I wrote those words a few years after my miscarriage in 2013. The memory, and the trauma, was still fresh. It isn’t so much now. But miscarriage is common, and trauma following a miscarriage is common too.
Different sources say that between 10% and 25% of confirmed pregnancies end in miscarriage.
A UK study that examined PTSD, anxiety, and depression following a miscarriage showed that the prevalence of these symptoms has been previously underestimated with miscarriage trauma lasting “longer than we realized.”
Those of us who experienced the trauma are probably not surprised by the statistics.
One month following a first trimester miscarriage, 29% of women had symptoms of PTSD, 24% had anxiety, and 11% had moderate to severe depression. A year later 1 in 6 still carried PTSD symptoms.
In miscarriage, we’re met with our own helplessness and often with feelings of guilt, shame, and inadequacy. We labor on our own with no support or knowledge of what to expect. Future pregnancies are met with fear. Our grief is often invalidated, so we are quiet.
Medical professionals tell us we have to have three miscarriages to do any tests, and they’ll let us miscarry “as a diagnostic tool” and refuse to test our progesterone. They refer to our babies as fetal tissue, biowaste, products of conception, and say things like, “Why were you even pregnant?”
Why am I sharing this?
Because the experience is lonely. If this is you, you’re not alone. Talk to someone who’s gone through it too. Even those of us who have experienced miscarriage won’t always have the right words to say, but sometimes we need to share the story and hear someone else’s just so we know we’re not crazy.
Because people are unaware. If this isn’t you, you almost undoubtedly know someone who has had this experience, and a friend to be present and patient in the midst of it all can be invaluable.
Because the terminology and the medical care should change. Care providers, take your cues from the parents. Talk about the baby and the loss the way the mother does. Save your clinical talk for other clinicians. You might not be able to make it better and that’s ok, but please try not to make it worse. Talk to mothers about their mental health. If you can’t help them or give them the care they’re requesting (like testing progesterone) send them to someone who can.
For so many women, their motherhood had traumatic beginnings, traumatic chapters, and holds lingering trauma. Please be gentle with us.
We might not ever go back to “normal”. Sometimes that’s a hard truth, but it’s because our babies mattered enough to change us.
Note: Because I know a lot of people who follow me know me in real life, I’m ok. I’m just sharing this, because some mothers aren’t.
My second son’s birthday was several weeks ago, and for those weeks I have struggled to know how to write his story. Do I write it as a combination of my own memories and what I was told? Do I write it based on my memories alone? Do I write it as a perceive it a year later? With all I’ve processed? Or do I just write it as a timeline of facts?
I have decided to write it based on my own memories, my own experience of it, perhaps with a bit of how I now perceive the experience, a year later. I had a great birth, and this is me honoring and protecting the memory of that birth.
A Second Rainbow
Before the births of Colt (my oldest son) and Abe (my second born), I experienced a devastating and traumatic miscarriage. That experience has left an ever-present mark on every area of my life. I wasn’t sure how my loss experience would affect my second live birth.
After all, I’d had one live birth and though my pregnancy had been fraught with anxiety and uncertainty, the birth had gone well. I’d had one empowering, confidence-building, joy-filled experience under my belt. Would that somehow balance out the fear and the sadness and the need for control that my first pregnancy and subsequent loss had bestowed upon me?
The answer is no. The uncertainty was still there. The anxiety was real. But perhaps for different reasons.
When I discovered I was pregnant with my second rainbow baby, my husband and I were thrilled. I had purposed during my first son’s pregnancy that I would hold onto happiness for as long as I could. That I would let myself feel all the joy, despite the possibility for loss and sorrow inherent in every pregnancy.
I would feel the anxiety right along with the joy, of course. Because it was so very real too. But I wouldn’t try to shut out the love and the joy out of a desire to protect myself from the possibility of sorrow.
