Our lovely son finally arrived in June 2021, however, our journey was not plain sailing having had 2 miscarriages. The affect miscarriages can have on one’s mental health can be significant, and can continue even through to a successful pregnancy. Below, I reflect on my anxieties as well as our lifestyle changes and tests and treatments we took. We’ll never know if any of the action we took made any impact physiologically, but they did encourage me to have a bit of hope to eventually try for a baby again. If you have had two miscarriages, I hope that this post helps you to feel you are not on your own and that there is hope.

My fears and mental health

My mental health suffered immediately after the 2nd miscarriage. Amongst our wide circle of friends, one or two had had one miscarriage, but no one had talked about having two. For some reason, the fact that no one in our circle of friends had experienced it made me worry that we would be “that couple” that sadly couldn’t have children. I always thought I had a steely mental strength, but now there was a sharp puncture in it's armour. I couldn't bear a third miscarriage, for it meant being clinically categorised as someone who suffered from “recurrent miscarriage”, which meant to me that something could be wrong. In the UK, you have to frustratingly wait to a 3rd miscarriage before you can be referred for more in depth assessments (campaigners are rightly trying to change this). Going through this process seemed like a double edged sword, on the one hand, action could be taken to verify why this was happening, and we might get a diagnosis with solutions that may or may not work, but on the other hand I knew that often doctors couldn’t find what was wrong and therefore there were no answers. The thought of no answers and everlasting uncertainty was what scared me the most. This road appeared in my mind like a dark tunnel with no light in sight, and I did not want to be on it.

My second miscarriage floored me with the fear that I was going to have a third, so I decided to put off trying for a baby. For a year I buried myself into work, and excelled at a ridiculous pace. During that year I distracted myself from the fear of infertility with the goal of getting a promotion or new job and threw everything at it. At times however, the fear would rear it's head and I'd have an evening of crying streams of tears and scream in frustration that perhaps I was only putting off the inevitable. I had somehow convinced myself deep down that I was infertile, it was an irrational fear that actually existed before we started to conceive, and was now being prematurely confirmed.

My husband continued to be positive and hopeful, even though I probably batted him down repeatedly with my doomed outlook. But it is clear looking back that he was a great strength that supported me.

My Year of Lifestyle Changes, Health Assessments, and Putting up with being told it’s just something we have to go through.

Although I don't understand why time makes things feel better, it did help my fear to fade a little. But a major catalyst for feeling better and getting ready to try again was actually the Covid pandemic. Lockdowns and working from home meant a drastic change in lifestyle that I wanted to take advantage of, and a chance to do things differently. Although there was nothing likely wrong with what we’d been doing, it felt important to me that I took actions to help lead a healthier lifestyle, to feel more in control and give me hope that the next pregnancy would be successful.

First I wanted to rule out any easily detectable health issues that might be causing problems, e.g. thyroid problems etc. We found out from a friend that you could take the miscarriage tissue (we miscarried at home) to the hospital for DNA testing (you need to do this within 24 hrs if not sooner and you need to store the tissue in the fridge). This is not widely publisized and not every hospital offers it, but it’s worth a try, if it can provide a reason or some closure on why the miscarriage happened. We were also very lucky that we had a great GP who sympathised with what we were going through and offered to refer us to get relatively simple blood and semen tests and he didn’t require us to have gone through a 3rd miscarriage. These all came back with the all clear. It’s only after these basic tests were done could he then refer us to see a consultant. I asked if we’d be turned away because we hadn’t had 3, and he said that it was likely they’d say nothing was wrong and to try again but he’d refer us anyway. I had a feeling this kind man understood the psychological importance of trying to get answers and getting professional reassurance, and that it was worth a try.

Unfortunately the consultant at Whipps Cross Hospital was awful, she spent the 30 minutes telling me many other women have it worse. I “needed to have 3 miscarriages in a row i.e. not with a successful baby in between” she said to me patronisingly. I looked at her in disbelief, if I could have ONE baby I’d be overjoyed, I certainly would NOT be in the room if that was the case! I was floored with how this woman talked to me with so much disdain and that I should just get on with it. When I got home I cried in the shower with indignation.

Depending on your luck and which doctor you come across, you may be taken seriously, or be treated like an overly dramatic self obsessed hypochondriac. However some doctors have been calling for a standardised level of care for all women who’ve gone through a miscarriage. I have no doubt that if miscarriages happened to men over the hundreds of years we’d be a lot further along with treatments.

It’s therefore worth doing the research about what support, tests or treatments exists out there. You may have to ask or push for it as it is clear the level of help available and at what stage is inconsistent across the board. Here is an NHS guide of the type of tests and work that can be done. I hope that women soon do not have to go through 3 miscarriages in order to be taken seriously and that assistance is offered as standard after 1 miscarriage. It is ridiculous, for example if one had an undiagnosed thyroid problem, to have to go through 3 miscarriages for that to be found out through a quick blood test. Standard support and healthcare measures after one miscarriage are being pushed for by many professionals now including The Lancet - an “internationally trusted source of clinical, public health, and global health knowledge”. So please never let anyone belittle what you have experienced and suffered through.

