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After the miscarriage, everyone told me to try again as soon as I could. It had been so easy the first time around that I never expected to find I couldn’t get pregnant again.
Once the IVF had worked, the last thing I had expected was to miscarry... once I was pregnant that was that as far as I was concerned.
© The Miscarriage Association and CHILD, 2003
Whether you’ve lost a baby after fertility problems, or are having difficulty getting pregnant again after a miscarriage or ectopic pregnancy, the pain of living with the double blow of pregnancy loss and infertility can seem almost impossible to bear. Both infertility and miscarriage can be devastating experiences, but taken together the impact often feels much greater.
You may feel lonely, angry, guilty, helpless, depressed or desperate. You may be experiencing a whole range of emotions at the same time. You may be wondering why this had to happen to you, and feeling as if you are the only person to have to live with these two traumatic life experiences at the same time. It is, however, important to remember that you are not alone and there is support out there if and when you feel you need it.
This leaflet is meant for everyone who has experienced infertility and pregnancy loss. Parts of it will be more relevant to you and to your personal experience than others, but we hope that whatever your situation you will be able to find something here which will help you.
Miscarriage
As many as a quarter of all pregnancies end in miscarriage, usually
during the first trimester. It’s often hard to establish a cause, and not
knowing why it has happened can make it harder to cope with. You can find
detailed information about causes, tests and treatment in The Miscarriage
Association’s leaflet Why did it happen to us?,
but a brief explanation of the main reasons miscarriages can occur is listed
below.
Hormonal: Women who have hormonal irregularities have a greater risk of miscarriage. Fertility problems caused by some kind of underlying hormonal imbalance may make it not just harder to conceive, but also increase the chances of miscarrying.
Genetic: About half of all early miscarriages are caused by some kind of chromosome abnormality in the embryo. It isn’t clear why such problems occur, although the risk is greater for older women.
Immunological: Raised levels of antibodies in the blood can affect the blood vessels supplying the placenta and cause miscarriage.
Infection: Minor infections like coughs and colds will not cause problems during pregnancy, but some specific illnesses or infections can increase the risk of miscarriage.
Anatomical: Later miscarriage can be caused by a weak cervix (neck of the womb), an irregular shaped womb, or by large fibroids.
Ectopic pregnancy
Around one in every hundred pregnancies is ectopic. This means that the embryo
implants outside the womb, usually in one of the Fallopian tubes which join the
womb to the ovary.
Sometimes the embryo will stop growing soon after it has implanted, but if it continues to get bigger it can start stretching the walls of the Fallopian tube, causing pain and/or bleeding. If the ectopic pregnancy is not diagnosed, there is a risk that the tube will rupture which may affect future fertility.
It isn’t always clear why the embryo has implanted outside the womb. One of the most common causes is some kind of existing damage to the Fallopian tube. Pelvic infection or appendicitis may be responsible for causing kinks or adhesions in or around the tubes.
I just kept thinking, ‘Why me?’ I know a
miscarriage is an awful thing to happen to anyone, but it was all so much worse
for us, because we’d waited so long for me to get pregnant in the first place
and I didn’t know if I’d ever be able to conceive again.
It is often claimed that miscarriage is more common after fertility
treatment, and statistics do seem to suggest that IVF (in vitro fertilisation)
pregnancies are slightly more likely to result in miscarriage than natural
pregnancies. However, there are a number of factors which may explain this.
Women who have fertility treatment are likely to be older and may have hormonal
or other problems which could put them at greater risk. Those who have had
fertility treatment are also more likely to be aware if they have had an early
miscarriage, which may make a difference to the statistics.
Your feelings can seem overwhelming, and you may find yourself hurtling through a variety of emotions from anger to despair, jealousy to helplessness. Everyone reacts differently: there is no right way to feel and no right way to deal with what has happened.
Some people find that they want to talk about their experience all the time, whilst for others talking is just too painful. Some end up isolated and lonely, certain that no one else could possibly understand. Whatever you are experiencing, be it guilt, rage or depression, it may help to remember that you won’t be the first, or the only person to feel this way.
Your partner will also be suffering, but may have completely different reactions to yours. You can be left feeling that they’re not experiencing the same pain and distress because they’re not responding in the same way.
Male partners sometimes feel powerless to help and concentrate their energies on trying to be strong for the woman. This can make it hard for them to talk about their own emotions and they may become isolated. It’s sometimes difficult to help one another at a time when you are both feeling so hurt and the Miscarriage Association leaflet Men and Miscarriage may prove useful for both partners.