I conceived my son on day 95 of a my third postpartum cycle. I had hoped that once my fertility returned after my first son’s birth, normal cycles would resume. But instead my cycles were long and irregular, as they had been for most of my life, all of it, in fact, except for the three cycles before conceiving my first son.
I knew the risk of miscarriage was higher with a later ovulation, and what about the dreaded possibility of another partially molar pregnancy (which my first miscarriage had turned out to be)? My due date was the 20th of June, just 5 days before the fourth anniversary of the loss of our first baby. Colt had been born 4 days past his due date, so I knew the possibility of this baby being born very near or on that anniversary was high.
A Stressful Pregnancy
When we found out we were expecting, it was in the midst of a very stressful year for us. This baby was a definite bright spot.
As with my first two pregnancies, I experienced constant nausea and vomiting multiple times a day. This time it held on longer than it had with my first son, and I was far more uncomfortable than I had been with him.
I was also bigger than I had been with Colt, and more people than I care to recall commented on it. Making the observation didn’t bother me; it was true, and I’m pretty comfortable in my own skin. What bothered me was the assumptions people made because of how big I was.
“There’s no way you’ll make it to your due date.”
“That’s a big baby!”
“I hope that delivery goes ok…” (with the voice filled with foreboding…)
“They must have your dates wrong!” (Actually, THEY don’t determine my dates. I tell THEM when I know I conceived – thank you fertility awareness! And THEY, being my midwife, trusts me as a woman highly aware of her own body and fertility.)
I found myself caught off guard by my anxiety about my upcoming labor and birth. Again, I thought I would be more confident since my first birth had gone so well. But this pregnancy was so different. Would my labor be different too? I’d had a great birth. Maybe now it my “turn” for a crappy birth…
“The second birth is often as virgin as the first.” my midwife said. How right she was!
As with my first son, I experienced frequent Braxton Hicks starting early in my second trimester. With my first, this had alarmed me, but my cervix had stayed closed and my baby safe, so I barely gave them a second thought the second time around.
Colt had been born 4 days past his due date, and his story is for another time, but my logical head said that this second baby would likely go a bit late too. My heart, however, thoroughly enjoyed the feeling that he would be a bit early. My head was right.
Four days past my due date, my husband was the best man in our dear friends’ wedding. I was so glad I wasn’t in labor. If I was going to go past my due date I might as well get to do the fun stuff! We danced to a bunch of our favorite songs, and I hoped all that activity would jumpstart labor. The next day when my muscles were aching I was glad that it hadn’t!
After the wedding I decided to stay at my parents’ house until the baby was born. As with my first, circumstances dictated that their home was the best place for me to give birth, and I had been feeling some anxiety about getting there once I knew I was in labor. Due to my nearly constant Braxton Hicks, by the time I’m sure I’m in labor, I’m far too uncomfortable to drive, and birth is too imminent to feel comfortable with the possibility of needing to wait for someone else to drive me. Also, the car ride in active labor with Colt really sucked. I wanted to be able to stay put this time.
The wedding was on a Saturday, and on Sunday when I got home from church I had some bloody show. That afternoon I napped with my husband, and in the evening I made brownies with Colt. I knew it was likely the last night we would go to bed just him and me, and I wanted to savor those bittersweet moments.
The next day, I felt tired and a bit crabby. I went to Meijer to get some snacks and had frequent, slightly more intense contractions as I walked around. I was a bit hopeful, but not too hopeful since I’d had that sort of pattern other times.
I came home and tried to take a nap with my son. He was struggling to wind down, so I ended up only sleeping 30-40 minutes, but I woke feeling a bit more refreshed.
That evening my mom made tacos and I was chatting with my sister and her fiance around 9 p.m. when I noticed a change in my contractions. “It’s real now.” I thought. I didn’t often get Ash and David to myself, so I chatted with them a little longer, ate three more tacos, and brewed myself a cup of red raspberry leaf tea. Then I went upstairs to my brother’s bedroom and did about 40 pelvic tilts and 20 lunges and called my husband, my friend, Abby, and my midwife.
