Emma chats with Clare about her experience of pregnancy after loss and coping with scans. You can listen to a recording of the chat and read the transcript here.
My name’s Emma. I am 36 years old. And me and my husband started trying for a family at the end of 2020. I got pregnant in the November and, unfortunately, had a missed miscarriage at 11 weeks.
I got pregnant again in the March last year. And unfortunately had another missed miscarriage quite quickly again.
The first one I had a scan scheduled anyway, but I’d actually started to bleed the night before and cramp. So I kind of knew that it wasn’t going to be great news. Then with the second pregnancy, I had a very light bleed very early on, and I had a scan at early pregnancy, which confirmed an ongoing heartbeat. But I was put on progesterone, and obviously they said it was a threatened miscarriage. I then had a scan privately, a week later, where the doctor confirmed that the heart beat was very slow, and the baby hadn’t grown anything.
So I had to have another scan a week later, which confirmed that the miscarriage had happened. I then had to have a medical miscarriage, which occurred, I think, maybe a couple of weeks later.
After that, I kind of knew… I’m a doctor by trade so I knew that because I was over 35 and I’d had two miscarriages in a row, I would be able to get some investigations. I actually managed to get them done quite quickly. I accessed a really brilliant recurrent miscarriage clinic in Northern Ireland and had all my investigations done about six weeks after my second miscarriage, which were all normal.
So I was basically advised, “Look, start progesterone on your next positive pregnancy test,” given some advice about various supplements, and they would follow me up once I got pregnant.
We kind of decided to stop trying for a bit, but then I fell pregnant again quite quickly by accident.
So, obviously, third pregnancy in the space of eight months. I was really, really, really anxious, and a bit fed up.
Yes, I can imagine.
I felt like I’d been pregnant forever and had nothing to show for it.
So I contacted the clinic who gave me loads of scans in my first trimester. I have to say, I had a scan pretty much every two weeks until my booking scan, which was a blessing and a curse, in hindsight.
I don’t think I would’ve got through my first trimester without it. But I found scans extremely triggering by that stage. I got very anxious on the run-up, particularly the 24 hours beforehand, to the point where I would practically be having a panic.
I would then get scanned and, thankfully, this pregnancy progressed as it should. So I had good news at every scan.
I was fully 100% expecting bad news, every time I went.
I would almost convince myself that that going to be the case so that if it did happen I thought that I might not feel so bad.
Yes you find a way of coping with it before it’s even happened.
It sounds like because in your second pregnancy you had so much… A miscarriage maybe threatened and having to wait, and then another scan. And there’s so much uncertainty around that. I can imagine that scans would be particularly difficult and triggering, perhaps. They’re always hard, but that sounds like a really tough one.
I always used to envy these people who would go into their booking scan really excited. Whereas I never managed to get to a 12-week booking scan. So when I did eventually get to it with this pregnancy, I was so worked up that it was just a really unpleasant experience, apart from, obviously, the sheer relief and joy when things were okay.
Scans were, kind of, a grim necessity, rather than a happy occasion.
In the moment of those scans it’s almost impossible to get through, isn’t it?
You said that you built up yourself, so your expectations were really, really, really low. Was there anything else that helped?
Shortly after my second miscarriage, I started counselling, which I accessed privately. Because after the first one, I just put my head in the sand and got on with it. I went back to work very quickly. I’m a GP, so I was dealing with lots of pregnant women, lots of women having miscarriages, which I found very tough. But I just got on with it and focused on getting pregnant again, which became a bit of an obsession.
Then after the second one, I thought, “I’m not coping very well, I’m going to have to get some help with this.” So I went to counselling, which I continued throughout the first trimester of my third pregnancy. And that helped me cope, just speaking about how anxious I was, because I really tried to do things like mindfulness, journaling… You know, I bought a couple of books to help with that. But employing those techniques, when I was really worked up, was just too hard.
So I kind of almost had to try and settle myself when things weren’t as crucial.
But I just had to accept that in the 24 hours in the lead-up to a scan I was going to be really anxious, and I would just have to put the time in.
And then I kind of thought that would magically go away after my 12-week scan, but it doesn’t. It just changes. I did feel better. I did feel better as the pregnancy progressed, but I had quite regular scans, even in my second and third trimester, which got easier every time, especially once I was able to feel movements.
