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The 5 Stages of Grief After a Miscarriage

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Losing a pregnancy hurts on many levels. It can be physically uncomfortable to downright painful, but the emotional aspects of a miscarriage are far more profound, multifaceted, and often require more time for resolution. Whether a woman is newly pregnant or farther along at the time of miscarriage is irrelevant - loss is loss. And with any loss, comes grief.

Once the OB provides a due date, we naturally construct a mental image of what life with a baby will look like, and thoughts about a new family flood our minds. Then when the pregnancy ends prematurely, a woman is left to grieve the actual loss along with this theoretical future family that will never be. It’s a double whammy.

Grief after miscarriage is similar to any other form of loss, and it conforms to the well known Kubler-Ross Grief steps, with a few alterations. Women often progress forwards and then take steps back before moving forward again and eventually feeling relatively comfortable with the past and the new normal. It can be difficult to process feelings about miscarriage because partners often experience grief at different speeds and may express their feelings in different ways.

Furthermore, it can be hard to talk about a loss with friends and family, many of whom will likely be unsure what to say and, with good intentions at heart, will end up saying something that feels disingenuous or preachy that inadvertently can be irritating or even hurtful to a woman who recently miscarried.

As a result, women often report feeling highly isolated and alone in their grief, which is unfortunate and unnecessary considering that one of two women have miscarried. Finding other women who have similarly suffered a miscarriage and can be there for you to empathize and provide a shoulder to cry on is incredibly helpful. Grief-based support groups in person and online often function to provide a safe place for women to open up about their feelings and begin to process and heal. If you or someone you know have recently gone through a miscarriage, it’s important to understand the chain of reactions that may follow.

So to mark Pregnancy and Infant Loss Awareness Month and shed light onto this particularly difficult time in someone’s life, here are the 5 stages of grief after a miscarriage.

1. Shock and denial. Being told there is no heartbeat on ultrasound or that miscarriage is inevitable often feels like a punch in the gut, followed by a sense of disbelief. How is it possible? Just a moment ago this pregnancy was real, and now my world is crashing down. All I had to do was pee and instead there’s blood everywhere. Why? This can’t be right.

Feeling as though one’s head is spinning or that you’re in a cloud is normal, as is the desire to confirm the doctor’s finding once or twice or more times because of disbelief. Many women continue to experience transient nausea until hormone levels drop, making it hard to believe the pregnancy has ended. If a pregnancy is far enough along, women may misattribute gas or cramping to phantom kicks, which also reinforce this sense of denial.

2. Anger. Why my pregnancy? Why my baby? Some women externalize anger: ‘I did everything right, I took my prenatal vitamins and I ate well. This isn’t fair...’ Others may be angry at themselves, wishing they had done things differently, despite being told and knowing on some level that miscarriage is not her fault. Women may be irritable and angry with their partners for not understanding their experience or for not having the same degree of reaction or response as they are. They may also be angry at her friends who have had babies despite realizing this is not logical.

Even the most rational woman may be very easily angered and hostile at those around her, seemingly without cause because she is angry at the situation. Miscarriage is not fair, it doesn’t make sense, and it is a good reason to be angry -- so when a woman is pissed, it’s ok. Don’t try to stifle the anger, just understand that it’s because a wanted pregnancy is gone and not really directed at the people who are trying to be supportive and loving and are grieving also.

3. Bargaining stage. ‘If I eat only organic foods, remove all chemicals from my makeup and skin care products, and keep all toxins out of my house, then my next pregnancy will be ok, right?’ This period is notable for looking for ways to right the wrong, to find a reason and to remedy it. The notion that a miscarriage can occur without cause or that one cannot prevent it is highly upsetting, and this stage is focused on fixing things. This is a time where women search for answers and try to make it all better. In fact, it’s not uncommon to try to conceive right away during this time while all is seemingly perfect, and then to be incredibly frustrated if things don’t go as planned.

4. Depression. This time is characterized by awareness of the magnitude of the loss and that nothing can change the past or can inherently ensure the future. Women frequently isolate themselves, even from those who want to help, and feel as if they are the only ones who have ever experienced such grief. They often have low energy and little motivation during that time.

The severity of the depression depends on a woman’s experience and likely on if she is otherwise prone to depression and other psychiatric illnesses. If this stage is severe enough to negatively impact daily life for more than several days or if there’s any thought of self-harm, please reach out for help from a trained mental professional. Ask your OBGYN for a referral or go to postpartum.net to connect with a local coordinator who can help you find a perinatal and reproductive psychiatry trained clinician in your area.

