Navigating Pregnancy Loss
& Miscarriage:
A Roundtable Discussion

Cindi  

Welcome! HER Health Collective hosts four roundtables each year in an effort to bring together our experts, and dive deep into topics that matter to moms. We have found that these roundtables are very well received by our community and very well liked. Today, we are going to be talking about a difficult topic, but it is also a very important topic to speak openly about. This topic includes pregnancy loss, and the potential death of an unborn baby or fetus at any time during pregnancy, pregnancy loss may occur and as many as one in every four pregnancies. We will hear our expert panelists discuss how parents can navigate pregnancy after loss, what resources are available, that often difficult decision to not have more children and being content with the family that one has, and dealing with the changes that the body goes through after loss, how to approach fitness after miscarriage or loss and a parent’s understandable array of mixed emotions and anxiety of losing a child and as well as protecting their children that they currently have the fear they have of something happening to their current children’s so so much more is on the agenda. We’re honored to be joined by several of our 2022 HER expert panelists, we will take a few minutes to let each of our experts introduce themselves and share their area of expertise so that our listeners can hear each experts voice. And therefore have a better idea of who’s speaking during the upcoming conversation. 

Nicole Wallace  

Hi! Thank you for this opportunity. today ladies, I really appreciate it. This is just such a big topic. I’m honored to be here. My name is Nicole Wallace. I’m a licensed clinical mental health counselor in Raleigh, North Carolina. I own a group practice. There’s four other clinicians there and we service women dealing with anxiety and depression as our specialty so this topic is near and dear to our hearts. So and as a mom as well, of six of blended family. This is also a topic that’s dear to my heart. So thank you.

Charryse Johnson  

I’m Dr. Charryse Johnson, also a licensed clinical mental health counselor. I’m the founder of Jade integrative counseling, which is in Charlotte, North Carolina. My primary specialties are trauma, eating disorders and identity development. And this is just such a vast and changing topic. So I’m honored to be here.

Jenna Somich  

Hi, I’m excited to be here. Thank you for having me. I’m Jenna Somich. I am a fitness professional. I work with those who are in the stage of the parenthood transition. So that can mean many things. preconception, prenatal postpartum, post loss, and then beyond postpartum, working with those who are working through their identity, and they don’t maybe identify as postpartum but they have gone through birth. And I love working with women in general.

Christy Maloney  

Glad to be here. I’m Christy Maloney. I am a registered dietitian and certified eating disorder specialist in Charlotte, I obviously specialize in helping people with eating disorders in all the various stages to get back to intuitive eating and healthy relationship with food. We focus a lot on body image as well and just kind of healthy relationship with self. My business is called Enhanced nutritionist Associates and there’s five dieticians in my practice that we treat all kinds of conditions from a weight neutral body positive perspective.

Crissy Fishbane  

Thanks everyone. I know that this topic is very heavy. But I am so excited for the panelists that we have present today, I think it’s going to be a very helpful conversation for so many families to hear. We know how many families deal with this struggle. And this issue. It is a very difficult topic, miscarriage and pregnancy loss. But we would love to hear from each of our experts from the perspective of your respective industry. What advice tips suggestions, can you offer for a mom that is navigating a miscarriage or pregnancy loss? And I guess additionally, how about a mother that is newly pregnant after having previously suffered a miscarriage because that has a lot of emotions wrapped up in it too. We would love to hear from each of you on that. 

Nicole Wallace  

Hi again, Nicole, licensed clinical mental health counselor and seeing women off frequently who come into our offices who have dealt with that situation of either recovering from a loss of a child or even recovering from a loss, how many years it may have been or months or days and then they’re pregnant, again, is not unusual. And so the tips that we usually give is to recognize your feelings first, to recognize that there’s so much anxiety that comes with that uncertainty, and that that’s okay. I think so many times in our society, we’ve normalized pregnancy as this thing that just kind of happens. It happens for every woman, and it’s going to be a wonderful experience. And, and for many women, that is not always the case.

Charryse Johnson  

Yeah, this is Dr. Charryse, I’ll just add to that. Recognizing that it will feel like a breach of trust in your body. And even at times make it difficult to be compassionate, right? How can you feel compassionate towards a body that you may feel like you can’t trust or that you feel like has let you down and know that it is a loss at any gestational period, you know, there can be the dynamic of experiencing loss. And sometimes that initial comparison is around if that loss was perinatal, is it as valid, it’s someone who’s came later. So being able to just honor and acknowledge your experience is going to be crucial, allowing yourself the space to see it as grief and as a loss and know that you’re going to go through all of those stages. And then to the new mom who has taken the courage because it can be very daunting to work on conceiving again, after you have a child know that it may take you some time to attach to the new pregnancy. I feel like that’s a piece that isn’t disclosed as much or isn’t talked about due to the fear and shame of there’s going to be some dissonance there because you’re likely afraid. If I get attached and something happens, can I handle it? So just really want to put that out there and normalize that that may be something that you experience and that’s okay.