But then I just worried about other things, I went to the Miscarriage Association website and Tommy’s, and I’d done a terrible amount of Googling and reading. I think I’d realised probably what I’d already known, to be fair, from my medical training, that things go wrong throughout pregnancies. And my anxieties just shifted from the fear of miscarriage to the fear of something else. But it was, on the whole, more manageable.
There’s an anxiety throughout, isn’t there, really? that’s always going to be in your mind throughout.
I mean, the movement thing definitely feels like it helps. But then it also feels like there’s quite a lot of pressure on you to decide…
Are these normal or not?
Is this okay? Is this normal? They will say, “Use your gut …” But that’s a lot of pressure in itself. You want someone to say, “Do this” or not, and make that decision for you.
Yes, I think there is a lot of autonomy put on women when they’re pregnant, which I don’t think I realised until I was, and then suddenly you get left with lots of choices to make. Even despite being a medical professional, I just wanted somebody to make those decisions for me, or at least tell me, “This is what I think you should do,” which sometimes doesn’t happen in maternity services. I think they want to give women choice, which is great-
But instead it’s on you, and I think if you’ve had experience of a loss before then you’re going to be putting a great deal of pressure on yourself. I think if you haven’t experienced it, it is very hard to understand the level of worry, and for a long time. I mean, I think that’s what’s the difficult thing, you’re coping with this high to low level anxiety for almost a year, and that takes a lot out of you.
Yes, it’s definitely changed me as a person, as a doctor, as a mother now, thankfully, probably as well. I think being under so much anxiety for so long and losing faith in your body as well for so long, it made even things like my delivery and stuff quite tricky and quite difficult. Then you suddenly have your rainbow baby, I guess, and there’s loads of pressure on you to enjoy every moment of it.
Especially if you’ve had quite a journey to having that baby, then there’s this expectation that you’ve got everything you ever wanted now, so go and enjoy it. And actually, is really tough.
And I think the trauma of going through a miscarriage, no matter how many you’ve had or what they were like or how far on or not they were, is trauma. And you probably delay dealing with that when you’re dealing with an ongoing pregnancy. I think that has impacted on me as well, you know, postnatally. You kind of think, “God…” You look back and think, “Oh, my goodness, I’ve been through a lot.”
It is the toughest thing I’ve ever been through.
It takes an enormous amount of strength to get through it.
I mean, I probably spent the first, maybe, 28 weeks of my pregnancy saying… When I was talking to my husband, it took me a long time to be able to say, “When she comes,” rather than, “If she comes.” Even as late as that, when I knew statistically it was very likely to be fine.
I think when you have your first miscarriage, I always knew it was a risk. When I had the first one, I thought, “Okay, one in four women, or probably more, have a miscarriage. Next time will be okay.” Because you think statistically that’s probably the case. Then statistics let you down if you have another one, and you suddenly lose all faith. You can’t trust that.
So I used to be scouring looking online for something that would reassure me, some magical statistic or paper that would reassure me that everything would be okay.
Even scans, I kind of felt better in that instant moment. And I was very lucky, I had an amazing doctor looking after me who was extremely reassuring. He was very, very good. But as soon as I walked out of the scan room, almost as soon as I got to the car in the car park, I thought, “Well, my baby’s heartbeat could have stopped now, and I won’t know. I won’t know until my next scan,” because that’s what happened last time.
Scans are tricky because I think they exacerbated my anxiety, and the payoff wasn’t that great.
I don’t think I would have psychologically managed with less. I think it was the lesser of two evils, in some ways.
Even thinking about how difficult it is makes me feel sad. But, you know, it gets better with time. And even if the worst happens, you’ve been there before, you will survive it. But if it doesn’t happen, it does get easier.
I think you need to keep talking to people you trust. If it helps, do access counselling. And I think accept that you’re going to feel really anxious. That will come and go. Some days will be better than others. But you will, at times, feel really anxious, and sometimes you just need to ride it out and know that tomorrow might or should be better.
Then you’ll get to certain milestones that you have in your head. The gestation that you miscarried last time, for example, is a big one, I think. And every time you hit a milestone; your anxiety will get a little bit less. I think you just need to break down the time into those sorts of manageable chunks, because when you’re four weeks pregnant… You know, we find out so early nowadays… When you’re four weeks pregnant, and twelve weeks is an eternity. The first trimester drags, you know. So breaking it down into chunks, six weeks, say, whatever gestation it happened last time, your twelve-week scan… Then things like that, I think made it more manageable for me.