Today’s column contains my final responses to the May 16 column’s question about reproductive misinformation.
Mary Jo’s response Two more reproductive health topics often associated with myths and misinformation are miscarriage and postpartum.
Miscarriage: A miscarriage is also known as a spontaneous abortion or early pregnancy loss. It is the natural loss of an embryo or fetus before it is able to survive independently. The myths surrounding miscarriage are typically sad and may involve judgment.
1. Miscarriage is rare: Unfortunately no.
- A miscarriage is more common than most people realize. According to ACOG (American College of Obstetricians and Gynecologists), 10 to 25 percent of clinically diagnosed pregnancies end in a pregnancy loss, typically in the first 13 weeks. If we remember not all pregnancies are confirmed prior to a loss, which may then be thought of as late, heavy period, then the reality of how common these losses are hits home. An average of 1 in 4 pregnancies end in an early loss. A fetal death after 20 weeks is called a stillbirth, not a miscarriage.
- New research by geneticist William Richard Rice shows more than half of all fertilizations end in miscarriage. Dr. Rice’s study is currently in peer-review status.
- Age plays a factor in early pregnancy loss. Under 35 years old there is a 15 percent chance of pregnancy loss. Between 35 and 45 years old, the chance of pregnancy loss is 20 to 35 percent, and over 45 years old there is about a 50 percent chance of pregnancy loss.
2. Miscarriage is easily overcome. Not at all.
- Most people grieve over a lost pregnancy. Since I’ve served young parents since the ’70s, I’m heard people pre-judge teens who experience a pregnancy loss through miscarriage by saying things like, “Well, this is better. You shouldn’t have been pregnant in the first place.” Such a statement shows a deep lack of empathy. Loss is loss.
- The due date (or due time) can be difficult for those who experience pregnancy loss. The date was a time of anticipation and can be a painful reminder. I try to connect with young people when their due dates arrive after a miscarriage.
3. Miscarriages are someone’s fault. No.
- Pregnancy is often complicated – pregnant people do not control their uteruses. A miscarriage can happen with a planned or an unplanned pregnancy. Self-blame is harsh and real. Offer support. Partners also grieve, and may blame self as well.
- Finally, a subsequent pregnancy after a pregnancy loss can be emotionally challenging. Most people feel a sense of relief when the time of miscarriage passes with the next pregnancy.
Postpartum: Post (after) partum (after birth, from the Latin partus or bringing forth) is the time after birth and is often referred to as the fourth stage of labor.
Postpartum consists of three phases: The initial or acute period involves the first six to 12 hours after birth. The potential for a physical crisis during this time is real due to rapid changes after birth. The second phrase is the subacute postpartum period, lasting two to six weeks. Major physical and emotional changes happen as the body begins to recover. The third phase is called the delayed postpartum phase, which lasts up to six months. Many books are written about postpartum, but I will address two myths.
1. Bodies return to pre-pregnancy size quickly. Nope. When Meghan Markle, the Duchess of Sussex, appeared for photos two days after the birth of her first child, people remarked that she “still looked pregnant.” Of course. Most “baby bumps” take weeks to disappear; the uterus returns to its pre-pregnancy size around six weeks postpartum.
2. “Baby blues” are normal and not depression. Sure, hormonal changes after birth can cause mood swings, but dismissing signs of postpartum depression (PPD) can be risky. Postpartum depression can cause feelings of extreme sadness, anxiety and exhaustion, and may make it difficult for new parents to complete daily care activities for themselves or for others. A 2017 study found 1 in 9 new mothers experience PPD.
- The National Institute of Mental Health (NIMH) lists postpartum depression signs here https://www.nimh.nih.gov/health/publications/postpartum-depression-facts/index.shtml.
- In Washington, the Postpartum Depression Project (PPDP) was founded by Kim Manfredi and Jatnely Gonzalez. The group’s focus is on Maternal Mental Health & Wellness (MMH) and their motto is “Keep the conversation going, stop the shame.”
PPDP’s free Peer Support program offers mothers a safe place to meet weekly where they can find hope, healing, understanding, and ultimately assist in their recovery. The group meets at the William R.Cameron Wellness Center; they can be reached at 724-705-7993.
Have a question? Send it to Dr. Mary Jo Podgurski’s email at email@example.com.