“well at least you know you can conceive”

Whilst some people would agree with the consultant, and even my husband to a certain extent believed it was all in my head, that my fear was irrational, and some friends would comment, “well at least you know you can conceive”, none of this comforted me, in fact it just made me angry that miscarriages were just seen as some small inconvenience, rather than something that can severely impact your outlook on life, and is not something you lightly want to chance again. There was no way that I’d just try again willy nilly without some way of improving our chances or ruling out a few obvious causes. So I decided to take action over things I could control, and that meant researching ways that could help fertility, leading a more healthy lifestyle and making the most of lockdown, working from home.

Pandemic related lifestyle changes

Working from home meant a lot less stress at work, (didn’t have to face my gaslighting boss)
Less exhaustion from less travel to and from work which totaled two hours day,
Not being exposed to as much pollution each day.
No pressure to drink alcohol as there were no work drinks
Having breakfast, which meant a more even blood sugar level throughout the day.

Non Pandemic related changes

1.) PCOS - Polycystic Ovaries

I’d booked to have a smear test at a private gynecology due to lockdown delaying my annual check up, and I decided to chance asking the doctor about my miscarriages. She mentioned PCOS being a possibility. I mentioned that in previous scans (for other reasons) doctors had seen a few cysts but had dismissed it at the time as not an issue. She then said, well there you go, you may have PCOS and subsequently recommended regulating my blood sugar levels through a healthier diet and reduction in simple carbs.

2.) Progesterone Supplements

The gynaecologist’ also prescribed me Progesterone, a hormone which could help build up a fleshy womb to help a fertilised egg embed itself and grow. I had done quite a lot of reading about progesterone prior to this and a few studies: PRISM and PROMISE found that there was a small but significant increase in women carrying a baby to full term if they’d had one or more miscarriage and had taken progesterone. Importantly, it found that there were no more adverse outcomes for women who had taken the progesterone vs women who had not. With the gynecologists’ encouragement that it wouldn’t hurt to give it a go, I started using progesterone immediately after getting a positive pregnancy test upon the doctor’s advice.

3.) No hot showers or baths for the husband!

One other change, was to ask my husband to make sure he wasn’t having too hot a shower. There is often an assumption that the miscarriage is usually down to the female, whilst there are lots of tests for the women, there are hardly any tests on the man. Yes a sperm count might be done, but is there any further analysis on the quality of the sperm? A small study in 2019 by the Imperial College London found “ sperm from men with partners who had suffered recurrent miscarriage had twice as much DNA damage compared to the control group”

It is well documented that the testicles need to keep cool (which is why they situated outside of the main body), and having hot baths decreases sperm count. Our shower at home is amazing, it’s powerful and HOT, but I wondered whether hot temperatures could also damage sperm, like how hot temperature can denature enzymes, could it damage the DNA? So simple enough, I ordered a shower head which would tell the temperature so that my husband would stick to cooler showers.

These simple changes helped me to feel positive about trying for a baby again, these were things I could control that could help our situation. My personal coping mechanism is to try and do the best I can and solve problems, rather than potentially let the same things happen all over again.

I want to be clear that I’m not saying any one of these methods or lifestyle changes can improve fertility. The chances are that we were always going to have a baby upon our third attempt, however, being able to do something which didn’t have adverse impacts on our health was personally worth trying.

Positive Result on a Pregnancy Stick - One Hurdle and Scan At a Time

The joy of finding out we were pregnant was always going to lead to caution rather than celebration. We were pleased that the first box was ticked, but knew that we’d been here before and there were higher hurdles to jump through later. The first, was going to an “early scan” to detect a heartbeat. Luckily the NHS allows if you’d had previous miscarriages. I’d never seen a heartbeat, as both my miscarriages were blighted ovums, and empty sacs of disappointment. But this time the midwife found one, and told me everything looked as it should!

A heartbeat was a MAJOR BOOST for us but my anxiety stayed with me. We did not tell family we were pregnant till after the 12 week scan, and friends till 20 weeks. In my first pregnancy I started bleeding in the 11th week and a scan showed that it was the size of a 5-6 week embryo, the thought that I’d been blissfully unaware that I was carrying a dead baby for weeks haunted me. I was constantly worried and did not let myself believe that everything would work out till the third trimester when the baby was luckily a regular kicker.

Regular scans

These definitely helped me to keep positive that everything was as it should be. Although sometimes there’s nothing that can be done to save a miscarriage, I also thought if anything went wrong, perhaps there could be me more information about what went wrong, even if it was just knowing the timings. The NHS had us in for the following usual scans:

6/7 week scan - Early Scan, available by calling your hospital Early Gynaelogical Unit and letting them know about a previous miscarriage.

12 week scan - an important scan, also measures for increased chance of Down’s Syndrome

20 week scan - scan to check for abnormalities, and check off all major organs and limbs etc.

In addition, we had private scans, at weeks 9, 17 and 37 weeks. Please make sure you go to a proper clinic run by specialists and certified doctors as there can be places which just do scans to make money off the photos and experience and if they are not a qualified sonographer, they may miss important issues as BBC has recently uncovered.

The Fear Never Fully Goes Away - Acceptance

Getting past the 12 week scan is a major milestone given the chance of miscarriage massively falls away at this point. However, if you’re anxious like me, at every stage there are worries. The worries will be smaller but they will be there. And even when the baby is born there will continue to be worries! And when the baby is a teenager there will be even more worries! So in a way you have to let it wash over you. Control what you can , but from then on, you can’t control everything, and you just have to accept that you will be able to handle whatever happens if and when it happens.

I hope this post will help anyone going through anything similar. You are not alone.

Good Luck