my life, but at the same time I am SHOCKED that miscarriage is so often overlooked as a birth event that requires tenderness and support (where are the miscarriage doulas and midwives?! While in a way, I feel proud of myself for have an “unassisted” birth-miscarriage, I could have used the care of a knowledgeable, caring woman rather than to just be left on my own trying to gauge how much blood loss is normal, etc.)

So, what about “miscarriage doulas” as an idea? I have seriously thought about becoming one. I am trained as a birth doula, but have no interest in actually working as one, but being a m/c doula does interest me a lot. I feel like adding a section to my business website (I’m a childbirth educator) that says, “having a miscarriage? Call me and I’ll come over and rub your back and bring you things to drink…”

I decided two things shortly after my first miscarriage: one, that I was going to write a book specifically about how to deal (i.e. “what to expect when you’re having a miscarriage”), because I felt very betrayed by having this huge wealth of pregnancy, birth, and midwifery books all around me and NONE of them had the information I was looking; And, two, that if anyone was ever to tell me she was in the process of miscarrying I would go to her right away (unfortunately, it seems like people feel like they have to tough it out alone or don’t want to “bother” anyone and so only tell after the fact). Well, if she wanted me to go, obviously, not against her will. And, that would include going to the hospital with her if she needed a m/c doula there, not just for “home miscarriage.” –Originally posted as Miscarriage Doulas…on June 29, 2010

This interest and post led to the co-founding of the organization The Amethyst Network, originally intended to train the miscarriage doulas I’d longed for during my own experiences. TAN took some time getting off the ground and in the meantime the thoroughly amazing organization Stillbirthday independently arose in vibrant support of women and is now skillfully fulfilling the mission of training loss doulas.

Thankfully, I had already read a long message board thread about, “what exactly do you see with a miscarriage” long before I ever had a miscarriage experience of my own, so I did know to expect mine to be somewhat “like labor” and not to be a “heavy period” (OMG, I wanted to scream when I saw miscarriages described like that in books over, and over, and over again! Though, then when I had my second miscarriage and it WAS, in fact, like the mythical “heavy period,” and so then I understood a little better why that was a prevalent descriptor.)

On Pregnancy and Infant Loss Remembrance Day this October I was out-of-town, but I shared past blog musings on jagged peace, acknowledging that the legacy of miscarriage is profound. I also linked to a friend’s story: Mormon Monkey Mama: A Few Thoughts on Miscarriage and to my own birth-miscarriage story: Noah’s Birth Story (Warning: Miscarriage/Baby Loss).

And, I updated my Facebook status with the following:

Today is Pregnancy and Infant Loss Remembrance Day. Babyloss is part of the spectrum of the childbearing year, and miscarriage is one type of birth experience that a large number of women experience. I appreciate the opportunity to recognize this, rather than to keep a lid on our “negative” stories of grief, loss, and a multitude of complicated emotions. Today I think of my own lost baby N and also my lost babystart. I also think of all the women who do not conceive and birth the rainbow babies they so long for. I also think of a friend whose baby died last month. And, I think about and appreciate my friend/doula from Peaceful Beginnings Doula Services who helped me so much to heal from loss and who has her own babystart to remember today as well.

There are many helpful babyloss organizations and one that was particularly helpful to me was Angel Whispers in Canada. They mailed me a birth certificate for my baby (with an official looking gold seal). It meant a lot to me because it acknowledged that he had lived and was born. It hangs in our hallway and it is amazing to me how meaningful a simple, small act of kindness from strangers can be.

Today we recognize the third anniversary of the birth-miscarriage of our little son Noah. I post not for “sympathy” or condolences, but because memories are important, and because even though he only stayed with us for a couple of months, he shaped our lives and in a very real sense is responsible for the life of Alaina. I share because his birth and the long, slow journey of grief was a pivotal, transformative point in my life as a mother/woman and because he helped change my destiny. And, I share because there are SO many loss mamas out there with stories of their own to tell and I hold them all in my heart and wish them all the love, caring, and wisdom that I was lucky enough to receive, both three years ago and ongoing today! ♥

“There is a sacredness in tears. They are messengers of overwhelming grief…and unspeakable love.” –Washington Irving

“Remember our heritage is our power; we can know ourselves and our capacities by seeing that other women have been strong.” – Judy Chicago

“Change, when it comes, cracks everything open.” ~Dorothy Allison

“She’s turning her life into something sacred: Each breath a new birth. Each moment, a new chance. She bows her head, gathers her dreams from a pure, deep stream and stretches her arms toward the sky.” –from a journal cover

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Related posts:

My memories of this time in 2011: Sand Tray Therapy
From 2010: Pregnancy Update
And memories of the anniversary of the second worst day of my life
And, some past thoughts about Honoring Miscarriage