5. Acceptance. The magnitude of the grief begins to lessen over time. Eventually, days will pass without thinking of the miscarriage, which can cause guilt. This sometimes throws a woman back to a lower step such as anger or depression. But, that’s ok - the idea is to move forwards along the process at your own pace. Eventually, this loss will be a part of your story without defining your life or being the focus of your thoughts, day in and day out. The memory never goes away, but the sharp pain fades with time.

Dr. Carly Snyder is a reproductive and perinatal psychiatrist with a unique approach that combines integrative medicine-based treatments. She maintains a private practice in Manhattan and specializes in women’s mental health. Dr. Snyder is a frequent lecturer on the subject of Women's Mental Health and Wellness and has received extensive medical training from New York University, Beth Israel Medical Center, and Payne Whitney Women’s Program at New York Presbyterian Hospital – Weill Cornell Medical Center. She is also an executive board member for Postpartum Support International. Her weekly radio show, "MD for Moms," can be heard Wednesdays at 1pm ET on the BBM Global Network and TuneIn radio, or anytime on BBMglobalnetwork.com/MD-for-moms. Dr. Snyder’s HuffPost parenting blog shares the MD for Moms moniker. Dr. Carly resides in NYC and the North Fork with her husband and three awesome children. In her free time you can find Dr. Carly training for a marathon, skiing or gardening.

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We spend a lot of time prepping for the arrival of a baby. But when it comes to the arrival of our breast milk (and all the massive adjustments that come with it), it's easy to be caught off guard. Stocking up on a few breastfeeding essentials can make the transition to breastfeeding a lot less stressful, which means more time and energy focusing on what's most important: Your recovery and your brand new baby.

Here are the essential breastfeeding tools you'll need, mama:

1. For covering up: A cute nursing cover

First and foremost, please know that all 50 states in the United States have laws that allow women to breastfeed in public. You do not have to cover yourself if you don't want to—and many mamas choose not to—and we are all for it.

That said, if you do anticipate wanting to take a more modest approach to breastfeeding, a nursing cover is a must. You will find an array of styles to choose from, but we love an infinity scarf, like the LK Baby Infinity Nursing Scarf Nursing Cover. You'll be able to wear the nursing cover instead of stuffing it in your already brimming diaper bag—and it's nice to have it right there when the baby is ready to eat.

Also, in the inevitable event that your baby spits-up on you or you leak some milk through your shirt, having a quick and stylish way to cover up is a total #momwin.

2. For getting comfortable: A cozy glider

Having a comfy spot to nurse can make a huge difference. Bonus points if that comfy place totally brings a room together, like the Delta Children Paris Upholstered Glider!

Get your cozy space ready to go, and when your baby is here, you can retreat from the world and just nurse, bond, and love.

3. For unmatched support: A wire-free nursing bra

It may take trying on several brands to find the perfect match, but finding a nursing bra that you love is 100% worth the effort. Your breasts will be changing and working in ways that are hard to imagine. An excellent supportive bra will make this so much more comfortable.

It is crucial to choose a wireless bra for the first weeks of nursing since underwire can increase the risk of clogged ducts (ouch).The Playtex Maternity Shaping Foam Wirefree Nursing Bra is an awesome pick for this reason, and because it is designed to flex and fit your breasts as they go through all those changes.

4. For maximum hydration: A large reusable water bottle

Nothing can prepare you for the intense thirst that hits when breastfeeding. Quench that thirst (and help keep your milk supply up in the process) by always having a water bottle with a straw nearby, like this Exquis Large Outdoor Water Bottle.

5. For feeding convenience: A supportive nursing tank

Experts recommend that during the first weeks of your baby's life, you breastfeed on-demand, meaning that any time your tiny boss demands milk, you feed them. This will help establish your milk supply and get everything off to a good start.

What does this mean for your life? You will be breastfeeding A LOT. Nursing tanks, like the Loving Moments by Leading Lady, make this so much easier. They have built-in support to keep you comfy, and you can totally wear them around the house, or even out and about. When your baby wants to eat, you'll be able to quickly "pop out" a breast and feed them.

6. For pain prevention: A quality nipple ointment

Breastfeeding shouldn't hurt, but the truth is those first days can be uncomfortable. Your nipples will likely feel raw as they adjust to their new job. This will get better! But until it does, nipple ointment is amazing.

