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March 10th, 2009:

Advice on Coping with a Miscarriage

As published on the Essential Baby website http://www.essentialbaby.com.au/parenting/pregnancy/advice-on-coping-with-a-miscarriage-20081111-5m73.html?page=-1

  • November 11, 2008
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    For further information, contact Melissa Maimann at www.essentialbirthconsulting.com.au

    Essential Baby member and midwife Melissa talks to EB members about how they coped with their miscarriage and what advice they can share with others.

    Give yourself time
    Grief takes time. Especially if it’s combined with anger, confusion and isolation. Give yourself permission to be sad, to grieve. Some people will try to offer advice: accept this if it helps you. Try not to shut out your partner and helpful friends and family.

    Say goodbye to your baby
    When we move from one phase of our life into another, it is important to acknowledge what was, and is no longer, by saying goodbye. This comes in various forms. Jamie-lee “had been keeping a pregnancy journal, so I wrote a goodbye. My husband read it and signed the book as well. The next day I felt different: a lot calmer.” Lia was able to say goodbye to her baby physically. Lia’s “OB came in to see me and picked her up and put her in my hands. It was really wonderful of him, he kind of knew I needed to do it, I’m glad I did I would have regretted it if I hadn’t.”

    Seek answers
    It’s important to get answers – especially if you have experienced more than one miscarriage. Roony found it helpful then her “obstetrician sent tissue from the D&C for chromosomal analysis and it was found that there was an abnormality incompatible with life. So I had a reason and also knew that this wouldn’t affect my chances of falling pregnant again.”

    Heather did not blame herself for the miscarriage when she found that the cause was likely to be a chromosomal/genetic abnormality.

    Support from loved ones
    Heather told her family about her pregnancy at five weeks. “This turned out to be a blessing as we had acknowledgment and support from our loved ones, which made it much easier to deal with.” Rebecca found that talking to others who had gone through the same experience helped. Don’t be shy to ask family and friends to help with housework, shopping, or the care of other children.

    Seek professional support
    Lia was given literature and support from Pastoral Care. “She took the time to not only talk to me, but also my husband who was having a really hard time with it.”

    Some women find enormous benefit in talking to counsellors or psychologists about their experiences.

    Providing sensitive care: advice for friends, family and care providers
    Many people do not realise that miscarriage requires a full period of mourning and grief. It’s important to recognise this period and validate the woman’s experience. When Amanda was told, “It’s meant to be, there was something wrong with it”, and “at least you know you can fall pregnant”, these comments made her really angry. She “just wanted someone to say “you poor bugger, I am here to listen”. Nicole’s advice to family and friends is “Just listen. The best thing you can do is let the person simply talk when they want to, cry when they want to and not try to make them feel better.”

    Rebecca’s experiences were upsetting as she recalls, “It may be an everyday occurrence for them, but it is not for us. This is the loss of a life, that we wanted very much, not just yet another person having a miscarriage. I would have loved for the staff to be a bit more caring and understanding towards me. Just because I was young and not married … does not mean the baby was not wanted, or that my partner was going to leave me.”

    Sally feels that some kind of recognition is needed: “Nothing was ever said to me about what happened to my child after the D&C. If you lose a baby later in pregnancy, they encourage you to hold it, photograph it, bury it, etc. I think there should be some recognition of that life even if it was so short. It was like the baby had never existed.” This is also important so that parents can say goodbye.

    Jamie-lee wanted information about when she could try again for a baby. She found, “the doctors at hospital were very vague. They said to wait a few months, but couldn’t tell me why I should wait. Then they said if you fall pregnant straight away its not a problem!  This confused me.” Consistent advice with good reasoning is really important.

    Professionals can provide sensitive care by allowing the woman time to talk, debrief and ask questions. It’s also important to provide choices wherever possible. Roony cautions health professionals: “Don’t use the term ‘abortion’. Even though it’s the medical term for a miscarriage, when people hear it, they think ‘termination’. Explain things and don’t rush to see other patients. Provide a follow-up 4-6 weeks post miscarriage to see how everything is going. Consider investigating possible causes of the miscarriage sooner rather than later.”

    Lia said, “There was one nurse who stands out in my memory. She wiped my tears away. She stroked my hair as they sedated me, and she was still there when I woke up to console me. Nothing could have made it easier, but this lady cared.” It’s about compassion.

    Heather’s experience was eased when a nurse recognised her loss. “We had a dreadful experience in the hospital, except for one kind male nurse who expressed compassion for both my husband and I. His simple ‘sorry for your loss’ permitted me to cry and begin to grieve. A little kindness and compassion goes a very long way.”