“It sounds like you’re in early labor,” my midwife said “so try to get some rest.”
“I can’t sleep through these.” I said. She encouraged me to rest my body even if I couldn’t sleep so I had enough energy as labor intensified. “Ok, I’ll try.” I thought. “But first, tea and a shower.”
While in the shower in the bathroom off my parents’ room, my contractions started to intensify and I started breathing through them. I checked my cervix and thought I was probably 4-5 cm dilated. Looking back, and after more recently seeing a dilation model, I’m guessing I was probably more like 6-7 cm.
By the time I got out, my contractions were about 4-7 minutes apart and becoming steadily stronger. I had to pause several times as I got dressed and resting in bed was actually starting to sound like a pleasant prospect. I lay down on the bed in my parents’ room and my contractions spaced out to 7-10 minutes, but continued to intensify.
Around this time I started texting my friend, Emily, whose due date was just a week after mine. We had shared our pregnancy news with each other early on and during our whole pregnancies had been joking about having our babies on the same day. She was just starting to have some mild contractions, and it was so cool to be sort of “laboring together”. It was also a welcome distraction! By the time I could no longer focus on texting her, she had arrived at the hospital and was 4 cm dilated.
Waiting for the Midwife
During the time I was “resting”, my sister, Ash, was there with me. In between my contractions I lay on my side, and during them I got on my hands and knees and Ash lifted my belly with a scarf or gave counterpressure on my lower back. I was having a bit of back labor this time around, which was different than Colt’s birth. It was really special to have that time with just her and me just shortly before she got married, and her calm and quiet presence was truly a comfort.
Eventually I felt the need to get up and move around and go pee, and as I stood leaning and swaying against the bathroom counter, I started feeling quite a bit of pressure. I think I called my midwife around that time, and after listening to me through a contraction she said she would start heading my way shortly.
Soon my mom heard the tell-tale grunts at the end of my contractions, signalling that I was starting to give some small, involuntary pushes. At this point she became a bit alarmed, and somewhere in there, Ty, Abby, and my other sister, Erin, had come into the bedroom. They were all quiet and unobtrusive and I hardly noticed their presence. Somewhere in there my water broke too.
I knelt beside the bed, which allowed me to still rest a bit between contractions, but I was definitely starting to feel the urge to push. My mom called the midwife again, and she instructed me to lie down on my side to try to slow things down. Soon the urge to push was overwhelming, and despite my mother’s pleas not to push, I couldn’t help at least pushing a little. My mom and her own birth stories and positive attitude toward birth has been an inspiration to me, and she has attended at least 5 other births, but I know being present for her daughters giving birth is quite a different thing for her, and she did not want me to have the baby before the midwife arrived!
My parents have a very long driveway, and it’s easy to miss, especially in the dark, so when my midwife called to tell us she was getting off on the exit to our house, my sisters raced to the end of the driveway with flashlights so that she wouldn’t miss the driveway. This was especially memorable to my midwife.
The Midwife Arrives!
She arrived and quickly began to set up. I was still being encouraged not to push, and I said, “She’s here now – I’m pushing!”
Soon someone said something about the baby having a lot of hair, and I was thrilled that they could see the baby’s head. At this point, labor was incredibly intense, and I was yelling, crying, and growling my way through contractions. I had pushed for an hour and a half with Colt, and wasn’t sure what to expect this time. The prospect of being almost done was so incredibly encouraging and gave me a renewed energy and strength.
Within minutes, the baby’s head was born. The cord was wrapped once around his neck, and my midwife calmly unwrapped it. With the next contraction I was being rather forcefully encouraged to push, but wasn’t really feeling an urge to, which makes pushing incredibly difficult and unproductive. I felt like if I could just get a good breath I would be able to have more force behind my pushing, but finally the baby’s shoulders were out. I still question this part of my experience, wondering if it’s really necessary to push before I feel any urge. Perhaps I perceive it as being far more urgent than it actually is, but in both my sons’ births, this part has been very stressful for me.
