'It's not just a foetus you've lost, it's all your dreams'

One in five pregnancies in Ireland ends in miscarriage, yet this emotionally scarring experience is seldom discussed in public, and some hospitals are ill-equipped to assist those who have experienced it, writes FIONA McCANN

‘WHEN YOU HAVE been pregnant you realise that from the very moment you see the two lines you start planning the baby’s future,” says Fiona McPhillips, who had six miscarriages between the births of her first and second child. Although all of these took place in the delicate first 12 weeks of pregnancy, each marked an enormous loss to the would-be parents.

“It’s not just a small foetus that you’ve lost, it’s all your hopes and dreams, the months and years you’ve been planning,” Fiona says.

According to the Miscarriage Association of Ireland, one in five pregnancies in this country ends in miscarriage, a statistic that translates into 50 miscarriages a day.

Sarah (not her real name), from Dublin, miscarried on her first pregnancy. “I had it all played out in my head, how I’d announce it. I pictured my mum crying. I was so excited. I was on all the websites, looking at diets, at what I could eat and not eat,” she recalls. But five weeks into her pregnancy, she miscarried. “My mum rang and I ended up telling her I was having a miscarriage without having told her I was pregnant.”

The early loss was a huge blow, and remained on her mind even when she became pregnant again. “Every time I got a twinge or a cramp I thought, ‘this is it, this is it’,” Sarah says.

Her second pregnancy also ended in miscarriage. The first indication was the discovery at a routine scan that there was no foetal heartbeat. She was sent home to let nature take its course. “To go home and know you have a dead baby inside you is really horrible.” Sarah began to bleed after returning home.

“I think I passed it at home, I don’t know,” she says, and there are still tears in her voice. “Then there was this awful moment of me trying to put my hand into the toilet to see if it was there.” She pauses. “Just to look at it.”

Sarah had an incomplete miscarriage and was put first on a course of tablets to help her expel what was left, which resulted in excruciating pain. Eventually, she was brought in for a dilation and curettage (DC) procedure, to remove the contents of her uterus. She arrived for her appointment at 7am and started a long and agonising wait.

“You’re getting up to go to the toilet and walking by pregnant women, rooms with dads staring into little cots, and I saw grandparents coming in with flowers, and you can hear babies crying,” she says.

After 12 hours in hospital, Sarah was finally wheeled in for her operation. “I woke up in the recovery room. There were two nurses there and another woman on the trolley beside me,” she recalls. “The woman beside me said, ‘I just had a baby boy! What did you have?’ I said, ‘I had nothing’.”

Lorraine, from Limerick, had a miscarriage on her second pregnancy and found her hospital equally ill-equipped to deal with women in her situation. “There’s no early pregnancy unit, so everybody comes to the same admissions desk: pregnant people, coming for their Caesarean sections, their inductions. You have to wait in admissions, and you can hear everything that’s going on,” she says. “I saw a few girls crying in the corridor. There’s nowhere to go, there’s no privacy.”

YET THE TRAUMA of a miscarriage does not end with a discharge from hospital. Many women find the emotional scars take longer to heal. Sarah says the pain still visits her at unexpected times.

“I was out for a walk the other day, on the pier in Dún Laoghaire, and there was a couple there talking about babies,” says Sarah. “And suddenly I’m walking down the pier bawling my head off.”

With the loss comes guilt and a sense of personal responsibility, though, as Fiona points out, the mother is rarely to blame. “Every now and again, reports come out that doing this, that or the other causes miscarriage,” she says. “It’s just the typical pseudo-science . . . It’s very difficult to kill a baby, so it’s nothing that anyone has done has caused it.”

It’s not easy for the potential fathers either, as Sarah admits. “It is hard on your relationship. It’s no fun living with someone who’s liable to cry or get moody at any second.”

Colm, from Donegal, says that his wife’s two miscarriages were difficult for both of them. “It’s hard for the man because we didn’t have this physical attachment to the little baby,” he says. “It did stick with my wife a while after – she’d be in bad humour.”

The hardest thing for him was being unable to alleviate her suffering. “I just felt useless,” he says. “My brother’s wife had a miscarriage as well, and he said the same: there’s nothing you can do.”

It was only after his wife’s miscarriages that Colm found out just how common these things are, though they are rarely common knowledge. “Afterwards, we found out that my mother had had five miscarriages – but that was never spoken about before.”