Jenna Somich  

And something I want to add, when Dr. Charryse just talked about that trust in the body. Working with those in the movement capacity, that’s always what I’m trying to help people discover or rediscover. And that is a huge piece after loss. So from a biomechanical standpoint, our body wherever we were in the pregnancy has gone through changes, and then we need to meet the body where it is and support rehab and recovery from that place. But a lot of times people are nervous, right, they’re there. They feel like their body. They they’re not sure about their body, they’re not sure about their abilities. They don’t want to make things worse, or or or cause other issues so reestablishing trust within their body through movement. Also, I find that a lot of people process through movement, that’s an outlet for them to  process their feelings to work through it. And it can feel tough for some, if they’re feeling disconnected to their body, they know that usually they enjoy movement, help them process, but they’re, they’re in this space they’re like, but I don’t know what to do, because this is new territory for me. So just taking it really slow with the individual working with them. And helping them get back to that place where they can trust their body or get start, start the journey. And then also process the feelings through movement. 

Christy Maloney  

Christy, again, registered dietitian, my thought that immediately came to mind the word was just betrayal, like, feeling like your body has betrayed you in some way. And for me, when I think about the word betrayal, I think about how that can create maybe a well, a disconnect, of course, but maybe even like a revenge like in a hate you kind of mentality. And from a nutrition perspective, you know, it’s really kind of want to emphasize that it’s, that’s the most important times to make sure that you’re, you’re eating adequately. I know that those bouts of depression and anxiety can decrease appetite. Sometimes, if you’re feeling like your body is betrayed, you might not want to feed it and take care of it. I think those are really normal responses, you know, but if we can focus on it, you know, the other word that comes to mind is just gentle, right, like gentle nutrition in terms of making sure you’re eating your meals and snacks, making sure you’re feeding your body so it can recover and heal. You know, if we think about the way food impacts mental health, we know that our brains are made of fat, and they run on carbohydrates. So we need consistent amounts of those things in order, you know, for our brains and our bodies to recover from that tough, tough physical condition.

Cindi  

Christy’s such a great point with that, because grief comes in so many different forms, and often people are turned off to eating or they’re turned off to exercise or taking care of themselves. So I love what everyone said. I did want to add in here, Maris Feeley is also on our expert panel. She is a co-owner of Carolina Birth & wellness and she is a full spectrum doula, which means that she has experience in supporting birth, postpartum loss and bereavement. And she sent me an email that had some additional things that she wanted to add in regard to what we were covering today. And one of the things that she said, for a parent newly pregnant after loss, she would recommend disclosing loss history to providers, however it feels best, including the nurses on staff at labor and delivery when delivering a partner support person or doula can do this for you outside the room. If that feels easiest. You deserve trauma informed care that reflects your experience. And that avoids triggering language. So she used the example, many labor and delivery nurses might try to make conversation with you and say, first baby, with a joyful, intense while trying to make conversation with you. But that can obviously be extremely painful if there’s a history of loss. And I have to say that I’ve personally gone through that where I’ve filled out forms and they say, How many times have you been pregnant, and I have to put four, but I’ve only had two deliveries, and it’s an awkward thing to do. So I just felt like that was really important to add.

Crissy Fishbane  

Thank you, Cindi. We would love to know if any of you guys have any recommended resources that you like to provide clients or patients that may be going through this.

Charryse Johnson  

One resource that I provide that I really enjoy and think is comprehensive is called RTZ hope.org. So it’s an online resource hub, but a database that gives individuals different options around blogs, different groups that are both for individuals, or if you want group support online. It also has a number of different connections to being able to find here are the resources that you can find in your state. So a lot of times, especially if it is someone who might not be a parent yet so they’re not in the world of parenting. They usually feel a lot more overwhelmed around, where do I go when I experience something like this, and I’m not already connected to other individuals who may have experienced this. And another one that I really enjoy is called Sbe mom.org. And it’s called Shades of Becoming a Mom. And it’s specifically for women of color. You know, one of the things that we want to do when we talk about trauma informed, but also making sure that we’re helping people connect to resources that also fit the context of what they might need, is making sure that we have diverse resources in case we have somebody that comes in to us. And they’re from a different culture, or they’re from a different ethnicity, or they speak a different language. So that’s something for us as providers to really even consider as we connect people to other resources, how to make sure that we have a comprehensive list. But those are two resources that I really enjoy, and had been really helpful to the people I’ve worked with. 

Cindi  

Thank you so much for sharing that Charryse. Where you have to also think when you’re helping people culturally, because different cultures might support individuals differently based on their belief system. So thank you for bringing that up. On Maris behalf, she also mentioned StillBirthday.com, I’m not sure if any of our other experts here have heard of that. She said that that’s a resource that she points parents to fairly often. Did anyone else have any other resources they wanted to offer?