I was in a side-lying position when I gave birth. I had anticipated being in a hands-and-knees position again, but by the time the midwife arrived and I was free to just push, trying to change positions just didn’t seem worth it. But I can say, I definitely like hands-and-knees better. When they handed the baby up on to my chest, I was lying back flat and it was really hard to see him, whereas with Colt, they had passed him between my legs and set him on the bed in front of me. I was upright and had a chance to look at him before lifting him up to my chest myself.
We were going to be surprised by the baby’s sex this time, and I didn’t have the strength to move the baby around to check, so I asked Ty too. “We’ve got another boy, babe!” he said.
A “Big Baby”
My family helped me get propped up with some pillows, and the placenta was delivered uneventfully. Within probably 20 minutes of birth, our baby boy had latched on and was nursing easily. I was startled by how simple breastfeeding was this second time around!
After an hour or so of skin-to-skin, my in-laws arrived to be present for the newborn exam, which is one of my favorite parts of the homebirth experience. My midwife carefully checked baby Abe’s reflexes and joints and then weighed him.
“9 pounds 6 ounces!” she said. I thought for sure the scale was broken. There was no way he was 9 pounds. He sure didn’t look like it to me. But a few days later we went to the chiropractor and he was 9 pounds 10 ounces, so I guess it was correct.
She measured his head and chest circumference. “He’s got a 15 inch head and no moulding!” she said. “You were built to birth babies!” I was pretty happy with that assessment and pretty proud of my 5’4”, 112 pounds not pregnant self for giving birth to such a good-sized baby. I have a pretty strong trust in God’s design for women and babies and the whole birth process, but I do wonder if I would have had more anxiety going into birth had I known how big Abe was.
Soon Colt woke up and sleepily met his new baby brother. He had the most fantastic bedhead, and of course he was hungry, so my mother brought him yogurt which he sat on the bed and ate.
Shortly after he was born, Emily texted and asked how things were going. I responded with a picture of Abe and “He’s here!” Several hours later, she gave birth to her second daughter, and I love that our babies share a birthday.
Sorrow for a Night and Joy in the Morning
Abe was born at 12:47 a.m. on the 27th of June, just 2 days after the fourth anniversary of the loss – and birth – of our first baby. Late June is always a hard time of year for me. I’m raw with emotion, sometimes traumatic flashbacks increase, but this time of year has now been redeemed. I still feel the pain and the sadness, yes, but it now exists alongside joyous memories of Abe’s birth. He has been pure grace in my life.
“Weeping may last for a night, but joy comes in the morning.” This verse (Psalm 30:5) is brief part of the psalmist’s testifying to the faithfulness, mercy, and healing of God. It doesn’t refer to birth directly, but later in John 16, Jesus says, “When a woman is giving birth, she has sorrow because her hour has come, but when she has delivered the baby, she no longer remembers the anguish, for joy that a human being has been born into the world.” Here he refers to His people waiting for His coming, but I’ve found this common theme in the Bible of sorrow and then joy to be such an encouragement in my motherhood journey.
Whether it be the overwhelming difficulty of labor followed by the overwhelming joy of holding my baby, or the overwhelming sadness of losing a child in some part redeemed by the joy of another baby born at just the right time, or of the hope of a future joy of meeting and knowing that baby in heaven, that thought was a deep comfort and encouragement to me as I gave birth. There is pain, but there will be joy. I have lost, but I am receiving a gift.
Birth and motherhood is difficult and unpredictable and full of both sorrow and joy. But we have a gracious and merciful God who is with us in our sorrow, who delights to redeem every part of our lives, a God who has given us our children, whether it be for a moment or a lifetime, and will carry us mothers through this journey He has called us to.