Colm, however, does not feel the need to keep silent about his loss. “At work, I told colleagues that my wife had a miscarriage,” he says. “I would never think about it as something that was unspoken, or something to be ashamed of.”

Sarah has been similarly open about her experiences, at least with close friends and family, but finds herself questioning her own willingness to talk. “I’m wondering am I being an eejit, talking about something that really shouldn’t be talked about?” she admits. “Is it like talking about your sex life, is it really taboo, what I’m doing? But then I feel I’m just trying to be more open.”

Fiona also chose to talk about her difficulties in getting and staying pregnant, rather than suffering in silence. “I wanted people to know what we were going through, and it was more important to have people’s support than to wait,” she says. “If anything happened, and it did keep happening, I didn’t want people not to know about it and not to be there for me when it happened.”

She is angered by any suggestion that the topic should remain taboo. “I understand it’s a very private thing for some people and they cope better without family intrusion, but I don’t see why there’s a stigma. I understand that people don’t want to talk about it, but I don’t understand why people think it’s something that shouldn’t be talked out.

“I went through this hugely traumatic, life-changing experience, a huge part of my life, and the idea that I shouldn’t talk about it and keep it hush-hush, I just don’t understand it at all. If I’d had another serious illness, people wouldn’t gasp at the idea of me talking about it.”

FIONA NOT ONLY talked about it, she kept a blog (makingbabies.ie) and went on to publish a book, Trying to Conceive: The Irish Couple’s Guide (Liberties Press, €16.99), which includes a chapter on miscarriage.

Lorraine also writes a blog, mammabella.wordpress.com, on which she has documented her own miscarriage just as she does other aspects of her life.

Yet being open can have its drawbacks. “The problem with being open about it is people want to tell you all their stories about people they know who had five miscarriages,” says Sarah. “I don’t want to hear all this stuff!”

So what should you say to a friend going through a miscarriage? “Acknowledge their babies if that seems important to them, and just listen, and don’t make assumptions about how they feel,” says Fiona. “Some people might just be very pragmatic about it and want to get on with it and not want an outpouring of condolences, and others might want people to remember their due date.”

Fiona also has advice for those who have been through a miscarriage themselves. “A lot of people want to know why it happened,” she says. “Despite the fact that there’s nothing you can do a lot of the time, there is always a reason for it, though it might be a reason that you’re never going to find out. If you do want more tests and treatments, especially if you’ve been through two and three or more miscarriages, keep pushing your doctor.”

For Fiona, informing herself and ensuring that she was tested for possible causes had benefits, despite the fact that she never found out what had led to her miscarriages. “That was helpful for me, to be doing something proactive and not just be going blindly from one pregnancy into another,” she says.

She also recommends talking to others who have had similar experiences, adding that if nobody in your circle fits the bill, it helps to go online and look for message boards on the subject.

For many, the feeling of loss after a miscarriage continues up to and beyond the date the baby was due to be born. “When you have to go through that date without having a baby, that’s as hard as the miscarriage itself,” says Fiona.

Yet despite all she went through, she has no regrets. “I went on to have two more children that I never thought I would have. Now I don’t look back on anything with regret. I just think I’m the luckiest mother in the history of the world, because I managed to do something doctors didn’t think was possible.”

Sarah remains conflicted about the thoughts of getting pregnant again. “It’s Catch 22. Half of me is saying, ‘Until I’m pregnant again and have a healthy baby, I’m not going to get over this’. And the other half is saying, ‘You have to get over this before you can be pregnant again’.”

The Miscarriage Association of Ireland can be found at miscarriage.ie

Miscarriage in Ireland

Miscarriage is defined as the spontaneous end of a pregnancy before 20 weeks of gestation.

About one in every five pregnancies in Ireland ends in miscarriage, which means there are approximately 50 miscarriages a day on average.

Approximately 14,000 women in Ireland each year have a miscarriage.

Many Irish hospitals still don't have an early pregnancy unit. In some hospitals, however, women are admitted to the gynaecological wards rather than the maternity wards if they are experiencing early pregnancy loss.

Most maternity hospitals offer counselling in the case of miscarriage. The Rotunda in Dublin has a full-time bereavement support midwife who sees most of the women who have experienced a pregnancy loss at the hospital.