Christy Maloney  

One book that I can recommend, and it’s not necessarily geared toward pregnancy loss and that kind of thing. But I think, you know, just kind of going with that. gentleness and compassion is called Body Kindness. It’s written by a dietician that just kind of gives helpful information about taking yourself care of yourself in a really gentle way, again, not targeted at this very specific population. But I think it will be a good resource to help people, you know, kind of bring back to the forefront like I need to eat and how can I eat in a way that supports my mental and physical health and move in a way that’s gentle and kind of work on a little bit of the body image piece there as well.

Cindi  

That’s great, Christy, thank you so much. I’m going to go into a question regarding family planning, and the size of your family. I know when I was a little girl, I used to think of how many kids I wanted to have when I was older. And so I’m sure I’m not alone with that I’m sure that many, many people begin planning their families when they’re really young. And then as you get older, and you’re faced with reality, it’s different, it might be very different. And off many times, parents are faced with difficult decisions to not have more children, regardless of what the situation is. It can be a difficult journey to learn to find contentment with the size of your family. If it doesn’t match up with the original vision you had held in your heart and your mind for years and years. What advice can you offer moms that are facing this particular situation? 

Jenna Somich  

I’ll speak to this because actually Crissy has inspired me with her sharing her experiences. And so one piece of advice that I read from one of your pieces was once you feel ready, kind of owning it, putting it out into the world, where you are at if that’s comfortable for you, so I’m a mother to one. And when I was younger, I thought oh, you know, two kids, three kids, that sort of thing. But just as you said, when it all unfolded, this is actually where our family is going to be in stay. And so that was a process to work through that. But when I read that article from Crissy and then I was like, Okay, I’m going to do this and it felt so good. To get to a place where I felt like I could own it, you know, and bring empowerment to our identity as a family and the three of us I will say kind

Crissy

Thank you so much for sharing that, Jenna. It is hard to share your story and open yourself up, but it’s so nice to hear when it resonates and helps someone. I appreciate you saying that.

Christy Maloney  

On the heels of that, from my own personal perspective, I was not that girl that was like, Oh, I’m gonna have three kids. I never wanted kids. I never wanted to get married, I did not care. I wanted a big house and a dog and a career. And, strangely, I have all of that. Not a huge house, but you know what I mean? But anyway, so I decided I didn’t want to have kids until I was 32. And at that point, you know, my husband and I had been married for just a little. And all of a sudden, I was like, actually do want kids, you know, so like, let’s get on it. And then, you know, we had trouble with conception, I figured out I had PCOS. And, you know, it took a while and took some interventions and things like that. And, you know, just from a family planning standpoint, because mine is a little bit reversed. I think of a lot of people’s. I felt like my body had betrayed me, I felt like I had cursed my body by saying all those years, I never want this, I never want this. And so then when I changed my mind, it was a whole different relationship with my body in a betrayal and frustration. That was there for a while.

Cindi  

How did you personally work through that Christy? 

Christy Maloney  

I am a let’s keep eyes on the prize go already to kind of person. So it’s what doctor do I need to go to? What thing Do we need to do. And then I’m very much like, let’s get to the finish line. And I’ll process after the fact. So we got to the finish line. And then there was like therapy.

Nicole Wallace  

So glad that you were able to say you did experience therapy, because I think as women, we are so driven, sometimes, you know, we care about everybody else’s feelings, we’re in tune with every sense of what our family should look like. And oftentimes, we are judged, even, you know, in microwaves by people. And so to seek therapy, to process your stuff, whether you choose to go on and have a family or whether you don’t, it’s such a huge part of I think what we started to have to start doing as women and that could be many different forms, it could been going to a psychotherapist, it mean finding that friend who can really be not unbiased and listen to you and hear you out and just sit and reflect, it could mean your religious or your faith based counseling. But having that is such a huge thing, because I think oftentimes, as women we just drive on, especially in the African American community, or we creates a really high numbers of death and loss, a maternal death of moms, and then also have babies, and oftentimes, we’re just talking to us, you know, we push it down, we don’t talk about it. And that is detrimental to the health of all of us.

Charryse Johnson  

And along the same lines of what’s been shared, it can also be helpful for us or for an individual to explore. Where did that vision come from? In the first place? You know, there can be a lot of our families or spiritual aspects of life that have created this vision that has been implicitly instilled to us all of our lives. And so it can be a tug of war around is it okay for me to accept that this is the reality? How much of that is my own? How much of that is connected to feeling like you’re letting someone else down? So you know, if I’m working with someone around that, I may have them really explore the, you know, the question, what do you believe it says about you, now that your family will not look, the way you envision, right? How are you connected with that? Is it a piece of identity loss to feel like, it’s going to look this way, in that way? Because, you know, similar to what even Nicole was saying, people place a lot of judgment, oh, you only have one child? Didn’t you want more like people say things and don’t recognize what someone could have gone through to even have the one, you know, that they had, and just exploring that for yourself. So that then when you’re kind of out there, and as Jen is saying, and you’re ready to share that with the world, you’re also ready to share it from a place of your truth. And really being able to validate your own story and knowing that people get very caught up in all the timetables of if you don’t have the white picket fence and 2.5 children by the time you know, you are 28 Then you’re failing. Or if you are a person of color, and you have a large family, why would you do that? Why would you want that many kids? You know, I’m the youngest of eight, right? And so there’s all these different aspects of just breaking away from what the world says about what your family should look like. And as you heal, really going, what can I accept for myself and how do I also move away from what other people have put on me? You’re around the type of wife that I’m supposed to be or the mom I’m supposed to be and how many kids I’m supposed to have.