    Alison recalls, “I saw two different GPs for my pregnancies, and sadly both of them seemed to lack the detailed knowledge of what is normal in early pregnancy. Even when things were clearly not going well, they were just too upbeat and optimistic.” In contrast, “My OB was great – he is a man of few words, but said to me ‘I’m sorry you are going through this’ which made all the difference to me at the time,” Ed.

    - There is a link between high blood levels of heavy metals, especially mercury, in women who experience recurrent miscarriage. You might try eating smaller types of fish to reduce your mercury levels.

    For further information, contact Melissa Maimann at www.essentialbirthconsulting.com.au

    Double is trouble when caring for premature babies

    For further information, contact Melissa Maimann at Essential Birth Consulting.

    Julie Robotham
    March 10, 2009 – 8:02AM

    Care facilities for the most fragile premature babies are under mounting pressure in NSW, as a baby boom collides with rising numbers of twins – the result of fertility treatment and the increasing age of new mothers.

    … half of the state’s neonatal intensive care units were now regularly closed to new infant patients, as unpublished figures … show twins and higher multiple births made up 22.5 per cent of … admissions in 2006 – despite in-vitro fertilisation clinics’ insistence they are reining in multiple births …

    NSW’s birth rate leapt 3 per cent in 2007 alone, to 93,583 births … Demand for intensive care has also been rising steadily, by 14 per cent between 2001 and 2006, when there were 2296 admissions.

    … twins conceived in profitable private clinics frequently fell to the public hospital system for care when they were born sick and fragile. “The cost to the public purse is huge and the people who are running [fertility clinics] are very wealthy.”

    Associate Professor Evans, who runs the hospital’s newborn intensive care unit, said twins were born on average at 37 weeks of pregnancy, and those born before 35 weeks could suffer feeding and breathing problems. Along with the overall rise in births, he said, “there’s no doubt [twins] create a significant service load for us”.

    Doctors said the state’s 10 units for the sickest newborns were now often on “code red” – meaning they cannot accept any more infants … “the state is full almost every day,” said the head of another neonatal department … Our safety margin continues to be diminished.” But hospitals would always find a place for a premature infant among the 88 beds statewide, he said.
    ….
    Michael Chapman … at … IVF Australia, said the proportion of IVF births that were twins or triplets was falling as single embryos were replaced in most cases …

    IVF clinics did not benefit financially from producing twins over single pregnancies, said Professor Chapman …

    Lillian and Erin, now three, were born at 30 weeks, after Mrs Carswell’s blood pressure soared as a result of pre-eclampsia. The girls needed hospital care for two months but have avoided long-term consequences.

    An interesting debate. No doubt as medical technology increases, we will be able to keep younger and younger babies alive, with increasing qualitity of life.

    I wonder what impact effective preconception care may have on this issue. If women accessed effective preconception care that increased their ability to conceive without IVF, then this could well see fewer preterm babies in our neonatal nurseries.

    Melissa Maimann, Essential Birth Consulting.

    Petition to Keep Home Birth Legal!

    Hello everyone,

    please sign this petition to keep midwife-attended home birth a legal – and safe – option for women in Australia.

    Melissa Maimann, Essential Birth Consulting.

    ‘Silence’ on risks of baby formula

    For further information, contact Melissa at Essential Birth Consulting

    Link to article

    * Leo Shanahan, Canberra
    * March 10, 2009

    FORMULA feeding is not being described as a health risk to children because researchers are too scared to do so … despite weighty evidence that breast-fed children are less likely to suffer from type 1 diabetes, allergies, infections, die of infant death syndrome or develop certain cancers, researchers are not willing to name formula as a danger in the titles or summaries of studies.

    … The Royal Australasian College of Physicians advice says breastfeeding is superior to formula with studies showing among other things that breast-fed babies have lower rates of diabetes and obesity, higher IQs and as well as lower breast cancer rate in breast-feeding mothers – but have found the causes remain inconclusive.

    We’ve known that breast feeding is superior to formula feeding for many many years now. The only thing that surprises me is that it continues to be researched. Surely the research funds can be allocated to more under-researched issues? The target needs to be around mass eduction campaigns around breastfeeding and ensuring compliance of hospitals with the WHO Breastfeeding Guidelines. Next, money needs to be put towards supporting women to breastfeed – eg paid maternity leave for all women for 6-12 months.

    Melissa Maimann, Essential Birth Consulting.