I am not a medical professional. Please research your options and discuss them with your care provider when making health decisions. This post may contain affiliate links. This means that if you make a purchase, I may make a small commission at no additional cost to you. Thank you for supporting this free resource! See full disclosure here.
Dear Expectant Mama,
You might be wondering what the big deal is about having a c-section versus having a vaginal birth. Perhaps you’ve seen news articles, health organizations, or advocacy groupscalling for lowering the cesarean rate, which is currently just over 30% in the US and globally is steadily climbing. Cesarean birth is so common now that on the one hand its relative safety and ready availability in an emergency is often taken for granted, and on the other hand its risks are often minimized. Some women are so fearful of vaginal birth that a cesarean seems like a desirable alternative.
So what ARE the benefits of a vaginal birth?
[Please note that in this post many of these benefits of vaginal birth are set in the context of risks of a cesarean birth, since cesarean birth is the other possibility. This is never meant as a criticism to mothers who have experienced cesarean birth, whether by choice or necessity.]
1 – A quicker, easier recovery for the mother.
Healing after birth is a big job for your body to complete, and so is caring for a brand new baby! Postpartum and adjusting to mothering a little human is challenging, and those few months following birth are especially significant to a mother and baby’s well-being. The better a mom is feeling physically, the easier it will be to focus on bonding, getting a good start to breastfeeding, and learning each other’s rhythms and patterns, which are all so important to your journey as a new mother.
After you give birth there is always healing to do. But if you give birth by cesarean, your body will have to heal the layers of skin and muscle where your incision was made, and, in all likelihood, this will simply take longer than healing vaginal stretching, tearing, or even an episiotomy. There may be pain or infection at the incision site, and there is also the possibility of other organs accidentally being injured during surgery. These circumstances may further prolong healing or require additional medical attention. Whether you give birth vaginally or surgically, the good news is that your body is designed to heal.
2 – A healthier microbiome for the baby.
Every human is colonized with a variety of microbes (mostly bacteria, along with fungi, viruses, protozoa, and archaea) that either helps or hinders the health and function of the body. Before your baby is born, she is for the most part protected from bacteria by the amniotic sac, but once your water breaks, your baby starts being exposed to bacteria from your vagina. Your own microbiome is passed on to her as she is “seeded” with the first bacteria she comes into contact with. As your baby is born and hopefully handed straight to your arms, she comes into contact with more bacteria from your skin. As you nurse your baby she is being fed with the perfect food to feed the right kind of bacteria in her gut, the seat of her immune system.
When a baby is born by cesarean, she doesn’t get the chance to pass through the vagina and be seeded with your bacteria. Instead she first comes into contact with the hospital environment and medical staff, so she is seeded by different bacteria. The method of birth isn’t the only factor to microbiome health, but babies born by cesarean generally have a less diverse microbiome with a less healthy balance of good and bad bacteria.
Higher rates of autoimmune and allergic diseases like asthma, type 1 diabetes, and celiac disease are correlated with cesarean birth, and microbiome health may very well be a contributing factor to these higher rates. It should be noted that correlation does not equal causation. There may perhaps be other factors that lead to an increased risk of both cesarean birth and autoimmune diseases, causing their increases rates to correlate. We simply do not know with certainty the exact factors involved in a child’s development of certain diseases.
If you have a cesarean birth…
At times, having a cesarean is due to factors completely outside your control, or you may have very personal reasons for wanting a cesarean birth. So if you do need or want a c-section, you can talk to your care provider about taking measures to help support a healthy microbiome in your baby. Vaginal swabbing, a procedure in which sponges are placed in your vagina prior to the birth and then are swabbed all over the baby, is a practice that helps to partially restore the microbiome. You may also be able to have immediate skin-to-skin in the operating room, and breastfeeding will also help create a healthier microbiome in your baby.
As your baby passes through the birth canal, the pressure squeezes amniotic fluid from the lungs. As already mentioned, your baby’s microbiome may play an important part in her risk of developing asthma, but this process of squeezing during birth along with exposure to hormones during labor are also thought to play an important part in respiratory health, as they ready the lungs for breathing.