Cindi  

I love that Charryse. Because I assume that it would be a really good thing for partners to do as well to step back and evaluate what they’re looking for. And why? Because, I’ve heard a lot of stories of myself included, where I had a different idea of how many children I wanted versus my husband, or it changes once you start to have kids. You know, they’re like, Whoa, this is harder than I thought.

Jenna Somich  

One thing I’ve noticed is, so my daughter is four, and people in her classroom are having younger siblings and things like that. And so there’s a lot of questions about well, why aren’t we, you know, why don’t I have a new baby and things like that? And then she starts to talk to me about, you know, can I have a baby when I’m older and things like that. And so I really, you know, going back to these ideas that we get in our heads about what things ought to be, it’s really created a situation where I’m trying to be very intentional about the messages that I send to her about conceiving, and, you know, if you want to do that, but you’re okay. It’s okay. If you change your mind, or, you know, what, I tried to not just say the things, the same things that were said to me to her, I try and kind of bring up questions around it, or possibilities or things like that, in the hopes that I that I don’t have her just believe that she needs to do one thing or have this set in stone identity.

Christy Maloney  

Yeah, Jenna, I wanted to add a thought there as well, I have a six year old daughter, she’ll be seven next Saturday. And she’s begged for a sibling, begged. And my husband and I, we knew like, we’re kind of we’re done, we’re where we want to be. And so there’s a part of me that, you know, when you think about family planning, I feel like I’ve let her down, you know, because she wants the sibling. And she would be an amazing, bigger sister. You know, one day, I had to go to the emergency room, and she was convinced I was coming home with a baby like mom, like went to the hospital to have a baby. And so that’s, you know, it’s an interesting perspective. And just, you know, something that it does bother me, you know, that, you know, we chose not to do that for a variety of reasons. And you know, she is disappointed.

Cindi  

Many of us will spend time with a friend or a loved one that is navigating this type of loss, the change in family structure, etc, that we’ve been discussing. Though our intentions are generally good and pure, we often have a tendency to say something that might not sit well, with a bereaved loved one, do you have any tips or suggestions or experiences, because we’ve all opened up a little bit on our own experiences, and things we can say or not say, in this particular scenario?

Charryse Johnson  

That’s a big list. I was like, where do we begin? Like, oh, my goodness. So I’ll start with two phrases, not to say anything that starts with at least right, at least you have another child, at least you have other children, at least it happened early on, at least you were at home when it happened. Anything that starts with at least immediately minimizes and invalidates and reduces the aspect and dynamic of what’s happening, and makes it very difficult for the person who’s experiencing that to get past that shock. And that hurt to say something because then they’ve moved from is this support to do I now need to debate, you know, an advocate and that can be really challenging when someone’s already hurting. And then similar to what Jen and Christy were just talking about. We often mean well, but really want to work on being cautious about saying, I’m sure that it’ll work out next time. I’m sure that at some point, this won’t be an issue x, y, z. because when you go through an experience like that uncertainty is one of the elephants in the room that has become crippling. And whether we want to acknowledge it or not, there isn’t certainty, even though we have data, and we have research that says, okay, 85% of people who lose a child do go on to conceive later, that other 15% is still very significant to their experience. And we’re also not considering what did that other 85% Go through, in order to even conceive again, so we don’t want to just say, Oh, well, it happens for 85% people. So I’m sure whether that’s because it creates false hope. Or, again, it makes it difficult for the person who’s experienced it to be honest about the fact that they may be terrified, and they’re not sure that they can even go through the process. Again, you know, there are some women who choose to stop trying, because they can’t handle the emotions of the recurring losses, and decide like hay for my own emotional health, or for the health of our family in our marriage. I can’t do this anymore. So we need to stop. So those are things that we would naturally do to think that we’re trying to be positive, and they can be really harmful.

Jenna Somich  

One thing that someone shared with me, someone that I’ve worked with, and is close with me, a lot of times people say, I can’t imagine, I’m so sorry, I just can’t imagine. And she said, You know, I want you to go there, I want you to imagine, I want you to mentally, physically go to the space that I am in. And, and imagine what it would be like, and then sit with me there and just be with me there. And I saw I thought that was so powerful, because the I you know, the perspective was I, I want you to be with me, you know, just saying I’m so sorry. I can’t imagine no, come with me Come on the journey, stick with me. So it was something different that I’ve really been thinking about, since this mom shared it.