For women who don’t have a partner, this can be a particularly lonely time and you may feel unsupported. It is important to try to find someone you can confide in, whether it’s a friend, a relative or a counsellor.
If you already have a child or children and they knew that you were pregnant, they may also be sad about the loss and find the situation confusing. Try to talk to them to dispel any fears or guilt they may have about what has happened.
Some of the ways people have felt about their experiences of infertility and pregnancy loss are detailed below. You may have completely different reactions to what has happened to you, but whatever your emotional response, it is important to recognise that your feelings are justified. Try not to allow yourself to worry that you are not dealing with things “properly”; to think that you should be coping better, or that you shouldn’t feel the way you do. You may have spent many years getting to this point and you may feel that this was your last chance to have a child, particularly if you cannot afford more treatment, or there is no more available. Whatever your situation, you have lost a baby and you have a right to feel angry, a right to cry, a right to grieve.
I was desperate and it got to the point where I
couldn’t enjoy anything or even think about anything else.
Many couples experience despair and helplessness. The future may look
hopelessly bleak and you may think there is nothing you can do to improve your
situation, but things WILL improve in time.
I felt so alone, as if I was the only person this
had ever happened to.
It is not unusual to feel isolated, but you are not the only one to go through
this. If you are able to talk to other people about your experience, you may be
surprised at how many have been through similar traumas.
Although I know it’s crazy, I can’t help feeling
a failure, let down by my body.
Many women and their partners feel that they have somehow failed when they
experience either miscarriage or infertility and blame themselves for what has
happened. It is not your fault and you have nothing to feel guilty about.
Seeing other people being pregnant was just awful.
Everywhere I looked there were people with bumps and I found it immensely
difficult to cope with.
It is often very difficult to deal with friends or family getting pregnant and
giving birth. Many women – and their partners – feel some jealousy and even
anger and resentment. This is very understandable.
I felt I had lost control of my life. Everything was
given over to trying to have a baby.
It can feel as if you can’t get back into the driving seat, as if you have no
part to play in what is happening to you because you can’t achieve what you
most want. Taking an active approach, seeking out sources of support and
information can help by allowing you to regain some control of your situation.
Just reading this leaflet can be a step down that route.
Many people find that it helps to talk about what has happened, and if you are uncomfortable doing this with friends or family, you can always turn to CHILD or The Miscarriage Association, where you will find a whole network of volunteers who have had similar experiences and can offer a sympathetic ear.
The fertility clinic didn’t seem interested that
we’d lost our baby. All that mattered was the fact that they’d managed to
get me pregnant.
When you’re trying to get pregnant, a fertility clinic should be offering help
and support. Once you’ve had a positive pregnancy test, most will only want to
see you to confirm the pregnancy. Women who miscarry can sometimes be left
feeling that they’re on their own, but this may depend on the type of
treatment you’ve had. All specialist fertility units which are licensed for
IVF treatment are required to offer their patients counselling and this can be
really helpful.
If you didn’t ever get as far as a specialist unit, you may not find the same kind of follow-up care and help available. Similarly, those who experience infertility after pregnancy loss may feel that they are not given the support or advice they need from their local hospital or GP. However, there are counselling and support systems which are available for anyone to tap into, whatever their experiences and they can offer advice and an understanding of the complex emotions involved.
At least you can conceive, they’d say, but I kept
thinking that just because I’d conceived once, that didn’t necessarily mean
I would again.
Friends and family may be finding it difficult to know what to say and how best
to help you. Comments meant to console you, can end up making you feel worse and
it can be hard not to feel angry and resentful if this happens.
Some people will avoid the subject entirely, as if they are trying to pretend that it hasn’t happened. They may think that you would rather not talk about it and that you don’t want to be reminded of it. Even those who are trying to help by talking to you about what has happened won’t always succeed. “Well, at least you know you can get pregnant”, is something you are bound to hear at some point and many couples find this very hard to cope with.
Although there may be some people who simply can’t understand how much you long for a baby, your friends and especially your family may feel upset themselves about what you are going through and may be at a loss as to how to help you. You may want to suggest that they read The Miscarriage Association leaflet Someone you know... which can give them practical advice about how to help you through this difficult time. Alternatively, CHILD operates a Friendship Scheme for the friends and family of infertility sufferers.
We dealt with it very differently and it came close
to splitting us up. We could have coped with the miscarriage, but the subsequent
infertility put a strain on us that knocked us for six.