My favorite is the Earth Mama Organic Nipple Butter. We love that it's organic, and it is oh-so-soothing on your hard-at-work nipples.

Psst: If it actually hurts when your baby latches on, something may be up, so call your provider or a lactation consultant for help.

7. For uncomfortable moments: A dual breast therapy pack

As your breasts adjust to their new role, you may experience a few discomforts—applying warmth or cold can help make them feel so much better. The Lansinoh TheraPearl 3-in-1 Breast Therapy Pack is awesome because you can microwave the pads or put them in the freezer, giving you a lot of options when your breasts need some TLC.

Again, if you have any concerns about something being wrong (pain, a bump that may be red or hot, fever, or anything else), call a professional right away.

8. For inevitable leaks: An absorbing breast pad

In today's episode of, "Oh come on, really?" you are going to leak breastmilk. Now, this is entirely natural and you are certainly not required to do anything about this. Still, many moms choose to wear breast pads in their bras to avoid leaking through to their shirts.

You can go the convenient and disposable route with Lansinoh Disposable Stay Dry Nursing Pads, or for a more environmentally friendly option, you can choose washable pads, like these Organic Bamboo Nursing Breast Pads.

9. For flexibility: A breast pump

Many women find that a breast pump becomes one of their most essential mom-tools. The ability to provide breast milk when you are away from your baby (and relieve uncomfortable engorged breasts) will add so much flexibility into your new-mom life.

For quick trips out and super-easy in-your-bag transport, opt for a manual pump like the Lansinoh Manual Breast Pump .

If you will be away from your baby for longer periods of time (traveling or working outside the home, for example) an electric pump is your most efficient bet. The Medela Pump In Style Advanced Double Electric Breast Pump is a classic go-to that will absolutely get the job done, and then some.

10. For quality storage: Breast milk bags

Once you pump your liquid gold, aka breast milk, you'll need a place to store it. The Kiinde Twist Pouches allow you to pump directly into the bags which means one less step (and way less to clean).

11. For keeping cool: A freezer bag

Transport your pumped milk back home to your baby safely in a cooler like the Mommy Knows Best Breast Milk Baby Bottle Cooler Bag. Remember to put the milk in a fridge or freezer as soon as you can to optimize how long it stays usable for.

12. For continued nourishment: Bottles

Nothing beats the peace of mind you get when you know that your baby is being well-taken of care—and well fed—until you can be together again. The Philips Avent Natural Baby Bottle Newborn Starter Gift Set is a fan favorite (mama and baby fans alike).

This article is sponsored by Walmart. Thank you for supporting the brands that support Motherly and mamas.

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Motherly is committed to covering all relevant presidential candidate plans as we approach the 2020 election. We are making efforts to get information from all candidates. Motherly does not endorse any political party or candidate. We stand with and for mothers and advocate for solutions that will reduce maternal stress and benefit women, families and the country.

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A viral video about car seat safety has parents everywhere cracking up and humming Sir-Mix-A-Lot.

"I like safe kids and I cannot lie," raps Norman Regional Health System pediatric hospitalist Dr. Kate Cook (after prefacing her music video with an apology to her children."I'm a doctor tryin' warn you that recs have changed," she continues.

Dr. Cook's rap video is all about the importance of keeping babies facing backward. It's aptly called "Babies Face Back," and uses humor and parody to drive home car seat recommendations from the American Academy of Pediatrics (AAP).

"Switching from rear-facing to forward-facing is a milestone many parents can't wait to reach," Dr. Cook said in a news release about her hilarious video. "But this is one area where you want to delay the transition as long as possible because each one actually reduces the protection to the child."

Last summer the AAP updated its official stance on car seat safety to be more in line with what so many parents were already doing and recommended that kids stay rear-facing for as long as possible. But with so many things to keep track of in life, it is understandable that some parents still don't know about the change. Dr. Cook wants to change that with some cringe-worthy rapping.

The AAP recommends:

  • Babies and toddlers should ride in a rear-facing car safety seat as long as possible, until they reach the highest weight or height allowed by their seat.
  • Once they are facing forward, children should use a forward-facing car safety seat with a harness for as long as possible. Many seats are good up to 65 pounds.
  • When children outgrow their car seat they should use a belt-positioning booster seat until the vehicle's lap and shoulder seat belt fits properly, between 8 and 12 years old.