Nicole Wallace  

I think the other part too, is too, if you do put your foot in your mouth, and you say something insensitive because it’s been known to happen to really be willing to go there as well. I, as I shared earlier, I have a big family, but my best friend, who has experienced a loss, has no children at all. And when I had my last child, it was a surprise baby. And I called her up. And I was emotional. I was upset. I was processing, you know, oh my goodness. And I didn’t key in who the who I was dumping on right? And so at the end after I finished having my rant, she says there a bigger problems than having another child. And it just, you know, they sent me into the president, oh, this, you know, who am I talking to? Like, this is someone who wanted a child didn’t get a chance to experience that. And so we hung up and I call back the next day and I had to really go there. I had to talk to her about how she was feeling in that moment. I had to apologize. And I think we have to be willing to have that uncomfortable conversation and that oftentimes people who have experienced a loss or have experienced infertility, that they are willing, as you said, Jenna to have that conversation to be uncomfortable. And it actually can help in their grief process. As they’re going through these uncertain times. And, uncomfortable is not wrong. It’s just uncomfortable sometimes. Yeah,

Christy Maloney  

Some thoughts I’ve had, when people say we don’t stress if you stress, you know, won’t happen. It’ll happen when it’s supposed to happen. Don’t worry about it. One, don’t tell me how to feel like that’s always my response is I’m going to feel what I’m going to feel. Don’t tell me not to stress and not to worry. But then, you know, kind of like what Sharif was saying it may or may not happen. You know, and when you’re feeling in a space that your body is so out of control, and there’s nothing to grasp on to it feels in my mind extremely invalidating to have somebody say, you know, it’ll happen when it’s supposed to happen, don’t worry, which is not helpful.

Cindi  

Would you recommend that someone says, “I want to support you, how do you feel more supported?” What could we say to somebody to let them know that we want to sit with them, be with them.

Charryse Johnson  

I mean, those statements I do feel like can be helpful. I’m sorry, I am here for you. When you are ready, please let me know how I can support you. And that when you’re ready, I think can be helpful. Because everyone is different on how they receive support, right. Some people do want support that’s close and consistent. And in the moment, some people may need space to process on their own first, and really just asking their permission. And then knowing that they’re going to be a lot of times where if you’ve been through that experience, you don’t know what you need. And you don’t know how to ask for support, you know, so also just finding a way to stay connected with that individual and really giving them permission, you know, and just being honest, similar to what Nicole was saying, around just letting someone know, I don’t want to be overbearing, but I also don’t want to be so silent, that you think that I don’t care. So I want to take your lead, I think it can even be helpful to someone that you’re closely connected with, to even have them come up with like a word or color, or food that they could either verbally say to you or communicate with you through text, when they’re in a space that they’re either struggling or overwhelmed. Or it will be helpful for them to have a conversation because sometimes it takes a lot to pick up the phone to dial somebody to call and talk about it, versus being able to just say Oreos, you know, and that person knows, that’s my cue. And they’ve actually talked about, here’s how I can tangibly help you when you give that distress call. And that may or may not involve conversation, right? So there are a lot of ways to also support people that doesn’t involve talking to them. That could be you’re just going over and maybe you bring the Oreos and you just watch a movie. And it’s just they needed to not be by themselves in that moment. But they also don’t need to go through and talk through everything. They just needed your presence. And so just really being patient with them along the way. Yeah, I

Christy Maloney  

Yeah, Oreos, let’s watch a movie… 

Charryse Johnson  

Now that you all want Oreos.

Christy Maloney  

My thought is, sometimes you don’t know exactly what you want or need. So it could be helpful to say, All right, do you want me to like, take the kids for a couple of hours that you have a minute alone? Or would it be better if I took you out and we had some time away from the house? You know, so, you know, providing like, okay, these are the ways that I think maybe do you want alone time or time with friends and offering things so that person could say, oh, yeah, like that one sounds good, when you’re not really able to sort it out for yourself. And if you know somebody, well enough to say, I’m gonna take the kids, you and your husband chill tonight and hang out. You know, stuff like that means a lot.

Crissy Fishbane  

I really appreciate all the very practical suggestions for navigating that because I personally feel that I have put my foot in my mouth too many times to count. It’s always coming from a good place. But sometimes you just don’t know what to say in those scenarios. So I’m gonna go back and listen to this section in particular several times and then take notes. So I appreciate that. I’d like to shift us into the body a little bit because the body goes through immense changes during pregnancy with hormonal fluctuations, body shifts, and the emotional adjustments that come through all of this. And that shift begins at the time of conception. Women undergoing IVF treatments in particular, go through a complex series of procedures that put a lot of demands on the body. These women also experience wide hormonal and emotional fluctuations, which all abruptly changes when a miscarriage or loss is experienced. They are most likely feeling a wide array of emotions, grief, anger, betrayal, distrust in their bodies. Just to name a few. Would you please talk us through how you in your particular profession nurture a woman through the process of finding her way back to her body again? Meaning, what would fitness look like post loss? What would you advise in regards to nourishing her body through the changes and through the grief? How can they begin trusting their body again?

