Simple, kind, and not uttered enough: what to say after miscarriage

At least every five minutes, someone in this country experiences the loss of a pregnancy before they hit 20 weeks. Beyond that point, it is called a stillbirth. But unlike stillbirth, miscarriage isn’t as widely acknowledged as a bereavement.

This is in part due to confusion over whether it constitutes a bereavement or is deserving of empathy, compounded by a general discomfort with grief, leading people to say things aimed at minimising the loss or in some cases erasing it completely.

The shifts needed in society’s treatment of this issue are just one way in which the situation can be improved for those who join an extraordinarily non-exclusive, non-selective club.

The reason Helen Perrottet came forward to make these disclosures is because the NSW Liberal Party is announcing a pledge of $2 million for “services supporting women and families dealing with miscarriage, stillbirth and pregnancy loss”.

For the amount of practical, structural and cultural change needed, $2 million, even if it was for miscarriage alone, would be light on the ground. But across both stillbirth (which has rightly had several rounds of dedicated funding) and miscarriage? It’s not even a drop in the ocean.

Public education is required, from school age, as is better training for emergency physicians, obstetric specialists, GPs and allied health professionals. Early pregnancy assessment clinics and services need to be better staffed and resourced. More research funding is needed to understand risk factors, genetic inputs and more.

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And we must establish changes in a medical system that prioritises men, both in care and research, to enable access to professional, miscarriage-specific psychological support (it can lead to depression, PTSD or suicidal tendencies), as well as ultrasounds, non-invasive pre-natal testing and procedures such as dilation and curettage (D&C) to manage miscarriage when surgical intervention is chosen by the patient.

We need to be collating data on miscarriage rates in this country (we have no idea how many there actually are and what the trends are showing) and educating patients about what this means for future health needs; early pregnancy loss can be a marker for potential health issues such as high blood pressure, cardiovascular disease, and type 2 diabetes.

Disclosures of miscarriage are becoming more common from people in the public eye. But we need more than acknowledging miscarriage and the silence around it. While miscarriages will always exist, there are practical ways that we can improve the situation for those who endure them, the care they receive and how they are treated during subsequent pregnancies in order to reduce their risk profile for recurrence.

But we’re going to need a bigger boat.

miscarriageaustralia.com.au

Isabelle Oderberg is the author of Hard to Bear: Investigating the science and silence around miscarriage (Ultimo Press), which is out on April 5.

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