Both infertility and miscarriage can put a strain on your relationship and the
combination of the two can be particularly hard to cope with. Much of the
attention is focused on the partner who has lost the baby and you may find that
your reactions and ways of trying to cope are different.
Sometimes one partner wants to talk about it, whilst the other doesn’t and it’s almost inevitable that some of the anger and pain you are feeling will end up being taken out on one another. A woman who has lost a baby can feel that she has let her partner down and this sense of guilt can sour a relationship. Try to understand one another’s needs as best you can, and to talk through your feelings.
Sometimes relationships don’t survive the strain of infertility and pregnancy loss and if this happens you may be left feeling lonely and unsupported. Talking to a close friend or relative, or to volunteers at CHILD or The Miscarriage Association may help. RELATE offers a counselling service for couples who are experiencing problems.
We were never offered counselling at all, but we
sought it out ourselves and we found it very helpful.
Some couples are reluctant to seek help from outside their immediate circle of
friends and family when it comes to coping with painful situations. Seeing a
counsellor isn’t a sign of weakness, but a positive way of dealing with a
difficult problem. It’s an opportunity to air the emotions you may not want to
let out elsewhere and can help you work through your feelings.
All specialist fertility clinics licensed for IVF by the Human Fertilisation and Embryology Authority are required to offer specialist counselling. If you’ve been treated at a clinic licensed by the HFEA, do consider this first, as it will be specific counselling from an independent counsellor who will be aware of all the particular problems of fertility treatment. If you’ve been treated elsewhere, you may not be automatically offered counselling, but you can still get help from a specialist counsellor by contacting BICA.
Alternatively, you can contact a general counselling organisation, or ask your GP to help you find a counsellor, but remember that this may not be someone who is experienced at dealing with infertility or miscarriage.
One of the most difficult things about living with pregnancy loss and infertility is not knowing when, or whether, you will become a parent. If only someone could answer that for you, it would all be much easier to handle. Without any certainties, couples often want to know how long they should carry on trying; how many miscarriages should they put themselves through, how many cycles of fertility treatment? There is no magic formula for this; everyone is different and there are no rights or wrongs.
Many couples find they want to take a break at some point, which can be beneficial. If you do decide you’ve had enough, you might want to start thinking about other routes to parenthood such as adoption or fostering.
Alternatively, you may want to think about living with childlessness. Try to allow yourself to be positive about this. Finding a way to enjoy your life again and to laugh about things, doesn’t mean that you have forgotten what has happened to you. Moving on is part of the healing process and not something to feel guilty about. Counselling can help you deal with this and there are good support networks available for couples who are looking at moving on in these ways, which can help to make this a positive experience.
Whatever your personal experience, the impact of infertility and pregnancy loss is often very difficult and distressing. We hope that you will have found something helpful in this leaflet, even if it is just a pointer in the right direction to get the support you need. We’ve included a list of useful contacts and whether you want more information, advice or just someone to talk to, the organisations below are there to help.
CHILD
Charter House, 43 St Leonard’s Road, Bexhill-on-Sea TN40 1JA
Tel: 01424 732361
ISSUE
114 Lichfield Street, Walsall WS1 1SZ.
Tel: 01922 722888; e-mail: webmaster@issue.co.uk; website: www.issue.co.uk
BICA
(British Infertility Counselling Association) 69 Division Street, Sheffield S1
4GE.
Tel: 0114 2631448; e-mail: info@bica.net; website: www.bica.net
RELATE
Herbert Gray College, Little Church Street, Rugby CV21 3AP.
Tel: 0845 456 1310; e-mail: enquiries@relate.org.uk; website: www.relate.org.uk
British Association for Counselling and Psychotherapy
1 Regent Place, Rugby CV21 2PJ.
Tel: 0870 443 5252; e-mail: bacp@bacp.co.uk; website: www.counselling.co.uk
HFEA (Human Fertilisation and Embryology Authority)
Paxton House, 30 Artillery Lane, London E1 7LS.
Tel: 020 7377 5077; e-mail: admin@hfea.gov.uk; website: www.hfea.gov.uk
We would like to express our sincere thanks to Kate Brian for generously sharing her time, knowledge and skills to write this leaflet. Thanks are also due to Peta Harrison and Judie Self for their ideas, inspiration and comments on each draft. We are most grateful to the Department of Health for funding the production of this leaflet.
| Ruth Bender Atik The Miscarriage Association Registered Charity No 1076829 |
Clare Brown CHILD Registered Charity No 277754 |
This leaflet, and many others, are available on order from The Miscarriage Association and also for download in pdf format