Jenna Somich  

From a fitness standpoint, similar to post birth, I think it’s important to take time, you know, post birth, you don’t just jump right back into fitness. As you were, you take time you give your body time space. I always start with breathing, just being still and breathing and reconnecting with our breath, getting some great big 360 degree breaths into our entire core, connecting with our body, that space that was going through that by those biomechanical changes, starting there. You know, a lot of times, big feelings, like feelings will come up during that. If people are comfortable putting their hands on their body, and physically touching, connecting with their body, while they’re engaging in that breathing can be great. From a core pelvic floor standpoint, I always then do some rehab type exercises for the core and pelvic floor, regardless of where they were in their pregnancy, because as Crissy mentioned, from the moment of conception, there’s hormonal changes, there’s postural shifts, there’s just biomechanical changes. So we’re wanting to approach though the core in the pelvic floor and rehab those areas. And then I will utilize movements that show up in life with individuals to help them feel confident in those movements again. So for example, I do like a lot of squatting and hip hinging, and I connect it to life. So we sit down and we stand up all day long, right. But doing that as a box squat, or, or whatever, you know, we’re hinging, so we’re picking up laundry, a laundry basket, and then standing it up, connecting that movement to fitness. But a lot of times when I’m working with people, and they’re in this space, they’ll start squatting or dead lifting, or pulling or pressing, and they’ll be like, Oh, I do feel strong, wait a second, this does feel good. So in those moments going slow, but showing them that they are strong, that they are resilient, and then they’re able to take that feeling when they’re ready and carry it into their day. And I feel like it can help you know, the mindset aspect throughout the day as well and reconnecting with the with the body and feeling strong and powerful in their body again. Little by little and as they’re ready. Yeah, I’ll jump

Christy Maloney  

in just from a nutrition standpoint. All the hormones in our bodies are made of fats. So it adequate nutrition is so important, but especially adequate intake of fats, because when your body is trying to reregulate hormonally, we want to give ourselves the nutrition to support that. I will say after pregnancy loss, if you have a DNC is a surgical procedure. Anytime we have a surgery of any type, a medical procedure, our nutritional needs go up. So that is definitely a time that you don’t skimp on calories. You don’t want to focus on a diet. You want to give your body adequate nutrition just overall to heal and recover, and especially inclusive of fats to support those hormone shifts. The other thing I would say too, at that point is, you know, I never tell anyone that food is there’s a perfect way to eat there is that that doesn’t exist. But I will say be extra compassionate with yourself if you are emotionally eating, if you have the Oreos if you have the ice cream. And you know what that gets you through a time and it helps you to feel better. It’s okay. We all emotionally eat. And it’s it’s fine. It’s acceptable. It’s yeah, it’s totally okay and very understandable.

Nicole Wallace  

I just love that Jenna talked about breathwork because even as a psychotherapist, that’s something that we go to, in working with clients from an emotional perspective. And so To hear it tied together as far as like recognizing their strengths, and sitting in that moment, but having that deep inhale and giving their body that oxygen, and how it can revitalize you, in so many different aspects, I just love it.

Charryse Johnson  

I love the way that we’re also describing this as a journey. And I feel like that can be such a helpful perspective. You know, depending upon the dynamics around how someone has a loss, it can feel very intense. And certain aspects of it are immediate, and then move on. And that can be the challenge of knowing. People often focus only on the physical aspect of what happened and assume that 468 weeks later that you all of a sudden feel completely back to quote unquote, normal, whatever that is. So really also encouraging women to view themselves as an integrated whole. And knowing that your emotions are going to impact how much you want to move, they’re going to impact how much you eat. And really being able to address all of those things in a gentle and compassionate manner at the same time, is going to be extremely helpful. Sometimes a defense mechanism to getting back to a certain place to the body is I want to change my body, I want to overcompensate, I want to go lose weight, have a trainer and look the best I can so that nobody really knows how much I’m hurting inside. And then being able to recognize that if you don’t connect with somebody like agenda, or Christie that knows how to support you from that bio, you know, mechanical, neuro relational aspect that you can end up looking like everything is okay. And then realizing that there’s still a lot of unresolved trauma and grief that hasn’t been addressed and will eventually come to the surface. And I feel like that’s where a lot of women also will struggle, they may minimize the impact of their miscarriage and their child loss and not always connected that, hey, a year later, the fact that your hair is falling out and you’re still struggling to sleep is connected. Right to you haven’t nourished yourself, well, since that happened. But everybody said, You look so good, right? And so you just kind of kept going to really knowing how important integrating all of those pieces is going to be for your long term health. And whatever the future of your life looks like with your family, and then just even as an individual.

Cindi  

That’s something that I know I haven’t really thought about. There’s a term and I think there’s a book out there that’s called the Body Keeps the Score. And you forget about that. You forget about how your body remembers trauma, even when your mind has moved on. And that there can be this trauma and these effects that happen retroactively in terms of, you know, your life might be a year later, but then you’re having these various different complications. And you’re like, I have no idea what this is about. So thank you Sharise, that was very eye opening to think about. Now we’re going to talk about anxiety, which is debilitating. For many moms dealing with the anxiety after losing a child can come at a parent from every direction. They might be thinking things like, what will happen if we try again, and it doesn’t work? Or what if there’s a complication this time? What if we shift and turn to adoption? Would we even be considered can we afford it? The anxiety can also be reflected into the surviving children. So parents might find themselves worrying about how can I protect my kids? What if we lose another child? I mean, I think you can even feel the energy through the screen right now. And I can feel it. I’m getting worked up thinking about all of these questions. Can you please talk through this a little bit and provide ways that a mother can work to create a sense of calm within herself and challenge? The what ifs that feed that anxiety?