Some studies have shown that vaginally born babies have a decreased risk of transient tachypnea, which is abnormally fast breathing during the first few days of life. If a baby is born by cesarean before 39 weeks and without proof of adequate lung maturity, she has an increased risk of respiratory distress syndrome. Vaginally born babies are also less likely to be admitted to the NICU, but this could be due to factors that make both cesarean and NICU care more likely. So if a baby has a known health concern that makes cesarean birth safer, that health concern may also mean the baby is more likely to need NICU care.
Here is my own experience with having a child with respiratory issues.
4 – Safer future pregnancies.
Perhaps you’ve heard “once a cesarean, always a cesarean”. The reality is in many cases if you’ve had a cesarean, a VBAC (vaginal birth after cesarean) may be a totally legitimate option for you, but finding a care provider who is truly supportive (and not just tolerant, or worse, actually opposed to VBAC) can be a challenge! On the other hand, depending on your individual circumstances a repeat cesarean may be the only safe option for you, or you may look at the risks and benefits of both VBAC and repeat cesarean and decide you are more comfortable with those of a repeat cesarean.
If you have a cesarean and still want more children you might want to think more seriously about trying for a VBAC (chances are you’ll be successful). Complications like placenta previa or placenta accreta that are more common after a cesarean also increase with each additional c-section, while the risk of uterine rupture, which is an increased risk during a VBAC, decreases with each additional VBAC. Both VBAC and repeat cesarean carry more risk than a second vaginal birth, and some studies have shown an increased risk of stillbirth after a cesarean while other studies have shown the increase to be only very slight. So if you can avoid a primary cesarean your future pregnancies simply carry fewer risks.
While secondary infertility can happen to anyone, some studies have shown that having a c-section may place you at higher risk of future infertility, and unplanned hysterectomy, and adhesions that may cause long-term pelvic pain are also increased risks for women who have had c-sections.
If you’re a cesarean mama struggling to conceive or struggling with pelvic pain, I highly recommend exploring NaPro technology to try to help address your concerns. NaPro used specialized surgery and works with a woman’s cycle to try to get to the root cause of a problem and is less invasive than many traditional fertility treatments. I wish I had known about it when I was struggling with infertility!
6- Easier breastfeeding and bonding.
For years the norm has been to whisk baby away to be cleaned, weighed, and monitored after a c-section. In fact, for many years that was even the norm after a vaginal birth. Many hospitals are now encouraging more “baby-friendly” practices, and unless there is some complication you can usually hold and breastfeed your baby immediately after a vaginal birth.
Oxytocin produced during labor makes you and your baby ready to bond, so even if your labor ends in a cesarean, being in labor beforehand still provides you and your baby with some of the benefits of labor hormones. If you have skin-to-skin immediately or quickly after birth, yourbaby can start smelling and exploring and may even latch on by herself.
After a vaginal birth you’re more able to sit in a more upright position that makes it easier to hold the baby, and your baby won’t be pressing against an incision while she’s nursing. There’s more to bonding than hormones and immediate skin-to-skin, and you absolutely can breastfeed after a c-section, but it may take more work and perseverance from you.
If you do need a cesarean, talk to your care provider (preferably during pregnancy) about gentle cesarean options. While it’s certainly not mainstream yet, many care providers are willing to support your wishes to have quick skin-to-skin and initiate breastfeeding without delay and without separating you and the baby while you’re in recovery. Because of the strong medications needed during a cesarean, you’ll need your partner, a doula, or a nurse to help you hold the baby securely, and you may feel too sick to hold the baby right away, but as long as you’re feeling up to it, you don’t have to miss out on those early moments of bonding immediately after birth. Whether you’re planning a cesarean or just want to be prepared in the case that a cesarean becomes necessary, you do need to make sure your care provider is supportive of this plan before your baby arrives!
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