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[Editor's note: Motherly is committed to covering all relevant presidential candidate plans as we approach the 2020 election. We are making efforts to get information from all candidates. Motherly does not endorse any political party or candidate. We stand with and for mothers and advocate for solutions that will reduce maternal stress and benefit women, families and the country.]

Suicide rates for girls and women in the United States have increased 50% since 2000, according to the CDC and new research indicates a growing number of pregnant and postpartum women are dying by suicide and overdose. Suicide rates for boys and men are up, too.

It's clear there is a mental health crisis in America and it is robbing children of their mothers and mothers of their children.

Medical professionals urge people to get help early, but sometimes getting help is not so simple. For many Americans, the life preserver that is mental health care is out of reach when they are drowning.

Democratic presidential candidate Pete Buttigieg just released a plan he hopes could change that and says the neglect of mental health in the United States must end. "Our plan breaks down the barriers around mental health and builds up a sense of belonging that will help millions of suffering Americans heal," says Buttigieg.

He thinks he can "prevent 1 million deaths of despair by 2028" by giving Americans more access to mental health and addictions services.

In a country where giving birth can put a mother in debt, it's not surprising that while as many as 1 in 5 new moms suffers from perinatal mood and anxiety disorders, more than half of new moms who need mental health treatment don't get it. Stigma, childcare and of course costs are factors in why women aren't seeking help when they are struggling.

Buttigieg's plan is interesting because it could remove some of these barriers. He wants to make mental health care more affordable by ensuring everyone has comprehensive coverage for mental health care and by ensuring that everyone can access a free yearly mental health check-up.

That could make getting help more affordable for some moms, and by increasing reimbursement rates for mental health care delivered through telehealth, this plan could help moms get face time with a medical professional without having to deal with finding childcare first.

Estimates from new research suggest that in some parts of America as many as 14% or 30% of maternal deaths are caused by addiction or suicide. Buttigieg's plan aims to reduce those estimates by fighting the addiction and opioid crisis and increasing access to mental health services in underserved communities and for people of color. He also wants to reduce the stigma and increase support for the next generation by requiring "every school across the country to teach Mental Health First Aid courses."

These are lofty goals with a lofty price tag. It would cost about $300 billion to do what Buttigieg sets out in his plan and the specifics of how the plan would be funded aren't yet known. Neither is how voters will react to this 18-page plan and whether it will help Buttigieg stand out in a crowded field of Democratic candidates.

What we do know is that right now, America is talking about mental health and whether or not that benefits Buttigieg's campaign it will certainly benefit America.

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[Editor's Note: Welcome to It's Science, a Motherly column focusing on evidence-based explanations for the important moments, milestones, and phenomena of motherhood. Because it's not just you—#itsscience.]

If you breastfeed, you know just how magical (and trying) it is, but it has numerous benefits for mama and baby. It is known to reduce the likelihood of developing cardiovascular disease, type 2 diabetes, and rheumatoid arthritis, and cuts the risk of sudden infant death syndrome (SIDS) by half.

If this wasn't powerful enough, scientists have discovered that babies who are fed breast milk have a stomach pH that promotes the formation of HAMLET (Human Alpha-lactalbumin Made Lethal to Tumor cells). HAMLET was discovered by chance when researchers were studying the antibacterial properties of breast milk. This is a combination of proteins and lipids found in breast milk that can work together to kill cancer cells, causing them to pull away from healthy cells, shrink and die, leaving the healthy cells unaffected.

According to researchers at Lund University in Sweden, this mechanism may contribute to the protective effect breast milk has against pediatric tumors and leukemia, which accounts for about 30% of all childhood cancer. Other researchers analyzed 18 different studies, finding that "14% to 19% of all childhood leukemia cases may be prevented by breastfeeding for six months or more."

And recently, doctors in Sweden collaborated with scientists in Prague to find yet another amazing benefit to breast milk. Their research demonstrated that a certain milk sugar called Alpha1H, found only in breast milk, helps in the production of lactose and can transform into a different form that helps break up tumors into microscopic fragments in the body.

Patients who were given a drug based on this milk sugar, rather than a placebo, passed whole tumor fragments in their urine. And there is more laboratory evidence to support that the drug can kill more than 40 different types of cancer cells in animal trials, including brain tumors and colon cancer. These results are inspiring scientists to continue to explore HAMLET as a novel approach to tumor therapy and make Alpha1H available to cancer patients.

Bottom line: If you choose to breastfeed, the breast milk your baby gets from your hard work can be worth every drop of effort.

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