Nicole Wallace  

Well, I’m going to promote therapy again, because I think not enough of us do it. So finding that person, finding that therapists that can help you walk through this. I’m not sure that it’s spoken of enough as we’re leaving the hospital or are with primary care or not. Are OBGYN that there are people out there that we can process this information with. There are people who specialize in it. And looking for that provider, you know, not just any therapist, but actually asking those questions, what background do you have in dealing with loss, child loss or infertility, and I’m doing interviews with therapists to make sure that it’s a good match for you before you do go into a relationship with a therapist. And knowing that that person is out there for you, especially today where telehealth is very prevalent, that you could find someone within your state that could assist you. So I hope that if anything comes out of this, many women begin to realize that there is help out there and that they can look into those resources. And find someone who can walk alongside them, while they’re processing those anxious thoughts and trying to utilize coping skills to deal with those things that are going to pop up that are very valid, right, all of those questions that you went through, are very valid, are very true for many people.

Christy Maloney  

Yeah, like for therapy, it’s helped me so many times in my life. So I love so much that you’re you know, you’re focusing on that and encouraging women to do that, because it’s I mean, it’s necessary for survival at times it has been for me, from a nutrition perspective, you know, I always kind of say, a starved brain is an anxious brain. So dietitian plug for keeping enough because otherwise, your brain gets wired up for anxiety in a state of malnutrition.

Charryse Johnson  

Yeah, and to, you know, pull both of those pieces together. Essentially, when anxiety occurs, it is a neurobiological process, which also is saying, your nervous system is offline, your body, your hormones are dysregulated, your nutrition is likely to dysregulated sleep, which keeps you in this constant state of feeling like your mind is going a million miles per hour. And that doesn’t even include anything else that you might be working through. So food, sleep, hydration, sunlight therapy, and then going into the body as well, with massage breathwork meditation because the body does keep the score, losing a child is a traumatic experience for the body. And that’s held in the fascia of your muscles and dysregulate your system. So there are definitely moments where just telling ourselves something good that we learned in therapy may not solve the dynamic, which is why some people will go to therapy, if they don’t have somebody that’s trained well, and they haven’t gotten, you know, a good depth of resources and go, that’s not working for me, again, look at the integrated process of allowing your body and really helping self soothe your body back down into a place where you can utilize those coping skills, you know, say this one last thing, when a body experiences trauma, such as the loss of a child and trying to manage all of those dynamics. It’s very difficult to access that prefrontal part of our brain that’s going to utilize those coping skills. If we feel anxious, the first thing that we do is what can I take away? Or what can I bring in to get out of what I feel, right? We’re not thinking about those rational thoughts that come later. So things like breath, work, massage, brainspotting EMDR, things that help bring the body state back down are going to give you more access to process those emotions in therapy, and then be able to use some of those coping skills on a day to day basis once you are kind of acclimated back to life.

Christy Maloney  

Yeah, one other thing that Sheree says you were talking that I did want to put out there too. There’s no shaman, medication, if you need it, as well, if you need to see your doctor and you need antidepressants, anti anxiety medication to get you through a short time or a long time. There’s no shame in that. Because sometimes we need a little help that way as well.

Nicole Wallace  

I would also recommend journaling. It can also be a great way to take some of those thoughts and process them into two different ways. One, you’re letting the thoughts out, you’re putting them on paper, you’re able to reflect on it, you can bring it with you to your therapist and process it there as well. And so that’s a good way to kind of get through some of those anxious moments.

Jenna Somich  

Something I’ll help people find or work on or identify is it He’s kind of creating that tool bag that you were talking about, but things that are accessible to them when they’re with a child, for example, because I’ve noticed that that can, you know, when you’re in a moment in your, your caregiving, and you have anxiety, and you’re like, Oh, I would go to my therapist or I would go get a massage, but I’m taking care of my child right now I can’t do these things. How do I, how do I help myself in this moment, so created a tool, a toolbox for when you are caregiving, whether it’s some breathing techniques, or going on a walk and putting them in the stroller, or in a carrier, or maybe you’re doing, you know, a little circuit of like 10 squats and 10, wall push ups and 10 overhead presses or something like that, just creating a little toolbox that you can access, when you’re not able to give yourself all all the tools.

Cindi  

I love it, all of the suggestions are just amazing. I’m going to take us in the last few minutes into a little bit of a controversial, not a little bit, It is a very controversial topic, the reversal of Roe versus Wade. And the reason that we’re bringing this up is because this particular topic adds elements of complication to everything that we have just discussed. We feel it’s important to let you know that her health collective believes in health, empowerment and respect for every mom. So with this, we recognize that this decision will negatively impact the health of mothers. We recognize that there’s going to be greater negative consequences on communities of color, limited resources and women undergoing IVF. It impacts the empowerment of mothers by stripping them of the opportunity to determine what’s best for their physical bodies, mental and emotional health, families and their life. And it also negatively impacts the respect of mothers by taking the right to make medical decisions and provide access to safe legal and informed options. Excuse me. Looking at this from the perspective of your industry, the way that you support women and the discussion that we’ve had regarding miscarriages and pregnancy loss, have you had to make any sudden shifts in the ways that you practice? And do you see this change affecting the women you serve?

Charryse Johnson  

I absolutely see this change affecting women on every level. And I think that’s part of the challenge is there are still a lot of individuals who don’t quite understand how this change at one level gets down to impact them again, unless they were already well versed in it. I won’t say that it’s a sudden shift because it’s something that I’ve been paying attention to and watching. But I’m definitely making more intentional shifts around making sure that I am aware of state policies around this topic, since it’s no longer at the federal level. So that’ll mean, understanding what’s happening in my State of North Carolina, but also particularly if I have someone that moves into North Carolina from a different state, doing a little due diligence of knowing well, what did they experience around this area before they came here, I do think it’s going to be important for us to really collaborate more as a community of all different specialties so that we can give women more access to care that they may not have needed before they didn’t know, was available, because there’s a lot of information that is in fine print that people don’t understand. So it has a lot of impact. And, you know, going along just for one more moment with our conversations around family planning, where I’m actually seeing it show up the most is around hesitation, to have a family in some of the younger generation who are looking at all of the new and glaring or returning risk factors on top of what it already means to be a mom is creating a train of terror of Do I even want to do this because they have a lot of information right around what’s coming out. So I do feel like even as parent, it is going to be important for us to have enough knowledge to help guide our children not towards Our vision for their life, but at least helping them find the resources so that they can ask that question for themselves. But that’s something that I haven’t heard discussed, but I’m definitely seeing in a lot of places,

Nicole Wallace  

I definitely have to agree with Dr. Sharifah. I’ve seen that as well in my clients who are in their early 20s. And teens, wanting to explore what’s happened within therapy and having a lot of anxiety about what it means for their personal futures, which I myself hadn’t expected to have those conversations. So I think our skill set stays the same. As she mentioned, like we still practice reflection, we still practice acceptance, but for us to continue to be aware of policies within our state, especially in North Carolina, where we reside.

Christy Maloney  

Yeah, from my, you know, I’m an eating disorder specialist. That’s my client population. And so in dealing with a population that already has, you know, pretty high body image dissatisfaction and pretty high, you know, amount of the time feeling very out of control of their bodies, very distressful their bodies very frustrated with their bodies, this adds on a whole other layer of I’m actually, like, really not in control of my body now, which can be played out with eating disorder behaviors to try to garner more control, when they feel it’s been stripped away.

Jenna Somich  

I would say from the perspective of my work, there hasn’t necessarily been a big shift, but in the beginning of every session or group class, it’s just kind of like a big check in with everybody like, okay, so how’s everyone doing? You know, like, where’s everyone at with whatever they want to share family planning, things like that. A lot of people share resources about their plans, or if their partners have plans, things like that. So just opening up the conversation and not pretending like something hasn’t happened, but rather starting the conversation and just laying it out there and letting people you know, talk about where they’re, they’re at and how it’s affecting them.

Cindi  

Maris actually provided some feedback on this as well. Maris is, like I had said previously, is a full spectrum doula. And she says that, at Carolina Birth and Wellness, we support families across the full spectrum of reproductive health. From birth to miscarriage to postpartum to fertility, we have had to adapt our language to include precautions around the shifting legal landscape, such as discussing the ways in which period tracking apps could be used in courts to prosecute women who miscarry, or need to terminate pregnancies. While North Carolina laws haven’t been greatly altered in the fallout of the reversal of Roe versus Wade, that could all change with the fall midterms or with national legislation, such as the recently proposed national ban on abortions after 15 weeks gestation. And I can actually speak from this too, when I heard about this reversal. I had an ectopic pregnancy for my first pregnancy, and it had to essentially be terminated. And I didn’t really even think of it as an abortion. I just thought of it as something that had to be done to save my life. And now that I think of the reversal, I think of what that means for even my daughters, if that was to happen to them. If there’s things that changed or if that was to happen to me now, would that be different? So it’s just an interesting perspective to have.

Crissy Fishbane  

We just want to thank all of our expert panelists so much for joining us today. Being willing to dive into a very heavy topic and share your expertise and knowledge. We jumped around a lot within a very heavy topic from talking about family planning and navigating the emotional elements of loss and helping loved ones through that loss to the physical healing that needs to happen from a fitness lens and nutrition lens. And that emotional mental health lens as well. So we are just so grateful to everybody for joining us and sharing with us. It was a wonderful conversation. We appreciate you.